背景:食管狭窄严重损害患者的生活质量,并提出了治疗挑战,特别是由于ESD/EMR后的高复发。目前的治疗管理症状,而不是解决疾病的病因。本文对食管狭窄的形成和复发机制进行综述。寻求突出潜在治疗干预的领域。
方法:通过PUBMED使用搜索词进行文献检索:食管狭窄,粘膜切除术,粘膜下剥离术.通过人工审查确定了相关文章,并审查了其他文章的参考清单。
结果:临床前研究和动物研究数据表明,可能导致食管狭窄的机制包括成纤维细胞过度分化,没有及时愈合的炎症反应,上皮屏障功能受损,以及导致它的多种方法因素。上皮屏障功能障碍可能是食管狭窄的起始机制。通过组织工程制造的细胞补片实现完美的上皮内化已被证明在治疗和预防食管狭窄方面是有效的。
结论:食管狭窄的发展包括三个阶段:对食管上皮屏障(EEB)的结构损害,慢性炎症,和严重的纤维化,其中EEB的功能障碍或损伤是导致食管狭窄的起始机制。再上皮化对食管狭窄的治疗和预防至关重要。这些信息将帮助临床医生或科学家开发未来治疗食管狭窄的有效技术。
Esophageal strictures significantly impair patient quality of life and present a therapeutic challenge, particularly due to the high recurrence post-ESD/EMR. Current treatments manage symptoms rather than addressing the disease\'s etiology. This review concentrates on the mechanisms of esophageal
stricture formation and recurrence, seeking to highlight areas for potential therapeutic intervention.
A literature search was conducted through PUBMED using search terms: esophageal
stricture, mucosal resection, submucosal dissection. Relevant articles were identified through manual review with reference lists reviewed for additional articles.
Preclinical studies and data from animal studies suggest that the mechanisms that may lead to esophageal stricture include overdifferentiation of fibroblasts, inflammatory response that is not healed in time, impaired epithelial barrier function, and multimethod factors leading to it. Dysfunction of the epithelial barrier may be the initiating mechanism for esophageal
stricture. Achieving perfect in-epithelialization by tissue-engineered fabrication of cell patches has been shown to be effective in the treatment and prevention of esophageal strictures.
The development of esophageal
stricture involves three stages: structural damage to the esophageal epithelial barrier (EEB), chronic inflammation, and severe fibrosis, in which dysfunction or damage to the EEB is the initiating mechanism leading to esophageal stricture. Re-epithelialization is essential for the treatment and prevention of esophageal
stricture. This information will help clinicians or scientists to develop effective techniques to treat esophageal stricture in the future.