肝移植后免疫抑制剂与肠道菌群相互作用的研究进展  

Research progress on the interaction between immunosuppressants and intestinal flora after liver transplantation

作　　者：鲁赛娟 宋沧桑[1,2] 李兴德[1,2] 王国徽[1] 毛盼盼 LU Saijuan;SONG Cangsang;LI Xingde;WANG Guohui;MAO Panpan(Dept.of Pharmacy,Kunming First People’s Hospital,Kunming 650224,China;Dept.of Pharmacy,Calmette Hospital Affiliated to Kunming Medical University,Kunming 650224,China)

机构地区：[1]昆明市第一人民医院药学部,昆明650224 [2]昆明医科大学附属甘美医院药学部,昆明650224

出　　处：《中国药房》2025年第3期362-366,共5页China Pharmacy

基　　金：云南省科技厅重大科技专项计划项目(No.202302AA310018);云南省卫生健康委员会医学领军人才培养计划项目(No.L-2018012);昆明市卫生科技人才培养(医学科技领军人才培养)项目[No.2023-SW(领军)-04]。

摘　　要：免疫抑制剂(包括环孢素、他克莫司、麦考酚酯类药物、糖皮质激素等)是肝移植后预防器官发生排斥反应的首选药物,能够有效地减少宿主对移植物的免疫反应,提高移植成功率,延长患者的生存期。肝移植与肠道生态失调有关,而免疫抑制剂与肠道菌群之间相互影响——免疫抑制剂的使用会改变肠道菌群的丰度、组成和代谢产物;肠道菌群产生的一系列酶和代谢产物可能会通过化学方式来改变免疫抑制剂的吸收和代谢。另外,肝移植患者术后感染的发生率较高,而肠道菌群会影响炎症因子,免疫抑制剂与炎症因子之间也相互影响。在一定程度上可认为,免疫抑制剂通过肠道菌群在肝移植患者中发挥作用。Immunosuppressants(including cyclosporine,tacrolimus,mycophenolate esters,glucocorticoids,etc.)are the first choice of drugs to prevent organ rejection after liver transplantation,which can effectively reduce the host immune response to the graft,improve the success rate of transplantation,and prolong the survival of patients.Liver transplantation is associated with intestinal flora,while immunosuppressive agents interact with intestinal flora.Immunosuppressive agents change the abundance,composition and metabolites of intestinal flora,while a series of enzymes and metabolites produced by intestinal flora may chemically alter the absorption and metabolism of immunosuppressants.In addition,the incidence of postoperative infection in liver transplantion patients is relatively high,while gut flora affects inflammatory factors,and immunosuppressants interact with inflammatory factors.To some extent,immunosuppressants can be thought of as acting through intestinal flora in patients after liver transplantation.

关 键 词：免疫抑制剂 肠道菌群 肝移植 他克莫司 环孢素 麦考酚酯 糖皮质激素 

分 类 号：R979.5[医药卫生—药品]