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双硫仑在肝脏疾病中的应用:一把双刃剑。

Disulfiram in liver diseases: a double-edged sword.

作者信息

Xiong Wanyuan, Tian Aiping, Qian Zibing, Li Junfeng, Mao Xiaorong

机构信息

The First Clinical Medical College, Lanzhou University, Lanzhou, China.

Department of Infectious Disease, The First Hospital of Lanzhou University, No.1 Donggang West Road, Chengguan District, Lanzhou City, 730000, Gansu Province, China.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4875-4889. doi: 10.1007/s00210-024-03710-7. Epub 2024 Dec 16.

Abstract

Disulfiram, a synthetic drug, has historically played a significant role in the treatment of alcoholic liver disease as the first medication approved by the U.S. Food and Drug Administration for alcohol use disorders. Beyond its efficacy in inhibiting alcohol addiction and treating alcoholic liver disease, disulfiram has also demonstrated potential in managing various liver conditions, including certain metabolic liver injuries and liver cancer. As an established, cost-effective drug with well-documented synthesis methods, disulfiram holds promise for broader application in liver disease treatment. However, its clinical use is hindered by the risk of inducing pharmacologic liver injury. This potential for liver toxicity necessitates careful patient selection, monitoring, and consultation with healthcare providers, which can limit its practicality in treating patients with existing liver conditions. This review aims to analyze the multifaceted role of disulfiram in liver diseases comprehensively. By exploring its therapeutic efficacy, potential benefits, and inherent limitations, we seek to provide a balanced perspective that maximizes disulfiram's therapeutic potential while ensuring the safety and well-being of patients. This thorough examination will also highlight areas for future research, paving the way for optimized treatment protocols that incorporate disulfiram in the context of liver disease management.

摘要

双硫仑是一种合成药物,作为美国食品药品监督管理局批准用于酒精使用障碍的第一种药物,在酒精性肝病的治疗中一直发挥着重要作用。除了在抑制酒精成瘾和治疗酒精性肝病方面的疗效外,双硫仑在管理各种肝脏疾病方面也显示出潜力,包括某些代谢性肝损伤和肝癌。作为一种成熟、具有成本效益且合成方法有充分记录的药物,双硫仑在肝病治疗中具有更广泛应用的前景。然而,其临床应用受到诱导药物性肝损伤风险的阻碍。这种肝毒性潜力需要仔细选择患者、进行监测并与医疗服务提供者进行咨询,这可能会限制其在治疗现有肝病患者中的实用性。本综述旨在全面分析双硫仑在肝病中的多方面作用。通过探索其治疗效果、潜在益处和固有局限性,我们力求提供一个平衡的观点,在确保患者安全和福祉的同时,最大限度地发挥双硫仑的治疗潜力。这种全面的审查还将突出未来研究的领域,为在肝病管理中纳入双硫仑的优化治疗方案铺平道路。

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