[沙利度胺：作用机制及血液学新见解]

[Thalidomide: mechanisms of action and new insights in hematology].

作者信息

Leleu X, Micol J B, Guieze R, Berthon C, Kuhnovsky F, Terriou L, Moreau A S, Yakoub-Agha I, Bauters F, Facon T

机构信息

Service des maladies du sang, hôpital Claude-Huriez, CHRU, Lille, France.

出版信息

Rev Med Interne. 2005 Feb;26(2):119-27. doi: 10.1016/j.revmed.2004.06.017.

DOI:10.1016/j.revmed.2004.06.017

PMID:15710258

Abstract

Purpose. - Thalidomide, a major teratogen drug, was rehabilitated mainly in malignant hemopathy. Current knowledge and key points. - Thalidomide-mechanisms of action are well known, multiple, they combine immunomodulatory, antiangiogenic properties, and the modulation of cytokines, particularly tumour necrosis factor-alpha. Multiple trials are ongoing, however, the main indication remain multiple myeloma with a response rate of 30% in relapsed patients. Future prospects and projects. - New structural analogues of the thalidomide which priviligiate some of the thalidomide-specific mechanisms of action, the selected cytokine inhibitory drugs (SelCIDS) and the immunomodulatory drugs (IMiDs) family are under evaluation. The IMiDs, which mechanism is based on stimulation of T lymphopoiesis rather than inhibition of tumour necrosis factor-alpha, are under clinical trials in multiple myeloma with interesting results.

摘要

目的。——沙利度胺是一种主要的致畸药物，目前主要在恶性血液病中得到重新应用。当前认知与要点。——沙利度胺的作用机制已为人熟知，具有多种机制，它兼具免疫调节、抗血管生成特性以及对细胞因子（尤其是肿瘤坏死因子-α）的调节作用。目前正在进行多项试验，然而，其主要适应证仍是多发性骨髓瘤，复发患者的缓解率为30%。未来前景与项目。——沙利度胺的新型结构类似物，即优先考虑沙利度胺某些特定作用机制的药物、选定的细胞因子抑制药物（SelCIDS）以及免疫调节药物（IMiDs）家族正在评估中。IMiDs的作用机制基于刺激T淋巴细胞生成而非抑制肿瘤坏死因子-α，目前正在多发性骨髓瘤的临床试验中，已取得了有趣的结果。