马来西亚克罗恩病:预防原则的应用是否可以减少未来的发病率?
Roger W Pickup1, Pei Boon Ooi2, Gaurav Agrawal3
1Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK.
马来西亚的克罗恩病 (CD) 发病率正在上升,反映了英国早期的趋势. 本综述检查了遗传,环境和微生物因素,包括Mycobacterium avium亚种结核病 (MAP),可能导致这种增加,并建议预防策略.
科学领域:
- 胃肠病学 胃肠病学
- 微生物学 微生物学
- 流行病学 流行病学
背景情况:
- 炎症性肠病 (IBD),包括克罗恩病 (CD) 和性结肠炎 (UC),在全球范围内越来越普遍.
- 疾病的确切发病原因尚不清楚,但涉及遗传易感性,免疫失调,环境因素和肠道微生物组的改变.
- 马来西亚正在经历IBD的显著上升,CD发病率不成比例地增加,类似于英国的历史趋势.
研究的目的:
- 审查目前关于遗传,环境和微生物因素的证据,这些因素有助于马来西亚CD的增加.
- 探索Mycobacterium avium亚种结核病 (MAP) 在马来西亚CD病例中的潜在作用,与西方研究进行并行.
- 根据审查的证据,在马来西亚提出CD的预防策略.
主要方法:
- 文献综述综合了有关CD病变发生的现有研究.
- 与西方国家相比,马来西亚的IBD趋势的流行病学数据分析.
- 鉴于马来西亚的农业和饮食习惯,评估MAP和CD之间的潜在联系.
主要成果:
- 马来西亚CD的发病率正在上升,与英国的历史轨迹相似.
- 马来西亚越来越依赖从约翰氏病流行率高的地区进口的牛和乳制品,这表明人类暴露于MAP的可能性可能会增加.
- 证据将MAP与CD联系起来,虽然在西方国家进行了辩论,但需要在马来西亚背景下进行调查.
结论:
- 马来西亚CD发病率上升需要全面了解导致的因素.
- 马来西亚可能通过牛和乳制品接触MAP是一种可信的环境因素,需要进一步调查.
- 如果确认存在关联,建议采取预防措施,包括对牛,乳制品和水源进行MAP查.
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