International Journal of Clinical Research
International Journal of Clinical Research. 2025; 9: (4) ; 10.12208/j.ijcr.20250203 .
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1 大理大学临床医学院 云南大理
2 大理大学第二附属医院 云南昆明
*通讯作者： 郑盛,单位： 大理大学第二附属医院 云南昆明；
溃疡性结肠炎（ulcerative colitis, UC）是一种慢性炎症性肠病，现有治疗包括5氨基水杨酸、糖皮质激素、生物制剂等。近年研究显示，新型生物制剂（如抗TL1A药物PF06480605）在II期试验中实现临床缓解率65%；间充质干细胞（MSC）联合人参皂苷Rg1显著降低炎症因子（IL6下降40%）；粪便微生物移植（FMT）可使50%难治性UC患者达到内镜缓解。本文综述指出，糖皮质激素通过纳米递送系统（如SAPEIDDS）可减少全身副作用（肝毒性降低30%），而乌司奴单抗（Ustekinumab）在难治性UC中维持4年疗效。尽管治疗手段多样，UC仍面临易复发、费用高等挑战，未来需探索基因编辑与AI驱动的精准医疗。
Ulcerative colitis (ulcerative colitis, UC) is a chronic inflammatory bowel disease. existing treatments include 5 aminosalicylic acid, glucocorticoids, biological agents, etc. Recent studies have shown that novel biologics (e. g., anti-TL 1 A drug PF06480605) achieved clinical remission rates of 65% in phase II trials; mesenchymal stem cells (MSC) combined with ginsenoside Rg 1 significantly reduced inflammatory factors (40% decrease in IL 6); and fecal microbial transplantation (FMT) achieved endoscopic remission in 50% of patients with refractory UC disease. This review showed that corticosteroids reduced systemic side effects through nanodelivery systems (e. g., SAPEIDDS) (30% reduction in hepatotoxicity), while uinumab (Ustekinumab) was maintained in refractory UC for 4 years. Despite the variety of treatments, UC still faces the challenges of easy recurrence and high cost. In the future, gene editing and AI-driven precision medicine should be explored.
[1] 铉力,孙凤霞.孙凤霞教授治疗溃疡性结肠炎经验[J].中国中医药现代远程教育,2025,23(02):74-76.
[2] 殷萱,徐世芬,郭修田.针灸治疗溃疡性结肠炎机制研究进展[J].中国中医药信息杂志,2025,32(01):186-191.
[3] 袁春梅,罗伟生,李众钦,等.罗伟生治疗溃疡性结肠炎的经验总结[J].中国民间疗法,2024,32(23):52-54+103.
[4] Mikami Y, Tsunoda J, Suzuki S, Mizushima I, Kiyohara H, Kanai T. Significance of 5-Aminosalicylic Acid Intolerance in the Clinical Management of Ulcerative Colitis. Digestion. 2023;104(1):58-65.
[5] Zhou Y, Zhou Z. Unraveling the causal link: fatty acids and inflammatory bowel disease. Front Immunol. 2024;15:1405790.
[6] Li R, Huang X, Yang L, et al. Integrated Analysis Reveals the Targets and Mechanisms in Immunosuppressive Effect of Mesalazine on Ulcerative Colitis.Front Nutr. 2022;9:867692.
[7] Jaafar FR, Abu-Raghif A. Comparative treatment of Sulfasalazine+Ezetimibe combination and Sulfasalazine in a rat model with induced colitis.J Med Life. 2023;16(8):1165-1169.
[8] Jin JJ, Ko IG, Hwang L, et al. Simultaneous Treatment of 5-Aminosalicylic Acid and Treadmill Exercise More Effectively Improves Ulcerative Colitis in Mice. Int J Mol Sci. 2024;25(10):5076.
[9] Chen Y, Wang P, Zhang Y, Du XY, Zhang YJ. Comparison of effects of aminosalicylic acid, glucocorticoids and immunosuppressive agents on the expression of multidrug-resistant genes in ulcerative colitis. Sci Rep. 2022;12(1):20656.
[10] Liu H, Ji M, Xiao P, et al. Glucocorticoids-based prodrug design: Current strategies and research progress. Asian J Pharm Sci. 2024;19(3):100922.
[11] Özdemir S, Üner B, Baranauskaite J, Sümer E, Yıldırım E, Yaba A. Design and characterization of dexamethasone loaded microsponges for the management of ulcerative colitis. Eur J Pharm Biopharm. 2023;187:34-45.
[12] Dong K, Deng SJ, He BY, et al. Mucoadhesive Nanoparticles Enhance the Therapeutic Effect of Dexamethasone on Experimental Ulcerative Colitis by the Local Administration as an Enema. Drug Des Devel Ther. 2023;17:191-207.
[13] Wang Y, Qin J, Dong L, et al. Suppression of mir-150-5p attenuates the anti-inflammatory effect of glucocorticoids in mice with ulcerative colitis. Mol Immunol. 2023;163:28-38.
[14] Luo J, Wang Y, Dong X, et al. miR-642a-5p increases glucocorticoid sensitivity by suppressing the TLR4 signalling pathway in THP-1 cells. Biochem Biophys Rep. 2022;32:101356.
[15] Sokic-Milutinovic A, Milosavljevic T. Inflammatory Bowel Disease: From Conventional Immunosuppression to Biologic Therapy. Dig Dis. 2024;42(4):325-335.
[16] Masuyama S, Kanazawa M, Tominaga K, et al. Short-Term and Intermediate Efficacy of Tacrolimus for Active Ulcerative Colitis: A Single-Center Retrospective Analysis in Japan. Cureus. 2024;16(11):e73552.
[17] Tubau-Juni N, Hontecillas R, Leber AJ, Alva SS, Bassaganya-Riera J. Treating Autoimmune Diseases With LANCL2 Therapeutics: A Novel Immunoregulatory Mechanism for Patients With Ulcerative Colitis and Crohn's Disease. Inflamm Bowel Dis. 2024;30(4):671-680.
[18] Chu X, Biao Y, Liu C, et al. Network meta-analysis on efficacy and safety of different biologics for ulcerative colitis. BMC Gastroenterol. 2023;23(1):346.
[19] D'Haens G, Reinisch W, Schreiber S, et al. Subcutaneous Infliximab Monotherapy Versus Combination Therapy with Immunosuppressants in Inflammatory Bowel Disease: A Post Hoc Analysis of a Randomised Clinical Trial. Clin Drug Investig. 2023;43(4):277-288.
[20] Smith PJ, Fumery M, Leong RW, Novak K, Dignass A. Real-world experience with subcutaneous infliximab: broadening treatment strategies for inflammatory bowel disease.Expert Rev Clin Immunol. 2023;19(9):1143-1156.
[21] Ishida N, Takahashi K, Asai Y, et al. Albumin change predicts failure in ulcerative colitis treated with adalimumab.PLoS One. 2024;19(1):e0295681.
[22] Miyoshi J, Matsuura M, Hisamatsu T. Safety evaluation of ustekinumab for moderate-to-severe ulcerative colitis.Expert Opin Drug Saf. 2022;21(1):1-8.
[23] Zhang W, Zhong G, Ren X, Li M. Research progress of Ustekinumab in the treatment of inflammatory bowel disease.Front Immunol.2024;15:1322054.
[24] Cohen S,Rolandsdotter H, Kolho KL, et al.Effectiveness and Safety of Ustekinumab in Pediatric Ulcerative Colitis: A Multi-center Retrospective Study from the Pediatric IBD Porto Group of ESPGHAN.Paediatr Drugs.2024;26(5):609-617.
[25] 梁瑜,孙加琳,孟真,等.维得利珠单抗致34例不良反应文献分析[J].中国医院药学杂志,2022,42(12):1243-1248.
[26] 淮漫修,段晓燕,葛文松.维得利珠单抗治疗中重度溃疡性结肠炎疗效分析[J].2023,58(01):117-120.
[27] Schweckendiek D, Rogler G. Antibodies Targeting the Tumor Necrosis Factor-Like Ligand 1A in Inflammatory Bowel Disease: A New Kid on the (Biologics) Block?. Digestion. 2024;105(6):411-418.
[28] Hassan-Zahraee M, Ye Z, Xi L, et al. Antitumor Necrosis Factor-like Ligand 1A Therapy Targets Tissue Inflammation and Fibrosis Pathways and Reduces Gut Pathobionts in Ulcerative Colitis. Inflamm Bowel Dis. 2022;28(3):434-446.
[29] Lenk L, Baccelli I, Laqua A, et al. The IL-7R antagonist lusvertikimab reduces leukemic burden in xenograft ALL via antibody-dependent cellular phagocytosis. Blood. 2024;143(26):2735-2748.
[30] Lelièvre O, Benoist S, Brouquet A. Indications, modalities, and outcomes of surgery for ulcerative colitis in 2024. J Visc Surg. 2024;161(3):182-193.
[31] Chen SY, Radomski SN, Stem M, et al. National trends and outcomes of total proctocolectomy and completion proctectomy ileal pouch-anal anastomosis procedures for ulcerative colitis. Colorectal Dis. 2024;26(3):497-507.
[32] Wong MCY, Rotondi G, Roso M, et al. Quality of life after colectomy and ileo-jpouch-anal anastomosis in paediatric patients with ulcerative colitis. Pediatr Surg Int. 2024;40(1):231.
[33] Magen-Rimon R, Day AS, Shaoul R. An Overview of Nutritional Interventions in Inflammatory Bowel Diseases. Nutrients. 2024;16(18):3055.
[34] Liu H, Li J, Yuan J, Huang J, Xu Y. Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews. BMC Microbiol. 2023;23(1):371.
[35] Yu Z, Li D, Sun H. Herba Origani alleviated DSS-induced ulcerative colitis in mice through remolding gut microbiota to regulate bile acid and short-chain fatty acid metabolisms. Biomed Pharmacother. 2023;161:114409.
[36] Świrkosz G, Szczygieł A, Logoń K, Wrześniewska M, Gomułka K. The Role of the Microbiome in the Pathogenesis and Treatment of Ulcerative Colitis-A Literature Review. Biomedicines. 2023;11(12):3144.
[37] Gou Y, Cai S, Chen Y, et al. Atorvastatin improved ulcerative colitis in association with gut microbiota-derived tryptophan metabolism. Life Sci. 2024;351:122790.
[38] Li DH, Li ZW, Sun Q, Wang L, Ning SB. Lower fecal microbiota transplantation ameliorates ulcerative colitis by eliminating oral-derived Fusobacterium nucleatum and virulence factor. Gut Pathog. 2024;16(1):42.
[39] Baran Z, Çetinkaya M, Baran Y. Mesenchymal Stem Cells in Cancer Therapy. Adv Exp Med Biol. 2025;1474:149-177.
[40] TomyTomcy A, Sindhu ER. Mesenchymal stem cells- an excellent therapeutic agent for cancer. Asia Pac J Clin Oncol. 2024;20(1):7-15.
[41] Wei S, Li M, Wang Q, et al. Mesenchymal Stromal Cells: New Generation Treatment of Inflammatory Bowel Disease. J Inflamm Res. 2024;17:3307-3334.
[42] Qu F, Xu B, Kang H, et al. The role of macrophage polarization in ulcerative colitis and its treatment. Microb Pathog. 2025;199:107227.
[43] Movaffaghbani B, Esmaeili Gouvarchinghaleh H, Farzanehpour M, Shayegh J. Therapeutic Effects of Tretinoin and Caffeine-Treated Bone Marrow-Derived Mesenchymal Stem Cell on Immunological Features of Ulcerative Colitis: An Animal Model Study. Adv Biomed Res. 2024;13:19.
[44] Aly RM, Abohashem RS, Ahmed HH, Halim ASA. Combinatorial intervention with dental pulp stem cells and sulfasalazine in a rat model of ulcerative colitis. Inflammopharmacology. 2024;32(6):3863-3879.
[45] Zhang R, Zhang Q, Chen Y, et al. Combined treatment with Rg1 and adipose-derived stem cells alleviates DSS-induced colitis in a mouse model. Stem Cell Res Ther. 2022;13(1):272.
[46] Chen H, Wang H, Xu X, et al. The impact of 5-aminosalicylates on the efficacy of mesenchymal stem cell therapy in a murine model of ulcerative colitis. Int Immunopharmacol. 2024;134:112255.
[47] Yang W, Zhang X, Qi L, et al. Colon-targeted EMSCs conditional medium hydrogel for treatment of ulcerative colitis in mice. Biomed Mater. 2023;18(6):10.1088/1748-605X/acfadb.
[48] Gonzalez-Pujana A, Beloqui A, Javier Aguirre J, Igartua M, Santos-Vizcaino E, Maria Hernandez R. Mesenchymal stromal cells encapsulated in licensing hydrogels exert delocalized systemic protection against ulcerative colitis via subcutaneous xenotransplantation. Eur J Pharm Biopharm. 2022;172:31-40.