急性胰腺炎药物治疗的趋势和最新进展。

IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Juliana Hey-Hadavi, Prasad Velisetty, Swapnali Mhatre
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引用次数: 3

摘要

急性胰腺炎(AP)是一种复杂的胰腺炎症性疾病,与发病率和死亡率增加有关。目前,没有特定的治疗方法被批准用于治疗,管理主要是基于支持性护理。尽管对AP发病机制的了解有所加强,但由于缺乏靶向药物治疗,患者仍然面临重大风险。因此,迫切需要有效的药物治疗措施,抑制早期全身性炎症,从而防止随后的器官衰竭。这篇叙述性的综述总结了现有的治疗方案,并强调了潜在的药物类别和药物治疗,包括那些正在临床开发。虽然已经研究了针对AP发病机制不同方面的几种治疗方法,但一些具有临床前活性的治疗方法在临床试验中无效。其他新型药物类别或分子,包括达比加群(抗凝血剂)、乌司他丁(蛋白酶抑制剂)、英夫利昔单抗(单克隆抗体)、spautin-A41(自噬抑制剂)和cm4620 -注射乳剂(钙通道抑制剂),有待进一步的临床评估。使用干细胞和纳米颗粒的替代治疗方案也在探索中,可能为AP治疗带来希望。然而,探索靶向治疗方法的挑战包括疾病复杂性、治疗干预的时机和建立适当的临床终点。了解特定生物标志物的作用可能有助于确定药物发现的适当靶点,并有助于确定相关的临床研究终点,以监测疾病的严重程度和进展,从而帮助设计更精确的治疗方法,改善临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trends and recent developments in pharmacotherapy of acute pancreatitis.

Acute pancreatitis (AP), a complex inflammatory disease of the pancreas, is associated with increased morbidity and mortality. Currently, no specific therapies are approved for its treatment, and management is primarily based on supportive care. Despite enhanced understanding of AP pathogenesis, patients remain at significant risk owing to a lack of targeted drug treatments. Therefore, there is an urgent need for effective pharmacological therapeutic measures which may inhibit the early systemic inflammation, thereby preventing subsequent organ failure. This narrative review summarizes the available treatment options for AP and highlights the potential drug classes and pharmacologic therapies including those under clinical development. Although, several therapies targeting different aspects of AP pathogenesis have been investigated, some therapies with promising preclinical activity have been rendered ineffective in clinical trials. Other novel drug classes or molecules including dabigatran (anticoagulant), ulinastatin (protease inhibitor), infliximab (monoclonal antibody), spautin-A41 (autophagy inhibitor), and CM4620-Injectible Emulsion (calcium channel inhibitor) await further clinical assessment. Alternative treatment options using stem cells and nanoparticles are also being explored and may hold promise for AP therapy. However, challenges for exploring targeted treatment approaches include disease complexity, timing of therapeutic intervention, and establishing appropriate clinical endpoints. Understanding the role of specific biomarkers may help in identifying appropriate targets for drug discovery and facilitate determining relevant clinical study endpoints to monitor disease severity and progression, thereby aiding in design of more precise therapies with improved clinical outcomes.

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来源期刊
Postgraduate Medicine
Postgraduate Medicine 医学-医学:内科
CiteScore
6.10
自引率
2.40%
发文量
110
审稿时长
6-12 weeks
期刊介绍: Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916,  Postgraduate Medicine  was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.
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