Mounting evidence underscores the pivotal role of the intestinal barrier and its convoluted network with diet and intestinal microbiome in the pathogenesis of inflammatory bowel disease (IBD) and colitis-associated colorectal cancer (CRC). Moreover, the bidirectional association of the intestinal barrier with the liver and brain, known as the gut-brain axis, plays a crucial role in developing complications, including extraintestinal manifestations of IBD and CRC metastasis. Consequently, barrier healing represents a crucial therapeutic target in these inflammatory-dependent disorders, with barrier assessment predicting disease outcomes, response to therapy and extraintestinal manifestations. New advanced technologies are revolutionising our understanding of the barrier paradigm, enabling the accurate assessment of the intestinal barrier and aiding in unravelling the complexity of the gut-brain axis. Cutting-edge endoscopic imaging techniques, such as ultra-high magnification endocytoscopy and probe-based confocal laser endomicroscopy, are new technologies allowing real-time exploration of the ‘cellular’ intestinal barrier. Additionally, novel advanced spatial imaging technology platforms, including multispectral imaging, upconversion nanoparticles, digital spatial profiling, optical spectroscopy and mass cytometry, enable a deep and comprehensive assessment of the ‘molecular’ and ‘ultrastructural’ barrier. In this promising landscape, artificial intelligence plays a pivotal role in standardising and integrating these novel tools, thereby contributing to barrier assessment and prediction of outcomes. Looking ahead, this integrated and comprehensive approach holds the promise of uncovering new therapeutic targets, breaking the therapeutic ceiling in IBD. Novel molecules, dietary interventions and microbiome modulation strategies aim to restore, reinforce, or modulate the gut-brain axis. These advancements have the potential for transformative and personalised approaches to managing IBD.

中文翻译：

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打开精准医学之门：评估炎症性肠病和结肠炎相关肿瘤肠道屏障的新工具


越来越多的证据强调了肠道屏障及其与饮食和肠道微生物组的复杂网络在炎症性肠病（IBD）和结肠炎相关结直肠癌（CRC）发病机制中的关键作用。此外，肠道屏障与肝脏和大脑的双向关联（称为肠脑轴）在并发症的发生中起着至关重要的作用，包括IBD和CRC转移的肠外表现。因此，屏障愈合是这些炎症依赖性疾病的关键治疗目标，屏障评估可预测疾病结果、治疗反应和肠外表现。新的先进技术正在彻底改变我们对屏障范式的理解，能够准确评估肠道屏障，并有助于揭示肠-脑轴的复杂性。尖端内窥镜成像技术，例如超高倍内吞细胞镜检查和基于探针的共焦激光内窥镜检查，是可以实时探索“细胞”肠道屏障的新技术。此外，新颖的先进空间成像技术平台，包括多光谱成像、上转换纳米粒子、数字空间分析、光谱学和质谱流式细胞仪，可以对“分子”和“超微结构”屏障进行深入、全面的评估。在这个充满希望的前景中，人工智能在标准化和集成这些新颖工具方面发挥着关键作用，从而有助于障碍评估和结果预测。展望未来，这种综合全面的方法有望发现新的治疗靶点，打破 IBD 的治疗上限。 新颖的分子、饮食干预和微生物组调节策略旨在恢复、加强或调节肠脑轴。这些进步有可能带来变革性和个性化的 IBD 管理方法。