人类和动物的甲毒性:临床谱,机制和管理
Serkan Yilmaz1, Bayram Göktaş2, İlker Ateş3
1Faculty of Nursing, Ankara University, Ankara, Turkey.
Journal of applied toxicology : JAT
|March 16, 2026
概括
伊弗梅克丁通常是安全的,但可以引起严重的神经毒性,特别是高剂量或易受影响的个体. 了解ivermectin的毒性需要考虑药物相互作用,遗传学和暴露水平.
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
- 神经科学是一个神经科学.
背景情况:
- 艾弗梅克丁是一种宏环酸乳,广泛用于寄生虫感染,具有安全性历史.
- 新出现的证据表明,ivermectin可以引起显著的中枢神经系统毒性.
- 在COVID-19大流行期间,非标签使用量增加,引发了人们对ivermectin毒性的担忧.
研究的目的:
- 综合审查ivermectin的毒理概况.
- 为了确定导致ivermectin诱导的神经毒性的因素.
- 描述与ivermectin使用相关的风险,特别是在COVID-19大流行期间.
主要方法:
- 整合来自人类临床试验,药物监测,病例报告,动物研究和环境调查的数据.
- 分析P-糖蛋白 (ABCB1/MDR1) 在血脑屏障运输中的功能.
- 在动物模型中评估物种,品种,年龄,剂量和路线依赖的敏感性.
主要成果:
- 人类受控试验表明,在治疗剂量下,ivermectin耐受性良好,并有轻微的不良事件.
- 现实世界的数据显示,在敏感个体的超治疗或标准剂量暴露后,罕见但严重的神经毒性事件 (脑病变,,昏迷) 发生.
- 通过P-糖蛋白功能障碍导致血脑屏障流失是神经毒性的关键机制.
- 动物研究表明,根据遗传学,年龄和剂量,敏感性存在显著的变化.
- 在大流行期间,非标签使用导致毒性暴露增加,没有证实的益处.
结论:
- 甲神经毒性是药理动力学和宿主特异性因素的可预测结果,而不是固有的缺陷.
- 了解载体生物学和暴露模式对于管理ivermectin毒性风险至关重要.
- 虽然ivermectin具有治疗价值,但其安全性需要仔细考虑剂量,个体敏感性和非标签使用,特别是在脆弱人群中.
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