摘要
肝移植临床常用的免疫抑制剂主要包括钙调磷酸酶抑制剂类药物,如环孢素(CsA)和他克莫司(FK506)等;糖皮质激素类药物,如泼尼松和泼尼松龙等;细胞毒类药物,如硫唑嘌呤、吗替麦考酚酯及环磷酰胺等;哺乳动物雷帕霉素靶蛋白(mTOR)抑制剂类药物,如西罗莫司和依维莫司;抗体类药物如多克隆抗体、单克隆抗体及白细胞介素(IL)-2受体抗体等。免疫抑制剂虽然种类繁多,但目前大多数肝移植受者主要使用FK506。然而,FK506在肝移植后期表现出明显的不良反应,尤其是引起严重感染和肾毒性。因此,研发免疫耐受作用强和不良反应小的新型免疫抑制剂成为临床上迫切需要解决的难题和研究热点。本文就目前肝移植免疫抑制剂的研究进展和新型免疫抑制剂的研发状况进行综述。
Immunosuppressants,which are commonly used for liver transplantation,mainly included calcineurin inhibitors,such as ciclosporin(CsA)and tacrolimus(FK506);glucocorticoid drugs,such as prednisone and prednisolone;cytotoxic drugs,such as azathioprine,mycophenolate mofetil and cyclophosphamide;mammalian target of rapamycin(mTOR)inhibitors,such as sirolimus and everolimus;antibody drugs,such as polyclonal or monoclonal antibodies and interleukin(IL)-2 receptor antibodies,etc.Although many categories of immunosuppressants are available,FK506 is the most commonly adopted in liver transplant recipients.However,FK506 can provoke significant adverse effects in the late stage of liver transplantation,especially severe infection and nephrotoxicity.Consequently,it is an urgent task and research hot spot to develop new immunosuppressants with strong immune tolerance and mild adverse effects in clinical practice.In this article,the research progress on immunosuppressants and the research and development status of new immunosuppressants for liver transplantation were reviewed.
作者
陈泉余
蒋师放
夏仁培
帅领
张宏宇
白莲花
Chen Quanyu;Jiang Shifang;Xia Renpei;Shuai Ling;Zhang Hongyu;Bai Lianhua(College of Life Science,Southwest University,Chongqing 400715,China;不详)
出处
《器官移植》
CAS
CSCD
北大核心
2020年第6期663-670,共8页
Organ Transplantation
基金
国家自然科学基金(81571566、81873586)。
关键词
免疫抑制剂
排斥反应
肝移植
免疫耐受
不良反应
淋巴细胞
信号转导
单克隆抗体
Immunosuppressant
Rejection
Liver transplantation
Immune tolerance
Adverse effect
Lymphocyte
Signal transduction
Monoclonal antibody
