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Zukünftige Therapieoptionen für chronisch-entzündliche Darmerkrankungen

Was zu erwarten ist

Future treatment options for inflammatory bowel disease

What to expect

  • Schwerpunkt
  • Published:
Die Gastroenterologie Aims and scope

Zusammenfassung

Chronisch-entzündliche Darmerkrankungen (CED) sind durch rezidivierende Entzündung des Gastrointestinaltrakts gekennzeichnet. Weltweit steigende Inzidenzen belasten das Gesundheitssystem. Neben anderen Faktoren tragen ein aberrantes Immunsystem, eine gestörte intestinale Barriere und Veränderungen des Darmmikrobioms zur Pathogenese der CED bei. Aktuelle und zukünftige Therapien basieren hauptsächlich auf einer Immunmodulation durch Inhibition von Zytokinen bzw. von deren Signalwegen oder durch die Blockade der Immunzellmigration. Ferner könnte auch die Modifikation der Mikrobiota in Zukunft eine wichtige Rolle spielen. Auch wenn bisher keine Prädiktion von primärem Therapieansprechen oder sekundärem Wirkverlust möglich ist, erreichen durch die zunehmenden therapeutischen Optionen immer mehr Menschen mit CED eine steroidfreie klinische Remission und mukosale Heilung.

Abstract

Inflammatory bowel disease (IBD) is characterized by chronic relapsing inflammation of the gastrointestinal tract. Increasing incidences worldwide put a growing strain on the healthcare system. Among other factors, an aberrant immune response, barrier defects, and changes in the intestinal microbiome contribute to the pathogenesis of IBD. Current and future therapies include targeted immune modulation using cytokine or cytokine-signaling inhibitors and inhibitors of immune cell migration. Furthermore, targeted modification of intestinal microbiota will likely play an important role in the future. Although prediction of primary response to therapy or secondary loss of effectiveness is not yet possible, more and more patients with IBD are achieving steroid-free remission and mucosal healing due to the rapidly increasing number of therapeutic options.

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Authors and Affiliations

  1. I. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    Franziska Bertram,  Jan Kempski &  Samuel Huber

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  1. Franziska Bertram
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  3. Samuel Huber
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Correspondence to Samuel Huber.

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Interessenkonflikt

F. Bertram erhielt Vortragshonorare von Abbvie und Falk Pharma. S. Huber erhielt Vortrags- und Beratungshonor von Abbvie, Janssen, Falk Pharma, Ferring und Galapagos. J. Kempski gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Irina Blumenstein, Frankfurt am Main

Sebastian Zundler, Erlangen

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Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

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Bertram, F., Kempski, J. & Huber, S. Zukünftige Therapieoptionen für chronisch-entzündliche Darmerkrankungen. Gastroenterologie 18, 432–439 (2023). https://doi.org/10.1007/s11377-023-00735-x

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