长期使用氨酸抑制剂对实体器官移植接受者的内分泌影响
Talia Diker Cohen1,2, Idit Dotan1,2, Bronya Calvarysky3,4
1Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski St., Petah Tikva 4941492, Israel.
European journal of endocrinology
|September 18, 2025
概括
在器官移植中使用的氨酸抑制剂 (CNIs) 可以导致糖尿病,骨质损失和矿物质失衡. 早期检测和多学科内分泌治疗对于管理这些常见但可修改的CNI毒性至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 移植医学 移植医学
背景情况:
- 像环素和塔克罗利斯这样的氨酸抑制剂 (CNIs) 在固体器官移植中对免疫抑制至关重要.
- 然而,CNI使用与显著的内分泌和代谢并发症有关.
研究的目的:
- 审查和综合关于CNI使用的内分泌和代谢后续的证据.
- 突出影响葡萄糖,脂质,矿物质,骨和神经内分泌轴的常见毒性.
主要方法:
- 对CNI相关的内分泌干扰现有文献进行系统审查.
- 分析CNI对特定代谢途径和器官系统的影响.
主要成果:
- 中枢抗胰岛素抑制剂,特别是塔克罗利,增加了移植后糖尿病和脂质失调的风险.
- CNI治疗加快骨质损失,导致骨折风险增加,并可能导致低磁性血和低阿尔多斯特隆症.
- 虽然像淋巴腺功能障碍这样的一些影响是轻微的,但需要对上腺功能不充分保持警.
结论:
- CNI诱导的内分泌毒性是频繁且可控的,需要在移植护理中进行常规内分泌咨询.
- 开发和验证监测算法和治疗策略可以改善患者的治疗结果和移植存活率.
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