他克莫司慢性肾毒性机制及其防治药物的研究进展  

Advances in the mechanism and treatment of tacrolimus-induced chronic nephrotoxicity

作　　者：程馨玮 张程亮 徐华[1] 高萍 CHENG Xin-wei;ZHANG Cheng-liang;XU Hua;GAO Ping(Department of Pharmacy,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430015,China;Department of Pharmacy,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院药学部,湖北武汉430015 [2]华中科技大学同济医学院附属同济医院药学部,湖北武汉430030

出　　处：《中国医院药学杂志》2023年第4期464-468,共5页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金(编号:82104300)。

摘　　要：他克莫司(tacrolimus)作为常用的免疫抑制剂,广泛用于器官移植术后和多种自身免疫性疾病。但长期服用他克莫司可导致慢性肾毒性,引起器官存活率下降、死亡率升高等,极大影响临床结局。近年研究表明,氧化应激、细胞自噬、细胞凋亡、肾素-血管紧张素系统(renin-angiotensin-system, RAS)以及炎症介导他克莫司慢性肾毒性(tacrolimus-induced chronic nephrotoxicity, TICN)的发生发展。相应地,抗氧化剂、RAS抑制剂、钙离子通道阻滞剂及某些天然药物等对TICN显示出了一定的防治效果。基于此,该文综述了TICN的发生机制和防治药物的研究进展,以期为TAC的临床安全使用和未来研究提供参考。As a common immunosuppressant, tacrolimus is widely used in organ transplantation and for treatment of various autoimmune diseases.However, chronic nephrotoxicity induced by long-term administration of tacrolimus may lead to decreased organ survival rate and increased mortality, which greatly affects the clinical outcomes.Recent studies suggest that oxidative stress, autophagy, apoptosis, RAS system and inflammation mediate the development of tacrolimus-induced chronic nephrotoxicity(TICN).Accordingly, anti-oxidative drugs, RAS inhibitors, calcium channel blockers______and some traditional Chinese medicines have shown remarkable prevention and treatment effects on TICN.Based on previous studies, we summarize the mechanisms of TICN and medicines for its prevention and treatment, so as to provide suggestions for clinical safety and further research of tacrolimus.

关 键 词：他克莫司 慢性肾毒性 机制 防治药物 

分 类 号：R979.5[医药卫生—药品]