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中国临床药理学与治疗学 ›› 2024, Vol. 29 ›› Issue (9): 1057-1061.doi: 10.12092/j.issn.1009-2501.2024.09.012

• 综述与讲座 • 上一篇    下一篇

偏向性μ-阿片受体激动剂奥赛利定的临床应用进展

朱昌茂1,谢力2,吴仔峰1,王森1,张琪1,徐祥清3,杨春1   

  1. 1南京医科大学第一附属医院麻醉与围术期医学科,南京  210029,江苏;2南京医科大学第四附属医院麻醉科,南京  211800,江苏;3江苏恩华药业股份有限公司药物研究院&江苏省中枢神经药物研究重点实验室,徐州  221116,江苏

  • 收稿日期:2023-11-13 修回日期:2024-01-03 出版日期:2024-09-26 发布日期:2024-08-21
  • 通讯作者: 杨春,男,教授/副主任医师,博士生导师,研究方向:麻醉药物的中枢神经机制。 E-mail: chunyang@njmu.edu.cn 徐祥清,男,博士,高级工程师,研究方向:麻醉药物开发。 E-mail: xuxiangqing@nhwa-group.com
  • 作者简介:朱昌茂,男,博士,主治医师,研究方向:疼痛发病及治疗机制。 E-mail: dr.analgesia@qq.com 谢力,女,硕士,主任医师,研究方向:疼痛诊疗与神经阻滞。 E-mail: 25120062@qq.com
  • 基金资助:
    国家自然科学基金(82301444,82271254,81974171,81703482);江苏省双创团队领军人才项目(JSSCTD202144);江苏省特聘医学专家(苏卫人[2020]64号);吴阶平医学基金会(320.6750.2024-05-51)

Progress in the clinical application of the biased μ-opioid agonist oliceridine

ZHU Changmao1, XIE Li2, WU Zifeng1, WANG Sen1, ZHANG Qi1, XU Xiangqing3, YANG Chun1   

  1. 1 Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China; 2 Department of Anesthesiology, the Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 211800, Jiangsu, China; 3 Jiangsu Nhwa Pharmaceutical Co., Ltd. Drug Research Institute & Jiangsu Provincial Key Laboratory of Central Nervous Drug Research, Xuzhou 221116, Jiangsu, China
  • Received:2023-11-13 Revised:2024-01-03 Online:2024-09-26 Published:2024-08-21

摘要:

阿片类药物受体μOR、δOR、κOR和NOPR均是G蛋白偶联受体(G protein-coupled receptors,GPCRs),主要通过G蛋白和β抑制蛋白发挥作用。新近研究发现G蛋白介导镇痛作用,而β抑制蛋白则降低镇痛效果并与阿片类药物的副作用发生有关。奥赛利定是第一个批准上市的偏向性μOR激动剂,主要通过激活G蛋白发挥镇痛作用,其起效迅速且镇痛效果确切;因对β抑制蛋白活性较低,其副反应发生率较阿片类经典药物吗啡低。奥赛利定代谢产物无活性,可安全用于肝肾功能不全患者。本文总结了奥赛利定的药理学研究与临床应用现状,以期为奥赛利定的临床实践提供参考。

关键词: 奥赛利定(TRV-130), 药理机制, 临床应用, 不良反应

Abstract:

Opioid receptors μOR, δOR, κOR and NOPR are all G protein-coupled receptors (GPCRs), which mainly function through G protein and β-arrestin. Recent studies have found that G protein mediates analgesia, while β-arrestin reduces analgesia and is related to the side effects of opioids. Oliceridine is the first biased μOR agonist approved for commerce. It mainly exerts analgesic effect by activating G protein. It has rapid onset of action and reliable analgesic effect. Due to its low activity on β-arrestin, the incidence of side effects is low, comparing to the classic opioid morphine. Oliceridine can be safely used in patients with liver or kidney insufficiency and its metabolite is inactive. This article summarizes the current progress of pharmacological research and clinical application of oliceridine, aiming to provide reference for the clinical practice of oliceridine.

Key words: oliceridine (TRV-130), pharmacological mechanism, clinical application, adverse reactions

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