浏览全部资源
扫码关注微信
1.昆明市第一人民医院药学部,昆明 650224
2.昆明医科大学附属甘美医院药学部,昆明 650224
硕士研究生。研究方向:临床药学。E-mail:3263684218@qq.com
主任药师,硕士生导师。研究方向:临床药学、药物基因组学。E-mail:songcs163@163.com
收稿日期:2024-07-18,
修回日期:2025-01-11,
录用日期:2025-01-13,
纸质出版日期:2025-02-15
移动端阅览
鲁赛娟,宋沧桑,李兴德,等.肝移植后免疫抑制剂与肠道菌群相互作用的研究进展[J].中国药房,2025,36(03):362-366.
LU Saijuan,SONG Cangsang,LI Xingde,et al.Research progress on the interaction between immunosuppressants and intestinal flora after liver transplantation[J].ZHONGGUO YAOFANG,2025,36(03):362-366.
鲁赛娟,宋沧桑,李兴德,等.肝移植后免疫抑制剂与肠道菌群相互作用的研究进展[J].中国药房,2025,36(03):362-366. DOI: 10.6039/j.issn.1001-0408.2025.03.18.
LU Saijuan,SONG Cangsang,LI Xingde,et al.Research progress on the interaction between immunosuppressants and intestinal flora after liver transplantation[J].ZHONGGUO YAOFANG,2025,36(03):362-366. DOI: 10.6039/j.issn.1001-0408.2025.03.18.
免疫抑制剂(包括环孢素、他克莫司、麦考酚酯类药物、糖皮质激素等)是肝移植后预防器官发生排斥反应的首选药物,能够有效地减少宿主对移植物的免疫反应,提高移植成功率,延长患者的生存期。肝移植与肠道生态失调有关,而免疫抑制剂与肠道菌群之间相互影响——免疫抑制剂的使用会改变肠道菌群的丰度、组成和代谢产物;肠道菌群产生的一系列酶和代谢产物可能会通过化学方式来改变免疫抑制剂的吸收和代谢。另外,肝移植患者术后感染的发生率较高,而肠道菌群会影响炎症因子,免疫抑制剂与炎症因子之间也相互影响。在一定程度上可认为,免疫抑制剂通过肠道菌群在肝移植患者中发挥作用。
Immunosuppressants (including cyclosporine, tacrolimus, mycophenolate esters, glucocorticoids, etc.) are the first choice of drugs to prevent organ rejection after liver transplantation, which can effectively reduce the host immune response to the graft, improve the success rate of transplantation, and prolong the survival of patients. Liver transplantation is associated with intestinal flora, while immunosuppressive agents interact with intestinal flora. Immunosuppressive agents change the abundance, composition and metabolites of intestinal flora, while a series of enzymes and metabolites produced by intestinal flora may chemically alter the absorption and metabolism of immunosuppressants. In addition, the incidence of postoperative infection in liver transplantion patients is relatively high, while gut flora affects inflammatory factors, and immunosuppressants interact with inflammatory factors. To some extent, immunosuppressants can be thought of as acting through intestinal flora in patients after liver transplantation.
中华医学会器官移植学分会 . 中国肝移植免疫抑制治疗与排斥反应诊疗规范: 2019版 [J ] . 器官移植 , 2021 , 12 ( 1 ): 8 - 14,28 .
Organ Transplantation Branch of Chinese Medical Association . Diagnosis and treatment specification for immunosuppressive therapy and rejection of liver transplantation in China:2019 edition [J ] . Organ Transplant , 2021 , 12 ( 1 ): 8 - 14,28 .
CHEN Y W , ZHOU J H , WANG L . Role and mechanism of gut microbiota in human disease [J ] . Front Cell Infect Microbiol , 2021 , 11 : 625913 .
缪丽燕 , 张彦 . 肠道菌群在器官移植免疫抑制剂个体化治疗中的作用 [J ] . 实用器官移植电子杂志 , 2020 , 8 ( 1 ): 11,14 - 17 .
MIAO L Y , ZHANG Y . Role of intestinal flora in individualized immunosuppressive therapy for organ transplantation [J ] . Pract J Organ Transplant Electron Version , 2020 , 8 ( 1 ): 11,14 - 17 .
GABARRE P , LOENS C , TAMZALI Y , et al . Immunosuppressive therapy after solid organ transplantation and the gut microbiota:bidirectional interactions with clinical consequences [J ] . Am J Transplant , 2022 , 22 ( 4 ): 1014 - 1030 .
MU J Z , CHEN Q Y , ZHU L , et al . Influence of gut microbiota and intestinal barrier on enterogenic infection after liver transplantation [J ] . Curr Med Res Opin , 2019 , 35 ( 2 ): 241 - 248 .
鲍志野 , 刘浩 . 肝移植术后肠道菌群失调的诊疗策略 [J ] . 器官移植 , 2022 , 13 ( 4 ): 469 - 474 .
BAO Z Y , LIU H . Diagnosis and treatment strategy of intestinal flora imbalance after liver transplantation [J ] . Organ Transplant , 2022 , 13 ( 4 ): 469 - 474 .
陈宗坤 , 牛志强 , 王妍 , 等 . 肝移植围手术期肠道微生态变化研究进展 [J ] . 中国微生态学杂志 , 2023 , 35 ( 1 ): 103 - 109 .
CHEN Z K , NIU Z Q , WANG Y , et al . Intestinal microecological changes during perioperative period of liver transplantation:research progress [J ] . Chin J Microecol , 2023 , 35 ( 1 ): 103 - 109 .
ROSA R L , JOHANSEN H K , MOLIN S . Persistent bacterial infections,antibiotic treatment failure,and microbial adaptive evolution [J ] . Antibiotics (Basel) , 2022 , 11 ( 3 ): 419 .
ZAZA G , DALLA GASSA A , FELIS G , et al . Impact of maintenance immunosuppressive therapy on the fecal microbiome of renal transplant recipients:comparison between an everolimus- and a standard tacrolimus-based regimen [J ] . PLoS One , 2017 , 12 ( 5 ): e0178228 .
JIA J J , TIAN X Y , JIANG J W , et al . Structural shifts in the intestinal microbiota of rats treated with cyclosporine A after orthotropic liver transplantation [J ] . Front Med , 2019 , 13 ( 4 ): 451 - 460 .
ZHANG Z , LIU L , TANG H , et al . Immunosuppressive effect of the gut microbiome altered by high-dose tacrolimus in mice [J ] . Am J Transplant , 2018 , 18 ( 7 ): 1646 - 1656 .
JIAO W J , ZHANG Z J , XU Y , et al . Butyric acid norma- lizes hyperglycemia caused by the tacrolimus-induced gut microbiota [J ] . Am J Transplant , 2020 , 20 ( 9 ): 2413 - 2424 .
ROOKS M G , GARRETT W S . Gut microbiota,metabolites and host immunity [J ] . Nat Rev Immunol , 2016 , 16 ( 6 ): 341 - 352 .
YUAN J J , CHANG X N , LI M , et al . Clinical utility of characterizing intestinal flora in septic kidney injury [J ] . Chin Med J (Engl) , 2020 , 133 ( 7 ): 842 - 846 .
陈刚 , 陈志东 , 蒋文涛 , 等 . 中国肝、肾移植受者霉酚酸类药物应用专家共识: 2023版 [J ] . 上海医药 , 2023 , 44 ( 19 ): 3 - 19,47 .
CHEN G , CHEN Z D , JIANG W T , et al . Expert consensus on the use of mycophenolic acid in Chinese liver and kidney transplant recipients:2023 edition [J ] . Shanghai Med Pharm J , 2023 , 44 ( 19 ): 3 - 19,47 .
JARDOU M , PROVOST Q , BROSSIER C , et al . Alteration of the gut microbiome in mycophenolate-induced enteropathy:impacts on the profile of short-chain fatty acids in a mouse model [J ] . BMC Pharmacol Toxicol , 2021 , 22 ( 1 ): 66 .
SHI W Y , LI Z J , WANG W D , et al . Dynamic gut microbiome-metabolome in cationic bovine serum albumin induced experimental immune-complex glomerulonephritis and effect of losartan and mycophenolate mofetil on microbiota modulation [J ] . J Pharm Anal , 2024 , 14 ( 4 ): 100931 .
FLANNIGAN K L , TAYLOR M R , PEREIRA S K , et al . An intact microbiota is required for the gastrointestinal toxicity of the immunosuppressant mycophenolate mofetil [J ] . J Heart Lung Transplant , 2018 , 37 ( 9 ): 1047 - 1059 .
WANG M Z , ZHU Z Y , LIN X Y , et al . Gut microbiota mediated the therapeutic efficacies and the side effects of prednisone in the treatment of MRL/Lpr mice [J ] . Arthritis Res Ther , 2021 , 23 ( 1 ): 240 .
ZHANG J , FENG D , LAW H K , et al . Integrative analysis of gut microbiota and fecal metabolites in rats after prednisone treatment [J ] . Microbiol Spectr , 2021 , 9 ( 3 ): e0065021 .
GIOCO R , CORONA D , EKSER B , et al . Gastrointestinal complications after kidney transplantation [J ] . World J Gastroenterol , 2020 , 26 ( 38 ): 5797 - 5811 .
VAN G T . How cyclosporine reduces mycophenolic acid exposure by 40% while other calcineurin inhibitors do not [J ] . Kidney Int , 2021 , 100 ( 6 ): 1185 - 1189 .
VICENTINI F A , KEENAN C M , WALLACE L E , et al . Intestinal microbiota shapes gut physiology and regulates enteric neurons and glia [J ] . Microbiome , 2021 , 9 ( 1 ): 210 .
周锦屏 , 张蕊 , 刘亚妮 , 等 . 肠道菌群与免疫抑制剂相互作用研究进展 [J ] . 中国医院药学杂志 , 2020 , 40 ( 22 ): 2377 - 2381 .
ZHOU J P , ZHANG R , LIU Y N , et al . Advances in the study of interaction between intestinal flora and immunosuppressive agents [J ] . Chin J Hosp Pharm , 2020 , 40 ( 22 ): 2377 - 2381 .
SAVAGE N . The complex relationship between drugs and the microbiome [J ] . Nature , 2020 , 577 ( 7792 ): S10 - S11 .
GUO Y K , CRNKOVIC C M , WON K J , et al . Commensal gut bacteria convert the immunosuppressant tacrolimus to less potent metabolites [J ] . Drug Metab Dispos , 2019 , 47 ( 3 ): 194 - 202 .
GUO Y K , LEE H , EDUSEI E , et al . Blood profiles of gut bacterial tacrolimus metabolite in kidney transplant reci- pients [J ] . Transplant Direct , 2020 , 6 ( 10 ): e601 .
SIMPSON J B , SEKELA J J , GRABOSKI A L , et al . Metagenomics combined with activity-based proteomics point to gut bacterial enzymes that reactivate mycophenolate [J ] . Gut Microbes , 2022 , 14 ( 1 ): 2107289 .
COHEN I , RUFF W E , LONGBRAKE E E . Influence of immunomodulatory drugs on the gut microbiota [J ] . Transl Res , 2021 , 233 : 144 - 161 .
TAYLOR M R , FLANNIGAN K L , RAHIM H , et al . Vancomycin relieves mycophenolate mofetil-induced gastrointestinal toxicity by eliminating gut bacterial β-glucuronidase activity [J ] . Sci Adv , 2019 , 5 ( 8 ): eaax2358 .
WANG J J , ZHU N N , SU X M , et al . Gut-microbiota-derived metabolites maintain gut and systemic immune homeostasis [J ] . Cells , 2023 , 12 ( 5 ): 793 .
KUMAR P , MONIN L , CASTILLO P , et al . Intestinal interleukin-17 receptor signaling mediates reciprocal control of the gut microbiota and autoimmune inflammation [J ] . Immunity , 2016 , 44 ( 3 ): 659 - 671 .
YANG W J , YU T M , HUANG X S , et al . Intestinal microbiota-derived short-chain fatty acids regulation of immune cell IL-22 production and gut immunity [J ] . Nat Commun , 2020 , 11 ( 1 ): 4457 .
KANDIKATTU H K , VENKATESHAIAH S U , VERMA A K , et al . Tacrolimus (FK506) treatment protects allergen-,IL-5- and IL-13-induced mucosal eosinophilia [J ] . Immunology , 2021 , 163 ( 2 ): 220 - 235 .
MEYER N , BRODOWSKI L , VON KAISENBERG C , et al . Cyclosporine A and tacrolimus induce functional impairment and inflammatory reactions in endothelial progenitor cells [J ] . Int J Mol Sci , 2021 , 22 ( 18 ): 9696 .
JOVER R , BORT R , JOSÉ GÓMEZ-LECHÓN M , et al . Down-regulation of human CYP3A4 by the inflammatory signal interleukin-6:molecular mechanism and transcription factors involved [J ] . FASEB J , 2002 , 16 ( 13 ): 1799 - 1801 .
XIE Y , HU F D , XIANG D W , et al . The metabolic effect of gut microbiota on drugs [J ] . Drug Metab Rev , 2020 , 52 ( 1 ): 139 - 156 .
0
浏览量
89
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构