当前位置: 首页 > 药学版 > 药品研究 > 药物评价
编号:176470
Hiv蛋白酶抑制剂研究进展
http://www.100md.com 2002年5月25日 新药网

     罗华军,蔡水洪

    (华东理工大学化工学院,上海,200237)

    【摘要】 HIV蛋白酶抑制剂是一类具有高度选择性的高效抗艾滋病药物。研究表明,HIV蛋白酶的作用是将gag和gag-pol基因表达产生的多聚蛋白裂解,变成各种有活性的病毒结构和酶,抑制该酶的活性会产生无感染能力的未成熟的子代病毒,从而阻止病毒进一步感染。本文介绍了已上市或正在临床研究的沙奎那韦、利托那韦、茚地那韦、奈非那韦、Am-prenavir、Lopinavir、BMS-232632等HIV蛋白酶抑制剂的作用机制、药理、疗效、不良反应、剂量及用法。

    【关键词】 HIV蛋白酶抑制剂;沙奎那韦;利托那韦;茚地那韦;奈非那韦;Amprenavir;Lopinavir

    Progress of HIV protease inhibitors

    LUO Hua-jun,CAI Shui-hong

    (Department of Chemical Engineering,East China University of Science and Technology,Shanghai 200237)

    【Abstract】 HIV protease inhibitors are potent and highly selective anti-AIDS agents.The HIV protease enzyme is responsible for processing of the gag and gag-pol gene polyprotein products into functional viral enzymes and proteins.Inhibition of the protease leads to the formation of immature,noninfectious virions and results in repression of viral replication.In this paper,the mechanism of action,pharmacokinetic properties,therapeutic efficacy,side effects,dosage and administration of HIV protease inhibitors,including saquinavir,ritonavir,indinavir,nelfinavir,amprenavir,lopinavir,BMS-232632 etc. were reviewed.

    【Key words】 HIV protease inhibitors;saquinavir;ritonavir;indinavir;nelfinavir;amprenavir;lopinavir

    【作者简介】

    罗华军(1974-),男,湖北三峡大学讲师,现为华东理工大学硕士研究生,主要从事手性药物的研究与开发,联系电话:(021)64252345,E-mail:luohuajun@21cn.com。

    【参考文献】

    [1] 张素敏,朱珠,李大魁.干扰素在治疗爱滋病相关综合征中的应用[J].中国新药杂志,1998,7(4):284-287.

    [2] 艾滋病在地球[N].南方周末,2000-11-30(4).

    [3] 曾毅,陈启民,耿运琪.人免疫缺陷病毒(HIV)[A].见:曾毅主编.艾滋病毒及其相关病毒[M].天津:南开大学出版社,1999.14-15.

    [4] 宋力崴,李伟章.HIV蛋白酶抑制剂与药物相互作用[J].国外医学药学分册,1999,26(6):337-341.

    [5] Noble S,Faulds D.Saquinavir:A review of its pharmacology and clinical potential in the management of HIV infection[J].Drugs,1996,52(1):93-112.

    [6] Drugs Future,1997,22(3):315-316.

    [7] Figgitt DP,Plosker GL.Saquinavir soft-gel capsule:A updated review of its use in the management of HIV infection[J].Drugs,2000,60(2):481-516.

    [8] Graul A,Castaner J.Ritonavir[J].Drugs Future,1996,21(7):700-705.

    [9] Drugs Future,1999,24(7):821.

    [10] Mealy N,Castaner J.Indinavir sulfate[J].Drugs Future,1996,21(6):600-609.

    [11] Polsker GL,Noble S.Indinavir:A review of its use in the management of HIV infection[J].Drugs,1999,58(6):1165-1203.

    [12] Kaldor SW,Kalish VJ,Davies JF,et al.Viracept(Nelfinavir mesylate,AG1343):A potent orally bioavailable inhibitor of HIV-1 protease[J].J Med Chem,1997,40(24):3979-3981.

    [13] Pai VB,Nahata MC.Nelfinavir mesylate:A protease inhibitor[J].Ann Pharmacother,1999,33(3):325-329.

    [14] Drugs Future,1999,24(4):460.

    [15] Anne BE,Polsker GL.Nelfinavir:A update on its use in HIV infection[J].Drugs,2000,59(3):581-620.

    [16] Painter GR,Ching S,Reynolds D,et al.141W94[J].Drugs Future,1996,21(4):347-350.

    [17] Drugs Future,1998,23(4):438.

    [18] Drugs Future,1999,24(4):442-444.

    [19] Hurst M,Faulds D.Lopinavir[J].Drugs,2000,60(6):1371-1379.

    [20] Rabasseda X,Silvestre J,Castaner J.BMS-232632[J].Drugs Future,1999,24(4):375-380.

    [21] Wroblewski T,Graul A,Castaner J.PNU-140690[J].Drugs Future,1998,23(2):146-151.

    [22] Drugs Future,2001,26(2):206-207.

    [23] Ireland CD,Castaner J.KNI-272[J].Drugs Future,1996,21(10):1022-1027.

    [24] Drugs Future,1999,24(10):1138-1139.
    濠电姷鏁搁崕鎴犲緤閽樺娲偐鐠囪尙顦┑鐘绘涧濞层倝顢氶柆宥嗙厱婵炴垵宕弸銈嗐亜閳哄啫鍘撮柡灞剧☉閳藉宕¢悙宸骄闂佸搫顦弲婊兾涢崘顔艰摕婵炴垶菤閺嬪酣鐓崶銊﹀皑闁稿鎸荤粋鎺斺偓锝庝簽閸旓箑顪冮妶鍡楀潑闁稿鎹囬弻娑㈡偐瀹曞洢鈧帗淇婇崣澶婂闁宠鍨垮畷鍫曞煘閻愵剛浜欓梺璇查缁犲秹宕曢崡鐐嶆稑鈽夐姀鐘靛姦濡炪倖甯掗ˇ顖炴倶閿旂瓔娈介柣鎰▕閸庢梹顨ラ悙鍙夊枠妞ゃ垺妫冨畷銊╊敇閻愰潧鎼稿┑鐘垫暩閸嬬娀骞撻鍡楃筏闁诡垼鐏愬ú顏勭闁绘ê鍚€缁楀姊洪幐搴g畵闁瑰嘲顑夊畷鐢稿醇濠㈩亝妫冮弫鍌滅驳鐎n亜濡奸梻浣告憸閸嬬偤骞愰幎钘夎摕闁哄洢鍨归獮銏ゆ煛閸モ晛孝濠碘€茬矙閺岋綁濮€閳轰胶浠╃紓鍌氱Т閿曨亪鐛繝鍥ㄦ櫢闁绘ǹ灏欓悿鈧俊鐐€栭幐楣冨磻閻斿摜顩烽柟鎵閳锋垿鏌涢敂璇插笌闁荤喐鍣村ú顏勎ч柛銉厛濞肩喖姊洪崘鍙夋儓闁瑰啿姘︾换姘舵⒒娴e懙褰掑嫉椤掑倻鐭欓柟鐑橆殕閸婂灚銇勯弬鍨挃缁炬儳銈搁弻锟犲礃閵娿儮鍋撶粙鎸庢瘎婵犵數濮幏鍐礋閸偆鏉归柣搴㈩問閸犳牠鎮ラ悡搴f殾婵せ鍋撳┑鈩冪摃椤︽娊鏌涢幘鏉戠仸缂佺粯绋撻埀顒佺⊕宀e潡鎯屾繝鍋芥棃鎮╅崣澶嬪枑闂佽桨绶¢崳锝夈€侀弴銏℃櫆闁芥ê顦介埀顒佺☉閳规垿鏁嶉崟顐$捕婵犫拃鍛珪缂侇喗鐟︾换婵嬪炊閵娧冨箰濠电姰鍨煎▔娑㈡晝閵堝姹查柡鍥╁枑閸欏繘鏌i悢鐓庝喊婵☆垪鍋撻梻浣芥〃缁€浣虹矓閹绢喗鍋╂繝闈涱儏缁€鍐┿亜椤撶喎鐏i柟瀵稿厴濮婄粯鎷呯粵瀣異闂佸摜濮甸幑鍥х暦濠靛﹦鐤€婵炴垼椴搁弲锝囩磽閸屾瑧鍔嶅畝锝呮健閸┿垽寮崼鐔哄幗闂佺懓顕崕鎴炵瑹濞戙垺鐓曢柡鍌氱仢閺嗭綁鏌″畝瀣瘈鐎规洘甯掗~婵嬵敇閻橀潧骞€缂傚倸鍊烽悞锕傘€冮崨姝ゅ洭鏌嗗鍛姦濡炪倖甯掗崰姘缚閹邦喚纾兼い鏃囧亹缁犲鏌ㄥ┑鍫濅槐闁轰礁鍟村畷鎺戭潩閸楃偞鎲㈤梻浣藉吹婵炩偓缂傚倹鑹鹃埢宥夋晲閸モ晝鐓嬮梺鍓茬厛閸犳捇鍩€椤掍礁绗掓い顐g箞椤㈡﹢鎮╅锝庢綌闂傚倷绶氬ḿ褍煤閵堝悿娲Ω閳轰胶鍔﹀銈嗗笒閸嬪棝寮ㄩ悧鍫㈢濠㈣泛顑囧ú瀵糕偓瑙勬磸閸ㄨ姤淇婇崼鏇炵倞闁靛ǹ鍎烘导鏇㈡煟閻斿摜鐭屽褎顨堥弫顔嘉旈崪鍐◤婵犮垼鍩栭崝鏍磻閿濆鐓曢柕澶樺灠椤╊剙鈽夐幘鐟扮毢缂佽鲸甯楀ḿ蹇涘Ω瑜忛悾濂告⒑瑜版帩妫戝┑鐐╁亾闂佽鍠楃划鎾诲箰婵犲啫绶炲璺虹灱濮婄偓绻濋悽闈涗粶妞ゆ洦鍘介幈銊︺偅閸愩劍妲梺鍝勭▉閸樺ジ宕归崒鐐寸厪濠电偟鍋撳▍鍡涙煕鐎c劌濡奸棁澶愭煥濠靛棙鍣归柡鍡欏枑娣囧﹪顢涘鍗炩叺濠殿喖锕ュ浠嬨€侀弴銏℃櫜闁糕剝鐟﹂濠氭⒒娴h櫣甯涢柟纰卞亞閹广垹鈹戠€n剙绁﹂柣搴秵閸犳牜绮婚敐鍡欑瘈濠电姴鍊搁顐︽煙閺嬵偄濮傛慨濠冩そ楠炴劖鎯旈敐鍌涱潔闂備礁鎼悧婊堝礈閻旈鏆﹂柣鐔稿閸亪鏌涢弴銊ュ季婵炴潙瀚—鍐Χ閸℃鐟愰梺缁樺釜缁犳挸顕i幎绛嬫晜闁割偆鍠撻崢閬嶆⒑閻熺増鎯堢紒澶嬫綑閻g敻宕卞☉娆戝帗閻熸粍绮撳畷婊冾潩椤掑鍍甸梺闈浥堥弲婊堝磻閸岀偞鐓ラ柣鏂挎惈瀛濋柣鐔哥懕缁犳捇鐛弽顓炵妞ゆ挾鍋熸禒顖滅磽娴f彃浜炬繝銏f硾閳洝銇愰幒鎴狀槯闂佺ǹ绻楅崑鎰枔閵堝鈷戠紓浣贯缚缁犳牠鏌i埡濠傜仩闁伙絿鍏橀弫鎾绘偐閼碱剦妲伴梻浣藉亹閳峰牓宕滃棰濇晩闁硅揪闄勯埛鎴︽偣閸ワ絺鍋撻搹顐や簴闂備礁鎲¢弻銊︻殽閹间礁鐓濋柟鎹愵嚙缁狅綁鏌i幇顓熺稇妞ゅ孩鎸搁埞鎴︽偐鐠囇冧紣闂佸摜鍣ラ崹鍫曠嵁閸℃稑纾兼慨锝庡幖缂嶅﹪骞冮埡鍛闁圭儤绻傛俊閿嬬節閻㈤潧袥闁稿鎹囬弻鐔封枔閸喗鐏撶紒楣冪畺缁犳牠寮婚悢琛″亾閻㈢櫥鐟版毄闁荤喐绮庢晶妤呮偂閿熺姴钃熸繛鎴欏灩缁犳娊鏌¢崒姘辨皑闁哄鎳庨埞鎴︽倷閸欏娅i梻浣稿簻缁茬偓绌辨繝鍥х妞ゆ棁濮ゅ▍銏ゆ⒑鐠恒劌娅愰柟鍑ゆ嫹

   闂備浇顕уù鐑藉极婵犳艾纾诲┑鐘叉搐缁愭鏌¢崶鈺佹灁闁崇懓绉撮埞鎴︽偐閸欏鎮欏┑鈽嗗亝閿曘垽寮诲☉銏犖ㄩ柕蹇婂墲閻濇牠鎮峰⿰鍐ㄧ盎闁瑰嚖鎷�  闂傚倸鍊烽懗鑸电仚缂備胶绮〃鍛村煝瀹ュ鍗抽柕蹇曞У閻庮剟姊虹紒妯哄闁稿簺鍊濆畷鏇炵暆閸曨剛鍘介梺閫涘嵆濞佳勬櫠椤斿浜滈幖鎼灡鐎氾拷  闂傚倷娴囧畷鍨叏閺夋嚚娲Χ閸ワ絽浜炬慨妯煎帶閻忥附銇勯姀锛勬噰妤犵偛顑夐弫鍐焵椤掑倻鐭嗛柛鏇ㄥ灡閻撶喐淇婇婵愬殭缂佽尪宕电槐鎾愁吋韫囨柨顏�  闂傚倸鍊烽懗鍫曞箠閹捐瑙﹂悗锝庡墮閸ㄦ繈骞栧ǎ顒€濡肩痪鎯с偢閺屾洘绻涢悙顒佺彅闂佸憡顨嗘繛濠囧蓟閳╁啫绶為悗锝庝簽閸旂ǹ鈹戦埥鍡楃伈闁瑰嚖鎷�