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21.
Cyclosporin nephrotoxicity in heart and lung transplant patients 总被引:1,自引:0,他引:1
Griffiths MH; Crowe AV; Papadaki L; Banner NR; Yacoub MH; Thompson FD; Neild GH 《QJM : monthly journal of the Association of Physicians》1996,89(10):751-763
Twenty-two patients with heart, lung or heart and lung transplants
maintained on cyclosporin for periods ranging from 3 months to 10 years
developed renal insufficiency which was investigated by renal biopsy. The
histopathological changes were: (i) severe vascular and glomerular damage
due to thrombotic microangiopathy (TM); (ii) a form of focal segmental
glomerulosclerosis (FSGS); (iii) glomerular ischaemia. Rather than being
separate entities, these changes appeared to represent a spectrum of
pathology, some biopsies showing all three forms of glomerular injury. In
all cases the glomerular changes were accompanied by arteriolar and
arterial pathology, and we identified novel ultrastructural changes in the
arteriolar endothelial basal lamina. Tubular atrophy was a consistent
feature, the severity of which reflected the severity of the glomerular
sclerosis, and which appeared to be a consequence of glomerular loss. Our
findings are consistent with the nephrotoxic effects of cyclosporin being
mediated chiefly via damage to preglomerular vessels and glomerular
capillary endothelium. From an analysis of the clinical aspects of these
cases, the effects of cyclosporin appear to be to some extent
idiosyncratic, and therefore not entirely preventable, but strict
monitoring of blood cyclosporin levels is essential to minimize the risk of
permanent renal damage. Monitoring urinary protein in addition to plasma
creatinine may detect the onset of FSGS, as proteinuria precedes creatinine
elevation.
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AM Holmes JA Rudd FD Tattersall Q Aziz PLR Andrews 《British journal of pharmacology》2009,157(6):865-880
Nausea and vomiting are among the most common symptoms encountered in medicine as either symptoms of disease or side effects of treatments. Developing novel anti-emetics and identifying emetic liability in novel chemical entities rely on models that can recreate the complexity of these multi-system reflexes. Animal models (especially the ferret and dog) are the current gold standard; however, the selection of appropriate models is still a matter of debate, especially when studying the subjective human sensation of nausea. Furthermore, these studies are associated with animal suffering. Here, following a recent workshop held to review the utility of animal models in nausea and vomiting research, we discuss the limitations of some of the current models in the context of basic research, anti-emetic development and emetic liability detection. We provide suggestions for how these limitations may be overcome using non-animal alternatives, including greater use of human volunteers, in silico and in vitro techniques and lower organisms. 相似文献
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以1,4-环己二酮为原料经与哌啶缩合、还原、乙酸汞环合、碱催化分子内缩合等11步反应完成了一叶萩碱的全合成。合成品的熔点及光谱数据与天然一叶萩碱的熔点及光谱数据一致。 相似文献
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