在抗生素的存在下降甲酸莫菲蒂尔血度:肺移植的囊性纤维化患者的病例报告
Giuliano Ponis1, Giuliana Decorti2, Egidio Barbi1,2
1Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", 34137 Trieste, Italy.
International journal of molecular sciences
|February 24, 2024
概括
抗生素可以通过破坏肠道细菌来降低患有囊性纤维化肺移植患者的免疫抑制剂水平. 在抗生素治疗期间和之后监测菌酸盐水平对于预防器官排斥至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 移植医学 移植医学
- 微生物学 微生物学
背景情况:
- 有效的免疫抑制对移植受体至关重要,特别是那些服用多种药物的受体.
- 药物相互作用可能会损害免疫抑制疗法的有效性.
- 接受肺移植的囊性纤维化患者容易感染需要抗生素治疗的感染.
研究的目的:
- 为了研究抗生素和免疫抑制剂在肺移植接受者中与囊性纤维化之间潜在的药物相互作用.
- 为了探索抗生素诱导的肠道菌群破坏对mycophenolate药理动学的影响.
主要方法:
- 一个46岁的双边肺移植接受者患有囊性纤维化病的案例报告.
- 在住院治疗肺部恶化期间服用各种抗生素.
- 在抗生素治疗之前和之后监测免疫抑制剂 (everolimus和mycophenolate) 的血度.
主要成果:
- 与治疗值相比,在抗生素治疗后观察到免疫抑制剂的血度明显降低.
- 在停止服用抗生素后,免疫抑制剂水平增加.
- 假设的药物相互作用通过抗生素介导肠道菌群的破坏,影响mycophenolate动力学.
结论:
- 抗生素治疗可以导致肺移植接受者患有囊性纤维化时免疫抑制剂水平低于治疗水平.
- 由肠道细菌影响的mycophenolate的肠肝循环是这种相互作用的可能机制.
- 建议在抗生素疗程期间和之后对mycophenolate度进行常规监测,以确保这种患者群体具有足够的免疫抑制.
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