Progress in the Mechanism of Pancreatitis Associated with Clozapine

doi:10.12114/j.issn.1007-9572.2019.00.101

Abstract

Abstract: Pharmaceutical therapy is still the primary treatment for schizophrenia.For refractory schizophrenia，which affects about 30% of the patients with schizophrenia，clozapine is a first choice.However，although the efficacy of clozapine is definite，the complex and intractable adverse reactions associated with its use have been troubled psychiatrists，such as granulocytopenia，aspiration pneumonia，intestinal obstruction，pancreatitis，and myocarditis.For clozapine-induced pancreatitis，the development process involves direct toxic effects of clozapine on the pancreas and pancreatic hypersensitivity to clozapine.Moreover，the complex inflammatory responses to clozapine，and a large number of inflammatory mediators and complex cellular pathways are also involved.We reviewed the studies about drug-induced pancreatitis in animal models，basic research，and human case reports，and based on this，summarized recent advances in clozapine-induced pancreatitis，providing ideas and directions for subsequent studies.

Key words: Pancreatitis, Schizophrenia, Clozapine, Drug toxicity, Molecular mechanisms of pharmacological action, Review

摘要： 目前精神分裂症（SZ）的治疗仍以药物治疗为主，其中约30%的患者属于难治性SZ。现有药物中氯氮平仍然是难治性SZ的首选。作为首选药物，氯氮平疗效确切的同时，复杂而棘手的药物不良反应也同样困扰着精神科医生，包括：粒细胞减少、吸入性肺炎、肠梗阻、胰腺炎、心肌炎等。氯氮平导致胰腺炎的机制涉及氯氮平对胰腺的直接毒性作用及胰腺对氯氮平的过敏反应，同时复杂的炎性反应和大量的炎性递质以及复杂的细胞通路也参与其中，本综述搜集了有关药物导致胰腺炎的文献，包括动物模型、基础研究、人体试验、个案报道等，总结目前关于氯氮平导致胰腺炎的最新研究进展，从而为后续的研究提供思路和方向。

关键词: 胰腺炎, 精神分裂症, 氯氮平, 药物毒性, 药理作用分子作用机制, 综述

LI Wenzheng,XIA Lei,HAO Rui, et al. Progress in the Mechanism of Pancreatitis Associated with Clozapine　[J]. Chinese General Practice, 2019, 22(26): 3246-3250. DOI: 10.12114/j.issn.1007-9572.2019.00.101.
李文正,夏磊,郝蕊等. 氯氮平导致胰腺炎作用机制的研究进展[J]. 中国全科医学, 2019, 22(26): 3246-3250. DOI: 10.12114/j.issn.1007-9572.2019.00.101.

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