摘要
血小板生成素(TPO)是人体内促进血小板生成最重要的细胞因子。TPO通过结合细胞表面的TPO受体(TPO-R),发挥促进血小板生成作用。TPO-R激动剂(TPO-RA)通过结合并激活TPO-R,有效地刺激血小板生成。目前,进入临床应用的TPO-RA包括重组人TPO(rhTPO)、肽类TPO-RA、非肽类TPO-RA,主要用于治疗复发/难治性免疫性血小板减少症(ITP)。此外,TPO-RA还可用于治疗其他原因导致的血小板减少症,包括难治性重型再生障碍性贫血(r-SAA)、造血干细胞移植(HSCT)、骨髓增生异常综合征(MDS)/急性髓细胞白血病(AML)、淋巴细胞增殖性疾病(LPD)、实体肿瘤化疗,以及肝病患者围手术期的血小板减少症。笔者拟就TPO的生物合成及其作用机制,TPO-RA的分类、作用机制、临床应用及其疗效、安全性进行介绍。
Thrombopoietin(TPO)is the most important cytokine to promote platelet production in human body.TPO acts to promote platelet production by binding to the TPO receptor(TPO-R)on the cell surface.TPO receptor agonists(TPO-RA)mimic the structure of TPO to bind and activate TPO-R,and effectively stimulate platelet production.Currently,TPO-RA entering clinical applications include recombinant human TPO(rhTPO),peptide TPO-RA,and non-peptide TPO-RA.TPO-RA are mainly applied for the treatment of relapsed/refractory immune thrombocytopenia(ITP).In addition,TPO-RA can be used to treat thrombocytopenia caused by other causes,including refractory severe aplastic anemia(r-SAA),hematopoietic stem cell transplantation(HSCT),myelodysplastic syndrome(MDS)/acute myeloid leukemia(AML),lymphoproliferative disorder(LPD),chemotherapy of solid tumor,and to treat thrombocytopenia induced by liver disease in perioperative period.This article summaries the biosynthesis and mechanisms of TPO,classifications of TPO-RA,TPO-RA mechanisms of action,clinical application,efficacy and safety.
作者
王少怡
余自强
Wang Shaoyi;Yu Ziqiang(Department of Hematology,First Affiliated Hospital of Soochow University/Jiangsu Institute of Hematology/Key Laboratory of Thrombosis and Hemostasis of Ministry of Health/Collaborative Innovation Center of Hematology,Soochow University,Suzhou 215006,Jiangsu Province,China)
出处
《国际输血及血液学杂志》
CAS
2020年第2期122-128,共7页
International Journal of Blood Transfusion and Hematology
基金
江苏省科教强卫工程-临床医学中心资助项目(YXZXA2016002)。
