Giles Francis J, Redman Rebecca, Yazji Salim, Bellm Lisa
The University of Texas, MD Anderson Cancer Center, Department of Leukaemia, 1515 Holcombe Boulevard, Box 428, Houston, TX 77030, USA.
Expert Opin Investig Drugs. 2002 Aug;11(8):1161-70. doi: 10.1517/13543784.11.8.1161.
Iseganan HCl is an antimicrobial peptide under development for the prevention of oral mucositis, a severe consequence of some chemotherapy and radiation therapy regimens. Several attributes of iseganan make it an optimal candidate for study in this clinical situation where both local and systemic host defenses may be impaired. These include broad spectrum and rapid bactericidal activity, a lack of observed resistance and cross-resistance and stability in biological fluids. Clinical trials of patients receiving stomatotoxic chemotherapy followed by a haematopoietic stem cell transplant show iseganan reduces the occurrence of oral mucositis and ameliorates sequelae such as mouth pain, throat pain and difficulty swallowing. Iseganan is well-tolerated, which is partly attributable to a lack of systemic absorption following topical oral administration. Other promising areas of investigation include topical oral application for the prevention of ventilator-associated pneumonia and nebulisation for treatment of chronic lung infection in patients with cystic fibrosis. Future studies will expand on the role of iseganan as a novel antimicrobial.
盐酸伊西加南是一种正在研发的抗菌肽，用于预防口腔黏膜炎，这是某些化疗和放疗方案的严重后果。伊西加南的几个特性使其成为在这种局部和全身宿主防御可能受损的临床情况下进行研究的理想候选药物。这些特性包括广谱和快速杀菌活性、未观察到耐药性和交叉耐药性以及在生物体液中的稳定性。对接受口腔毒性化疗后进行造血干细胞移植的患者进行的临床试验表明，伊西加南可减少口腔黏膜炎的发生，并改善诸如口腔疼痛、喉咙疼痛和吞咽困难等后遗症。伊西加南耐受性良好，这部分归因于局部口服给药后缺乏全身吸收。其他有前景的研究领域包括局部口服用于预防呼吸机相关性肺炎，以及雾化用于治疗囊性纤维化患者的慢性肺部感染。未来的研究将进一步拓展伊西加南作为新型抗菌药物的作用。
