定量系统毒理学预测Ivacaftor诱导的氧化应激有助于CFTR调节器肝毒性
Alan Shi1, Cole Cornwell1, Kyunghee Yang2
1Department of Clinical Pharmacy, Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, California, USA.
Clinical pharmacology and therapeutics
|September 23, 2025
概括
在囊性纤维化患者中,elexacaftor/tezacaftor/ivacaftor (ETI) 可能导致肝损伤. 这项研究发现ivacaftor通过氧化应激驱动这种损伤,但剂量减少和抗氧化剂可能有助于预防它.
科学领域:
- 药理学 药理学是指药理学的学科.
- 毒理学 毒理学 毒理学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 囊性纤维化 (CF) 是一种影响全球众多个体的遗传性疾病.
- 包括elexacaftor/tezacaftor/ivacaftor (ETI) 在内的CFTR调节器疗法已经改变了CF患者的护理.
- 肝酶升高和药物诱导的肝损伤 (DILI) 是ETI的不良影响.
研究的目的:
- 阐明ETI引起的DILI背后的机制.
- 为了确定ETI负责肝损伤的特定组成部分.
- 评估ETI介导的DILI的潜在缓解策略.
主要方法:
- 实验室试验用于研究细胞对ETI组件的反应.
- 使用DILIsym的定量系统毒理学建模被用于模拟DILI.
- DILIsym用于预测ETI对肝酶水平的影响,并评估缓解策略.
主要成果:
- 伊瓦卡夫托被确定为ETI介导的DILI的主要贡献者.
- 通过抑制电子运输链,反应性氧物种的产生和线粒体功能障碍被认为是关键机制.
- DILIsym准确地预测了与ETI相关的肝酶升高 (6.0%对8.0%的临床数据).
结论:
- 伊瓦卡夫托诱导的线粒体功能障碍是ETI介导的DILI的一个关键机制.
- 剂量降低和抗氧化剂的使用在缓解与ETI相关的肝酶升高方面表现有前途.
- 了解ETI的DILI机制可以为CF患者指导更安全的治疗策略.
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