新创肾移植免疫疗法:在管道是什么?

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ibsen Pinheiro特德斯科席尔瓦H Jr, Machado P,罗索费利佩·C,麦地那Pestana乔

新创肾移植免疫疗法:在管道是什么?

药。2006;66 (13):1665 - 84。

PubMed ID

16978033 (在PubMed

]

文摘

免疫抑制药物一直是传统发达,防止短期肾移植急性排斥反应,改善的结果。仍有医疗需要改善结果子组的患者在移植失败的风险更高,减少心血管疾病,传染病和malignancy-associated发病率和死亡率,提高长期坚持。一些新的免疫抑制剂和配方进行临床研究,进行了综述。每日一次修改版本他克莫司配方(MR4)政府正在经历第三阶段试验。它已经发展到管理新创或维护使用相同的治疗目标他克莫司谷浓度的原始配方。Belatacept (LEA29Y),第二代cytotoxic-T-lymphocyte-associated抗原免疫球蛋白(CTLA4-Ig),模块之间的交互CD80/86和CD28 costimulatory通路。二期试验,belatacept ciclosporin一样有效(环孢霉素)管理结合basiliximab,霉酚酸酯(MMF)和糖皮质激素。目前,belatacept是其中一个进行第三期临床试验研究捐赠者的器官接受者扩大标准。Janus蛋白酪氨酸激酶抑制剂(木菠萝)3显示一些选择性的淋巴细胞谱系和已被证明是有效的临床前年底移植模型。最常见的不良反应与非特异性结合JAK2激酶。cp - 690550, JAK3抑制剂是目前在二期临床试验。FK778, is a synthetic malononitrilamide that targets the critical enzyme of the de novo pyrimidine synthesis, dihydroorotic acid dehydrogenase, and receptor-associated tyrosine kinases has completed phase II trials. FK778 also shows antiviral activities that have been tested in patients with polyomavirus nephropathy. Fingolimod (FTY720), a synthetic sphingosine phosphate receptor modulator that reduces the recirculation of lymphocytes to blood and peripheral tissues including inflammatory lesions and graft sites is undergoing phase III trials. Although the efficacy of fingolimod is similar to MMF in patients receiving full doses of ciclosporin, safety issues such as a negative chronotropic effect, macular oedema, pulmonary adverse reactions and graft function resulted in premature discontinuation of the development programme for kidney transplantation. Because there was no clear clinical benefit over treatment options, the clinical development programme of FK778 was discontinued.Finally, a new evolving strategy with powerful induction-induced prolonged T-cell depletion followed by low-dose immunosuppressive monotherapy is showing promising results.

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药物靶点

药物	目标	类	生物	药理作用	行动
Belatacept	早期活化抗原CD80	蛋白质	人类	是的	拮抗剂	细节