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Mycophenolate mofetil, azathioprine and tacrolimus: mechanisms in rheumatology.
Nature Reviews Rheumatology ( IF 29.4 ) Pub Date : 2020-02-13 , DOI: 10.1038/s41584-020-0374-8
Jasper C A Broen 1 , Jacob M van Laar 2
Affiliation  

The introduction of biologic DMARDs into rheumatology has resulted in a substantial reduction of the burden of many rheumatic diseases. In the slipstream of the success achieved with these biologic DMARDs, some conventional immunosuppressive drugs have also found use in new indications. Notably, mycophenolate mofetil, azathioprine and tacrolimus have made their way from solid organ transplantation drugs to become useful assets in rheumatology practice. Mycophenolate mofetil and azathioprine inhibit the purine pathway and subsequently diminish cell proliferation. Both drugs have a pivotal role in the treatment of various rheumatic diseases, including lupus nephritis. Tacrolimus inhibits lymphocyte activation by inhibiting the calcineurin pathway. Mycophenolate mofetil and tacrolimus are, among other indications, increasingly being recognized as useful drugs in the treatment of interstitial lung disease in systemic rheumatic diseases and skin fibrosis in systemic sclerosis. A broad array of trials with mycophenolate mofetil, azathioprine and/or tacrolimus are ongoing within the field of rheumatology that might provide further novel avenues for the use of these drugs. In this Review, we discuss the historical perspective, pharmacodynamics, clinical indications and novel avenues for mycophenolate mofetil, azathioprine and tacrolimus in rheumatology.

中文翻译:

霉酚酸酯,硫唑嘌呤和他克莫司:风湿病学的机制。

将生物DMARDs引入风湿病学已大大降低了许多风湿病的负担。在这些生物DMARD取得成功的基础上,一些常规的免疫抑制药物也被用于新的适应症。值得注意的是,霉酚酸酯,硫唑嘌呤和他克莫司已从固体器官移植药物中脱颖而出,成为风湿病学实践中有用的资产。霉酚酸酯和硫唑嘌呤抑制嘌呤途径并随后减少细胞增殖。两种药物在各种风湿性疾病(包括狼疮肾炎)的治疗中都起着关键作用。他克莫司通过抑制钙调神经磷酸酶途径来抑制淋巴细胞活化。除其他适应症外,霉酚酸酯和他克莫司是 在系统性风湿病中的间质性肺病和系统性硬化症中的皮肤纤维化的治疗中,越来越多的人公认其是有用的药物。在风湿病学领域内,正在进行霉酚酸酯,硫唑嘌呤和/或他克莫司的广泛试验,这可能为使用这些药物提供新的途径。在这篇综述中,我们讨论了风湿病学上霉酚酸酯,硫唑嘌呤和他克莫司的历史观点,药效学,临床适应症和新途径。硫唑嘌呤和/或他克莫司正在风湿病学领域内发展,这可能为使用这些药物提供进一步的新颖途径。在这篇综述中,我们讨论了风湿病学上霉酚酸酯,硫唑嘌呤和他克莫司的历史观点,药效学,临床适应症和新途径。硫唑嘌呤和/或他克莫司正在风湿病学领域内发展,这可能为使用这些药物提供进一步的新颖途径。在这篇综述中,我们讨论了风湿病学上霉酚酸酯,硫唑嘌呤和他克莫司的历史观点,药效学,临床适应症和新途径。
更新日期:2020-02-13
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