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糖尿病是一组以慢性血葡萄糖(简称血糖)水平增高为特征的代谢性疾病,是由于胰岛素分泌和(或)作用缺陷引起。P-糖蛋白(P-glycoprotein,P-gp)作为血脑屏障(blood brain barrier,BBB)上的药物的外排泵,可以调节许多药物的吸收、分布和排泄过程。糖尿病所引起的体内环境的变化,会导致BBB中的P-gp功能和表达发生改变,从而影响中枢神经系统药物的药理毒理效应,甚至导致并发神经系统疾病。因此弄清糖尿病状态下影响BBB上P-gp表达的因素,对于疾病的治疗及临床合理用药尤为重要。本文总结了糖尿病状态下BBB上P-gp改变的现象以及影响BBB上P-gp改变的因素的最新研究进展。
Diabetes mellitus is a group of metabolic diseases characterized by an increase in chronic blood glucose (referred to as blood glucose), which is caused by insulin secretion and / or deficiencies in action. P-glycoprotein (P-gp) acts as an efflux pump for drugs on the blood-brain barrier (BBB) that regulate the absorption, distribution and excretion of many drugs. The changes of the in vivo environment caused by diabetes will lead to the change of P-gp function and expression in BBB, which will affect the pharmacological and toxicological effects of central nervous system drugs and even lead to the concurrent neurological diseases. Therefore, to clarify the factors that affect the expression of P-gp on the BBB under the state of diabetes is particularly important for the treatment of the disease and the clinical rational use of drugs. This review summarizes the recent research progress on the changes of P-gp on BBB and the factors that affect the changes of P-gp on BBB.