Pharmacological management of polycystic kidney disease

被引:26
作者
Wuethrich, Rudolf P. [1 ]
Mei, Changlin [2 ]
机构
[1] Univ Zurich Hosp, Div Nephrol, CH-8091 Zurich, Switzerland
[2] Second Mil Med Univ, Kidney Inst, Shanghai Changzheng Hosp, Dept Nephrol, Shanghai, Peoples R China
基金
瑞士国家科学基金会; 中国国家自然科学基金;
关键词
bosutinib; everolimus; lanreotide; mammalian target of rapamycin; octreotide; polycystic kidney disease; sirolimus; somatostatin; tolvaptan; triptolide; ANGIOTENSIN-ALDOSTERONE SYSTEM; LEFT-VENTRICULAR HYPERTROPHY; TYROSINE KINASE INHIBITOR; LONG-ACTING SOMATOSTATIN; V2 RECEPTOR ANTAGONIST; AUTOSOMAL-DOMINANT; CLINICAL-TRIAL; LIVER-DISEASE; CYST GROWTH; SYMPATHETIC ACTIVITY;
D O I
10.1517/14656566.2014.903923
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: Autosomal-dominant polycystic kidney disease (ADPKD) represents a therapeutic challenge as effective treatment to retard the growth of cysts in the kidneys and the liver has not been available despite decades of intense basic and clinical research. Areas covered: Several clinical trials have been performed in recent years to study the effect of diverse drugs on the growth of renal and hepatic cysts, and on functional deterioration of the glomerular filtration rate. The drug classes that have been tested in randomized clinical trials include the mammalian target of rapamycin (mTOR) inhibitors, sirolimus and everolimus, the somatostatin analogues (octreotide, lanreotide, pasireotide), and most recently, the vasopressin V-2 receptor antagonist, tolvaptan. The results with the mTOR inhibitors were disappointing, but more encouraging with the somatostatin analogues and with tolvaptan. Additional drugs are being tested, which include among others, the SRC-ABL tyrosine kinase inhibitor, bosutinib, and the traditional Chinese herbal medication, triptolide. Additional therapeutic strategies to retard cyst growth aim at blood pressure control via inhibition of the renin-angiotensin system and the sympathetic nervous system. Expert opinion: Given the accumulated knowledge, it is currently uncertain whether drugs will become available in the near future to significantly change the course of the relentlessly progressing polycystic kidney disease.
引用
收藏
页码:1085 / 1095
页数:11
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