Royer B, Arock M
Laboratoire de pharmacologie fondamentale, Faculté mixte de médecine et de pharmacie, Besançon.
Ann Biol Clin (Paris). 1998 Mar-Apr;56(2):143-52.
Modern molecular haematology is characterized by the great strides made in the use of cytokines, especially haematopoietic growth factors. These factors constitute a heterogeneous group of molecules that ensure the survival, proliferation and differentiation of the haematopoietic cells. Present detailed knowledge of the structure of the main haematopoietic growth factors and their receptors, and of the cloning and sequencing of their genes, permits the use of genetic engineering to produce recombinant human growth factors whose therapeutic applications have raised very great hopes for clinical haematology. Data obtained from several clinical studies have allowed the use of some of these molecules in France. This is the case concerning erythropoietin (Eprex, Recormon), G-CSF (Neupogen, Granocyte) and GM-CSF (Leucomax), each with specific uses. Others haematopoietic growth factors, such as stem cell factor (SCF) are presently evaluated for their clinical interest. Finally, interleukin 3 (IL3), whose in vitro activities seemed to be of potential interest, has been evaluated during clinical studies. Its toxicity and lack of specificity have been evidenced and do not allow its present utilization. The first part of this review is focused on the general structure and biological activity of haematopoietic growth factors and presents the actual therapeutic field of the use of erythropoietin and the promising application of recombinant thrombopoietin.
现代分子血液学的特点是在细胞因子尤其是造血生长因子的应用方面取得了巨大进展。这些因子构成了一组异质性分子，可确保造血细胞的存活、增殖和分化。目前对主要造血生长因子及其受体的结构、以及它们基因的克隆和测序有详细了解，这使得利用基因工程生产重组人生长因子成为可能，其治疗应用给临床血液学带来了极大希望。从多项临床研究中获得的数据已使法国能够使用其中一些分子。促红细胞生成素（利血宝、促红素）、粒细胞集落刺激因子（惠尔血、格拉诺赛特）和粒细胞巨噬细胞集落刺激因子（生白能）就是这种情况，每种都有特定用途。其他造血生长因子，如干细胞因子（SCF）目前也在评估其临床价值。最后，白细胞介素3（IL3），其体外活性似乎具有潜在价值，已在临床研究中进行了评估。已证实其毒性和缺乏特异性，目前不允许使用。本综述的第一部分重点关注造血生长因子的一般结构和生物学活性，并介绍促红细胞生成素的实际治疗领域以及重组血小板生成素的应用前景。
