炎症性肠病的发生发展关键环节及其干预药物

IBD:essential links of pathogenesis and drugs for intervention

近年来,炎症性肠病(inflammatory bowel disease,IBD)的发病率显著上升,但是仍然缺乏有效的治疗策略.IBD通常是环境因素干扰、遗传易感和肠道微生物异常等相互作用的结果.鉴于其发病机制的复杂性,确定IBD的关键发展阶段将成为突破当前临床药物使用瓶颈的重要环节.基于此,本文详细综述了多种因素对IBD发生的影响,重点阐述了氧化应激介导的肠上皮细胞异常死亡引起的肠上皮细胞屏障的受损,肠道免疫微环境失调导致的免疫屏障损害等几个关键环节,同时,根据上述关键环节探讨了IBD的新治疗策略,为用于临床药物干预的新药物递送系统提供新思路.

The incidence of inflammatory bowel disease(IBD)has increased significantly in recent years but the efficient treatment strategies are still lacking.Generally,IBD results from the complicated interactions among interference of environmental factors,genetic susceptibility,and abnormal intestinal microorganism.Considering the complex pathogenesis,it will be a significant process to identify the key development stage of IBD for the purpose of breaking the bottleneck of clinic drug treatment.For this purpose,this review makes a detailed summarization on the effect of various factors on the disease occurrence with an emphasis on several key issues including the damage of the intestinal epithelial cell barrier caused by the oxidative stress-mediated abnormal death of intestinal cells,the impairment of the innate immune barrier induced by the dysregulation of the intestinal immune microenvironment.At the same time,this review explored new therapeutic strategies capable of targeting the key processes mentioned above,which will be useful for clinical drug intervention via advanced drug delivery systems.