临床儿科杂志 ›› 2023, Vol. 41 ›› Issue (11): 801-807.doi: 10.12372/jcp.2023.23e0957
• 述评 • 下一篇
收稿日期:2023-10-07
出版日期:2023-11-15
发布日期:2023-11-08
通讯作者:
吴捷 电子信箱:基金资助:Received:2023-10-07
Published:2023-11-15
Online:2023-11-08
摘要:
儿童炎症性肠病(PIBD)是一组病因不明的慢性复发性非特异性肠道炎症性疾病,发病机制复杂,目前在诊断和治疗方面仍然面临挑战。近年来,儿童IBD在国内外的发病率呈现上升趋势,引起了儿科医师的广泛关注。文章在儿童IBD发病机制进展、最佳治疗目标的监测策略、治疗方法进展、青春期IBD管理及向成人转诊过渡衔接等方面进行了总结,旨在为我国儿科医师IBD的研究提供参考。
吴捷, 张添卓. 儿童炎症性肠病的研究现状及展望[J]. 临床儿科杂志, 2023, 41(11): 801-807.
WU Jie, ZHANG Tianzhuo. An analysis of the present status and future prospects of pediatric inflammatory bowel disease[J]. Journal of Clinical Pediatrics, 2023, 41(11): 801-807.
| [1] |
Ruemmele FM, Veres G, Kolho KL, et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease[J]. J Crohns Colitis, 2014, 8(10): 1179-1207.
doi: 10.1016/j.crohns.2014.04.005 pmid: 24909831 |
| [2] |
Turner D, Ruemmele FM, Orlanski-Meyer E, et al. Management of paediatric ulcerative colitis, part 1: ambulatory care-an evidence-based guideline from European Crohn's and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition[J]. J Pediatr Gastroenterol Nutr, 2018, 67(2): 257-291.
doi: 10.1097/MPG.0000000000002035 |
| [3] |
Birimberg-Schwartz L, Zucker DM, Akriv A, et al. Development and validation of diagnostic criteria for IBD subtypes including IBD-unclassified in children: a multicentre study from the pediatric IBD Porto group of ESPGHAN[J]. J Crohns Colitis, 2017, 11(9): 1078-1084.
doi: 10.1093/ecco-jcc/jjx053 pmid: 28430891 |
| [4] |
Benchimol EI, Fortinsky KJ, Gozdyra P, et al. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends[J]. Inflamm Bowel Dis, 2011, 17(1): 423-439.
doi: 10.1002/ibd.21349 pmid: 20564651 |
| [5] |
Kuenzig ME, Fung SG, Marderfeld L, et al. Twenty-first century trends in the global epidemiology of pediatric-onset inflammatory bowel disease: systematic review[J]. Gastroenterology, 2022, 162(4): 1147-1159.
doi: 10.1053/j.gastro.2021.12.282 pmid: 34995526 |
| [6] | Windsor JW, Buie M, Coward S, et al. A28 relative rates of ulcerative colitis to Crohn’s disease: parallel epidemiologies in newly vs. highly industrialized countries[J]. Journal of the Canadian Association of Gastroenterology, 2020, 3(Supplement_1): 34-35. |
| [7] |
Kugathasan S, Baldassano RN, Bradfield JP, et al. Loci on 20q13 and 21q22 are associated with pediatric-onset inflammatory bowel disease[J]. Nat Genet, 2008, 40(10): 1211-1215.
doi: 10.1038/ng.203 pmid: 18758464 |
| [8] |
Muise AM, Snapper SB, Kugathasan S. The age of gene discovery in very early onset inflammatory bowel disease[J]. Gastroenterology, 2012, 143(2): 285-288.
doi: 10.1053/j.gastro.2012.06.025 pmid: 22727850 |
| [9] |
Bequet E, Sarter H, Fumery M, et al. Incidence and phenotype at diagnosis of very-early-onset compared with later-onset paediatric inflammatory bowel disease: a population-based study [1988-2011][J]. J Crohns Colitis, 2017, 11(5): 519-526.
doi: 10.1093/ecco-jcc/jjw194 pmid: 28453757 |
| [10] |
Ong C, Aw MM, Liwanag MJ, et al. Rapid rise in the incidence and clinical characteristics of pediatric inflammatory bowel disease in a South-East Asian cohort in Singapore, 1994-2015[J]. J Dig Dis, 2018, 19(7): 395-403.
doi: 10.1111/cdd.2018.19.issue-7 |
| [11] |
Turpin W, Goethel A, Bedrani L, et al. Determinants of IBD heritability: genes, bugs, and more[J]. Inflamm Bowel Dis, 2018, 24(6): 1133-1148.
doi: 10.1093/ibd/izy085 pmid: 29701818 |
| [12] |
Suarez RG, Osornio-Vargas AR, Wine E. Ambient air pollution and pediatric inflammatory bowel diseases: an updated scoping review[J]. Dig Dis Sci, 2022, 67(9): 4342-4354.
doi: 10.1007/s10620-022-07597-3 |
| [13] |
Forbes JD, Van Domselaar G, Bernstein CN. Microbiome survey of the inflamed and noninflamed gut at different compartments within the gastrointestinal tract of inflammatory bowel disease patients[J]. Inflamm Bowel Dis, 2016, 22(4): 817-825.
doi: 10.1097/MIB.0000000000000684 pmid: 26937623 |
| [14] |
Parada Venegas D, De la Fuente MK, Landskron G, et al. Corrigendum: short chain fatty acids (SCFAs)-mediated gut epithelial and immune regulation and its relevance for inflammatory bowel diseases[J]. Front Immunol, 2019, 10: 1486.
doi: 10.3389/fimmu.2019.01486 pmid: 31316522 |
| [15] |
Di Vincenzo F, Puca P, Lopetuso LR, et al. Bile acid-related regulation of mucosal inflammation and intestinal motility: from pathogenesis to therapeutic application in IBD and microscopic colitis[J]. Nutrients, 2022, 14(13): 2664.
doi: 10.3390/nu14132664 |
| [16] |
Kurilshikov A, Wijmenga C, Fu J, et al. Host genetics and gut microbiome: challenges and perspectives[J]. Trends Immunol, 2017, 38(9): 633-647.
doi: S1471-4906(17)30106-0 pmid: 28669638 |
| [17] |
Flannigan KL, Geem D, Harusato A, et al. Intestinal antigen-presenting cells: key regulators of immune homeostasis and inflammation[J]. Am J Pathol, 2015, 185(7): 1809-1819.
doi: 10.1016/j.ajpath.2015.02.024 pmid: 25976247 |
| [18] |
Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: an update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the international organization for the study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD[J]. Gastroenterology, 2021, 160(5): 1570-1583.
doi: 10.1053/j.gastro.2020.12.031 pmid: 33359090 |
| [19] |
Plevris N, Lees CW. Disease monitoring in inflammatory bowel disease: evolving principles and possibilities[J]. Gastroenterology, 2022, 162(5): 1456-1475.
doi: 10.1053/j.gastro.2022.01.024 |
| [20] |
Kuharic M, Krugliak Cleveland N, Candela N, et al. P042 Early versus later use of vedolizumab In IBD: patient characteristics and treatment patterns in the real world (RALEE)[J]. Am J Gastroenterol, 2021, 116(Suppl 1): S11.
doi: 10.14309/01.ajg.0000798768.43978.95 pmid: 34848629 |
| [21] |
Feuerstein JD, Nguyen GC, Kupfer SS, et al. American gastroenterological association institute guideline on therapeutic drug monitoring in inflammatory bowel disease[J]. Gastroenterology, 2017, 153(3): 827-834.
doi: S0016-5085(17)35963-2 pmid: 28780013 |
| [22] |
Hyams J, Crandall W, Kugathasan S, et al. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children[J]. Gastroenterology, 2007, 132(3): 863-873.
doi: 10.1053/j.gastro.2006.12.003 pmid: 17324398 |
| [23] |
Hyams J, Damaraju L, Blank M, et al. Induction and maintenance therapy with infliximab for children with moderate to severe ulcerative colitis[J]. Clin Gastroenterol Hepatol, 2012, 10(4): 391-399.
doi: 10.1016/j.cgh.2011.11.026 |
| [24] |
Papamichael K, Afif W, Drobne D, et al. Therapeutic drug monitoring of biologics in inflammatory bowel disease: unmet needs and future perspectives[J]. Lancet Gastroenterol Hepatol, 2022, 7(2): 171-185.
doi: 10.1016/S2468-1253(21)00223-5 |
| [25] | Vvan Rheenen PF, Aloi M, Assa A, et al. The medical management of paediatric Crohn's disease: an ECCO-ESPGHAN guideline update[J]. J Crohns Colitis, 2020-jjaa161. |
| [26] |
Cheifetz AS, Abreu MT, Afif W, et al. A comprehensive literature review and expert consensus statement on therapeutic drug monitoring of biologics in inflammatory bowel disease[J]. Am J Gastroenterol, 2021, 116(10): 2014-2025.
doi: 10.14309/ajg.0000000000001396 pmid: 34388143 |
| [27] |
Venkatesh K, Cohen M, Evans C, et al. Feasibility of confocal endomicroscopy in the diagnosis of pediatric gastrointestinal disorders[J]. World J Gastroenterol, 2009, 15(18): 2214-2219.
doi: 10.3748/wjg.15.2214 |
| [28] |
Miele E, Shamir R, Aloi M, et al. Nutrition in pediatric inflammatory bowel disease: a position paper on behalf of the Porto inflammatory bowel disease group of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition[J]. J Pediatr Gastroenterol Nutr, 2018, 66(4): 687-708.
doi: 10.1097/MPG.0000000000001896 |
| [29] |
Bischoff SC, Bager P, Escher J, et al. ESPEN guideline on clinical nutrition in inflammatory bowel disease[J]. Clin Nutr, 2023, 42(3): 352-379.
doi: 10.1016/j.clnu.2022.12.004 pmid: 36739756 |
| [30] |
Sarbagili-Shabat C, Albenberg L, Van Limbergen J, et al. A novel UC exclusion diet and antibiotics for treatment of mild to moderate pediatric ulcerative colitis: a prospective open-label pilot study[J]. Nutrients, 2021, 13(11): 3736.
doi: 10.3390/nu13113736 |
| [31] |
Radziszewska M, Smarkusz-Zarzecka J, Ostrowska L, et al. Nutrition and supplementation in ulcerative colitis[J]. Nutrients, 2022, 14(12): 2469.
doi: 10.3390/nu14122469 |
| [32] |
Turner D, Ruemmele FM, Orlanski-Meyer E, et al. Management of paediatric ulcerative colitis, part 2: acute severe colitis-an evidence-based consensus guideline from the European Crohn's and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition[J]. J Pediatr Gastroenterol Nutr, 2018, 67(2): 292-310.
doi: 10.1097/MPG.0000000000002036 |
| [33] |
Nakase H, Uchino M, Shinzaki S, et al. Evidence-based clinical practice guidelines for inflammatory bowel disease 2020[J]. J Gastroenterol, 2021, 56(6): 489-526.
doi: 10.1007/s00535-021-01784-1 pmid: 33885977 |
| [34] |
Atia O, Shavit-Brunschwig Z, Mould DR, et al. Outcomes, dosing, and predictors of vedolizumab treatment in children with inflammatory bowel disease (VEDOKIDS): a prospective, multicentre cohort study[J]. Lancet Gastroenterol Hepatol, 2023, 8(1): 31-42.
doi: 10.1016/S2468-1253(22)00307-7 |
| [35] |
Singh N, Rabizadeh S, Jossen J, et al. Multi-center experience of vedolizumab effectiveness in pediatric inflammatory bowel disease[J]. Inflamm Bowel Dis, 2016, 22(9): 2121-6.
doi: 10.1097/MIB.0000000000000865 pmid: 27542130 |
| [36] |
Dayan JR, Dolinger M, Benkov K, et al. Real world experience with ustekinumab in children and young adults at a tertiary care pediatric inflammatory bowel disease center[J]. J Pediatr Gastroenterol Nutr, 2019, 69(1): 61-67.
doi: 10.1097/MPG.0000000000002362 |
| [37] | Wlazło M, Kierkuś J. Dual biologic therapy for the treatment of pediatric inflammatory bowel disease: a review of the literature[J]. J Clin Med, 2022, 11(7). |
| [38] |
Panés J, Loftus EV, Higgins PDR, et al. Induction and maintenance treatment with upadacitinib improves health-related quality of life in patients with moderately to severely active ulcerative colitis: phase 3 study results[J]. Inflamm Bowel Dis, 2023, 29(9): 1421-1430.
doi: 10.1093/ibd/izac260 |
| [39] |
D'Haens G, Panés J, Louis E, et al. Upadacitinib was efficacious and well-tolerated over 30 months in patients with Crohn's disease in the celest extension study[J]. Clin Gastroenterol Hepatol, 2022, 20(10): 2337-2346..
doi: 10.1016/j.cgh.2021.12.030 |
| [40] |
Collen LV. Rapid clinical remission with upadacitinib in a pediatric patient with refractory Crohn's disease[J]. Inflamm Bowel Dis, 2023, 29(7): 1175-1176.
doi: 10.1093/ibd/izad048 |
| [41] |
Moore H, Dubes L, Fusillo S, et al. Tofacitinib therapy in children and young adults with pediatric-onset medically refractory inflammatory bowel disease[J]. J Pediatr Gastroenterol Nutr, 2021, 73(3): e57-e62.
doi: 10.1097/MPG.0000000000003190 |
| [42] |
Kassam Z, Lee CH, Yuan Y, et al. Fecal microbiota transplantation for clostridium difficile infection: systematic review and meta-analysis[J]. Am J Gastroenterol, 2013, 108(4): 500-508.
doi: 10.1038/ajg.2013.59 pmid: 23511459 |
| [43] | 黄瑛, 王玉环. 粪菌移植治疗儿童炎症性肠病[J]. 中华实用儿科临床杂志, 2017, 32(7): 491-493. |
| [44] |
Tan P, Li X, Shen J, et al. Fecal microbiota transplantation for the treatment of inflammatory bowel disease: an update[J]. Front Pharmacol, 2020, 11: 574533.
doi: 10.3389/fphar.2020.574533 |
| [45] |
Reider S, Binder L, Fürst S, et al. Hematopoietic stem cell transplantation in refractory Crohn's disease: should it be considered?[J]. Cells, 2022, 11(21): 3436.
doi: 10.3390/cells11213436 |
| [46] |
Liang J, Zhang H, Wang D, et al. Allogeneic mesenchymal stem cell transplantation in seven patients with refractory inflammatory bowel disease[J]. Gut, 2012, 61(3): 468-469.
doi: 10.1136/gutjnl-2011-300083 pmid: 21617158 |
| [47] |
Bollegala N, Brill H, Marshall JK. Resource utilization during pediatric to adult transfer of care in IBD[J]. J Crohns Colitis, 2013, 7(2): e55-60.
doi: 10.1016/j.crohns.2012.05.010 |
| [48] |
Menon T, Afzali A. Inflammatory bowel disease: a practical path to transitioning from pediatric to adult care[J]. Am J Gastroenterol, 2019, 114(9): 1432-1440.
doi: 10.14309/ajg.0000000000000222 pmid: 30985298 |
| [49] |
Sexton KA, Walker JR, Graff LA, et al. Evidence of bidirectional associations between perceived stress and symptom activity: a prospective longitudinal investigation in inflammatory bowel disease[J]. Inflamm Bowel Dis, 2017, 23(3): 473-483.
doi: 10.1097/MIB.0000000000001040 pmid: 28221251 |
| [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] | 贾世辰, 徐国锋. 胱氨酸尿症的诊治进展[J]. 临床儿科杂志, 2026, 44(8): 740-746. |
| [9] | 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. |
| [10] | 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. |
| [11] | 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. |
| [12] | 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. |
| [13] | 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. |
| [14] | 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. |
| [15] | 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. |
|
||
沪公网安备 31011002000392号
