摘要
炎症性肠病(IBD)包括溃疡性结肠炎(UC)和克罗恩病(CD),是一类慢性复发性肠道炎症性疾病,对患者健康造成严重影响。该文介绍IBD传统治疗药物、生物制剂及小分子靶向药物的作用机制及临床研究进展。特别关注了近年来新型治疗策略,例如针对肿瘤坏死因子样细胞因子1A(TL1A)、白细胞介素-6(IL-6)、IL-22等新靶点的药物,以及CAR调节性T细胞(CAR-Tregs)疗法、间充质干细胞疗法、人工智能(AI)辅助治疗和先进药物联合疗法等新型治疗方法。分析了当前IBD治疗面临的挑战,包括治疗靶点预测的困难、生物制剂的原发性或继发性不应答、黏膜愈合的疗效瓶颈、耐药机制的影响以及长期用药带来的感染、肿瘤和血栓风险等。未来,结合AI和组学技术的精准治疗、无创监测和新型药物研发将是提升IBD管理效能的关键方向。
Inflammatory bowel disease(IBD),encompassing ulcerative colitis(UC)and Crohn's disease(CD),is a chronic relapsing inflammatory disorder that poses severe health and economic burdens due to its chronic and relapsing nature.The review examines traditional therapy,biologics,and small-molecule targeted drugs,highlighting their mechanisms and clinical advancements.Special attention is given to emerging therapeutic strategies,including novel drug development targeting TNF-like ligand 1A(TL1A),interleukin-6(IL-6),interleukin-22(IL-22),as well as innovative modalities such as chimeric antigen receptor T-Cell immunotherapy(CAR-Tregs),mesenchymal stem cell therapy,artificial intelligence(AI)-assisted treatment,and advanced combination therapies.Major challenges in IBD treatment,including difficulties in predicting therapeutic targets,primary or secondary non-response to biologics,mucosal healing efficacy limits,drug resistance mechanisms,and long-term risks of infection,cancer,and thrombosis,are also analyzed.The future of IBD management lies in precision medicine,non-invasive monitoring,and innovative drug development using AI and omics technologies.
作者
张嘉琦
时艳婷
张甜甜
周禾
梁洁
ZHANG Jiaqi;SHI Yanting;ZHANG Tiantian;ZHOU He;LIANG Jie(Xijing Hospital of Digestive Diseases,State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases,Fourth Military Medical University,Xi'an 710032,China)
出处
《医药导报》
北大核心
2026年第1期31-40,共10页
Herald of Medicine
基金
陕西省重点产业创新项目(2023-ZDLSF-44)
空军翱翔计划
2018教育部青年长江学者科技人才专项
国家自然科学基金面上项目(82370588)
国家自然科学基金重大研究计划集成项目(92259302)
肿瘤生物学国家重点实验室项目(CBSKL2022ZZ34)。
关键词
炎症性肠病
生物制剂
小分子药物
Inflammatory bowel disease
Biologics
Small-molecule drugs
