Predictive, preventive and personalised approach as a conceptual and technological innovation in primary and secondary care of inflammatory bowel disease benefiting affected individuals and populations

IF 6.5 2区 医学 Q1 Medicine
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Abstract

Inflammatory bowel disease (IBD) is a global health burden which carries lifelong morbidity affecting all age groups in populations with the disease-specific peak of the age groups ranging between 15 and 35 years, which are of great economic importance for the society. An accelerating incidence of IBD is reported for newly industrialised countries, whereas stabilising incidence but increasing prevalence is typical for countries with a Westernised lifestyle, such as the European area and the USA. Although the aetiology of IBD is largely unknown, the interplay between the genetic, environmental, immunological, and microbial components is decisive for the disease manifestation, course, severity and individual outcomes. Contextually, the creation of an individualised patient profile is crucial for the cost-effective disease management in primary and secondary care of IBD. The proposed pathomechanisms include intestinal pathoflora and dysbiosis, chronic inflammation and mitochondrial impairments, amongst others, which collectively may reveal individual molecular signatures defining IBD subtypes and leading to clinical phenotypes, patient stratification and cost-effective protection against health-to-disease transition and treatments tailored to individualised patient profiles—all the pillars of an advanced 3PM approach. The paradigm change from reactive medical services to predictive diagnostics, cost-effective targeted prevention and treatments tailored to individualised patient profiles in overall IBD management holds a promise to meet patient needs in primary and secondary care, to increase the life-quality of affected individuals and to improve health economy in the area of IBD management. This article analyses current achievements and provides the roadmap for future developments in the area in the context of 3P medicine benefiting society at large.

将预测、预防和个性化方法作为炎症性肠病初级和中级治疗的概念和技术创新,使受影响的个人和群体受益
摘要 炎症性肠病(IBD)是一种全球性的健康负担,影响所有年龄组人群的终生发病率,15 至 35 岁年龄组是发病高峰期,对社会经济具有重要意义。据报道,在新兴工业化国家,IBD 的发病率呈加速趋势,而在生活方式西方化的国家,如欧洲地区和美国,IBD 的发病率趋于稳定,但流行率却呈上升趋势。虽然 IBD 的病因在很大程度上还不清楚,但遗传、环境、免疫和微生物等因素之间的相互作用对疾病的表现、病程、严重程度和个体结局起着决定性作用。在此背景下,建立个体化的患者档案对于在 IBD 一级和二级护理中进行经济有效的疾病管理至关重要。所提出的病理机制包括肠道病原菌群和菌群失调、慢性炎症和线粒体损伤等,这些因素共同揭示了定义 IBD 亚型的个体分子特征,并导致临床表型、患者分层、经济有效地防止从健康到疾病的转变,以及根据个体化患者特征量身定制的治疗方法--所有这些都是先进的 3PM 方法的支柱。在 IBD 的整体管理中,从反应性医疗服务到预测性诊断、具有成本效益的针对性预防和根据患者个体情况量身定制的治疗,这种模式的转变有望满足患者在初级和二级医疗中的需求,提高患者的生活质量,并改善 IBD 管理领域的卫生经济效益。本文分析了目前取得的成就,并在 3P 医学造福全社会的背景下为该领域的未来发展提供了路线图。
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来源期刊
Epma Journal
Epma Journal Medicine-Biochemistry (medical)
CiteScore
11.30
自引率
23.10%
发文量
0
期刊介绍: PMA Journal is a journal of predictive, preventive and personalized medicine (PPPM). The journal provides expert viewpoints and research on medical innovations and advanced healthcare using predictive diagnostics, targeted preventive measures and personalized patient treatments. The journal is indexed by PubMed, Embase and Scopus.
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