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中华移植杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 58 -61. doi: 10.3877/cma.j.issn.1674-3903.2020.01.015

所属专题: 文献

综述

肾移植术后常用免疫抑制剂诱发胃肠道症状的机制探讨
宋文彬1, 马葵芬2, 李兴德1, 张阳1, 宋沧桑1,()   
  1. 1. 650224 昆明市第一人民院 昆明医科大学附属甘美医院药学部
    2. 310009 杭州,浙江大学医学院附属第一医院药学部
  • 收稿日期:2019-10-28 出版日期:2020-02-25
  • 通信作者: 宋沧桑
  • 基金资助:
    云南省医疗卫生单位内设研究机构科研项目(2014NS205)

The mechanisms of gastrointestinal symptoms induced by immunosuppressive agents in kidney transplant recipients

Wenbin Song1, Kuifen Ma2, Xingde Li1, Yang Zhang1, Cangsang Song1,()   

  1. 1. Department of Pharmacy, Calmette Hospital Affiliated to Kunming Medical University, Kunming First People′s Hospital, Kunming 650224, China
    2. Department of Pharmacy, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
  • Received:2019-10-28 Published:2020-02-25
  • Corresponding author: Cangsang Song
  • About author:
    Corresponding author: Song Cangsang, Email:
引用本文:

宋文彬, 马葵芬, 李兴德, 张阳, 宋沧桑. 肾移植术后常用免疫抑制剂诱发胃肠道症状的机制探讨[J/OL]. 中华移植杂志(电子版), 2020, 14(01): 58-61.

Wenbin Song, Kuifen Ma, Xingde Li, Yang Zhang, Cangsang Song. The mechanisms of gastrointestinal symptoms induced by immunosuppressive agents in kidney transplant recipients[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2020, 14(01): 58-61.

他克莫司和吗替麦考酚酯是诱发肾移植术后胃肠道症状的主要免疫抑制剂,其机制可能与药物暴露增加以及二者对肠道相关淋巴组织的抑制作用相关。他克莫司暴露受细胞色素P450 3A4、3A5和P-糖蛋白基因多态性以及胃肠道功能和肠道内菌群丰度变化等多重因素的影响,他克莫司高暴露可促进胃肠道蠕动和霉酚酸类药物吸收。霉酚酸类药物胃肠道不良反应可能与其抗胃肠道上皮细胞增殖特性有关。

Tacrolimus and mycophenolate mofetil are the main cause of gastrointestinal symptoms in kidney transplant recipients. The possible induced mechanisms include the increase of drug exposure and inhibition on gut associated lymph tissue. Tacrolimus exposure is associated with the genetic polymorphisms of CYP 3A4, 3A5 and P-glycoprotein, and changes in the gastrointestinal function and abundance of intestinal bacterial flora, and so on. Increasing tacrolimus exposure promotes gastrointestinal motility and mycophenolic acid (MPA) absorption. MPA induced gastrointestinal side effects is associated with its antiproliferative effect on the basal epithelial cells of the gastrointestinal tract.

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