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[抗血管生成药物的肾毒性]

[Nephrotoxicity of anti-angiogenesis drugs].

作者信息

Grechukhina K S, Chebotareva N V, Krasnova T N

机构信息

Lomonosov Moscow State University.

Loginov Moscow Clinical Scientific Center.

出版信息

Ter Arkh. 2020 Jul 9;92(6):93-98. doi: 10.26442/00403660.2020.06.000672.

Abstract

Neoangiogenesis is a basic factor for most physiological as well as pathological processes i.e. tumor metastases. The most important is vascular endothelium growth factor (VEGF) and its receptors (VEGFR1/2) in angiogenesis processes. Nowadays antiangiogenic agents (which inhibit VEGF like bevacizumab neither VEGFR2 like ramucirumab) are widely used in very different chemotherapeutic regimens in clinical oncology. The signalling pathway VEGF-VEGFR plays a crucial role in supporting of adequate kidney function. Appearance of antiangiogenic drugs led to adverse nephrotoxic effects: arterial hypertension, proteinuria, rarely nephrotic syndrome, and kidney dysfunction. Various hystological variants of nephropathy are described, however, in most cases, signs of thrombotic microangiopathy of the renal vessels are noted. This literature review discusses mechanisms, clinical and morphological aspects of nephropathy associated with antiangiogenic drugs.

摘要

新生血管形成是大多数生理以及病理过程(如肿瘤转移)的一个基本因素。血管生成过程中最重要的是血管内皮生长因子(VEGF)及其受体(VEGFR1/2)。如今,抗血管生成药物(如抑制VEGF的贝伐单抗和抑制VEGFR2的雷莫西尤单抗)在临床肿瘤学的不同化疗方案中被广泛使用。VEGF-VEGFR信号通路在维持正常肾功能方面起着关键作用。抗血管生成药物的出现导致了不良肾毒性作用:动脉高血压、蛋白尿,很少出现肾病综合征和肾功能障碍。虽然描述了肾病的各种组织学变体,但在大多数情况下,会观察到肾血管血栓性微血管病的迹象。这篇文献综述讨论了与抗血管生成药物相关的肾病的机制、临床和形态学方面。

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