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자료유형
학술저널
저자정보
Steven Nicolaides (Eastern Health Box Hill Hospital) Abhinav Vasudevan (Eastern Health Box Hill Hospital) Tony Long (Department of Gastroenterology Eastern Health Box Hill Hospital) Daniel Van Langenberg (Eastern Health Box Hill Hospital)
저널정보
대한장연구학회 Intestinal research Intestinal research Vol.19 No.2
발행연도
2021.1
수록면
158 - 170 (13page)

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Smoking significantly increases the risk of developing and worsens Crohn’s disease (CD), yet protects against the development and reduces the severity of ulcerative colitis. It is less clear whether smoking impacts the efficacy of therapeutics in inflamma- tory bowel disease (IBD). We review the literature regarding the relationship between smoking and the efficacy of medical and surgical therapy in IBD. Smoking is associated with alterations in thiopurine metabolism and may affect time to disease relapse. The outcomes of anti-tumor necrosis factor therapy in active smokers appear neutral with data lacking for newer biologics. Smoking increases the risk of postoperative recurrence in those requiring resection for CD, likely attributable to perturbations of the gut microbiota although further implications of these for disease onset/progression and treatment efficacy remain un- clear. Multiple lifestyle and psychosocial confounders are likely under-recognized cofactors in the association between smok- ing and IBD. Despite the widely promulgated risks associated with cigarette smoking in CD, more incisive data are required to further elucidate the actual relationship between smoking and disease pathways, while accounting for the several negative cofactors prevalent in smokers which cast uncertainty on the magnitude of the direct effect of smoking on disease pathophysi- ology and the efficacy of therapy.

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