斑蝥致肝、肾毒性研究进展

芫菁科昆虫斑蝥(Mylabris)是我国经典大毒抗肿瘤中药之一,斑蝥素(cantharidin,CTD)是其主要活性成分。因其具有独特的升白提高免疫的优势,斑蝥素类上市中药大品种已成为目前临床联合化疗的主流用药。然而,民间常因为误食、多食频发斑蝥中毒事件,临床应用也常出现不良反应,尤其是肝、肾毒性。其靶器官损伤机制尚不十分清楚,极大地制约了其临床应用,因此亟须厘清斑蝥病理损伤及毒理机制。本文对近年来斑蝥致肝、肾毒性研究进行综述,探析其共性毒性规律、毒理机制及减毒保护策略,以期为斑蝥的减毒策略及新药研发提供参考。

Research Advances of Mylabris-induced Hepatorenal Toxicity in Recent Years

Mylabris, a classical anti-tumor traditional Chinese medicine, belongs to insect of the Coriolus family. Cantharidin (CTD) is the main active ingredient of Mylabris, with the unique advantages of promoting apoptosis of tumor cells and enhancing immune function by elevating the number of leukocytes. It has been used as a classical drug with combination of chemotherapy. However, there are frequent cases of Mylabris poisoning due to accidental ingestion, polyphagia and clinical application. Its severe toxic effects cannot be ignored, especially in nephrotoxicity and hepatoxicity. The mechanism of Mylabris poisoning have not been clarified yet. Therefore, there is an urgent need to clarify the toxic pathological damage, toxic mechanism, and protective strategy of CTD and its analogs, providing a basic reference for the strategy of toxicity reduction and drug development of Mylabris.