Tanaka Hiroshi, Oki Ei-Shin, Tsugawa Koji, Suzuki Koich, Tsuruga Kazushi, Ito Etsuro
Department of Pediatrics, Hirosaki University School of Medicine, Hirosaki, Japan.
Nephrology (Carlton). 2007 Aug;12(4):376-9. doi: 10.1111/j.1440-1797.2007.00793.x.
Mizoribine (MZR), a novel selective inhibitor of inosine monophosphate dehydrogenase in the de novo pathway, whose mode of action is very similar to that of mycophenolate mofetil, has been successfully applied without serious adverse effects for the treatment of renal diseases. We have previously reported the efficacy and safety of a new MZR treatment regimen, namely, oral MZR intermittent pulse therapy, which we examined based on the observation that it might show superior efficacy to the conventional daily low-dose MZR regimen on account of the higher peak serum MZR levels, in selected patients with lupus nephritis. Two Japanese patients with severe lupus nephritis (WHO class IV-G) who were administered long-term intermittent MZR pulse therapy, and in whom pre- and post-treatment renal biopsies were reported. Post-treatment renal biopsy confirmed the marked attenuation of histologic progression by the treatment. These clinical observations may lend further support, from the histologic standpoint, to the efficacy of long-term MZR intermittent pulse therapy for selected patients with active lupus nephritis.
咪唑立宾（MZR）是一种新型的从头合成途径中次黄嘌呤单磷酸脱氢酶的选择性抑制剂，其作用模式与霉酚酸酯非常相似，已成功应用于肾脏疾病的治疗且无严重不良反应。我们之前报道了一种新的MZR治疗方案的疗效和安全性，即口服MZR间歇脉冲疗法。我们基于这样的观察进行了研究：在选定的狼疮性肾炎患者中，由于血清MZR峰值水平较高，该疗法可能比传统的每日低剂量MZR方案具有更高的疗效。两名患有严重狼疮性肾炎（WHO分类IV-G）的日本患者接受了长期间歇性MZR脉冲治疗，并报告了治疗前后的肾活检情况。治疗后的肾活检证实治疗使组织学进展明显减轻。从组织学角度来看，这些临床观察结果可能进一步支持长期MZR间歇脉冲疗法对选定的活动性狼疮性肾炎患者的疗效。
