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中华移植杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 55 -59. doi: 10.3877/cma.j.issn.1674-3903.2021.01.013

所属专题: 文献

综述

吗替麦考酚酯相关性胃肠炎研究进展
杨其顺1, 张琳1, 托娅1, 谢铁强1, 黄赤兵2,()   
  1. 1. 066100 中国人民解放军联勤保障部队解放军北戴河康复疗养中心外一科
    2. 400038 重庆,陆军军医大学第二附属医院泌尿外科
  • 收稿日期:2020-04-27 出版日期:2021-02-25
  • 通信作者: 黄赤兵
  • 基金资助:
    国家自然科学基金(81570675); 秦皇岛市科技计划项目(201602A237)

Research progress of mycophenolate mofetil associated gastroenteritis

Qishun Yang1, Lin Zhang1, Ya Tuo1, Tieqiang Xie1, Chibing Hang2,()   

  1. 1. Department of NO.1 Surgery, Beidaihe Rehabilitation and Recuperation Center of PLA, Qinhuangdao 066100, China
    2. Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400038, China
  • Received:2020-04-27 Published:2021-02-25
  • Corresponding author: Chibing Hang
引用本文:

杨其顺, 张琳, 托娅, 谢铁强, 黄赤兵. 吗替麦考酚酯相关性胃肠炎研究进展[J]. 中华移植杂志(电子版), 2021, 15(01): 55-59.

Qishun Yang, Lin Zhang, Ya Tuo, Tieqiang Xie, Chibing Hang. Research progress of mycophenolate mofetil associated gastroenteritis[J]. Chinese Journal of Transplantation(Electronic Edition), 2021, 15(01): 55-59.

吗替麦考酚酯(MMF)是广泛用于实体器官移植术后的一种免疫抑制剂,口服后在胃内快速水解为生物活性物质霉酚酸,通过非竞争性抑制次黄嘌呤单核苷酸脱氢酶的活性,从而抑制嘌呤的合成途径,有选择地抑制T/B细胞活化,进而发挥抑制器官发生排斥反应的功能。移植受者对MMF普遍耐受,但其不良反应主要为胃肠道反应、造血障碍以及致病微生物机会性感染增加。MMF相关性胃肠炎表现为腹泻、体质量下降,或伴有腹部不适、恶心、呕吐和纳差等。本文主要针对MMF药理学和药代动力学、MMF相关性胃肠炎的可能机制和胃肠道病理变化及其治疗策略进行综述。

Mycophenolate mofetil (MMF) is an immunosuppressive agent widely used in solid organ transplantation. After oral administration, it is rapidly hydrolyzed into the active drug moiety mycophenolic acid (MPA) in the stomach, which selectively inhibits T/B cell proliferation by inhibiting the activity of inosine-5′-monophosphate dehydrogenase through non-competitive inhibition. MPA inhibits organ rejection and maintains the function of transplanted organs. MMF is generally tolerated by patients, main adverse reactions include gastrointestinal adverse reactions, bone marrow suppression and opportunistic infections. MMF associated gastroenteritis is characterized by diarrhea, weight loss, abdominal discomfort, nausea, vomiting, anorexia, etc. In this paper, we reviewed the pharmacology and pharmacokinetics of MMF, the possible mechanism of MMF associated gastroenteritis, the pathological changes of gastrointestinal tract and its treatment strategies.

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