Perazella Mark A
Acute Dialysis Services, Section of Nephrology, Department of Medicine, Yale University School of Medicine, LMP 2071, 333 Cedar Street, New Haven, CT 06520-8029, USA.
Expert Opin Drug Saf. 2002 May;1(1):53-64. doi: 10.1517/14740338.1.1.53.
COX-2 selective inhibitors provide analgesia and blunt inflammation while also sparing the gastrointestinal tract from classic NSAID toxicity. Therapeutic effects are thought to result from inhibition of the inflammatory COX-2 isoform. Organ sparing is considered the result of preservation of homeostatic COX-1 enzyme function. Similar roles of the COX isoforms in the kidney would reduce NSAID-associated nephrotoxicity. However, human kidney tissue expresses COX-2 enzyme, suggesting a role for this isoform in maintenance of physiological renal processes. Available clinical data on the renal effects of COX-2 selective inhibitors in humans also demonstrate nephrotoxic potential.
COX-2选择性抑制剂可提供镇痛作用并减轻炎症，同时还能使胃肠道免受传统非甾体抗炎药的毒性影响。其治疗效果被认为是由于抑制了炎性COX-2同工型。器官保护作用被认为是维持稳态的COX-1酶功能得以保留的结果。COX同工型在肾脏中的类似作用可能会降低非甾体抗炎药相关的肾毒性。然而，人类肾脏组织表达COX-2酶，这表明该同工型在维持生理性肾脏过程中发挥作用。关于COX-2选择性抑制剂对人类肾脏影响的现有临床数据也显示出肾毒性潜力。
