Arias Marta, Campistol Josep M, Vincenti Flavio
Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain 08036.
Transplant Rev (Orlando). 2009 Apr;23(2):94-102. doi: 10.1016/j.trre.2009.01.004.
A decade of spectacular innovation in maintenance immunosuppressive drugs has resulted in dramatic reductions in acute rejection and improvement in short- and long-term outcomes after renal transplantation. However, the new drugs continue to lack specificity, many require frequent therapeutic drug monitoring, and all of them are associated with acute and chronic toxicities. The new biologic agents, monoclonal antibodies, and receptor-fusion proteins lack immunogenicity, have long half-life and prolonged biologic effects, require intermittent administration, and have minimal toxicity. The specificity and selectively of the targets of the new biologic agents render them less toxic than the oral maintenance drugs and thus could possibly replace those drugs most frequently associated with long-term toxicity such as the corticosteroids and the calcineurin inhibitors.
在维持性免疫抑制药物方面十年的显著创新已使肾移植术后急性排斥反应大幅减少，短期和长期预后得到改善。然而，这些新药仍缺乏特异性，许多药物需要频繁进行治疗药物监测，并且它们都与急慢性毒性相关。新型生物制剂、单克隆抗体和受体融合蛋白缺乏免疫原性，半衰期长且生物效应持久，需要间歇性给药，并且毒性极小。新型生物制剂靶点的特异性和选择性使其毒性低于口服维持药物，因此有可能取代那些最常与长期毒性相关的药物，如皮质类固醇和钙调神经磷酸酶抑制剂。
