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[干扰素的治疗用途及其毒性。重点关注周围神经病变]

[Therapeutic use of interferons and their toxicity. Focus on peripheral neuropathy].

作者信息

Dentale Nicola, Manfredi Roberto

出版信息

Recenti Prog Med. 2007 Jun;98(6):329-34.

Abstract

When evaluating the tolerability profile of interferons, the authors focus their attention on peripheral neuropathy, by assessing the epidemiological, pathogenetic, clinical, and outcome aspects, in relation with the administration of these drugs and the concurrent increase of risk factors associated with underlying diseases (including chronic viral hepatitis, solid organ malignancies, hematological disorders, autoimmune diseases, HIV infection). Even though it is often impossible to exclude a direct or indirect interferon-associated pathogenetic pathways in the occurrence of peripheral neuropathies, predominatly through immune-mediated mechanisms, the episodes reported by the international literature are steadily on the rise, paralleling the enlargement of therapeutic indications, and the availability of novel interferon formulations for clinical use. The increased indications of interferons in a broadening spectrum of clinical disorders, and especially their use in chronic hepatitis, recommend a strict monitoring of all possible adverse events, in order to reach a better epidemiological, pathogenetic, and clinical awareness of clinical events which are still infrequent, but potentially severe, such as those involving the peripheral nervous system.

摘要

在评估干扰素的耐受性时,作者通过评估流行病学、发病机制、临床和预后等方面,关注周围神经病变,这些方面与这些药物的使用以及与基础疾病(包括慢性病毒性肝炎、实体器官恶性肿瘤、血液系统疾病、自身免疫性疾病、HIV感染)相关的危险因素的同时增加有关。尽管在周围神经病变的发生中,通常无法排除主要通过免疫介导机制的直接或间接的干扰素相关发病途径,但国际文献报道的病例数仍在稳步上升,这与治疗适应症的扩大以及新型干扰素临床制剂的可获得性相平行。干扰素在越来越广泛的临床疾病中的应用增加,尤其是在慢性肝炎中的应用,建议对所有可能的不良事件进行严格监测,以便更好地从流行病学、发病机制和临床角度认识那些仍然不常见但可能严重的临床事件,例如涉及周围神经系统的事件。

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