外周血单个核细胞内免疫抑制剂的浓度与实体器官移植术后不良反应相关性的研究进展  

Research progress of the relationship between the concentration of immunosuppressive drugs in peripheral blood mononuclear cells and adverse reactions after solid organ transplantation

作　　者：魏叶 刘亚妮[1] 师少军[1] 张蕊 WEI Ye;LIU Ya-ni;SHI Shao-Jun;ZHANG Rui(Department of Pharmacy,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院药学部,湖北武汉430022

出　　处：《中国医院药学杂志》2020年第8期946-951,共6页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金面上项目(编号:81874326);吴阶平医学基金会临床科研专项资助基金(编号:320.6750.19090-43);湖北省卫健委中医药科研项目(重点项目)(编号:ZY2019Z004);国家重点研发计划资助(编号:2017YFC0909900)。

摘　　要：目的:随着临床治疗中器官移植技术的发展和广泛应用,免疫抑制剂的正确使用是预防器官移植术后的排斥反应和提高移植器官存活率的关键环节。目前,临床采用常规全血中免疫抑制药物浓度监测联合药物遗传学监测能够提高疗效,避免药物不良反应,但部分患者仍出现全血浓度处于治疗窗,发生排斥反应的情况。由于外周血单个核细胞是免疫抑制剂的作用靶细胞,越来越多的研究显示监测外周血单个核细胞中药物浓度可能比全血中的药物浓度更有意义。本综述以外周血单个核细胞为研究模型,总结了免疫抑制剂在全血和外周血单个核细胞中浓度与急性排斥反应之间的潜在的相关性的最新进展。With the development and widespread application of organ transplantation technology,the appropriate use of immunosuppressive drugs is the key of preventing acute cellular rejection and improving the survival rate of transplanted organs.At present,the clinical use of routine monitoring of immunosuppressive drug concentration combined with pharmacogenetic monitoring can improve the efficacy and avoid adverse drug reactions in clinical treatment,but some patients still have the concentration in the therapeutic window with occurrence of rejection.Since peripheral blood mononuclear cells are the target cells of immunosuppressive agents,increasing studies have shown that monitoring the drug concentration in peripheral blood mononuclear cells may be more meaningful than the drug concentration in the whole blood.This review summarizes recent advances in the potential correlation between the concentration of immunosuppressive agents and acute rejection in peripheral blood mononuclear cells.

关 键 词：外周血单个核细胞 全血 治疗药物监测 免疫抑制剂 

分 类 号：R96[医药卫生—药理学]