摘要
甲氨蝶呤(MTX)在临床应用已近70余年。实践证明MTX在一些血液肿瘤和自身免疫性疾病中疗效可靠,但毒副作用较强,需要个体化用药。一些影响MTX代谢、转运和作用靶标基因的多态性,如亚甲基四氢叶酸还原酶(MTHFR)C677T和A1298C基因、γ-谷氨酰水解酶(GGH)C401T和C16T、溶质载体家族19-A1(SLC19A1)G80A等基因的多态性不仅与MTX疗效相关,也与其毒副作用密切相关。但不同研究间结果的差异较大,目前尚无法利用这些基因多态性分析准确指导MTX的个体化治疗。血药浓度的监测仍是MTX监测的主要方法。
Methotrexate (MTX) has been used clinically for nearly 70 years. It has been proved in practice that MTX is effective in some hematologic neoplasms and autoimmune diseases, but it has strong toxic side effects and needs individualized medication. Polymorphisms of some genes affecting MTX metabolism, transport and target of action, such as methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, gamma-glutamyl hydrolase (GGH) C401T and C16T, solute carrier family 19-A1 (SLC19A1) G80A, are closely related not only to efficacy, but also to toxic side effects of MTX therapy. However, the results of different studies are quite different. At present, it is not possible to use these genetic polymorphisms to guide clinical individualized treatment accurately. Blood concentration monitoring is still the main method of MTX monitoring.
作者
张相林
Zhang Xianglin(Department of Pharmacy,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《药物不良反应杂志》
CSCD
2019年第3期162-165,共4页
Adverse Drug Reactions Journal
关键词
甲氨蝶呤
药物监测
基因多态性
药物毒性
Methotrexate
Drug monitoring
Polymorphism, genetic
Drug toxicity
