环孢菌素。回顾其药效学和药代动力学性质,和治疗中使用免疫调节紊乱。

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Faulds D,果阿KL,苯菲尔P

环孢菌素。回顾其药效学和药代动力学性质,和治疗中使用免疫调节紊乱。

药。1993年6月,45 (6):953 - 1040。doi: 10.2165 / 00003495-199345060-00007。

PubMed ID

7691501 (在PubMed

]

文摘

环孢菌素是一种亲脂性的环状多肽产生calcium-dependent,具体的、可逆的抑制白介素2和其他细胞因子的转录,特别是在辅助T淋巴细胞。这减少了生产一系列细胞因子,抑制激活和/或成熟的各种细胞类型,包括那些参与细胞介导的免疫反应。因此,环孢菌素具有免疫抑制特性,证明作为第一线治疗移植排斥反应的预防和治疗。环孢菌素也被评估在一个大范围的疾病,免疫调节功能障碍是一个疑似或证明病原学的因素,这是目前的重点审查。严重疾病患者耐火材料标准治疗,口服环孢菌素是一种有效的疗法在急性眼遗传病的综合症,内源性葡萄膜炎、银屑病,过敏性皮肤炎、风湿性关节炎、活跃克罗恩氏病和肾病综合征。伴随低剂量皮质类固醇治疗可能提高响应率在一些障碍。这种药物可以看作一种中度或重度患者的一线治疗再生障碍性贫血骨髓移植的资格,减少血小板同种抗体的额外好处滴定度。也可能相当大的治疗原发性胆汁性肝硬化患者受益,尤其是那些用更少的先进的疾病。有限的证据表明环孢菌素是有效的棘手的患者脓皮病gangrenosum,多发性肌炎/皮肌炎或严重,corticosteroid-dependent哮喘。事实上,steroid-sparing环孢菌素的影响是一个重要的优势的迹象。 Furthermore, the drug has shown some efficacy in a wide range of other, generally uncommon disorders in which controlled clinical trials are lacking and/or are unlikely to be performed. Cyclosporin does not appear to be effective in patients with allergic contact dermatitis, multiple sclerosis or amyotrophic lateral sclerosis. It is only temporarily effective in patients with type I (insulin-dependent) diabetes mellitus and should not be used in this indication. To avoid relapse after control of active disease, patients should receive cyclosporin maintenance therapy at the lowest effective dosage. However, maintenance therapy appears to be of no benefit in patients with Crohn's disease and cyclosporin should be discontinued in these patients once active disease is controlled. Hypertrichosis, gingival hyperplasia, and neurological and gastrointestinal effects are the most common adverse events in cyclosporin recipients, but are usually mild to moderate and resolve on dosage reduction. Changes in laboratory variables indicating renal dysfunction are relatively common, although serious irreversible damage is rare.(ABSTRACT TRUNCATED AT 400 WORDS)

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药物

环孢霉素