维得利珠单抗联合糖皮质激素治疗重度溃疡性结肠炎的研究进展

Research progress on vedolizumab combined with glucocorticoids in treatment of severe ulcerative colitis

  • 摘要: 溃疡性结肠炎(UC)是一种以结肠黏膜连续性慢性炎症和溃疡形成为特征的炎症性肠病, 其发病机制复杂,涉及细胞因子、免疫调节和病理反应等多个方面。传统治疗策略包括糖皮质激素、免疫抑制剂(如环孢素、硫唑嘌呤)及生物制剂。然而,部分患者对现有疗法反应不佳或出现继发性失应答,难以实现临床缓解与黏膜愈合。维得利珠单抗是一种靶向α4β7整合素的人源化单克隆抗体,通过选择性抑制淋巴细胞向肠道黏膜的迁移,在UC治疗中展现出良好的疗效与安全性。糖皮质激素作为强效抗炎与免疫调节剂,可迅速控制急性炎症反应。近年来,维得利珠单抗与糖皮质激素联合使用在UC治疗中的潜在作用在临床实践中受到关注。本文系统综述了维得利珠单抗与糖皮质激素的作用机制、联合治疗在UC中相关研究进展,包括两种药物的作用机制、联合疗法的临床应用效果、安全性评价以及可能的治疗机制。

     

    Abstract: Ulcerative colitis (UC) is an inflammatory bowel disease characterized by continuous chronic inflammation and ulcer formation in the colonic mucosa. Its pathogenesis is complex, involving multiple aspects such as cytokines, immune regulation, and pathological responses. Traditional treatment strategies include glucocorticoids, immunosuppressants (such as cyclosporine and azathioprine), and biologics. However, some patients respond poorly to existing therapies or develop secondary non-response, making it difficult to achieve clinical remission and mucosal healing. Vedolizumab is a humanized monoclonal antibody targeting the α4β7 integrin. By selectively inhibiting the migration of lymphocytes to the intestinal mucosa, it demonstrates favorable efficacy and safety in the treatment of UC. Glucocorticoids, as potent anti-inflammatory and immunomodulatory agents, can rapidly control acute inflammatory responses. In recent years, the potential role of the combined use of vedolizumab and glucocorticoids in the treatment of UC has garnered attention in clinical practice. This article systematically reviewed the mechanisms of action of vedolizumab and glucocorticoids, as well as the research progress in their combined treatment for UC, including the mechanisms of action of the two drugs, the clinical application effects of the combined therapy, safety evaluations, and possible therapeutic mechanisms.

     

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