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1.
<正>溃疡性结肠炎(UC)是结肠黏膜层和黏膜下层连续性炎症。目前认为促炎细胞因子与抗炎细胞因子失衡对UC的发病起着非常重要的作用。感染、病毒及药物等刺激因素诱发患者肠道黏膜产生免疫反应,释放各种炎症介质,使损伤部位炎症持续存在,最终发作为UC。近年来,UC的微生物致病观点正逐渐受到重视。多项研究发现,微生态制剂在UC治疗过程中起重要作用[1]。肠内菌群的变化能够对肠道上皮细胞产生刺激作用,改善黏膜的微循环障碍,同时调节黏膜的  相似文献   

2.
现代医学证实许多细胞因子在慢性阻塞性肺疾病(COPD)的发病过程中起重要作用。近年来国内外医疗工作者以细胞因子为切入点,深入研究了COPD的发病机制,并取得了很多成果。文章从炎症、蛋白酶与抗蛋白酶失衡、氧化与抗氧化失衡等五个方面对各因子在COPD病程中所起的作用进行简单总结。  相似文献   

3.
目的:检测Th17类细胞因子IL-17和Th1类细胞因子IFN-γ在溃疡性结肠炎(UC)患者中的表达,以此来探讨溃疡性结肠炎的发病机制。方法:用ELISA法分别检测溃疡性结肠炎患者和正常对照组结肠组织及血单核细胞中IL-17和IFN-γ的表达。结果:UC组结肠组织中IL-17表达较正常对照组显著增加(P〈0.05);而UC组结肠组织IFN-γ表达较正常对照组无显著增加(P〉0.05);UC组血单核细胞IL-17、IFN-γ表达较正常对照组无显著差异(P〉0.05)。结论:局部IL-17升高在UC的发病中可能起重要作用。  相似文献   

4.
近年来的研究发现,细胞因子在哮喘发病过程中起着关键性的作用。细胞因子对免疫球蛋白(IgE)的合成以及嗜酸性粒细胞、肥大细胞、淋巴细胞等炎症细胞起调控作用。因此,了解细胞因子在哮喘发病过程中的作用方式,有助于寻找新的治疗哮喘的药物,同时也有助于解释一些免疫抑制剂治疗哮喘的作用机理。  相似文献   

5.
溃疡性结肠炎(UC)病因不明,目前认为是多种因素相互作用所致,主要包括环境、免疫以及遗传等因素,目前认为炎症前细胞因子与抗炎细胞因子之间的平衡失调被视为UC的一个重要的发病机制。美沙拉嗪肠溶片(惠迪)是一种控释剂型的5-氨基水杨酸,治疗UC疗效确切。  相似文献   

6.
细胞因子作为哮喘治疗新靶点的进展   总被引:6,自引:0,他引:6  
近年来的研究发现,细胞因子在哮喘发病过程中起着关键性的作用。细胞因子对免疫球蛋白(IgE)的合成以及嗜酸性粒细胞、肥大细胞、淋等炎症细胞起调控作用。因此,了解细胞因子在哮喘发病过程中的作用方式,有助于寻找新的治疗哮喘的药物,同时也有助于解释一些免疫抑制剂治疗哮喘的作用机理。  相似文献   

7.
炎症性肠病(inflammatory bowel disease,IBD),是一种原因不明的顽同性难治的慢性非特异性肠炎,它主要包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD).IBD发病在我国呈逐年上升的趋势.然而其病因和发病机制尚不明确.目前认为它是环境、遗传、病原体和机体免疫等多囚素棚互作用失衡产生的疾病.有研究发现促炎细胞因子和抗炎细胞因子之间的失调可能是IBD发病机制中的一个重要环节.其中促炎因子IL-6及TNFa在IBD发病中作用受到越来越多的关注,褪黑素对IL-6及TNFa的影响又在其中起一定作用.本文就这方面的研究进展进行综述.  相似文献   

8.
<正>溃疡性结肠炎(ulcerative colitis,UC)是一种反复发作的肠道慢性非特异性炎症性疾病,发病机制尚未明确,细胞因子IL-6及其介导的信号通路在非可控性肠道炎症过程中起关键作用[1]。导师沈洪教授所拟清肠化湿方(QHR),治疗轻、中度UC,取得良好效果[2]。课题组前期研究表明该方能调控UC大鼠NF-κB/COX-2通路、PPAR-γ/NF-κB及Toll通路,减少IL-1β、TNF-α等促炎因子分泌,促进抑炎因子IL-10分泌  相似文献   

9.
心理及饮食调节对慢性溃疡性结肠炎患者的影响   总被引:4,自引:0,他引:4  
目的:探讨心理和饮食调节在慢性非特异性结肠炎(UC)治疗中的意义。方法:在治疗UC过程中,根据患者不同情况,采用相应的心理治疗措施及饮食调节。结果:观察组总有效率98.3%,对照组总有效率为89.1%,两者在统计学上有显著性差异。结论:精神、饮食因素在UC的治疗中起着非常重要的作用。  相似文献   

10.
干细胞移植治疗炎症性肠病研究进展   总被引:1,自引:0,他引:1  
强锋  胡奕 《中国基层医药》2009,16(5):934-935
溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn sdisestse,CD)都属于炎症性肠病(inflammatory bowel disease,IBD),发病可能由感染、遗传、免疫反应异常等多种因素相互作用所致。IBD的治疗以往多采用糖皮质激素及免疫抑制剂,但长期应用不良反应大,所以寻找不良反应小,且更有效的治疗方法有着十分重要的意义。目前的生物治疗主要是针对IBD免疫发病机制的生物学治疗方法,即针对炎症发生过程中的关键环节进行抗细胞因子治疗,主要包括阻断抗原的加工递增、T细胞活化、炎症前细胞因子的产生、炎症细胞迁移过程中效应信号的治疗以及干细胞移植治疗等。  相似文献   

11.
The role of TNFalpha in ulcerative colitis   总被引:2,自引:0,他引:2  
Standard of care for ulcerative colitis involves long-term pharmacotherapy or colectomy. Approximately 20% to 30% of patients eventually require a colectomy because patients either do not respond or cannot tolerate the currently available pharmacotherapies. Advances in our knowledge of the pathophysiology of ulcerative colitis have highlighted the importance of cytokines such as tumor necrosis factor alpha (TNFalpha) in the inflammatory process. TNFalpha is a proinflammatory mediator that plays an integral role in the pathogenesis of inflammatory bowel disease. In addition, mounting evidence indicates a genetic association between TNFalpha and ulcerative colitis. Furthermore, increased TNFalpha levels have been demonstrated in studies of patients with ulcerative colitis. TNFalpha is likely an important component in the pathophysiology of ulcerative colitis, and thus agents targeting TNFalpha in ulcerative colitis have been studied. Recent randomized controlled trials have confirmed that biologic anti-TNFalpha therapy is effective in ulcerative colitis. Soluble TNFalpha receptors or biologic agents that suppress or inhibit TNFalpha production may also show therapeutic promise.  相似文献   

12.
BACKGROUND: The imbalance of pro- and anti-inflammatory cytokines plays an important role in the pathogenesis of inflammatory bowel disease. Shifting this disturbed ratio by means of TNF-antibodies or interferon has been shown to be helpful in treating Crohn's disease and multiple sclerosis, respectively. AIM: This pilot study investigated whether interferon-beta can induce clinical remission in corticoid-refractory ulcerative colitis. METHODS: Twenty-five patients with steroid-refractory active ulcerative colitis (Clinical activity index according to Rachmilewitz: 13.5 +/- 5.2) were treated in an open pilot trial with 0.5 MIU human natural interferon-beta (hn-IFN-beta) i.v. (n=18) or 1 MIU recombinant interferon-beta-1a (r-IFN-beta-1-a) s.c. (n=7) daily with the goal of induction of remission. Subsequent maintenance treatment was carried out for 52.0 +/- 78.8 weeks (range 4-336 weeks) with the same dose, three times per week. RESULTS: Twenty-two of 25 patients (88%) went into remission during induction treatment (hn-IFN-beta 16/18, r-IFN-beta-1a 6/7). Mean time to response was 3.0 +/- 1.3 weeks. Mean length of remission was 13.0 +/- 19.7 months. Only eight of 22 patients in remission relapsed during maintenance treatment. Five of these went into remission again after increasing the dose. Adverse events consisted of slight to moderate flu-like symptoms and slight to moderate hair loss in five of 15 female patients. CONCLUSION: Although this open pilot study included only a small number of patients, the high response rate suggests that interferon-beta may be a safe and effective treatment for steroid-refractory active ulcerative colitis.  相似文献   

13.
The introduction of steroid therapy by Truelove and Witts in the 1950s revolutionized the treatment of ulcerative colitis. Corticosteroids are potent inhibitors of T-cell activation and proinflammatory cytokines and still represent the mainstay of therapy of patients with ulcerative colitis. About 15% of patients are resistant to steroids, and about a quarter of patients become dependent within 1 year of therapy. Steroid-related adverse events are numerous and occur frequently. So, new steroids with low systemic absorption and better safety profile have been studied, but they show an overall lower efficacy compared with traditional steroids. A new drug-delivery system based on the use of autologous erythrocytes loaded with dexamethasone 21-phosphate has been recently developed. Several studies have demonstrated its efficacy in steroid-dependent patients leading to complete withdrawal of oral steroids and disappearance of the most steroid-related adverse events. In this review we elaborate on the role of steroids in the treatment of ulcerative colitis, focusing on the aspects related to the mechanisms of action and resistance to the steroids, and their secondary effects. Moreover, we analyse the alternatives to traditional systemic steroids such as the new steroids with low bioavailability and the steroids encapsulated into erythrocytes.  相似文献   

14.
Proinflammatory cytokines released from monocytes/macrophages, in particular tumor necrosis factor (TNF)-alpha, interleukin (IL)-1, IL-6, and IL-8 seem to play an important role in Inflammatory Bowel Disease (ulcerative colitis and Crohn's disease). Endotoxins or lipopolysaccharides, derived from the outer membrane of Gram-negative bacteria interact with CD14 on surface membrane of macrophages, thus triggering a signal cascade, which leads to the production and release of proinflammatory cytokines, particularly TNF-alpha. Therefore, in IBD, lipopolysaccharides could play a pathogenic role. In this respect, plasma endotoxins have been demonstrated in a not negligible percentage of patients with ulcerative colitis and in their unaffected relatives. The presence of circulating endotoxins could be due, at least in part, to the impaired natural immunity in either patients with ulcerative colitis or in their first degree unaffected relatives. Lactoferrin is an iron-binding glycoprotein, which binds to the lipid A region of lipopolysaccharide with a high affinity and this interaction prevents the binding of lipopolysaccharide to CD14, thus inhibiting the release of proinflammatory cytokines. Therefore, based on the possible pathogenic role exerted by endotoxins in ulcerative colitis, lactoferrin may deserve attention as a possible therapeutical agent in experimental models of Inflammatory Bowel Disease.  相似文献   

15.
BACKGROUND: Approximately 20% of patients with ulcerative colitis have a chronic active disease often requiring several courses of systemic steroids in order to achieve remission, but followed by relapse of symptoms during steroid tapering or soon after their discontinuation. Although short term control of symptoms can be achieved with steroid treatment, this pattern of drug response, known as steroid-dependency, leads to important complications of the treatment, while a significant proportion of patients requires colectomy. AIM: To review the studies currently available specifically evaluating the management of steroid-dependent ulcerative colitis. RESULTS: The clinical and biological mechanisms of steroid-dependency are not well understood compared with those determining steroid-refractoriness. Very few evidence-based data are available concerning the management of patients with steroid-dependent ulcerative colitis. The therapeutic role of aminosalicylates, thiopurines, methotrexate, infliximab, leukocyte apheresis and other drugs in the treatment of steroid-dependent ulcerative colitis are evaluated. CONCLUSIONS: Outcomes of studies in steroid-refractory patients may not be applicable to steroid-dependency. Trials are needed to define the correct approaches and new strategies to ameliorate the therapy of steroid-dependent ulcerative colitis.  相似文献   

16.
溃疡性结肠炎的发病机制与治疗进展   总被引:1,自引:0,他引:1  
孙芳美 《中国医药指南》2012,10(12):445-447
目的探讨溃疡性结肠炎的发病机制与治疗进展。方法对当前溃疡性结肠炎的发病机制与治疗的研究成果进行分析。结果溃疡性结肠炎的病因和发病机制可能与免疫因素、遗传因素和环境因素有关。溃疡性结肠炎的治疗药物主要有激素、磺胺类和免疫抑制等。结论溃疡性结肠炎的发病机制现在不明确,是多种因素联合作用的结果,现阶段的治疗仍以药物治疗为主,且生物制剂将会在治疗中起到越来越重要的作用。  相似文献   

17.
Unfractioned heparin was recently reported to be beneficial in the treatment of inflammatory bowel disease. The available uncontrolled data show that it may be effective in steroid-resistant ulcerative colitis with a percentage of complete clinical remission of over 70% after an average of 4-6 weeks of therapy. The administration of unfractioned heparin is not currently justified by the very limited available data. The worsening of rectal bleeding is infrequent in treated ulcerative colitis patients and only rarely does it require blood transfusion or a colectomy. Low molecular weight heparin was used in a single trial in patients with steroid-refractory ulcerative colitis, with results similar to those observed with unfractioned heparin. Since a prothrombotic state has been described in inflammatory bowel disease, and microvascular intestinal occlusion seems to play a role in the pathogenesis of inflammatory bowel disease, it is reasonable that part of the beneficial effects of unfractioned heparin in inflammatory bowel disease may result from its anticoagulant properties. However, beyond its well-known anticoagulant activity, unfractioned heparin also exhibits a broad spectrum of immunomodulating and anti-inflammatory properties, by inhibiting the recruitment of neutrophils and reducing pro-inflammatory cytokines. Moreover, it can restore the high-affinity receptor binding of basic fibroblast growth factor and this would aid healing of the ulcerated mucosa. In conclusion, unfractioned heparin may represent a safe therapeutic option for severe, steroid-resistant ulcerative colitis, although randomized, controlled trials are needed to confirm these data.  相似文献   

18.
目的:观察瑞巴派特联合左氧氟沙星、地塞米松保留灌肠疗法对溃疡性结肠炎(UC)的临床疗效及安全性.方法:选择44例UC患者随机分为治疗组和对照组,治疗组应用瑞巴派特联合左氧氟沙星、地塞米松保留灌肠治疗,对照组应用左氧氟沙星、地塞米松灌肠治疗.结果:治疗组患者总有效率(90.9%)明显高于对照组(63.6%),P<0.05...  相似文献   

19.
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