临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (3): 226-232.doi: 10.12372/jcp.2025.24e0499
收稿日期:2024-05-16
录用日期:2024-08-12
出版日期:2025-03-15
发布日期:2025-02-27
通讯作者:
吴捷 电子信箱:基金资助:
JIA Shuangzhen, KONG Yan, LIU Qian-chao, ZHU Ailin, WU Jie(
)
Received:2024-05-16
Accepted:2024-08-12
Published:2025-03-15
Online:2025-02-27
摘要:
儿童炎症性肠病(IBD)是一种慢性复发性肠道炎性疾病,其病因不明,发病机制复杂,目前在诊治方面仍然面临挑战。IBD严重影响患儿的生长发育和生活质量,并可能对患儿的心理和社会行为产生不良影响,给社会带来巨大的经济负担。近年来,我国儿童IBD的发病率呈上升趋势,引起了儿科医师的高度重视。建立儿童IBD的精准治疗新模式成为国内外儿科医师和学者的目标。精准医学已被证明在肿瘤、新生儿遗传病的早期筛查与诊断等领域中发挥了重要作用,同时也为儿童IBD的治疗提供了新的方法和视角。本文就当前精准治疗在儿童IBD中的应用情况,阐明精准治疗在儿童IBD治疗中的作用。
贾双珍, 孔琰, 刘前超, 朱艾琳, 吴捷. 儿童炎症性肠病的精准治疗研究与应用[J]. 临床儿科杂志, 2025, 43(3): 226-232.
JIA Shuangzhen, KONG Yan, LIU Qian-chao, ZHU Ailin, WU Jie. Application of precision therapy in pediatric inflammatory bowel disease[J]. Journal of Clinical Pediatrics, 2025, 43(3): 226-232.
| [1] | El-Matary W, Carroll MW, Deslandres C, et al. The 2023 impact of inflammatory bowel disease in Canada: Special Populations-Children and Adolescents with IBD[J]. J Can Assoc Gastroenterol, 2023, 6(2): S35-S44. |
| [2] |
Benchimol EI, Bernstein CN, Bitton A, et al. Trends in epidemiology of pediatric inflammatory bowel disease in Canada: distributed network analysis of multiple population-based provincial health administrative databases[J]. Am J Gastroenterol, 2017, 112(7): 1120-1134.
doi: 10.1038/ajg.2017.97 pmid: 28417994 |
| [3] |
Fabián O, Kamaradová K. Morphology of inflammatory bowel diseases (IBD)[J]. Cesk Patol, 2022, 58(1): 27-37.
pmid: 35387455 |
| [4] | Berinstein JA, Aintabi D, Higgins PDR. In-hospital management of inflammatory bowel disease[J]. Curr Opin Gastroenterol, 2023, 39(4): 274-286. |
| [5] | Cho J, Kim S, Yang DH, et al. Mucosal immunity related to FOXP3+ regulatory T cells, Th17 cells and cytokines in pediatric inflammatory bowel disease[J]. J Korean Med Sci, 2018, 33(52): e336. |
| [6] | Yan JB, Luo MM, Chen ZY, et al. The function and role of the Th17/Treg cell balance in inflammatory bowel disease[J]. J Immunol Res, 2020: 8813558. |
| [7] | Gomez-Bris R, Saez A, Herrero-Fernandez B, et al. CD4 T-cell subsets and the pathophysiology of inflammatory bowel disease[J]. Int J Mol Sci, 2023, 24(3): 2696. |
| [8] | Gao H, Liu R, Huang H, et al. Susceptibility gene profiling elucidates the pathogenesis of inflammatory bowel disease and provides precision medicine[J]. Clin Transl Med, 2023, 13(9): e1404. |
| [9] | O'Brien CL, Summers KM, Martin NM, et al. The relationship between extreme inter-individual variation in macrophage gene expression and genetic susceptibility to inflammatory bowel disease[J]. Hum Genet, 2024, 143(3): 233-261. |
| [10] | White Z, Cabrera I, Kapustka I, et al. Microbiota as key factors in inflammatory bowel disease[J]. Front Microbiol, 2023, 14: 1155388. |
| [11] | Tani M, Shinzaki S, Asakura A, et al. Seasonal variations in gut microbiota and disease course in patients with inflammatory bowel disease[J]. PLoS One, 2023, 18(4): e0283880. |
| [12] | Yan J, Wang L, Gu Y, et al. Dietary patterns and gut microbiota changes in inflammatory bowel disease: current insights and future challenges[J]. Nutrients, 2022, 14(19): 4003. |
| [13] | McCoy J, Miller MR, Watson M, et al. Paediatric obesity and Crohn's disease: a descriptive review of disease phenotype and clinical course[J]. Paediatr Child Health, 2023, 29(3): 158-162. |
| [14] |
Ghione S, Sarter H, Fumery M, et al. Dramatic increase in incidence of ulcerative colitis and Crohn's disease (1988-2011): a population-based study of french adolescents[J]. Am J Gastroenterol, 2018, 113(2): 265-272.
doi: 10.1038/ajg.2017.228 pmid: 28809388 |
| [15] | Wang XQ, Zhang Y, Xu CD, et al. Inflammatory bowel disease in Chinese children: a multicenter analysis over a decade from Shanghai[J]. Inflamm Bowel Dis, 2013, 19(2): 423-428. |
| [16] | Mao R, Chen M. Precision medicine in IBD: genes, drugs, bugs and omics[J]. Nat Rev Gastroenterol Hepatol, 2022, 19(2): 81-82. |
| [17] |
Samuels A, Whaley KG, Minar P. Precision dosing of anti-TNF therapy in pediatric inflammatory bowel disease[J]. Curr Gastroenterol Rep, 2023, 25(11): 323-332.
doi: 10.1007/s11894-023-00895-4 pmid: 37695555 |
| [18] | Leung PY, Lui R, Chien MM. Asia-Pacific's first position papers on pediatric inflammatory bowel disease: Tackling unique challenges in the region[J]. J Gastroenterol Hepatol, 2023, 38(4): 481-482. |
| [19] | Bai BYH, Reppell M, Smaoui N, et al. Baseline expression of immune gene modules in blood is associated with primary response to anti-TNF therapy in Crohn's disease patients.[J]. J Crohns Colitis, 2024, 18(3):431-445. |
| [20] |
van den Broek WWA, Ten Berg JM. Is a genotype-guided therapy the optimal strategy to personalize anti-thrombotic management in patients with acute coronary syndrome?[J]. Eur Heart J, 2022, 43: 4599-4600.
doi: 10.1093/eurheartj/ehac219 pmid: 35678582 |
| [21] | Shi X, Zhang Y, Zhang Y, et al. Personalized antiplatelet therapy based on CYP2C19 genotypes in Chinese ACS patients undergoing PCI: a randomized controlled trial[J]. Front Cardiovasc Med, 2021, 8: 676954. |
| [22] | Vuyyuru SK, Solitano V, Hogan M, et al. Efficacy and safety of IL-12/23 and IL-23 inhibitors for Crohn's disease: systematic review and meta-analysis[J]. Dig Dis Sci, 2023, 68(9): 3702-3713. |
| [23] | Wyatt NJ, Watson H, Anderson CA, et al. Defining predictors of responsiveness to advanced therapies in Crohn's disease and ulcerative colitis: protocol for the IBD-RESPONSE and nested CD-meta RESPONSE prospective, multicentre, observational cohort study in precision medicine[J]. BMJ Open, 2024, 14(4): e073639. |
| [24] |
Neurath MF. Current and emerging therapeutic targets for IBD[J]. Nat Rev Gastroenterol Hepatol, 2017, 14(5): 269-278.
doi: 10.1038/nrgastro.2016.208 pmid: 28144028 |
| [25] | Akhter N, Wilson A, Arefanian H, et al. Endoplasmic reticulum stress promotes the expression of TNF-α in THP-1 cells by mechanisms involving ROS/CHOP/HIF-1α and MAPK/NF-κB pathways[J]. Int J Mol Sci, 2023, 24(20): 15186. |
| [26] | Chen J, Xu F, Ruan X, et al. Therapeutic targets for inflammatory bowel disease: proteome-wide Mendelian randomization and colocalization analyses[J]. EBioMedicine, 2023, 89: 104494. |
| [27] | Lu H, Lin J, Xu C, et al. Cyclosporine modulates neutrophil functions via the SIRT6-HIF-1α-glycolysis axis to alleviate severe ulcerative colitis[J]. Clin Transl Med, 2021, 11(2): e334. |
| [28] |
Viennois E, Baker MT, Xiao B, et al. Longitudinal study of circulating protein biomarkers in inflammatory bowel disease[J]. J Proteomics, 2015, 112: 166-179.
doi: 10.1016/j.jprot.2014.09.002 pmid: 25230104 |
| [29] | Glapa-Nowak A, Szczepanik M, Banaszkiewicz A, et al. C-reactive protein/albumin ratio at diagnosis of pediatric inflammatory bowel disease: a retrospective multi-center study[J]. Med Sci Monit, 2022, 28: e937842. |
| [30] | Essmann J, Keil C, Unruh O, et al. Fecal calprotectin is significantly linked to azathioprine metabolite concentrations in Crohn's disease[J]. Eur J Gastroenterol Hepatol, 2019, 31(1): 99-108. |
| [31] | Lee JY, Hall JA, Kroehling L, et al. Serum amyloid a proteins induce pathogenic Th17 cells and promote inflammatory disease[J]. Cell, 2020, 183(7): 2036-2039. |
| [32] |
Mello JDC, Gomes LEM, Silva JF, et al. The role of chemokines and adipokines as biomarkers of Crohn's disease activity: a systematic review of the literature[J]. Am J Transl Res, 2021, 13(8): 8561-8574.
pmid: 34539979 |
| [33] |
Polosukhina D, Singh K, Asim M, et al. CCL11 exacerbates colitis and inflammation-associated colon tumorigenesis[J]. Oncogene, 2021, 40(47): 6540-6546.
doi: 10.1038/s41388-021-02046-3 pmid: 34625710 |
| [34] | Kim Y, Park JH, Cho YR. Network-based approaches for disease-gene association prediction using protein-protein interaction networks[J]. Int J Mol Sci, 2022, 23(13): 7411. |
| [35] | Jha K, Saha S, Singh H. Prediction of protein-protein interaction using graph neural networks[J]. Sci Rep, 2022, 12(1): 8360. |
| [36] | Balogh OM, Benczik B, Horváth A, et al. Efficient link prediction in the protein-protein interaction network using topological information in a generative adversarial network machine learning model[J]. BMC Bioinformatics, 2022, 23(1): 78. |
| [37] | Wang X, Zhu H, Jiang Y, et al. PRODeepSyn: predicting anticancer synergistic drug combinations by embedding cell lines with protein-protein interaction network[J]. Brief Bioinform, 2022, 23(2): bbab587. |
| [38] |
Yuan Q, Chen J, Zhao H, et al. Structure-aware protein-protein interaction site prediction using deep graph convolutional network[J]. Bioinformatics, 2021, 38(1): 125-132.
doi: 10.1093/bioinformatics/btab643 pmid: 34498061 |
| [39] | Fiocchi C, Dragoni G, Iliopoulos D, et al. Results of the seventh scientific workshop of ECCO: precision medicine in IBD-What, Why, and How[J]. J Crohns Colitis, 2021, 15(9): 1410-1430. |
| [40] | LeVatte M, Keshteli AH, Zarei P, et al. Applications of metabolomics to precision nutrition[J]. Lifestyle Genom, 2022, 15(1): 1-9. |
| [41] | Hart L, Verburgt CM, Wine E, et al. Nutritional therapies and their influence on the intestinal microbiome in pediatric inflammatory bowel disease[J]. Nutrients, 2021, 14(1): 4. |
| [42] | Kasapoglu M, Yadavalli R, Nawaz S, et al. The impact of microbiome interventions on the progression and severity of inflammatory bowel disease: a systematic review[J]. Cureus, 2024, 16(5): e60786. |
| [43] | Höyhtyä M, Korpela K, Saqib S, et al. Quantitative fecal microbiota profiles relate to therapy response during induction with tumor necrosis factor α antagonist infliximab in pediatric inflammatory bowel disease[J]. Inflamm Bowel Dis, 2023, 29(1): 116-124. |
| [44] | Sitkin S, Pokrotnieks J. Targeted probiotics against bacterial-fungal biofilms: a new concept seems to bring us closer to microbiome-modulating therapy for inflammatory bowel disease[J]. Inflamm Bowel Dis, 2023, 29(11): e40-e41. |
| [45] | Al Radi ZMA, Prins FM, Collij V, et al. Exploring the predictive value of gut microbiome signatures for therapy intensification in patients with inflammatory bowel disease: a 10-year follow-up study[J]. Inflamm Bowel Dis, 2024: izae064. |
| [46] | Syed S, Boland BS, Bourke LT, et al. Challenges in IBD research 2024: precision medicine[J]. Inflamm Bowel Dis, 2024, 30(2): S39-S54. |
| [47] |
Dart RJ, Ellul P, Scharl M, et al. Results of the seventh scientific workshop of ECCO: Precision Medicine in IBD - Challenges and Future Directions[J]. J Crohns Colitis, 2021, 15(9): 1407-1409.
doi: 10.1093/ecco-jcc/jjab049 pmid: 33783484 |
| [1] | 林锦凤, 陈伊, 邓燕, 冯爱, 黄隽, 陈丽珠, 谢靖麒, 聂晓晶. 化学发光法与细胞间接免疫荧光法检测儿童肾病综合征血清抗Nephrin抗体的比较研究[J]. 临床儿科杂志, 2026, 44(8): 682-689. |
| [2] | 郑方圆, 王淼, 丁明明, 陆爱东, 贾月萍, 曾慧敏, 张乐萍. 儿童费城染色体阳性急性淋巴细胞白血病二代测序基因变异及预后意义的回顾性队列研究[J]. 临床儿科杂志, 2026, 44(8): 690-697. |
| [3] | 张晓, 方红军, 旷小军, 王丽娟, 吴照, 蒋莎, 李佩, 吴丽文. 儿童失张力发作的临床与电生理特征分析[J]. 临床儿科杂志, 2026, 44(8): 698-704. |
| [4] | 王梦倩, 杨辉. 儿童肠型贝赫切特综合征13例病例系列分析[J]. 临床儿科杂志, 2026, 44(8): 705-711. |
| [5] | 吴喜蓉, 高琦, 郭思远, 尹青琴, 秦强, 殷菊, 焦安夏, 陈诚豪, 吴迪, 王蓓, 段晓岷, 彭芸, 徐保平, 高立伟. 儿童糖尿病合并肺毛霉病患者临床特征及预后分析[J]. 临床儿科杂志, 2026, 44(8): 712-720. |
| [6] | 韩亚男, 葛兰兰, 崔洁媛. 1例EYA1基因变异所致鳃-耳-肾综合征患儿的6年诊治及随访报告[J]. 临床儿科杂志, 2026, 44(8): 721-726. |
| [7] | 时嘉仪, 高春林, 贾丽丽, 陆云云, 孙涛, 朱小东, 夏正坤, 张沛. COQ2基因复合杂合突变致儿童孤立性肾病综合征1家系表型特征与预后分析[J]. 临床儿科杂志, 2026, 44(8): 727-732. |
| [8] | Rachel Rosen, Osvaldo Borrelli, Christophe Faure, Katja Karrento, Usha Krishnan, Samuel Nurko, Nathalie Rommel, Alan Silverman, Michiel van Wijk, Marc Benninga (著), 中华医学会肠外肠内营养学分会儿科学组, 中华医学会儿科学分会消化学组, 中国医师协会儿科医师分会消化学组(译). 罗马Ⅴ诊断标准核心释义与解读:肠-脑互动异常的儿童与青少年上消化道疾病[J]. 临床儿科杂志, 2026, 44(7): 595-608. |
| [9] | Carlo Di Lorenzo, Miguel Saps, Bruno P. Chumpitazi, Shaman Rajindrajith, Annamaria Staiano, Nikhil Thapar, Miranda van Tilburg, Carlos Velasco-Benítez, Arine Vlieger(著), 中华医学会肠外肠内营养学分会儿科学组, 中华医学会儿科学分会消化学组, 中国医师协会儿科医师分会消化学组(译). 罗马Ⅴ诊断标准核心释义与解读:肠-脑互动异常的儿童与青少年下消化道及胆道疾病[J]. 临床儿科杂志, 2026, 44(7): 609-621. |
| [10] | 李旭峰, 唐浩勋, 李兴军, 张立泽, 高晨晴, 赵顺英, 刘建华. 儿童肺炎衣原体肺炎76例临床特点及影像学分型与预后相关性分析[J]. 临床儿科杂志, 2026, 44(7): 622-627. |
| [11] | 王真, 邵静波, 张娜, 夏敏, 朱嘉莳, 杜成坎, 李红. 初诊低危组儿童急性淋巴细胞白血病远期复发影响因素:基于单中心254例患儿的5年随访分析[J]. 临床儿科杂志, 2026, 44(7): 628-635. |
| [12] | 郭雪梅, 薛瑶, 王永韧, 戎留成, 方拥军, 林如峰. 伴CBFA2T3::GLIS2融合基因的儿童急性髓系白血病临床特征及预后分析[J]. 临床儿科杂志, 2026, 44(7): 636-643. |
| [13] | 杨丽君, 付东霞, 崔岩, 杨俊梅, 张利明. CHD7基因变异致CHARGE综合征临床特征及遗传学分析[J]. 临床儿科杂志, 2026, 44(7): 644-650. |
| [14] | 胡燕, 杨凡, 梁爱民, 毛萌. 生长减缓儿童的识别与管理:第十三届国际营养与生长会议要点解读[J]. 临床儿科杂志, 2026, 44(6): 485-488. |
| [15] | 刘子尧, 王聪颖, 王宏茂, 张明明, 许瑛杰, 赖建铭, 牛文全, 李晓惠. 伴关节症状川崎病与川崎病样症状起病全身型幼年特发性关节炎的早期鉴别:一项单中心回顾性研究[J]. 临床儿科杂志, 2026, 44(6): 489-498. |
|
||
沪公网安备 31011002000392号