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尿毒症毒素与白蛋白、膜转运体的相互作用及药物相互作用。

The Interplay between Uremic Toxins and Albumin, Membrane Transporters and Drug Interaction.

机构信息

Experimental Nephrology Laboratory, Basic Pathology Department, Universidade Federal do Paraná, Curitiba 81531-980, Brazil.

Laboratory of Cardiovascular Immunology, Center of Natural and Human Sciences (CCNH), Federal University of ABC, Santo André 09210-580, Brazil.

出版信息

Toxins (Basel). 2022 Feb 26;14(3):177. doi: 10.3390/toxins14030177.

Abstract

Uremic toxins are a heterogeneous group of molecules that accumulate in the body due to the progression of chronic kidney disease (CKD). These toxins are associated with kidney dysfunction and the development of comorbidities in patients with CKD, being only partially eliminated by dialysis therapies. Importantly, drugs used in clinical treatments may affect the levels of uremic toxins, their tissue disposition, and even their elimination through the interaction of both with proteins such as albumin and cell membrane transporters. In this context, protein-bound uremic toxins (PBUTs) are highlighted for their high affinity for albumin, the most abundant serum protein with multiple binding sites and an ability to interact with drugs. Membrane transporters mediate the cellular influx and efflux of various uremic toxins, which may also compete with drugs as substrates, and both may alter transporter activity or expression. Therefore, this review explores the interaction mechanisms between uremic toxins and albumin, as well as membrane transporters, considering their potential relationship with drugs used in clinical practice.

摘要

尿毒症毒素是一组异质分子,由于慢性肾脏病(CKD)的进展,这些毒素在体内积累。这些毒素与肾功能障碍和 CKD 患者的合并症的发展有关,仅部分通过透析治疗清除。重要的是,临床治疗中使用的药物可能会影响尿毒症毒素的水平、其组织分布,甚至通过与白蛋白和细胞膜转运蛋白等蛋白质的相互作用来影响其消除。在这种情况下,由于与白蛋白的高亲和力,蛋白结合尿毒症毒素(PBUT)受到关注,白蛋白是最丰富的血清蛋白,具有多个结合位点,并具有与药物相互作用的能力。膜转运蛋白介导各种尿毒症毒素的细胞内摄入和流出,这些毒素也可能作为底物与药物竞争,两者都可能改变转运蛋白的活性或表达。因此,本综述探讨了尿毒症毒素与白蛋白以及膜转运蛋白之间的相互作用机制,同时考虑了它们与临床实践中使用的药物的潜在关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/8949274/eb50b98fd2d1/toxins-14-00177-g001.jpg

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