慢性肾功能衰竭对P-糖蛋白及其介导的药物转运的影响

Influences of chronic renal failure on P-glycoprotein and P-glycoprotein mediated drug transportation

综述慢性肾功能衰竭(chronic renal failure,CRF)对P-糖蛋白(P-glycoproteins,P-gp)及其介导的药物转运的影响。通过查阅资料,选取有代表性的文献,分别从动物水平、细胞水平、临床研究三个方面进行综述。CRF会使药物的肾脏和非肾脏清除发生改变,但不同组织细胞中P-gp的表达与活性改变是不同的,总体而言,CRF会抑制肠道、肾脏和血脑屏障中P-gp的外排作用而促进肝脏中P-gp的药物外排作用。了解CRF对P-gp的影响,充分认识CRF对药物体内过程的影响,将有助于提高CRF患者用药的安全性。

To review the effects of chronic renal failure （CRF） on P-glycoprotein （P-gp） and P-gp mediated drug transporta- tion. Relevant studies were reviewed from animal levels, molecular levels and clinical researches by researching data and selecting representative literatures. CRF could modify renal and non-renal clearance of drugs. However, different tissues and cells had different changes in expression and activity of P-gp. In summary, CRF can inhibit excretion of P-gp in intestine, kidney and blood-brain barrier, but promote excretion of P-gp in liver. It is helpful to improve medication safety in CRF patients by learning the effects of CRF on P-gp, and sufficiently know about the influences of CRP on internal process of drugs in human body.