1955年引入类固醇疗法，使严重溃疡性结肠炎（UC）的死亡率从安慰剂组的24%显着降低至7%，目前在专科中心不到1%。尽管取得了这一进展，但过去 50 年来，严重 UC 对类固醇的反应一直停滞不前，重度至中重度病例的结肠切除率仍然很高。英夫利昔单抗 (IFX)（Remicade，Centocor Inc.，马尔文，宾夕法尼亚州，美国）是一种针对肿瘤坏死因子-α (TNF-α) 的静脉注射嵌合单克隆免疫球蛋白 G1 抗体，已在许多随机对照试验中显示出治疗中度疾病的功效。严重和瘘管性克罗恩病，特别是对传统疗法无反应的患者。这导致美国食品和药物管理局于 1998 年批准其用于治疗活动性和瘘管性克罗恩病。大多数 IFX 临床研究都集中在克罗恩病上，该病的特点是由 TNF-α 等促炎细胞因子驱动的 Th1 型疾病。相反，UC 传统上被视为 Th2 型疾病，其中 TNF-α 的作用较小。然而，最近的研究表明 TNF-α 也可能有助于 UC 的发病机制。这些发现强调了进行更大型随机对照试验的必要性，以进一步研究 IFX 等疗法的益处，最终目标是改善炎症性肠病患者的治疗结果和生活质量。版权所有 © 2024，Vallejo 等人。

The introduction of steroid therapy in 1955 markedly decreased the mortality rate of severe ulcerative colitis (UC) from 24% in the placebo group to 7%, and it is currently less than 1% in specialist centers. Despite this advancement, the response of severe UC to steroids has stagnated over the past 50 years, with a high rate of colectomy persisting for severe to moderately severe cases. Infliximab (IFX) (Remicade, Centocor Inc., Malvern, PA, United States), an intravenously administered chimeric monoclonal immunoglobulin G1 antibody targeting tumor necrosis factor-alpha (TNF-α), has shown efficacy in numerous randomized controlled trials for treating moderate to severe and fistulizing Crohn's disease, particularly in patients unresponsive to conventional therapies. This led to its approval by the US Food and Drug Administration in 1998 for treating active and fistulizing Crohn's disease. Most clinical research on IFX has focused on Crohn's disease, which is characterized as a Th1-type condition driven by pro-inflammatory cytokines like TNF-α. Conversely, UC has traditionally been viewed as a Th2-type condition where TNF-α plays a lesser role. However, recent studies indicate that TNF-α might also contribute to the pathogenesis of UC. These findings highlight the necessity for larger randomized controlled trials to further investigate the benefits of therapies like IFX, with the ultimate goal of improving treatment outcomes and quality of life for patients with inflammatory bowel disease.Copyright © 2024, Vallejo et al.