霉酚酸酯对肾病综合征大鼠肾组织白细胞介素8的影响

目的 探讨白细胞介素8(IL-8)在肾病综合征大鼠蛋白尿形成中的作用及霉酚酸酯(MMF)对其的影响。方法 应用阿霉素肾病模型，用MMF对肾病形成过程进行干预。采用放射免疫法测定血清及肾组织IL-8含量。结果MMF可减轻肾病蛋白尿，降低肾组织IL-8含量。结论 MMF降低肾组织IL-8含量，可能是其对肾病综合征大鼠保护作用的机制之一。     

麦考酚酸联合迪银片治疗寻常型银屑病的近期临床疗效观察

目的研究麦考酚酸(MMF)联合迪银片治疗寻常型银屑病的使用方法、近期临床疗效及其副作用。方法46例患者随机分为治疗组和对照组。治疗组23例,MMF1.5 g/d分3次口服,1月后,减为1.0 g 2次/d,共4周,同时服用迪银片5片,3次/d共8周;对照组32例,服用迪银片和火把花根各5片,均3次/d,共8周。结果治疗组基本痊愈14例,显效5例,进步2例,无效2例,有效率91.30%;对照组基本痊愈16例,显效8例,进步2例,无效6例,有效率81.25%。两组疗效差异无显著性(P>0.05)。结论MMF联合迪银片治疗寻常型银屑病疗效与迪银片联合火把花根片相当,有较好的疗效。但因其价格昂贵,可作为二线银屑病治疗药物。     

麦考酚酸酯及其临床应用进展

目的:麦考酚酸酯(MMF)是一种新型的免疫抑制剂.在临床应用中,MMF的使用也越来越广泛,已不仅仅局限于器官移植,还涉及到系统性红斑狼疮(SLE)、自体免疫风湿性疾病的治疗,以及在糖尿病,肺部血管高压的辅助治疗等诸多方面.肠包衣麦考酚酸钠,是一种新的可抵抗胃溶作用的麦考酚酸肠包衣剂型,药物在肠内释放,可以降低胃肠道(GI)不良反应的发生.     

Renoprotective effects of combination of angiotensin converting enzyme inhibitor with mycophenolate mofetil in diabetic rats

Objective and design Previously it was shown that blocking of the renin-angiotensin system (RAS) by angiotensin converting enzyme (ACE) inhibitors, or suppression of inflammatory responses by immunosuppressive drugs such as mycophenolate mofetil (MMF) could attenuate renal injury in diabetic rats. Whether RAS blockade combined with an immunosuppressive drug provides superior renoprotection against diabetic nephropathy has not been clearly delineated. Materials Diabetes was induced by injection of streptozotocin after uninephrectomy. Treatment Rats were randomly separated into five groups: control, diabetes, diabetes treated with enalapril (an ACE inhibitor, 10 mg/kg/d by gastric gavage), diabetes treated with MMF (10 mg/kg/d by gastric gavage), or diabetes treated with a combination of both agents and were followed for 8 weeks. Methods 24 h urinary albumin excretion rate (AER) was determined, renal injury was evaluated, immunohistochemistry for ED-1 macrophage marker, intercellular adhesion molecule-1 (ICAM-1) and monocyte chemoattractant protein-1 (MCP-1) were performed, and expression of transforming growth factor (TGF)-β1 protein was determined by Western blotting analysis. Results Diabetes was associated with a considerable increase in AER. Both enalapril and MMF retarded the increase in albuminuria, which was nearly completely abrogated by combination therapy. Increased glomerular volume and tubulointerstitial injury index in diabetic rats was attenuated by treatment with either enalapril or MMF and further reduced by the combination of the two. Elevated malondialdehyde levels in renal tissue were reduced by enalapril or MMF and, more effectively, by combined enalapril with MMF. Renal overexpression of ICAM-1 was not retarded by enalapril and attenuated by MMF or combined enalapril with MMF. Combination therapy was associated with a superior suppression of diabetes-induced macrophage recruitment and overexpression of MCP-1 and TGFβ1 compared to either monotherapy in renal tissue. Conclusion The combination of enalapril and MMF confers superiority over monotherapy in renoprotection, a mechanism which may be at least partly correlated with synergistic suppression of increased macrophage recruitment and overexpression of MCP-1 and TGF-β1 in renal tissue in diabetic rats. Received 26 July 2005; returned for revision 5 October 2005; returned for final revision 9 January 2006; accepted by M. Katori 23 January 2006     

新型免疫抑制剂霉酚酸酯治疗狼疮性肾炎

目的观察新型免疫抑制剂霉酚酸酯(M.MF)治疗狼疮性肾炎的临床疗效和安全性。方法经肾活检证实的20例狼疮性肾炎,给予糖皮质激素联合MMF治疗。MMF初始剂量1.0～1.5g/d,治疗时间321个月,平均(10.9±6.2)个月。结果MMF治疗后24h尿蛋白定量从治疗前的平均5.55g下降至1.54g;d清白蛋白治疗前平均26.87g升至39g;6/8例肾功能不全患者3个月内Scr恢复正常;d清自身抗体产生明显减少,补体上升,其中ANA转阴率3个月达63％,6个月达81％;抗ds-DNA由治疗前23.77IU／ml下降至9.19IU／ml;2例重复活检,肾小球活动性病变明显减轻。MMF治疗的不良反应较少,偶有白细胞减少、感染、带状疱疹等。结论MMF对于各型狼疮性肾炎,尤其是Ⅳ型重症狼疮,经传统治疗无效者均有较好疗效,且长期应用不良反应少。     

他克莫司、霉酚酸酯和甲基强的松龙联合治疗慢性移植物抗宿主病

目的 探讨他克莫司（FK506）、霉酚酸酯（MMF）和甲基强的松龙（MP）联合免疫抑制剂治疗慢性移植物抗宿主病（cGVHD)的疗效。方法 对4例异基因造血干细胞移植后发生广泛性cGVHD的儿童患者,应用FK506,MMF和MP联合治疗,观察其毒副作用和疗效。结果 4例患者使用该联合免疫抑制方案治疗2－4d后症状明显改善,1－2周后症状消失,有效率达100％。除3例出现轻度肾功能损害外,未发现严重副作用。结论 FK506,MMF和MP联合治疗cGVHD为一种行之有效的方法。     

他克莫司联合糖皮质激素治疗儿童IgA肾病的疗效观察

目的 观察他克莫司（TAC）和霉酚酸酯（MMF）分别联合糖皮质激素（GC）治疗儿童原发性IgA肾病（IgAN）的疗效及安全性。方法 回顾性分析2012年1月至2017年12月经肾脏病理证实为原发性IgAN患儿,根据治疗方案不同分为TAC组和MMF组。收集两组患儿治疗前及治疗1、3、6个月时的临床资料,比较研究期间IgAN的缓解情况和不良反应。结果 共纳入43例符合研究标准的患儿,TAC组15例,MMF组28例。治疗1月时两组患儿缓解情况差异无统计学意义（P > 0.05）;治疗3月及6月时TAC组缓解情况优于MMF组（P < 0.05）。治疗1月时TAC组血清白蛋白高于MMF组（P < 0.05）。两组在治疗后各时点的血清白蛋白均高于基线值,差异有统计学意义（P < 0.0083）;两组治疗3月及6月时肾小球滤过率（GFR）均高于基线值,差异有统计学意义（P < 0.0083）。研究期间两组患儿不良反应总发生率差异无统计学意义（P > 0.05）,但TAC组有1例发生真菌感染。结论 TAC联合GC治疗儿童原发性IgAN有良好的减低尿蛋白的作用,近期疗效优于MMF,且安全性良好。     

麦考酚酯联合糖皮质激素治疗肾小球肾炎临床疗效观察

目的：探讨麦考酚酯联合糖皮质激素治疗肾小球肾炎的临床疗效。方法：选取2009年8月-2010年8月间于我院治疗的肾小球肾炎患者70例，随机平均分为实验组（35例）与对照组（35例）。对照组予以常规加单独激素治疗；实验组在对照组治疗基础上以麦考酚酯联合糖皮质激素联合用药代替单纯激素治疗。一年后对治疗前后的相关临床指标进行比较。结果：两组治疗前后对比，治疗效果实验组明显优于对照组，两组问比较差异具有统计学意义（P〈0．05）。结论：麦考酚酯联合糖皮质激素治疗肾小球肾炎效果安全有效。     

Renal injury induced in alloxan diabetic rats. Role of Mycophenolate Mofetil as therapeutic agent

BackgroundRenal injury may develop in uncontrolled chronic hyperglycemia due to increased oxidative stress and release of pro-inflammatory mediators, leading to diabetic complications.MethodsMycophenolate Mofetil (MMF) is an immunosuppressant drug, an inhibitor of inosine monophosphate dehydrogenase (IMPDH), relevant to inflammation processes. MMF effect was tested in alloxan-diabetic rats on selected parameters like oxidative stress, gene expression of tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1), in relation to microalbuminuria and renal function.ResultsWe found that the onset of microalbuminuria preceded the increase in serum glucose after alloxan treatment. Gene expression of TNF-α and TGF-β1 showed gradual increase after one and two weeks of alloxan administration as compared to the normal group. MMF administration decreased the gene expression of TNF-α and TGF-β1 in kidney tissues, serum glucose, fructosamine, urea, creatinine, C-reactive protein, malondialdehyde, urinary microalbumin and total protein. Histological examination of kidney tissues showed significant improvement in MMF treated rats as compared to diabetic control.ConclusionsMMF modulated renal injury of alloxan diabetic rats. Collective data may support its therapeutic effect but further clinical trials may be requested.