摘要
目前临床常用血药浓度来监测移植术后患者钙调神经磷酸酶抑制剂(CNIs)环孢素A和他克莫司的药效,但由于CNIs的药动学及药效学个体差异大,仍需更有效的方法来监测其生物学效应。CNIs药效的测定方法可分为非特异性测定和特异性测定。常见的非特异性药效靶标有:T细胞增殖水平、T细胞表面抗原、T细胞亚群、CD4+中ATP水平、抗HLA抗体以及可溶性CD30等。CNIs药效通路上其主要的特异性药效参数包括:CaN活性、NFAT核转位、细胞因子释放和细胞因子基因表达等。这些不同水平上的生物靶标仍需更多的前瞻性介入研究来验证。在未来,有望通过这些生物靶标,监测CNIs的免疫抑制效果,优化CNIs个体化给药。
Blood concentrations of calcineurin inhibitors(CNIs)cyclosporine and tacrolimus are currently measured to monitor immunosuppression in transplant patients.However,due to the individual differences in pharmacokinetics and pharmacodynamics of CNIs,more effective methods are needed to monitor the immunosuppression effects of CNIs.The methods for determining the efficacy of CNIs consist of non-specific assays and specific assays.Common non-specific targets are:T cell proliferation levels,T cell surface antigens,T cell subsets,ATP levels in CD4^+,anti-HLA antibodies and soluble CD30.Specific pharmacodynamic parameters include:CaN activity,NFAT nuclear translocation based on flow cytometry,cytokine release and cytokine gene expression.More prospective intervention studies are needed to validate these different levels of biomarkers.In the future,it is expected that through these biological targets,the immunosuppression of CNIs will be monitored and individualized administration of CNIs will be optimized.
作者
姚婧
林榆杰
YAO Jing;LIN Yujie(Taizhou People's Hospital,Taizhou 225300,China)
出处
《药学与临床研究》
2019年第1期64-66,共3页
Pharmaceutical and Clinical Research
