INTESTINE Vol.22 No.4(1)


特集名 炎症性腸疾患の粘膜治癒を考える
題名 総論─炎症性腸疾患における粘膜治癒の定義と臨床的意義
発刊年月 2018年 07月
著者 梁井 俊一 岩手医科大学内科学講座消化器内科消化管分野
著者
【 要旨 】 炎症性腸疾患において生物学的製剤は必須の治療法となった.とくに,抗TNF-α抗体製剤の登場により炎症性腸疾患の治療戦略は大きな変化を遂げ,従来の治療目標であった症状改善から,消化管病変の瘢痕化,すなわち粘膜治癒や消化管機能の回復を目標とする治療が推奨されるようになった.このような,治療目標を個別化した考え方が,treat-to-targetという概念で提言されている.なかでも,粘膜治癒を目指すことで,再発予防や外科的切除の回避など,きわめて良好な長期予後が得られることが示されている.一方で,粘膜治癒自体の定義が未だ明確ではない点は今後の重要な課題と思われる.
Theme Recent advances in detection of mucosal healing in inflammatory bowel disease
Title Mucosal healing with inflammatory bowel disease
Author Shunichi Yanai Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University
Author Takayuki Matsumoto Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University
[ Summary ] Since biologics have become essential treatments for patients with inflammatory bowel disease, there have been great advances in the treatment goals for the disease. Specifically, mucosal healing as well as resolution of symptoms have been suggested as appropriate treatment targets. As a consequence, the concept of "treat-to-target" has been introduced in the management of inflammatory bowel disease to improve long-term prognoses. However, there are still controversies as to the definition of mucosal healing and to the scoring systems for mucosal lesions. In order to treat patients appropriately and rapidly, there is a need to define mucosal healing clearly in both cases of ulcerative colitis and Crohn's disease.
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