中国药物警戒 ›› 2025, Vol. 22 ›› Issue (5): 523-527.
DOI: 10.19803/j.1672-8629.20250035

• 免疫细胞介导的药物性肝损伤研究专栏 • 上一篇    下一篇

自身免疫性疾病药物相关肝损伤研究进展

孙小蕊1, 赵宁1, 张陆勇1,2, 江振洲1, 王欣之1,*   

  1. 1中国药科大学多靶标天然药物全国重点实验室新药筛选与药效评价中心,江苏 南京 210009;
    2广东药科大学新药研发中心,广东 广州 510006
  • 收稿日期:2025-01-16 出版日期:2025-05-15 发布日期:2025-05-19
  • 通讯作者: *王欣之,女,副研究员·博导,分子药理学与毒理学。E-mail: wangxz@cpu.edu.cn
  • 作者简介:孙小蕊,女,硕士,分子药理学与毒理学。
  • 基金资助:
    国家自然科学基金资助项目（82073948、81703626、82274200）

Research Progress in Drug-Related Liver Injury in the Treatment of Autoimmune Diseases

SUN Xiaorui1, ZHAO Ning1, ZHANG Luyong1,2, JIANG Zhenzhou1, WANG Xinzhi1,*   

  1. 1New Drug Screening and Pharmacodynamics Evaluation Center, National Key Lab of Natural Medicines Multitargeting Research, China Pharmaceutical University, Nanjing Jiangsu 210009, China;
    2Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou Guangdong 510006, China
  • Received:2025-01-16 Online:2025-05-15 Published:2025-05-19

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摘要： 目的 探讨自身免疫性疾病治疗中药物诱导的肝损伤及其发病机制,为临床合理用药提供参考。方法 检索中国知网、万方数据、PubMed等数据库,从治疗自身免疫性疾病（Autoimmune Disense, AIDs）的传统药物、生物制剂和小分子抑制剂2个方面,总结甲泼尼龙、甲氨蝶呤、英夫利昔单抗、阿达木单抗等自身免疫性疾病治疗药物相关的药物性肝损伤机制。结果 不同类别的自身免疫性疾病治疗药物引起肝损伤的机制各有不同,但多表现为1种或多种肝细胞酶的升高,但仍有部分药物诱导药物性肝损伤的机制尚未明确。结论 自身免疫性疾病治疗药物相关的药物性肝损伤的发生与药物特性和患者个体差异密切相关。临床应加强随访,密切监测患者肝功能。

关键词: 自身免疫性疾病, 药物性肝损伤, 肝细胞酶, 甲氨蝶呤, 英夫利昔单抗, 阿达木单抗, 药品不良反应

Abstract: Objective To explore the pathogenesis of drug-induced liver injury in the treatment of autoimmune diseases, and to provide references for rational clinical use. Methods CNKI, Wanfang Data, PubMed and other databases were searched for literature on the mechanisms of drug-induced liver injury associated with drugs used in the treatment of autoimmune diseases, including methylprednisolone, methotrexate, infliximab, and adalimumab. The search focused on two categories: traditional drugs, as well as biologics and small molecule inhibitors. Results The mechanisms of liver injury caused by different classes of autoimmune disease drugs varied. However, most of these drugs led to an increase in one or more liver cell enzymes. For some drugs, the underlying mechanism of drug-induced liver injury remained unclear. Conclusion The incidence of drug-induced liver injury associated with drugs used to treat autoimmune diseases is closely linked to the characteristics of the drugs and the individual differences between patients. Clinical follow-up should be ensured, and liver function should be monitored.

Key words: Autoimmune Diseases, Drug-Induced Liver Injury, Liver Cell Enzymes, Methotrexate, Infliximab, Adalimumab, Adverse Drug Reaction

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