肝移植患者的祸福参半之物——雷帕霉素。
A mixed blessing for liver transplantation patients - Rapamycin.
作者信息
Fan Guang-Han, Zhang Chen-Zhi, Gao Feng-Qiang, Wei Xu-Yong, Ling Sun-Bin, Wang Kai, Wang Jian-Guo, Zheng Shu-Sen, Nikfarjam Mehrdad, Xu Xiao
机构信息
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China; Zhejiang University School of Medicine, Hangzhou 310058, China; Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, China; Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer, Guangzhou 510060, China.
出版信息
Hepatobiliary Pancreat Dis Int. 2023 Feb;22(1):14-21. doi: 10.1016/j.hbpd.2022.10.004. Epub 2022 Oct 20.
BACKGROUND
Liver transplantation (LT) is an effective treatment option for end-stage liver disease. Mammalian target of rapamycin (mTOR) inhibitors, such as rapamycin, are widely used post LT.
DATA SOURCES
In this review, we focused on the anti-cancer activities and metabolic side effects of rapamycin after LT. The literature available on PubMed for the period of January 1999-September 2022 was reviewed. The key words were rapamycin, sirolimus, liver transplantation, hepatocellular carcinoma, diabetes, and lipid metabolism disorder.
RESULTS
Rapamycin has shown excellent effects and is safer than other immunosuppressive regimens. It has exhibited excellent anti-cancer activity and has the potential in preventing hepatocellular carcinoma (HCC) recurrence post LT. Rapamycin is closely related to two long-term complications after LT, diabetes and lipid metabolism disorders.
CONCLUSIONS
Rapamycin prevents HCC recurrence post LT in some patients, but it also induces metabolic disorders. Reasonable use of rapamycin benefits the liver recipients.
背景
肝移植（LT）是终末期肝病的一种有效治疗选择。雷帕霉素等哺乳动物雷帕霉素靶蛋白（mTOR）抑制剂在肝移植后被广泛使用。
数据来源
在本综述中，我们重点关注了雷帕霉素在肝移植后的抗癌活性和代谢副作用。对1999年1月至2022年9月期间PubMed上的可用文献进行了综述。关键词为雷帕霉素、西罗莫司、肝移植、肝细胞癌、糖尿病和脂质代谢紊乱。
结果
雷帕霉素已显示出良好的效果，且比其他免疫抑制方案更安全。它具有出色的抗癌活性，在预防肝移植后肝细胞癌（HCC）复发方面具有潜力。雷帕霉素与肝移植后的两种长期并发症密切相关，即糖尿病和脂质代谢紊乱。
结论
雷帕霉素可预防部分患者肝移植后HCC复发，但也会诱发代谢紊乱。合理使用雷帕霉素对肝移植受者有益。
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