疾病狀態(tài)下藥物代謝酶和藥物轉(zhuǎn)運體的異常調(diào)控會引起藥物動力學過程的改變，進而影響藥物療效，甚至增加不良反應發(fā)生的風險。代謝酶/轉(zhuǎn)運體異常調(diào)控的機制主要涉及炎癥相關(guān)的信號通路/核受體、表觀遺傳修飾和蛋白質(zhì)翻譯后修飾等。系統(tǒng)回顧并總結(jié)了幾類主要常見疾病狀態(tài)下的藥物代謝酶/轉(zhuǎn)運體的調(diào)控變化及相關(guān)機制，同時介紹了生理藥動學模型在指導疾病患者臨床合理用藥方面的應用，以期為基于疾病狀態(tài)下藥物代謝酶/轉(zhuǎn)運體的安全有效的個體化用藥提供借鑒和思路。

Dysregulation of drug metabolizing enzymes and transporters (DMET) during diseases leads to altered pharmacokinetics.It has profound impact on drug safety and efficacy.The mechanisms of this dysregulation include inflammation associated signal pathway/nuclear receptor,epigenetic regulation and post-translational modification.This article reviews the regulation of DMET under disease status and its related mechanisms.The application of physiologically-based pharmacokinetic model in rational drug usage in patients is also summarized.Our work will benefit personalized medicine according to DMET phenotype.

國家自然科學基金（81573494，81803625，81573496）；江蘇省自然科學基金（BK20160076，BK20180558）