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顺铂诱导的肾功能障碍及改善治疗策略的展望

Cisplatin-induced Kidney Dysfunction and Perspectives on Improving Treatment Strategies.

作者信息

Oh Gi-Su, Kim Hyung-Jin, Shen AiHua, Lee Su Bin, Khadka Dipendra, Pandit Arpana, So Hong-Seob

机构信息

Center for Metabolic Function Regulation, Department of Microbiology, Wonkwang University School of Medicine, Iksan, Jeonbuk, Korea.

出版信息

Electrolyte Blood Press. 2014 Dec;12(2):55-65. doi: 10.5049/EBP.2014.12.2.55. Epub 2014 Dec 31.

Abstract

Cisplatin is one of the most widely used and highly effective drug for the treatment of various solid tumors; however, it has dose-dependent side effects on the kidney, cochlear, and nerves. Nephrotoxicity is the most well-known and clinically important toxicity. Numerous studies have demonstrated that several mechanisms, including oxidative stress, DNA damage, and inflammatory responses, are closely associated with cisplatin-induced nephrotoxicity. Even though the establishment of cisplatin-induced nephrotoxicity can be alleviated by diuretics and pre-hydration of patients, the prevalence of cisplatin nephrotoxicity is still high, occurring in approximately one-third of patients who have undergone cisplatin therapy. Therefore it is imperative to develop treatments that will ameliorate cisplatin-nephrotoxicity. In this review, we discuss the mechanisms of cisplatin-induced renal toxicity and the new strategies for protecting the kidneys from the toxic effects without lowering the tumoricidal activity.

摘要

顺铂是治疗各种实体瘤最广泛使用且高效的药物之一;然而,它对肾脏、耳蜗和神经具有剂量依赖性副作用。肾毒性是最广为人知且临床上重要的毒性。众多研究表明,包括氧化应激、DNA损伤和炎症反应在内的多种机制与顺铂诱导的肾毒性密切相关。尽管通过利尿剂和患者预先水化可减轻顺铂诱导的肾毒性的发生,但顺铂肾毒性的发生率仍然很高,约三分之一接受顺铂治疗的患者会出现该情况。因此,开发能改善顺铂肾毒性的治疗方法势在必行。在本综述中,我们讨论了顺铂诱导的肾毒性机制以及在不降低肿瘤杀伤活性的情况下保护肾脏免受毒性作用的新策略。

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