Preventing fibrosis in IBD: update on immune pathways and clinical strategies.

IF 3.9 3区 医学 Q2 IMMUNOLOGY Expert Review of Clinical Immunology Pub Date : 2024-07-01 Epub Date: 2024-03-21 DOI:10.1080/1744666X.2024.2330604
Jie Wang, Bo Yang, Jyotsna Chandra, Andrei Ivanov, J Mark Brown, Florian Rieder
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Abstract

Introduction: Intestinal fibrosis is a common and serious complication of inflammatory bowel diseases (IBD) driving stricture formation in Crohn's disease patients and leading to submucosal damage in ulcerative colitis. Recent studies provided novel insights into the role of immune and nonimmune components in the pathogenesis of intestinal fibrosis. Those new findings may accelerate the development of anti-fibrotic treatment in IBD patients.

Areas covered: This review is designed to cover the recent progress in mechanistic research and therapeutic developments on intestinal fibrosis in IBD patients, including new cell clusters, cytokines, proteins, microbiota, creeping fat, and anti-fibrotic therapies.

Expert opinion: Due to the previously existing major obstacle of missing consensus on stricture definitions and the absence of clinical trial endpoints, testing of drugs with an anti-fibrotic mechanism is just starting in stricturing Crohn's disease (CD). A biomarker to stratify CD patients at diagnosis without any complications into at-risk populations for future strictures would be highly desirable. Further investigations are needed to identify novel mechanisms of fibrogenesis in the intestine that are targetable and ideally gut specific.

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预防 IBD 纤维化:免疫途径和临床策略的最新进展。
简介肠纤维化是炎症性肠病(IBD)常见而严重的并发症,可导致克罗恩病患者的狭窄形成,并导致溃疡性结肠炎患者的黏膜下损伤。最近的研究对免疫和非免疫成分在肠纤维化发病机制中的作用提供了新的见解。这些新发现可能会加速开发针对 IBD 患者的抗纤维化治疗方法:本综述旨在介绍有关 IBD 患者肠纤维化的机理研究和治疗发展的最新进展,包括新细胞群、细胞因子、蛋白质、微生物群、爬行脂肪和抗纤维化疗法:专家观点:由于先前存在的主要障碍是对狭窄定义缺乏共识,以及缺乏临床试验终点,因此在严格治疗克罗恩病(CD)方面,具有抗纤维化机制的药物试验才刚刚开始。最好能找到一种生物标志物,将诊断时未出现任何并发症的克罗恩病患者分层,使其成为未来出现狭窄的高危人群。还需要进一步的研究来确定肠道纤维化的新机制,这些机制是可靶向的,最好是肠道特异性的。
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来源期刊
CiteScore
7.60
自引率
2.30%
发文量
221
审稿时长
6-12 weeks
期刊介绍: Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.
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