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Upalne bolesti crijeva su kronične upale cijeloga probavnog trakta ili samo jednog njegovog dijela, a najčešće su Chronova bolest i ulcerozni kolitis. Simptomi koji se najčešće javljaju su proljev, bol i grčevi u abdomenu, gubitak težine, krv u stolici i smanjen apetit. Mogu uzrokovati i anemiju zbog krvavih proljeva. Muškarci i žene izloženi su jednakom riziku od obolijevanja. Dijagnoza se najčešće postavlja između 15. i 40. godine života. Cilj liječenja je smanjiti upalu koja aktivira znakove i simptome bolesti uz upotrebu lijekova usmjerenih na potiskivanje imunološkog sistema. Jedna od terapija u liječenju upalnih bolesti crijeva su biološki lijekovi, koji se definiraju kao lijekovi s jednim ili više aktivnih sastojaka koji su izvedeni ili sintetizirani iz bioloških materijala. Proizvode se metodom rekombinirane DNA, na način da se uz pomoć vektora geni sinteze proteina ugrađuju u genom matičnih stanica. Protein se potom sintetizira i izolira iz matične stanice i upotrebljava se kao aktivni sastojak. Dijele se na anti-TNF-alfa, antiintegrinske, anti-IL-12/23 lijekove i JAK-inhibitore. Anti-TNF-α lijekovi se najčešće koriste te se u njih ubrajaju još i blokatori TNF-α receptora i solubilni receptori za TNF-α. Cilj ovog rada je prikazati učinkovitost i sigurnost primjene biološke terapije kod bolesnika s upalnim bolestima crijeva na način da će za svaku od bolesti biti objašnjena terapija i tijek liječenja. U radu će se prikazati primjena biološke terapije u Općoj bolnici Zadar u bolesnika koji su oboljeli od ulceroznog kolitisa ili Chronove bolesti, ovisno o spolu, dobi i lijekovima koje uzimaju. Inflammatory bowel diseases involve chronic inflammation of all digestive tract or only part of it, which mostly includes Crohn’s disease and ulcerative colitis. The most common symptoms are diarrhea, pain and cramps in the abdomen, weight loss, blood in the stool and decreased appetite. They can also cause anemia due to bloody diarrhea. Men and women are at equal risk of getting the disease. The diagnosis is most often made between the ages of 15 and 40. The aim of medical treatment is to reduce the inflammation that activates the signs and symptoms of the disease, and the drugs used are mainly aimed at non-specific suppression of the immune system. One of the therapies in the treatment of inflammatory bowel disease is biological therapy. Biological drugs are defined as drugs with one or more active substances that are derived or synthesized from biological materials. They are produced by the recombinant DNA method in such a way that the genes required for the synthesis of a particular protein are incorporated into the stem cell genome by a vector, after which the protein is synthesized and isolated from the cell and can be used as an active substance. They are divided into anti-TNF-alpha, anti-integrin, anti-IL-12/23 drugs and JAK inhibitors. Anti-TNF-α drugs are the most commonly used and include TNF-α receptor blockers and soluble TNF-α receptors. The aim of this paper is to present the efficacy and safety of biological therapy in patients with inflammatory bowel disease in a way that for each of the diseases will be explained therapy and course of treatment. The paper will present the application of biological therapy in the Zadar General Hospital in patients with Crohn's disease and ulcerative colitis, depending on gender, age and medications they take. |
