关键词： 免疫抑制药物   角膜移植   排斥反应   研究进展   化学免疫抑制剂   淋巴细胞   生长因子  

摘要： 免疫排斥反应是角膜移植失败的主要原因[1].目前,临床上防治排斥主要依靠皮质类固醇激素和环孢霉素A,这些药物长期使用会产生较严重的毒、副作用.最近研究显示,在高危角膜移植中,尽管术后全身和局部应用常规免疫抑制剂,仍有49%的排斥反应不可逆转[2]。

关键词： 药品动态学   剂型   cyclosporine   tacrolimus   疗剂监测   肾脏移植   sirolimus  

摘要： Sirolimus (SRL) solution was launched in Taiwan in 2001. It could enhance the effect of cyclosporine (CsA)-based or tacrolimus (FK)-based regimen. SRL, CsA and FK are the most potent immunosuppressants in current use. As a potent immunosuppressant, blood concentration determination is important for SRL. As 95% of the drug partitions in red blood cells, tedious extraction procedure is required. It is unstable at temperature above 25 degree Celsius and light-sensitive. Protected from light is essential in sample handling, storage and analysis. Currently, SRL blood concentrations can be analyzed by high performance liquid chromatography (HPLC) only, which makes routine blood level monitoring difficult. Fix-dose regimen of SRL was therefore recommended by manufacturer. However, clinical trial in National Taiwan University Hospital (NTUH) in 2000 revealed that frequent dosage reduction of the concurrent CsA was necessary. At that time, SRL could not be assayed domestically, and it cost US$ 1000 per sample when assayed abroad. The author therefore set up a SRL lab in NTUH. A new protocol with addition of SRL and reduced dose of CsA or FK based on the original critical pathway was designed. With blood levels of SRL, CsA and FK, as well as ADRs and effectiveness, we could individualize therapy and had better understanding of the pharmacokinetics and posology of *** the help of Wyeth-Ayerst Laboratories, a validated HPLC/UV method developed by them with small modification was set up in NTUH to determine SRL concentration in human whole blood. The accuracy and precision of the SRL assay were validated by Wyeth-Ayerst Laboratories. By reviewing the chemical properties and different HPLC-UV method of SRL, the author wrote an article to share our experience as the first SRL lab in Taiwan using HPLC-UV method, which contributed the keys to *** limitation of quantification was 2.5 ng/mL and the standard curve was linear at the concentration range of 2.5

关键词： 肾移植   药物   免疫抑制剂   免疫应答   副作用  

摘要： 近三十年来随着排斥反应的免疫抑制机制研究的进展和环孢霉素作为新一代高效免疫抑制剂的广泛应用,促进了肾移植的发展,尤其是移植肾长期存活率得以明显地提高.但在肾移植失败的病例中,免疫排斥仍然是最主要的原因之一.因此,预防和治疗排斥反应是当前肾移植中迫切需要解决的问题.现将临床使用的化学药物和生物免疫抑制剂的应用现状简要介绍如下.

关键词： 树突状细胞   免疫抑制药物   移植耐受   诱导   作用   移植排斥反应   抗原提呈功能   免疫耐受   免疫反应   免疫应答  

摘要： 树突状细胞具有调控免疫应答的作用,不仅可激发免疫反应,也可介导免疫耐受。近年来研究发 现,许多免疫抑制药物可以通过影响树突状细胞的抗原提呈功能诱导免疫耐受或免疫低反应状 态,这种特性决定了树突状细胞在移植排斥反应中起着重要的作用。

关键词： 免疫抑制   青蒿素   SM735   佐剂性关节炎  

摘要： 青蒿素(artemisinin,qinghaosu)是从植物黄花蒿中提取出的含过氧桥键的环状化合物,也是中国自行研制成功的代表性抗疟药物.近年来,人们发现青蒿素类化合物在作为免疫抑制剂的应用方面也有潜在的价值.我们选取其中有代表性的一个化合物,SM735,作进一步药理学研究,探索青蒿素类衍生物在免疫抑制药物开发方面的应用价值及可行性. 综上所述,无论在体外还是体内,青蒿素新衍生物SM735都显示了较强的免疫抑制活性作用.特别在一些炎症性病理实验动物模型中,研究结果也初步显示其有明显的抗炎免疫抑制活性.这些研究结果表明,青蒿素类新化合物SM735作为新一类免疫抑制药物有进一步研究的价值和良好的开发前景.

关键词： Benznidazole   Chemotherapy   Experimental infection   Immunosuppressive drugs   Non-Hodgkin's lymphoma   Trypanosoma cruzi  

摘要： Benznidazole is recommended in Brazil for the treatment of Trypanosoma cruzi infection in acute and early chronic phases of Chagas' disease. Observations by others have indicated a higher incidence of neoplasias in immunosuppressed patients, presenting Chagas' disease reactivation, submitted to treatment with benznidazole. In the present study, we investigated whether there is a potentiation in the generation of lymphomas in chronically infected mice, treated with immunosuppressive drugs and benznidazole. For this, 142 Swiss mice chronically infected with the 21 SF strain of T. cruzi and 72 normal Swiss mice were used. Both infected and normal mice were divided into experimental groups and submitted to one of the following treatment regimens: benznidazole alone;immunosuppressive drugs (azathioprine, betamethasone and cyclosporin);a combination of immunosuppressive drugs and benznidazole;and untreated controls. In the infected group treated with benznidazole, one mouse developed a non-Hodgkin's lymphoma. This finding has been interpreted as a spontaneous tumor of mice. The study of the chronically infected mice treated with the combination of immunosuppressive drugs and benznidazole demonstrated an absence of lymphomas or other neoplasias. These findings support the indication of benznidazole, as the drug of choice, for immunosuppressed patients that develop a reactivation of Chagas' disease.

关键词： 免疫抑制药物   霉酚酸酯   他克罗姆   作用机制   移植排异反应  

摘要： 综述霉酚酸酯与他克罗姆对临床器官移植和自身免疫性疾病的治疗应用及其免疫抑制作用机制的研究进展。

关键词： 器官移植   免疫抑制剂   药理学   免疫学   排斥反应  

摘要： 免疫抑制剂的应用与药理学及免疫学的进展密切相关。近些年来 ,许多药理免疫学家及外科医生经过大量的动物实验及临床研究 ,努力寻找高效、低毒的新型免疫抑制剂。现将近些年来新开发的几类免疫抑制剂 。

关键词： 多囊肾   药物疗法   免疫抑制剂   APKD  

摘要： 目的：探讨免疫抑制药物对成人型多囊肾病（ Ａ Ｐ Ｋ Ｄ）的治疗作用及其作用机制。方法：回顾总结２４ 例 Ａ Ｐ Ｋ Ｄ患者肾移植并免疫抑制治疗［均为常规的环孢素 Ａ（ Ｃｓ Ａ）、硫唑嘌呤（ Ａｚａ）、泼尼松（ Ｐｒｅｄ）三联方案］前后情况，对比观察的指标是腰部胀痛、肉眼血尿、高血压、多囊肾大小。结果：移植术后腰部胀痛症状改善最为明显； 术前频发肉眼血尿者为８３．３％ ，术后减为１２．５％ ，相差非常显著（ Ｐ＜ ０．０１）；高血压在术后 １ 个月内改善不明显，而在术后１ 年时改善非常明显（ Ｐ＜ ０．０１）；多囊肾 Ｂ超测定值，术前与术后各期相比， 大小无显著差异，呈现“稳定”状态。结论： Ａ Ｐ Ｋ Ｄ 患者肾移植术后腰部胀痛、血尿、高血压等症状的改善可归因于免疫抑制药物的治疗作用。推测其作用机制，可能 Ａ Ｐ Ｋ Ｄ属基因决定基础上的免疫性疾病，或免疫因素在其病程中起重要作用，因此免疫抑制药物可能对 Ａ Ｐ Ｋ Ｄ 具有治疗作用。

关键词： 免疫抑制药物   肺结核   药源性疾病   治疗  

摘要： 对１１例长期使用免疫抑制药物过程中出现肺结核分析，结果是早期临床症状轻、不典型，以血行播散形多，继续使用免疫抑制药物治疗原发病时，结核病易复发，宜延长化疗方案。