[关键词]
[摘要]
Teprotumumab-trbw是一种作用于胰岛素样生长因子-Ⅰ受体的单克隆抗体,于2020年被批准用于治疗甲状腺相关眼病,然国内对其了解较少。通过综述其分子结构、药代动力学、治疗机制、临床研究及安全性,希望能为临床使用提供指导。Teprotumumab-trbw可通过阻断促甲状腺激素受体/胰岛素样生长因子-Ⅰ受体串扰信号,抑制免疫炎症反应而减少透明质酸和炎症因子的产生,并能促进眶后成纤维细胞/脂肪细胞凋亡和抑制甲状腺激素的合成有关基因表达而明显改善突眼、复视等临床症状。Teprotumumab-trbw常见的不良反应是肌肉痉挛、高血糖、听力损伤等。Teprotumumab-trbw治疗甲状腺相关眼病疗效显著且耐久,二次治疗的患者也能从中受益,为甲状腺相关眼病的治疗提供了新的途径和希望。
[Key word]
[Abstract]
Teprotumumab-trbw,a monoclonal antibody that acts on the insulin growth factor-Ⅰ receptor, was approved in 2020 for the treatment of thyroid-associated ophthalmopathy, but little is known about it in China. It is hoped to provide guidance for clinical use through the review of its molecular structure, pharmacokinetics, therapeutic mechanism, clinical research and safety. It inhibits immune inflammation by blocking thyroid-stimulating hormone receptor /insulin growth factor-Ⅰ receptor crosstalk signaling, so as to reduce the production of hyaluronic acid and inflammatory factors in response. It can also promote the apoptosis of retro-orbital fibroblasts/adipocytes and inhibit the expression of genes related to the synthesis of thyroid hormones, thereby significantly improving the clinical symptoms such as exophthalmos and diplopia. The common adverse reactions of Teprotumumab-trbw are muscle spasm, hyperglycemia, hearing loss and so on. Teprotumumab-trbw is effective and durable in the treatment of thyroid-associated ophthalmopathy, and patients with secondary treatment can also benefit from it, which provides a new way and hope for the treatment of thyroid-associated ophthalmopathy.
[中图分类号]
[基金项目]
河南省中医药传承与创新人才工程(仲景工程)中医药拔尖人才(No.CZ0237-02); 河南省中医药科学研究专项课题(No.20-21ZY1016)