对于非糖尿病脏病的矿物甲类皮质体受体对抗作用
Frédéric Jaisser1,2, Jonatan Barrera-Chimal3
1Université de Lorraine, INSERM Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116, CHRU de Nancy, French-Clinical Research Infrastructure Network (F-CRIN) INI-CRCT, Nancy 54500, France.
概括
矿物质皮质类受体抗剂 (MRAs) 在临床前模型中显示出治疗非糖尿病慢性病 (CKD) 的前景,通过保护脏和心血管系统. 临床翻译是具有挑战性的,因为高血症的风险,促使研究更安全的MRA替代品.
科学领域:
- 腎病學和心血管醫學.
- 药理学和治疗学 药理学和治疗学
背景情况:
- 在非上皮细胞中,矿物甲类受体 (MR) 的激活有助于在非糖尿病病中导致脏和心血管损伤.
- 临床前研究始终表明MR抗剂 (MRAs) 的保护性和心脏保护性作用.
研究的目的:
- 审查最近关于非糖尿病病中MR抑制机制的临床前证据.
- 总结临床试验评估类固醇和非类固醇MRA在晚期非糖尿病CKD.
主要方法:
- 从非糖尿病性病的动物模型中对临床前数据的审查.
- 对慢性病患者的MRA临床试验结果的摘要.
主要成果:
- 在临床前模型中,MRAs可以预防脏结构损伤,减少白膜尿,并保持功能.
- 心血管方面的好处包括预防心脏纤维化和血管化.
- 类固醇MRAs的临床应用受限于CKD患者的高血症风险.
结论:
- 在非糖尿病病模型中,MR抑制提供了显著的心脏和脏益处.
- 较新的非类固醇MRA可能为晚期CKD的临床使用提供了更好的安全性.
- 需要进一步的临床研究来确定MRA在CKD患者的疗效和安全性.
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