Erasmus MC Sophia Children's Hospital, Pediatric Surgery & Intensive Care, GJ Rotterdam, The Netherlands.
Expert Opin Drug Metab Toxicol. 2011 Aug;7(8):935-48. doi: 10.1517/17425255.2011.577739. Epub 2011 May 8.
There are profound changes that take place in drug metabolism enzymes during fetal and postnatal development. These changes may significantly impact drug therapy in children.
A combination of focused and comprehensive literature searches using PubMed and reference lists (from inception to 7 November 2009) is undertaken to identify reports on in vitro and in vivo development of drug metabolism enzymes as well disposition of selected drugs and their effect in children. The article provides an update on development of drug metabolism enzymes and their impact on drug substrate disposition and disease, which may aid to improve clinical practice and optimally design clinical trials in children.
Drug metabolism enzyme activity changes profoundly throughout the continuum of postnatal development and often results in different disposition pathways than in adults. Genetics and co-morbidity interact significantly with these developmental changes. Translation of existing knowledge into age-adjusted dosing guidelines and clinical trial design is highly needed for there to be an improvement in drug therapy in children.
在胎儿和出生后的发育过程中，药物代谢酶会发生深刻的变化。这些变化可能会对儿童的药物治疗产生重大影响。
使用 PubMed 和参考文献（从创建到 2009 年 11 月 7 日）进行了重点和全面的文献检索，以确定有关药物代谢酶体外和体内发育以及选定药物的处置及其在儿童中的作用的报告。本文介绍了药物代谢酶的发展及其对药物底物处置和疾病的影响，这可能有助于改善临床实践并优化儿童临床试验的设计。
药物代谢酶的活性在整个出生后发育过程中发生深刻变化，通常导致与成人不同的处置途径。遗传和合并症与这些发育变化有很大的相互作用。为了改善儿童的药物治疗，迫切需要将现有知识转化为年龄调整的剂量指南和临床试验设计。
