免疫调控与特异质型药物性肝损伤发生机制研究进展

发布时间：2018-02-02 15:02

本文关键词： 特异质型药物性肝损伤免疫调控化学药物中药机制假说　出处：《药学学报》2017年07期 　论文类型：期刊论文

【摘要】：特异质型药物性肝损伤(idiosyncratic drug-induced liver injury,IDILI)是仅在少数人群发生的药物不良反应,其发生往往与服药时间、剂量无明确对应关系,具有不可预测性和发病率低等特点。研究表明,IDILI是机体、环境和药物因素协同作用的结果,而机体免疫是IDILI发生的主要诱因。目前,化学药物诱导的IDILI研究较为广泛和深入,形成了多种免疫学机制假说,较好地阐释了其发病特点和机制。近年来,中药特异质肝损伤也逐步被证实,并且形成了中药特异质肝损伤免疫应激"三因致毒"机制假说,较为全面地揭示了中药IDILI的发病特点和机制。本文就化学药物和中药诱导的IDILI免疫学机制假说进行综述,以期为IDILI评价和临床风险防控对策建立提供科学依据。
[Abstract]:Idiosyncratic drug-induced liver injury. IDILI is an adverse drug reaction that occurs only in a small number of people. The occurrence of IDILI often has no clear relationship with the time and dosage of taking medicine. It has the characteristics of unpredictability and low incidence. IDILI is the result of the synergistic effect of organism, environment and drug factors, and body immunity is the main inducement of IDILI. At present, the study of chemotherapy-induced IDILI is more extensive and in-depth. Many hypotheses of immunological mechanism have been formed, which have explained its pathogenesis and mechanism. In recent years, the special heterogenous liver injury of traditional Chinese medicine has been gradually proved. And the hypothesis of "three causes of toxic" mechanism of immune stress caused by special heterogenous liver injury of traditional Chinese medicine was formed. The pathogenesis and mechanism of traditional Chinese medicine (IDILI) were comprehensively revealed. The hypothesis of immunological mechanism of IDILI induced by chemical drugs and traditional Chinese medicine was reviewed in this paper. In order to provide scientific basis for the evaluation of IDILI and the establishment of clinical risk prevention and control countermeasures.
【作者单位】：解放军302医院全军中医药研究所;北京中医药大学中药学院;解放军302医院中西医结合诊疗与研究中心;
【基金】：国家自然科学基金青年基金资助项目(81503350);国家自然科学基金重点资助项目(81630100) 国家“重大新药创制”科技重大专项课题(2015ZX09501-004-001-008) 国家公益性行业科研专项课题(201507004-04)
【分类号】：R595.3
【正文快照】： 药物性肝损伤是指由药物或其代谢产物导致的的发生特点和机制。虽然上述假说尚未全面阐释肝脏损伤,是药物研发失败及撤市的重要原因之一。IDILI的发生特点和机制,但免疫在IDILI中的关键药物性肝损伤可分为固有型和特异质型,固有型由作用已被广泛认可,本节就化学药物诱导的IDIL

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