对乙酰氨基酚肝毒性生物标志物的研究进展

Biomarkers of hepatotoxicity induced by acetaminophen:research advances

对乙酰氨基酚(APAP)是目前临床应用最广泛的OTC类解热镇痛药,肝毒性是其主要不良反应之一。近年来对APAP肝毒性生物标志物的研究成为了热点,使用miRNA芯片、蛋白质组学、代谢组学等技术发现的新型生物标志物如循环miRNA和血清酶等,在临床和动物研究中都得到了广泛的关注,与经典生物标志物谷丙转氨酶和谷草转氨酶联合评价有利于提高预测和诊断药物性肝损伤的敏感性和特异性。本文结合APAP肝毒性机制的研究,对近年来发现的APAP肝毒性的生物标志物进行了分类描述,为临床应用APAP时出现肝毒性的早发现早治疗提供依据;同时供其他具有潜在肝毒性类药物的研究提供借鉴。

Acetaminophen（ APAP） is one of the widely-used OTC antipyretic analgesics in clinical activities,and hepatotoxicity is the main adverse reaction during use. In recent years,research on biomarkers of APAP induced hepatotoxicity has become a hot spot. New biomarkers,such as circle miRNAs and serum enzyme discovered via such technologies as miRNA chips,proteomics and metabonomics,have received widespread attention in clinical and animal studies. Combined with classical biomarkers,namely glutamic-pyruvic transaminase and glutamic-oxal acetic transaminase, the new biomarkers can help promote the sensitivity and specificity of prediction and diagnosis of drug-induced liver injuries. In this paper,based on the study of APAP induced hepatotoxicity mechanisms,the biomarkers found in recent years are described after classification in order to provide references for early detection of hepatotoxicity caused by APAP and other drugs.