小鼠全身类过敏试验方法及其评价标准的研究  

Establishment of new evaluation standards for systemic anaphylactoid reactions using mouse model

作　　者：谢家骏[1] 张立波[1] 易娟娟[1] 康黎静 赵琳[1] XIE Jia-jun;ZHANG Li-bo;YI Juan-juan;KANG Li-jing;ZHAO Lin(Center for Drug Satety Evaluation,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学药物安全评价研究中心

出　　处：《中国中药杂志》2019年第17期3763-3772,共10页China Journal of Chinese Materia Medica

基　　金：国家“重大新药创新”科技重大专项(2011ZX09301-009)

摘　　要：药物类过敏性检测是一个国际性的难题,至今尚无一个成熟而可靠的动物模型或试验方法。为探索和建立一种适用于注射类药物临床前类过敏性评价的试验方法和评定标准,该研究根据静脉注射C48/80或聚氧乙烯脱水山梨醇单油酸酯(Tween 80)导致的小鼠类过敏反应症状,整理出小鼠全身类过敏反应症状表,通过引入能表证类过敏症状强弱的症状强度系数(K)及其计算公式,制订了小鼠全身类过敏症状强度评定标准。以此评定标准为对照,筛选出组胺、类胰蛋白酶和Ig E等3个血液生物标志物作为评定药物类过敏性的实验室检测指标,建立了症状评定与血液指标检测联合评价小鼠全身类过敏性的试验方法。该试验方法评定类过敏性的特征:K值、血液组胺水平与C48/80或Tween 80静注剂量呈高度相关;血液组胺对数值升高与K值呈高度正相关;类胰蛋白酶水平表现为升高、持平或下降,其变化状态可能与受试物特性和取血时间有关;Ig E水平表现为持平或下降,但不会升高,此可明显区别于Ⅰ型过敏反应。在此基础上,选用碘海醇、碘普罗胺、紫杉醇以及血塞通注射液、注射用双黄连、生脉注射液等进行适用性考察,检测结果与临床实际用药后情况呈现高度的一致性。结果提示,小鼠全身类过敏试验方法敏感性高,特异性强,与临床一致性好,建议进一步验证和推广使用。The detection of drug-induced anaphylactoid reactions remains a global challenge,still lacking mature and reliable animal models or test methods. Therefore,the purpose of this paper is to explore and establish the test methods and evaluation standards for anaphylactoid reactions that apply to injection drugs. Based on the anaphylactoid reaction symptoms of mice induced by intravenous injection drugs C48/40 and Tween 80,a list of systemic anaphylactoid reaction symptoms in mice was sorted out and an evaluation standard of anaphylactoid reactions symptoms was established by applying symptom intensity coefficient K( that can represent these verity of anaphylactoid reaction symptoms) and its calculation formula Accordingly,histamine,tryptase,and Ig E were selected as blood indicators of anaphylactoid reactions,so that a test method combining symptoms evaluation and blood makers detection was established.This test method could be used to evaluate the characteristics of anaphylactoid reactions: coefficient K,blood histamine levels were highly and positively correlated with C48/80 and Tween 80 dose;The log value of histamine was highly and positively correlated with K;tryptase level may rise,or remain steady,or drop,possibly associated with the characteristics of the tested object and time for blood taking;and Ig E level would drop or remain steady,but it would not rise,which can be clearly distinguished from type I allergic reactions. On this basis,tiohexol,iopromide,paclitaxel,Xuesaitong Injection,Shuanghuanglian Injection and Shengmai Injection were used to investigate the applicability. The testing results showed a high degree of consistency with the actual clinical situation. The results suggest that the method of systemic anaphylaxis test in mice has high sensitivity,specificity and good consistency with clinical practice.It is suggested to be further validated and popularized.

关 键 词：类过敏 小鼠全身类过敏试验方法 类过敏反应强度评定标准 症状强度系数 组胺 类胰蛋白酶 免疫球蛋白E 

分 类 号：R28[医药卫生—中药学]