Muromonab CD3:重新评价其药理学和使用实体器官移植排斥反应的预防。

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王尔德MI,果阿吉隆坡

Muromonab CD3:重新评价其药理学和使用实体器官移植排斥反应的预防。

药。1996年5月,51 (5):865 - 94。

PubMed ID

8861551 (在PubMed

]

文摘

小鼠单克隆抗体muromonab CD3 (OKT3)是针对人类T细胞CD3抗原在外围和有效块所有T细胞的功能。静脉注射预防muromonab CD3(5毫克每天一次10到14天)诱导疗法与糖皮质激素用药和延迟环孢菌素(序贯疗法)优化早期移植肾功能延迟环孢菌素的潜在肾毒性和肝毒素的影响,直到建立移植肾功能。虽然临床数据是有限的(大小不一致的试验设计和试验),预防muromonab CD3-based序贯疗法明显比标准三联疗法更有效的预防同种异体移植物排斥在肾和肝,但不是心脏移植受者。好处是特别明显的患者的移植肾功能延迟恢复。处理间差异不显著观察到在病人的存活率。的整体功效muromonab CD3 - polyclonal-based预防性方案似乎是相似的,尽管结果不同调查和确认是必要的。一个anti-interleukin-2单克隆抗体类预防性方案改善移植物和患者的生存而muromonab CD3-based预防肝移植受者。Antimuromonab CD3抗体可能发展;然而,muromonab CD3可能成功地重用患者低滴定度。初步pharmacoeconomic数据表明,平均成本与四大免疫抑制药物方案包含muromonab CD3、antithymocyte球蛋白(ATG)或抗淋巴细胞球蛋白(ALG)比三联疗法。 Drug costs with prophylactic muromonab CD3-based regimens were similar or greater than those with polyclonal-based protocols. The first doses of muromonab CD3 are associated with the 'cytokine-release syndrome'. More severe first-dose events include aseptic meningitis, intragraft thromboses, seizures and potentially fatal pulmonary oedema. The incidence and/or severity of cytomegalovirus infection with prophylactic muromonab CD3 based immunosuppression is similar to or greater than that with triple therapy and ATG- or ALG-based regimens. However, the risk of infection and also the observed increase in lymphoproliferative disorders appears to be related to the degree of immunosuppression rather than to the drug itself Thus, sequential muromonab CD3-based therapy is more effective than standard triple therapy (in renal and hepatic transplant recipients) and appears to be similar to that of polyclonal-based regimens in the prophylaxis of transplant rejection. Although the routine use of prophylactic muromonab CD3 in low-risk patients with primary graft function does not appear to be justified, prophylactic muromonab CD3-based therapy has a role in patients at high risk of rejection.

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药物靶点

药物	目标	类	生物	药理作用	行动
Muromonab	t细胞表面糖蛋白CD3三角洲链	蛋白质	人类	是的	不可用	细节
Muromonab	t细胞表面糖蛋白CD3γ链	蛋白质	人类	是的	不可用	细节
Muromonab	t细胞表面糖蛋白CD3ζ链	蛋白质	人类	是的	不可用	细节