他克莫司治疗肾脏疾病的研究进展
摘要
<正>他克莫司是一种新型免疫抑制剂,应用于实体器官移植术后排斥反应、炎性皮肤病、类风湿关节炎等疾病的治疗。近年大量研究表明他克莫司治疗肾脏疾病具有较好的疗效及安全性。本文就他克莫司治疗肾脏疾病的研究进展进行阐述,为肾脏疾病的治疗提供新的思路和方向。1 他克莫司药理作用机制他克莫司是1984年由日本藤泽制药公司从筑波链霉素的培养基中提取出来的大环内酯类化合物[1-2],分子式为C44H69NO2,相对分子量为822.05,常温下呈晶状粉
引文
[1]陈单丹,岑沛霖,刘文,等.大环内酯类免疫抑制剂他克莫司的生物合成机制研究进展[J].有机化学,2013,33(6):1254-1262.
[2]Kino T,Hatanaka H,Hashimoto M,et al.FK-506,a novel immunosuppressant isolated from a Streptomyces.I.Fermentation,isolation,and physicochemical and biological characteristics[J].J Antibiot(Tokyo),1987,40(9):1249-1255.
[3]夏梦迪,谢席胜,艾娜.他克莫司治疗肾小球疾病的研究进展[J].中华临床医师杂志(电子版),2014,7(7):1334-1337.
[4]Ke H,Huai Q.Structures of calcineurin and its complexes with immunophilins-immunosuppressants[J].Biochem Biophys Res Commun,2003,311(4):1095-1102.
[5]Hashimoto Y,Matsuoka N,Kawakami A,et al.Novel immunosuppressive effect of FK506 by augmentation of T cell apoptosis[J].Clin Exp Immunol,2001,125(1):19-24.
[6]Choi S J,You H S,Chung S Y.Tacrolimus-induced apoptotic signal transduction pathway[J].Transplant Proc,2008,40(8):2734-2736.
[7]周帆.探讨微小病变型肾病综合征激素抵抗的相关危险因素[J].世界最新医学信息文摘(连续型电子期刊),2016,16(39):58-59.
[8]汪年松,桂定坤,李军辉.他克莫司在肾脏病中的合理应用[J].中华肾病研究电子杂志,2014,3(4):200-203.
[9]Beck L,Bomback A S,Choi M J,et al.KDOQI UScommentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis[J].Am J Kidney Dis,2013,62(3):403-441.
[10]Li X,Li H,Chen J,et al.Tacrolimus as a steroidsparing agent for adults with steroid-dependent minimal change nephrotic syndrome[J].Nephrol Dial Transplant,2008,23(6):1919-1925.
[11]Li H,Shi X,Shen H,et al.Tacrolimus versus intravenous pulse cyclophosphamide therapy in Chinese adults with steroid-resistant idiopathic minimal change nephropathy:a multicenter,open-label,nonrandomized cohort trial[J].Clin Ther,2012,34(5):1112-1120.
[12]李洁,姚丽莉,金烈.单用他克莫司治疗微小病变性肾病综合征的临床研究[J].海峡药学,2012,24(9):153-156.
[13]黄雯.成人微小病变性肾病的治疗[J].北京医学,2012,34(4):245-246.
[14]Ren H,Shen P,Li X,et al.Tacrolimus versus cyclophosphamide in steroid-dependent or steroid-resistant focal segmental glomerulosclerosis:a randomized controlled trial[J].Am J Nephrol,2013,37(1):84-90.
[15]Kallash M,Aviles D.Efficacy of tacrolimus in the treatment of children with focal segmental glomerulosclerosis[J].World J Pediatr,2014,10(2):151-154.
[16]张意舒.小剂量激素联合他克莫司胶囊对局灶节段性肾小球硬化并发早期肾衰竭的影响[J].中国民康医学,2018,30(1):51,93.
[17]董冲霄,刘盼,张璐,等.小剂量激素联合他克莫司胶囊治疗局灶节段性肾小球硬化并发早期肾衰竭对血压﹑血糖和血钾的影响[J].临床和实验医学杂志,2016,15(24):2420-2422.
[18]Sun Z,Ren M,Wu Q,et al.Co-administration of Wuzhi capsules and tacrolimus in patients with idiopathic membranous nephropathy:clinical efficacy and pharmacoeconomics[J].Int Urol Nephrol,2014,46(10):1977-1982.
[19]Liu S,Li X,Li H,et al.Comparison of tripterygium wilfordii multiglycosides and tacrolimus in the treatment of idiopathic membranous nephropathy:a prospective cohort study[J].BMC Nephrol,2015,16:200.
[20]Liang Q,Li H,Xie X,et al.The efficacy and safety of tacrolimus monotherapy in adult-onset nephrotic syndrome caused by idiopathic membranous nephropathy[J].Ren Fail,2017,39(1):512-518.
[21]Qin H Z,Liu L,Liang S S,et al.Evaluating tacrolimus treatment in idiopathic membranous nephropathy in a cohort of 408 patients[J].BMCNephrol,2017,18(1):2.
[22]Chen M,Li H,Li X Y,et al.Tacrolimus combined with corticosteroids in treatment of nephrotic idiopathic membranous nephropathy:a multicenter randomized controlled trial[J].Am J Med Sci,2010,339(3):233-238.
[23]He L,Peng Y,Liu H,et al.Treatment of idiopathic membranous nephropathy with combination of lowdose tacrolimus and corticosteroids[J].J Nephrol,2013,26(3):564-571.
[24]Yuan H,Liu N,Sun G D,et al.Effect of prolonged tacrolimus treatment in idiopathic membranous nephropathy with nephrotic syndrome[J].Pharmacology,2013,91(5-6):259-266.
[25]Xu J,Zhang W,Xu Y,et al.Tacrolimus combined with corticosteroids in idiopathic membranous nephropathy:a randomized,prospective,controlled trial[J].Contrib Nephrol,2013,181:152-162.
[26]Cui W,Lu X,Min X,et al.Therapy of tacrolimus combined with corticosteroids in idiopathic membranous nephropathy[J].Braz J Med Biol Res,2017,50(4):e5976.
[27]Zhu L B,Liu L L,Yao L,et al.Efficacy and Safety of Tacrolimus Versus Cyclophosphamide for Primary Membranous Nephropathy:A Meta-Analysis[J].Drugs,2017,77(2):187-199.
[28]Wyatt R J,Julian B A.Ig A nephropathy[J].N Engl J Med,2013,368(25):2402-2414.
[29]Wang W,Chen N.Treatment of progressive Ig A nephropathy:an update[J].Contrib Nephrol,2013,181:75-83.
[30]Song Y H,Cai G Y,Xiao Y F,et al.Efficacy and safety of calcineurin inhibitor treatment for Ig A nephropathy:a meta-analysis[J].BMC Nephrol,2017,18(1):61.
[31]Peng W,Tang Y,Jiang Z,et al.The effect of calcineurin inhibitors in the treatment of Ig A nephropathy:A systematic review and meta-analysis(PRIS-MA)[J].Medicine(Baltimore),2016,95(35):e4731.
[32]Kim Y C,Chin H J,Koo H S,et al.Tacrolimus decreases albuminuria in patients with Ig A nephropathy and normal blood pressure:a double-blind randomized controlled trial of efficacy of tacrolimus on Ig Anephropathy[J].PLo S One,2013,8(8):e71545.
[33]Hu T,Liu Q,Xu Q,et al.Tacrolimus decreases proteinuria in patients with refractory Ig A nephropathy[J].Medicine(Baltimore),2018,97(18):e0610.
[34]Zhang Q,Shi S F,Zhu L,et al.Tacrolimus improves the proteinuria remission in patients with refractory Ig A nephropathy[J].Am J Nephrol,2012,35(4):312-320.
[35]Zhang Y,Luo J,Hu B,et al.Efficacy and safety of tacrolimus combined with glucocorticoid treatment for Ig A nephropathy:a meta-analysis[J].J Int Med Res,2018,46(8):3236-3250.
[36]Yu M Y,Kim Y C,Koo H S,et al.Short-term antiproteinuric effect of tacrolimus is not related to preservation of the glomerular filtration rate in Ig A nephropathy:A 5-year follow-up study[J].PLo S One,2017,12(11):e0188375.
[37]Maroz N,Segal M S.Lupus nephritis and end-stage kidney disease[J].Am J Med Sci,2013,346(4):319-323.
[38]Choi C B,Won S,Bae S C.Outcomes of multitarget therapy using mycophenolate mofetil and tacrolimus for refractory or relapsing lupus nephritis[J].Lupus,2018,27(6):1007-1011.
[39]Gordon S,Denunzio T,Uy A.Success using tacrolimus in patients with proliferative and membranous lupus nephritis and refractory proteinuria[J].Hawaii J Med Public Health,2013,72(9S4):18-23.
[40]张杏珍,周志宏.他克莫司联合甲泼尼龙治疗狼疮性肾炎的疗效分析及安全性评价[J].中华全科医学,2017,15(8):1342-1344.
[41]刘笑芬.他克莫司治疗狼疮性肾炎的临床观察[J].临床合理用药杂志,2017,10(5):46-47.
[42]陈娜娜.他克莫司与环磷酰胺诱导治疗狼疮性肾炎的临床效果分析[J].临床研究,2018,26(3):68-69.
[43]Hannah J,Casian A,D'Cruz D.Tacrolimus use in lupus nephritis:A systematic review and meta-analysis[J].Autoimmun Rev,2016,15(1):93-101.
[44]Tanaka H,Watanabe S,Aizawa-Yashiro T,et al.Long-term tacrolimus-based immunosuppressive treatment for young patients with lupus nephritis:a prospective study in daily clinical practice[J].Nephron Clin Pract,2012,121(3-4):c165-c173.
[45]Webster P,Wardle A,Bramham K,et al.Tacrolimus is an effective treatment for lupus nephritis in pregnancy[J].Lupus,2014,23(11):1192-1196.
[2]Kino T,Hatanaka H,Hashimoto M,et al.FK-506,a novel immunosuppressant isolated from a Streptomyces.I.Fermentation,isolation,and physicochemical and biological characteristics[J].J Antibiot(Tokyo),1987,40(9):1249-1255.
[3]夏梦迪,谢席胜,艾娜.他克莫司治疗肾小球疾病的研究进展[J].中华临床医师杂志(电子版),2014,7(7):1334-1337.
[4]Ke H,Huai Q.Structures of calcineurin and its complexes with immunophilins-immunosuppressants[J].Biochem Biophys Res Commun,2003,311(4):1095-1102.
[5]Hashimoto Y,Matsuoka N,Kawakami A,et al.Novel immunosuppressive effect of FK506 by augmentation of T cell apoptosis[J].Clin Exp Immunol,2001,125(1):19-24.
[6]Choi S J,You H S,Chung S Y.Tacrolimus-induced apoptotic signal transduction pathway[J].Transplant Proc,2008,40(8):2734-2736.
[7]周帆.探讨微小病变型肾病综合征激素抵抗的相关危险因素[J].世界最新医学信息文摘(连续型电子期刊),2016,16(39):58-59.
[8]汪年松,桂定坤,李军辉.他克莫司在肾脏病中的合理应用[J].中华肾病研究电子杂志,2014,3(4):200-203.
[9]Beck L,Bomback A S,Choi M J,et al.KDOQI UScommentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis[J].Am J Kidney Dis,2013,62(3):403-441.
[10]Li X,Li H,Chen J,et al.Tacrolimus as a steroidsparing agent for adults with steroid-dependent minimal change nephrotic syndrome[J].Nephrol Dial Transplant,2008,23(6):1919-1925.
[11]Li H,Shi X,Shen H,et al.Tacrolimus versus intravenous pulse cyclophosphamide therapy in Chinese adults with steroid-resistant idiopathic minimal change nephropathy:a multicenter,open-label,nonrandomized cohort trial[J].Clin Ther,2012,34(5):1112-1120.
[12]李洁,姚丽莉,金烈.单用他克莫司治疗微小病变性肾病综合征的临床研究[J].海峡药学,2012,24(9):153-156.
[13]黄雯.成人微小病变性肾病的治疗[J].北京医学,2012,34(4):245-246.
[14]Ren H,Shen P,Li X,et al.Tacrolimus versus cyclophosphamide in steroid-dependent or steroid-resistant focal segmental glomerulosclerosis:a randomized controlled trial[J].Am J Nephrol,2013,37(1):84-90.
[15]Kallash M,Aviles D.Efficacy of tacrolimus in the treatment of children with focal segmental glomerulosclerosis[J].World J Pediatr,2014,10(2):151-154.
[16]张意舒.小剂量激素联合他克莫司胶囊对局灶节段性肾小球硬化并发早期肾衰竭的影响[J].中国民康医学,2018,30(1):51,93.
[17]董冲霄,刘盼,张璐,等.小剂量激素联合他克莫司胶囊治疗局灶节段性肾小球硬化并发早期肾衰竭对血压﹑血糖和血钾的影响[J].临床和实验医学杂志,2016,15(24):2420-2422.
[18]Sun Z,Ren M,Wu Q,et al.Co-administration of Wuzhi capsules and tacrolimus in patients with idiopathic membranous nephropathy:clinical efficacy and pharmacoeconomics[J].Int Urol Nephrol,2014,46(10):1977-1982.
[19]Liu S,Li X,Li H,et al.Comparison of tripterygium wilfordii multiglycosides and tacrolimus in the treatment of idiopathic membranous nephropathy:a prospective cohort study[J].BMC Nephrol,2015,16:200.
[20]Liang Q,Li H,Xie X,et al.The efficacy and safety of tacrolimus monotherapy in adult-onset nephrotic syndrome caused by idiopathic membranous nephropathy[J].Ren Fail,2017,39(1):512-518.
[21]Qin H Z,Liu L,Liang S S,et al.Evaluating tacrolimus treatment in idiopathic membranous nephropathy in a cohort of 408 patients[J].BMCNephrol,2017,18(1):2.
[22]Chen M,Li H,Li X Y,et al.Tacrolimus combined with corticosteroids in treatment of nephrotic idiopathic membranous nephropathy:a multicenter randomized controlled trial[J].Am J Med Sci,2010,339(3):233-238.
[23]He L,Peng Y,Liu H,et al.Treatment of idiopathic membranous nephropathy with combination of lowdose tacrolimus and corticosteroids[J].J Nephrol,2013,26(3):564-571.
[24]Yuan H,Liu N,Sun G D,et al.Effect of prolonged tacrolimus treatment in idiopathic membranous nephropathy with nephrotic syndrome[J].Pharmacology,2013,91(5-6):259-266.
[25]Xu J,Zhang W,Xu Y,et al.Tacrolimus combined with corticosteroids in idiopathic membranous nephropathy:a randomized,prospective,controlled trial[J].Contrib Nephrol,2013,181:152-162.
[26]Cui W,Lu X,Min X,et al.Therapy of tacrolimus combined with corticosteroids in idiopathic membranous nephropathy[J].Braz J Med Biol Res,2017,50(4):e5976.
[27]Zhu L B,Liu L L,Yao L,et al.Efficacy and Safety of Tacrolimus Versus Cyclophosphamide for Primary Membranous Nephropathy:A Meta-Analysis[J].Drugs,2017,77(2):187-199.
[28]Wyatt R J,Julian B A.Ig A nephropathy[J].N Engl J Med,2013,368(25):2402-2414.
[29]Wang W,Chen N.Treatment of progressive Ig A nephropathy:an update[J].Contrib Nephrol,2013,181:75-83.
[30]Song Y H,Cai G Y,Xiao Y F,et al.Efficacy and safety of calcineurin inhibitor treatment for Ig A nephropathy:a meta-analysis[J].BMC Nephrol,2017,18(1):61.
[31]Peng W,Tang Y,Jiang Z,et al.The effect of calcineurin inhibitors in the treatment of Ig A nephropathy:A systematic review and meta-analysis(PRIS-MA)[J].Medicine(Baltimore),2016,95(35):e4731.
[32]Kim Y C,Chin H J,Koo H S,et al.Tacrolimus decreases albuminuria in patients with Ig A nephropathy and normal blood pressure:a double-blind randomized controlled trial of efficacy of tacrolimus on Ig Anephropathy[J].PLo S One,2013,8(8):e71545.
[33]Hu T,Liu Q,Xu Q,et al.Tacrolimus decreases proteinuria in patients with refractory Ig A nephropathy[J].Medicine(Baltimore),2018,97(18):e0610.
[34]Zhang Q,Shi S F,Zhu L,et al.Tacrolimus improves the proteinuria remission in patients with refractory Ig A nephropathy[J].Am J Nephrol,2012,35(4):312-320.
[35]Zhang Y,Luo J,Hu B,et al.Efficacy and safety of tacrolimus combined with glucocorticoid treatment for Ig A nephropathy:a meta-analysis[J].J Int Med Res,2018,46(8):3236-3250.
[36]Yu M Y,Kim Y C,Koo H S,et al.Short-term antiproteinuric effect of tacrolimus is not related to preservation of the glomerular filtration rate in Ig A nephropathy:A 5-year follow-up study[J].PLo S One,2017,12(11):e0188375.
[37]Maroz N,Segal M S.Lupus nephritis and end-stage kidney disease[J].Am J Med Sci,2013,346(4):319-323.
[38]Choi C B,Won S,Bae S C.Outcomes of multitarget therapy using mycophenolate mofetil and tacrolimus for refractory or relapsing lupus nephritis[J].Lupus,2018,27(6):1007-1011.
[39]Gordon S,Denunzio T,Uy A.Success using tacrolimus in patients with proliferative and membranous lupus nephritis and refractory proteinuria[J].Hawaii J Med Public Health,2013,72(9S4):18-23.
[40]张杏珍,周志宏.他克莫司联合甲泼尼龙治疗狼疮性肾炎的疗效分析及安全性评价[J].中华全科医学,2017,15(8):1342-1344.
[41]刘笑芬.他克莫司治疗狼疮性肾炎的临床观察[J].临床合理用药杂志,2017,10(5):46-47.
[42]陈娜娜.他克莫司与环磷酰胺诱导治疗狼疮性肾炎的临床效果分析[J].临床研究,2018,26(3):68-69.
[43]Hannah J,Casian A,D'Cruz D.Tacrolimus use in lupus nephritis:A systematic review and meta-analysis[J].Autoimmun Rev,2016,15(1):93-101.
[44]Tanaka H,Watanabe S,Aizawa-Yashiro T,et al.Long-term tacrolimus-based immunosuppressive treatment for young patients with lupus nephritis:a prospective study in daily clinical practice[J].Nephron Clin Pract,2012,121(3-4):c165-c173.
[45]Webster P,Wardle A,Bramham K,et al.Tacrolimus is an effective treatment for lupus nephritis in pregnancy[J].Lupus,2014,23(11):1192-1196.