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非甾体抗炎药(NSAIDs)与器官损伤:当前观点。

Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective.

机构信息

Department of Zoology, Cooch Behar Panchanan Barma University, Cooch Behar, West Bengal 736101 India.

Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4 Raja S.C. Mullick Road, Kolkata 700032, West Bengal, India.

出版信息

Biochem Pharmacol. 2020 Oct;180:114147. doi: 10.1016/j.bcp.2020.114147. Epub 2020 Jul 10.


DOI:10.1016/j.bcp.2020.114147
PMID:32653589
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7347500/
Abstract

Owing to the efficacy in reducing pain and inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) are amongst the most popularly used medicines confirming their position in the WHO's Model List of Essential Medicines. With escalating musculoskeletal complications, as evident from 2016 Global Burden of Disease data, NSAID usage is evidently unavoidable. Apart from analgesic, anti-inflammatory and antipyretic efficacies, NSAIDs are further documented to offer protection against diverse critical disorders including cancer and heart attacks. However, data from multiple placebo-controlled trials and meta-analyses studies alarmingly signify the adverse effects of NSAIDs in gastrointestinal, cardiovascular, hepatic, renal, cerebral and pulmonary complications. Although extensive research has elucidated the mechanisms underlying the clinical hazards of NSAIDs, no review has extensively collated the outcomes on various multiorgan toxicities of these drugs together. In this regard, the present review provides a comprehensive insight of the existing knowledge and recent developments on NSAID-induced organ damage. It precisely encompasses the current understanding of structure, classification and mode of action of NSAIDs while reiterating on the emerging instances of NSAID drug repurposing along with pharmacophore modification aimed at safer usage of NSAIDs where toxic effects are tamed without compromising the clinical benefits. The review does not intend to vilify these 'wonder drugs'; rather provides a careful understanding of their side-effects which would be beneficial in evaluating the risk-benefit threshold while rationally using NSAIDs at safer dose and duration.

摘要

由于具有减轻疼痛和炎症的功效,非甾体抗炎药(NSAIDs)是最常用的药物之一,这也证实了它们在世界卫生组织(WHO)基本药物示范清单中的地位。从 2016 年全球疾病负担数据可以明显看出,肌肉骨骼并发症不断增加,因此 NSAID 的使用显然是不可避免的。除了镇痛、抗炎和退热作用外,NSAIDs 还被进一步证明可以预防多种严重疾病,包括癌症和心脏病发作。然而,多项安慰剂对照试验和荟萃分析研究的数据令人震惊地表明,NSAIDs 会引起胃肠道、心血管、肝脏、肾脏、大脑和肺部等并发症。尽管大量研究已经阐明了 NSAIDs 临床危害的机制,但没有一篇综述将这些药物的各种多器官毒性的结果综合在一起。在这方面,本综述提供了对 NSAID 诱导的器官损伤的现有知识和最新进展的全面了解。它准确地涵盖了 NSAIDs 的结构、分类和作用模式的当前理解,同时重申了 NSAID 药物再利用和药效团修饰的新实例,旨在更安全地使用 NSAIDs,在不影响临床益处的情况下控制毒性作用。本综述并不是要诋毁这些“神奇药物”;而是要对它们的副作用有一个谨慎的理解,这将有助于在合理使用 NSAIDs 时评估风险-效益阈值,以更安全的剂量和持续时间使用 NSAIDs。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/092ef10e90ed/gr6_lrg.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/b7016fc1713b/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/1b0fd4b4746d/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/edbf38e5ba42/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/7b334e4b2be0/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/092ef10e90ed/gr6_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/a4a13a943dfb/ga1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/621e7d67520c/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/b7016fc1713b/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/1b0fd4b4746d/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/edbf38e5ba42/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/7b334e4b2be0/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/7347500/092ef10e90ed/gr6_lrg.jpg

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本文引用的文献

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