Gharbi Chems, Gueutin Victor, Izzedine Hassan
Department of Nephrology , Pitié Salpetriere Hospital , Paris , France.
Clin Kidney J. 2014 Apr;7(2):115-20. doi: 10.1093/ckj/sfu001. Epub 2014 Feb 24.
Mammalian target of rapamycin inhibitor (mTOR-I)/proliferation signal inhibitors (PSI) including sirolimus and everolimus represent a new class of drugs increasingly used in solid-organ transplantation as alternatives to calcineurin inhibitors for patients with renal dysfunction, transplant coronary arterial vasculopathy or malignancy. The most frequently occurring mTOR-I/PSI-related adverse events are similar to those associated with other immunosuppressive therapies, but some side effects are more characteristic of proliferation signal inhibitors (e.g. lymphocele, arthralgia, oedema and hyperlipidaemia). The present paper review incidence, clinical presentation and mechanism of oedema within the clinical experience of mTOR-I/PSI in solid organ transplantation.
哺乳动物雷帕霉素靶蛋白抑制剂(mTOR-I)/增殖信号抑制剂(PSI),包括西罗莫司和依维莫司,代表了一类新型药物,越来越多地用于实体器官移植,作为肾功能不全、移植冠状动脉血管病变或恶性肿瘤患者钙调神经磷酸酶抑制剂的替代品。最常发生的mTOR-I/PSI相关不良事件与其他免疫抑制疗法相关的不良事件相似,但有些副作用更具增殖信号抑制剂的特征(如淋巴囊肿、关节痛、水肿和高脂血症)。本文在实体器官移植中mTOR-I/PSI的临床经验范围内综述水肿的发生率、临床表现及机制。