病例报告：Dupilumab相关性溃疡性结肠炎：阐明Th2阻断与Th17极化肠道炎症之间的病理机制联系
Case Report: Dupilumab-associated ulcerative colitis: elucidating the pathomechanistic link between Th2 blockade and Th17 polarized intestinal inflammation.
摘要(中文译文)
尽管度普利尤单抗（dupilumab）通过靶向IL-4/IL-13受体拮抗在中重度特应性皮炎（AD）的治疗中高度有效，但其更广泛的免疫调节效应值得临床审慎关注。我们报告一例63岁男性患者在度普利尤单抗治疗后发生溃疡性结肠炎（UC）的病例。尽管其皮肤病变迅速改善，但患者在开始治疗三个月内出现急性胃肠道不适，包括便血和里急后重。随后的结肠镜检查和组织病理学分析确诊为UC。停用度普利尤单抗后，患者获得显著的临床和内镜下缓解。结肠黏膜的纵向免疫组化分析显示，活动性结肠炎期间IL-17升高、IL-4表达受抑，临床恢复后上述指标恢复正常。这些发现提供了提示局部Th2向Th17免疫偏移的假设生成性证据。尽管作为单例报告存在固有局限性，但本病例强调了在接受IL-4Rα阻断治疗的患者中，对矛盾性Th17驱动炎症保持多学科警惕的 critical 必要性。
Abstract
While dupilumab is highly effective in managing moderate-to-severe atopic dermatitis (AD) through targeted IL-4/IL-13 receptor antagonism, its broader immunomodulatory effects warrant careful clinical scrutiny. We report the case of a 63-year-old male who developed ulcerative colitis (UC) following dupilumab therapy. Although his cutaneous condition improved rapidly, the patient developed acute gastrointestinal distress, including hematochezia and tenesmus, within three months of initiating therapy. Subsequent colonoscopy and histopathological analyses confirmed the diagnosis of UC. Discontinuation of dupilumab was followed by a robust clinical and endoscopic remission. Longitudinal immunohistochemical profiling of the colonic mucosa demonstrated elevated IL-17 and suppressed IL-4 expression during active colitis, which normalized upon clinical recovery. These findings offer hypothesis-generating evidence indicative of a localized Th2-to-Th17 immune shift. Although inherently limited as a single-patient report, this case underscores the critical necessity for multidisciplinary vigilance regarding paradoxical Th17-driven inflammation in patients undergoing IL-4Rα blockade.
如何引用
AMA
Fanghui Fu, Qing Zhao, Lei Ma, Aili Wang, Zhe Wang, Xiaoyang Xu. Case Report: Dupilumab-associated ulcerative colitis: elucidating the pathomechanistic link between Th2 blockade and Th17 polarized intestinal inflammation.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1875748.
APA
Fanghui Fu, Qing Zhao, Lei Ma, Aili Wang, Zhe Wang, Xiaoyang Xu (2026). Case Report: Dupilumab-associated ulcerative colitis: elucidating the pathomechanistic link between Th2 blockade and Th17 polarized intestinal inflammation.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1875748
GB/T 7714
Fanghui Fu, Qing Zhao, Lei Ma, Aili Wang, Zhe Wang, Xiaoyang Xu. Case Report: Dupilumab-associated ulcerative colitis: elucidating the pathomechanistic link between Th2 blockade and Th17 polarized intestinal inflammation.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1875748.
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