ангиотензин阻塞对慢性肺异位移植功能障碍的发展的影响
Spenser E January1, Julie Hubbard1, Keith A Fester1
1Department of Pharmacy, Barnes-Jewish Hospital, Saint Louis, MO, USA.
Journal of pharmacy practice
|November 3, 2023
概括
这项研究发现,氨酸- ангиотензин- алдостерон系统抑制剂 (RAASi) 在肺移植接受者中没有改善无慢性肺全移植功能障碍 (CLAD) 的生存率. RAASi耐受性很好,不良事件的发生率很低,如高胆血症和急性损伤.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 氨酸- ангиотензин- алдостерон系统 (RAAS) 影响免疫反应,包括细胞因子促进 (TGF-β,IL-6,IL-8),这与慢性肺异位移植功能障碍 (CLAD) 有关.
- 临床前模型表明,RAAS阻断减少了促炎性细胞因子和中性粒细胞的招募,可能减轻了CLAD.
研究的目的:
- 在肺移植接受者中,调查使用氨酸- ангиотензин- 阿尔多素系统抑制剂 (RAASi) 与无CLAD存活率之间的关联.
- 评估RAASi对肺移植后长期结果的影响.
主要方法:
- 追溯性,单中心研究,将35名RAASi肺移植接受者与70名非RAASi对照者进行比较.
- 移植后长达5年的随访时间,以评估CLAD的发展.
- 多变量考克斯比例危险模型用于分析RAASi作为时间变化的共变量.
主要成果:
- 在RAASi使用者 (34.3%) 和非使用者 (38.6%) 之间,CLAD发病率没有显著差异 (P = .668).
- 多变量分析证实RAASi和CLAD风险之间没有关联 (危险比率=1.01,P=.986).
- 在RAASi组中观察到高卡利米亚和急性损伤的低发病率.
结论:
- 移植后的RAASi使用与患有CLAD的风险降低无关.
- 在研究的肺移植人群中,RAASi表现出良好的耐受性.
- 可能需要进一步的研究来探索其他治疗点来预防CLAD.
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