器官移植术后免疫抑制剂的药物基因组学研究进展  

Research Progress in Pharmacogenomics of Immunosuppressants after Organ Transplantation

作　　者：李嘉丽[1] 黄民[1] LI Jiali;HUANG Min(Institute of Clinical Pharn acology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510080, China)

机构地区：[1]中山大学药学院临床药理研究所,广东广州510080

出　　处：《药学进展》2018年第4期243-258,共16页Progress in Pharmaceutical Sciences

基　　金：国家重点研发计划(No.2017YFC0909303;No.2016YFC0905001);国家自然科学基金(No.81320108027);广东省新药设计与评价重点实验室(No.2011A060901014)

摘　　要：器官移植是救治器官功能衰竭最有效的手段,但术后急、慢性排斥反应是导致移植物功能丧失的重要原因之一,因此免疫抑制剂的安全合理应用起着至关重要的作用。然而,临床常用免疫抑制剂普遍具有治疗窗窄、药代动力学及药效动力学个体差异显著的特点,导致其给药剂量难以把握。综述近年来器官移植术后常用免疫抑制剂,包括他克莫司、环孢素、麦考酚酸类药物、西罗莫司、依维莫司、糖皮质激素及抗体类药物的药动学、药效学的相关遗传多态性的研究进展,以期为器官移植术后免疫抑制剂临床个体化治疗提供参考。Organ transplantation is the most effective treatment for end-stage organ failure, however, post-operative acute and chronic rejection is one of the major reasons for the loss of graft function. Therefore, safe and reasonable use of immunosuppressants is of vital importance. However, the dosage of immunosuppressants is difficult to determine due to their narrow therapeutic window and considerable interindividual variations in pharmacokinetics and pharmacodynamics. This paper reviewed the latest research progress in genetic polymorphisms related to pharmacokinetics and pharmacodynamics of commonly used immunosuppressants after organ transplantation, including tacrolimus, cyclosporine, mycophenolic acid, sirolimus, everolimus, glucocorticoids and antibodies, aiming to provide reference for the pharmacogenomicsguided personalized immunosuppression therapy after organ transplantation.

关 键 词：器官移植 免疫抑制剂 药代动力学 药效动力学 药物基因组学 

分 类 号：R968[医药卫生—药理学] R979.5[医药卫生—药学]