薬剤耐性および擬似耐性:腸内膜アスピリンの意図しない結果
Tilo Grosser1, Susanne Fries, John A Lawson
1Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Circulation
|December 6, 2012
まとめ
アスピリンに対する真の薬理学的耐性症は稀である. 明らかにアスピリン抵抗性の原因は,特に腸内コーティングアスピリンでは,吸収が変化しているためであり,真の薬剤耐性ではありません.
科学分野:
- 心血管医学は,心臓血管医学である.
- 薬理学 薬理学とは
- 遺伝学 遺伝学とは
背景:
- 低用量のアスピリンは,二次性心筋梗塞と脳卒中を予防するために重要である.
- アスピリン耐性は治療の失敗につながる可能性があるが,その定義と発生率は不明である.
- この研究では,潜在的に遺伝因子に関連しているアスピリンに対する真の薬理学的耐性を調査しました.
研究 の 目的:
- アスピリンに対する真の薬理学的耐性の安定した特定の現象型の有病率を決定する.
- 吸収の問題によって引き起こされる偽抵抗から真のアスピリン抵抗を区別するために.
主な方法:
- 400人の健康なボランティアをスクリーニングし,即効アスピリンまたは腸内コーティングアスピリンの1回325mgの投与に反応した.
- アスピリンの分子標的であるサイクロオキシゲネーゼ-1の活性が評価されました.
- 繰り返し検査を行い,異なるアスピリン製剤 (81 mg enteric-coated) とクロピドグレル (75 mg) を使用して,看似の耐性のある個人を検査した.
主要な成果:
- 吸収の変動は,単一投与の腸内コーティングアスピリンに対する高頻度 (最大49%) の明らかな耐性をもたらしたが,即効アスピリン (0%) はそうではなかった.
- すべての被験者は,再検査,投与間隔の延長,またはex vivo血小板の追加でアスピリンに反応しました.
- アスピリンに対する真の薬理学的耐性の症例は特定されなかった.
結論:
- アスピリンに対する真の薬理学的耐性症は稀である.
- 薬剤の吸収が遅れて減少したために起こる偽抵抗は,特に腸内コーティングアスピリンの場合,重要な要因です.
- 即時放出アスピリンの投与は,吸収の変動に関連した偽抵抗を回避します.
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