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溃疡性结肠炎的新疗法

Ulcerative colitis: Fresh approaches to taming inflammation

Ulcerative colitis is one of the most common forms of inflammatory bowel disease
溃疡性结肠炎是最常见的炎症性肠病
and is characterised by inflammation of the colon and the rectum.
其特征是结肠和直肠发炎
The walls of the colon — also known as the mucosa — become inflamed
当结肠壁——也称为粘膜——发炎后
and no longer provide an effective barrier between the inner cavity and the surrounding connective tissue
它就不能在内腔和周围的结缔组织之间提供有效屏障
allowing gut microbes to cross the epithelial layer.
导致肠道微生物可以穿过上皮细胞层
This causes inflammation of the mucosa and leads to a raft of unpleasant symptoms
这会引起粘膜发炎和一系列不良症状
such as abdominal pain, diarrhea, fatigue and rectal bleeding.
如腹痛 腹泻 疲劳和直肠出血
There are several commonly used anti-inflammatory and immunosuppressive drugs,
目前已经有几种常用消炎和免疫抑制类药物
but they come with side effects and aren’t long-lasting for many patients.
但它们有副作用 并且对很多患者而言 药效不够持久
Currently, 15% of people with ulcerative colitis will require surgery
目前 15%的溃疡性结肠炎患者
to remove some or all of the colon within 20 years of diagnosis.
要在确诊后的20年内接受手术 切除部分或全部直肠
Luckily, new insights into the immunology of this condition
幸运的是 免疫学对此新的见解
are helping scientists develop new effective treatments.
正帮助科学家们开发新的有效治疗方法
One new class of treatments is aimed at preventing the inflammation in the first place,
一种新的治疗方法 是通过增强上皮细胞的物理完整性
by bolstering the physical integrity of the colon’s epithelium.
以达到预防炎症的目的
This keeps the immune-triggering bugs confined to the interior of the colon.
这使得免疫触发的错误局限在结肠内部
Some of these treatments work by exploiting a human protein called IL-22
其中一些疗法是通过使用一种叫IL-22的人类蛋白起作用的
which helps strengthen the epithelial layer.
IL-22有助于加强上皮细胞层
One new drug in development targets the receptor for IL-22 on the epithelium itself,
一种研发中的新药 靶向IL-22 在上皮细胞上的受体
activating it and thereby initiating healing of epithelial cells and the mucus layer.
以此来激活上皮细胞 并促进上皮细胞和粘液层愈合
This drug is currently in phase two trials.
这种药目前正在进行Ⅱ期临床试验
Researchers are also trying to use a plant product called indigo naturalis
研究人员正试图使用一种叫青黛的植物产物
which encourages immune cells in the area to release IL-22, again healing the epithelial barrier.
来促进免疫细胞释放IL-22 再次修复上皮组织屏障
There are also new therapies emerging that prevent immune cells from entering the affected area.
还有一些新的疗法 阻止免疫细胞进入感染区域
where they might become activated to invoke an inflammatory response.
因为在炎症区域 免疫细胞可能会被激活并引发炎症反应
One way to do this is to inhibit proteins called integrins which live on the surface of T cells.
其中一种方法是抑制T细胞表面一种名为整合素的蛋白
A new antibody drug that works this way stops T cells from getting across the blood vessel wall into the mucosa
一种新的抗体药应用此法来阻止T细胞穿过血管壁进入粘膜层
and also blocks their binding to the epithelium.
并且阻断其与上皮细胞的结合
This drug appears to effectively reduce pain and inflammation.
这种药物似乎能有效减轻疼痛和炎症
Another group of drugs uses a totally different approach,
另一组药物使用了完全不同的方法
targeting key inflammatory signals between different immune cells.
即靶向不同免疫细胞之间的关键炎症信号
For example, one new drug tampers with the cellular machinery inside T cells
例如 一种新药通过破坏T细胞内的机制
so that they no longer respond to messages from macrophages.
使它们对自噬细胞的信号无法应答
In a pivotal phase three trial, this drug induced remission in over 40% of patients
在重要的Ⅲ期试验中 这种药物使40%以上的患者缓解病情
and has now been approved for the treatment of active ulcerative colitis.
目前已获批用于治疗溃疡性结肠炎
A final approach to treating this disease is to restore the healthy balance of the gut microbiome.
最后一种治疗方法是恢复肠道微生物菌群的健康平衡
One way of doing this is to use probiotic bacteria streams.
其中一种方式是使用益生菌株
Adding these commensal bacteria back into the intestine’s gut community
将这些共生益生菌重新添加回肠道菌群中
has been shown to quell inflammation and restore normal intestinal function.
这种方法被证明能抑制炎症并恢复正常的肠道功能
One particular probiotic, known as E. coli nissle, has been shown to keep symptoms at bay
一种被称为E.coli nissle的特殊益生菌已被证明可以控制症状
just as effectively as widely used anti-inflammatory drugs.
并且它和广泛使用的抗炎药一样有效
Fecal transplantation from healthy donors is also being experimented with,
来自健康捐赠者的粪便移植也在试验中
although results to date are conflicting.
尽管目前的结果是相互矛盾的
At least one recent study on multi-donor stool transplantation
但是 至少最近一项关于多供体粪便移植的研究
has shown promising results however,
有了振奋人心的结果
eliminating symptoms in a quarter of patients.
四分之一的患者被治愈
As new approaches to tackling this disease come onto the market,
随着对付这种疾病的新疗法进入市场
the hope is that more patients will be free of symptoms for longer
有望让更多的病人能在更长时间内摆脱症状
and won’t go on to need aggressive surgery.
并不再需要做大手术

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视频概述

溃疡性结肠炎患者一直以来都承受着病痛的折磨,科学家们针对此情况,正不断开发新的疗法,以减轻患者的痛苦。

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视频来源

https://www.youtube.com/watch?v=KynVWc2dGNs

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