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首页> 外文期刊>Artificial Organs >Mycophenolates: The latest modern and potent immunosuppressive drugs in adult kidney transplantation: What we should know about them?
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Mycophenolates: The latest modern and potent immunosuppressive drugs in adult kidney transplantation: What we should know about them?

机译：霉酚酸盐：最新的现代和有效的免疫抑制药物在成人肾移植中：我们应该了解的是什么？

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Abstract Introduced in 1995, mycophenolate mofetil (MMF) would become the most powerful antiproliferative agent in the field of organ transplantation, thereby supplanting azathioprine, the first antiproliferative agent introduced in the early 1960s. Its association with tacrolimus greatly improved kidney transplant (KT) prognosis by significantly reducing the incidence of posttransplant acute rejection. MMF is also reputed to be a safe medication, but the frequency of the gastrointestinal complications associated with it, even minor ones, has induced the marketing of a second molecule called enteric‐coated mycophenolate sodium. This late form of mycophenolate was supposed to be better tolerated thanks to its pharmacokinetic properties but the studies did not show significant differences between the two molecules. Otherwise, the combination of MMF with tacrolimus has significantly increased the risk of infections, particularly viral, and of neoplasia. To reduce this risk and avoid any situation of under?or overexposure while remaining effective, only a strict and long‐term monitoring of MMF allows the maintenance of already established therapeutic targets within the predefined ranges. In KT, individualizing the prescription and targets of MMF according to immunologic risk, global immunosuppression, and posttransplant period, as for other immunosuppressants, is open to discussion and may be beneficial.
机译：摘要在1995年推出，霉酚酸酯Mofetil（MMF）将成为器官移植领域中最强大的抗增殖剂，从而在20世纪60年代初推出的第一抗增殖剂。通过显着降低后翻转急性排斥的发病率，它与他克莫司的关系大大改善了肾移植（KT）预后。 MMF也被誉为安全的药物，但与其相关的胃肠道并发症的频率甚至是次要的药物，已经诱导了称为肠溶蛋白霉酚钠钠的第二分子的营销。由于其药代动力学特性，这种霉酚酸的晚期形式应该更好地耐受，但研究在两个分子之间没有显示出显着差异。否则，MMF的组合具有Tacrolimus的影响显着增加了感染的风险，特别是病毒和瘤形成。为了减少这种风险并避免任何情况下的？或过度曝光的情况，同时剩下有效的，只有严格和长期的MMF监测允许在预定范围内维持已经建立的治疗目标。在KT中，根据免疫系统，全球免疫抑制和后翻转期，适用于其他免疫抑制剂的单一性能和靶标，对于其他免疫抑制剂，是开放的讨论，可能是有益的。

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