摘要
药物不良反应(ADR)是全世界发病率和死亡率的重要原因。他汀类药物是一类药物,其主要不良反应是药物性肝损伤(DILI)和肌病。由于它们的药代动力学和药效学特性,其中一些可能是可预测的,而不幸的是,其他一些是特殊的。在他汀类药物的情况下,遗传因素也可能影响患者对DILI和肌病的易感性。本综述将首先讨论他汀类药物在心血管疾病治疗和预防中的作用以及潜在的作用机制。此外,为了探讨他汀类药物引起的不良事件(如肌病和肝毒性)的易感性,它将重点关注最近的全基因组关联研究(GWAS),涉及转运基因,细胞色素P450(CYP),有机阴离子转运多肽( OATP)和ABCB1和ABCC1,似乎在临床相关不良事件的发展中发挥作用。最后,我们评估了在代谢综合征和HCV感染患者中使用他汀类药物的证据,包括他们在心血管事件中的安全性和有效性。
关键词: 他汀类药物,肝损伤,遗传易感性,单核苷酸多态性(SNPs),MetS,HCV。
Current Medicinal Chemistry
Title:Liver and Statins: A Critical Appraisal of the Evidence
Volume: 25 Issue: 42
关键词: 他汀类药物,肝损伤,遗传易感性,单核苷酸多态性(SNPs),MetS,HCV。
摘要: Adverse drug reactions (ADRs) represent an important cause of morbidity and mortality worldwide. Statins are a class of drugs whose main adverse effects are drug-induced liver injury (DILI) and myopathy. Some of these may be predictable, due to their pharmacokinetic and pharmacodynamic properties, while others, unfortunately, are idiosyncratic. Genetic factors may also influence patient susceptibility to DILI and myopathy in the case of statins. This review will first discuss the role of statins in cardiovascular disease treatment and prevention and the underlying mechanisms of action. Furthermore, to explore the susceptibility of statin-induced adverse events such as myopathy and hepatotoxicity, it will then focus on the recent Genome-Wide Association Studies (GWAS) concerning the transporter genes, Cytochrome P450 (CYP), organic anion-transporting polypeptide (OATP) and ABCB1 and ABCC1, which seem to play a role in the development of clinically relevant adverse events. Finally, we appraise the evidence for and against the use of statins in metabolic syndrome and in HCV-infected patients, in terms of their safety and efficacy in cardiovascular events.
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Cite this article as:
Liver and Statins: A Critical Appraisal of the Evidence, Current Medicinal Chemistry 2018; 25 (42) . https://dx.doi.org/10.2174/0929867325666180327095441
DOI https://dx.doi.org/10.2174/0929867325666180327095441 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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