Dionne Raymond A, Bartoshuk Linda, Mogil Jeffrey, Witter James
NIDCR, National Institutes of Health, 10 Center Drive, Room 1N-103, Bethesda, MD 20892-1197, USA.
Trends Pharmacol Sci. 2005 Mar;26(3):125-30. doi: 10.1016/j.tips.2005.01.009.
The outcomes of clinical trials are based on the mean responses of large numbers of subjects but fail to address inter-individual differences. The molecular mechanisms that underlie pain vary among individuals over time and among different types of pain to produce wide inter-individual variations in pain perception and response. Gender, ethnicity, temperament and genetic factors also contribute to individual variation in pain sensitivity and responses to analgesics. Pain measurement scales can be used differently across individuals based on the past pain experiences of individuals. We propose that individual responder analyses could be used in clinical trials to better detect analgesic activity across patient groups and within sub-groups, and to identify molecular-genetic mechanisms that contribute to individual variation.
临床试验的结果基于大量受试者的平均反应，但未能解决个体间差异问题。疼痛背后的分子机制会随时间在个体间以及不同类型的疼痛之间发生变化，从而在疼痛感知和反应方面产生广泛的个体间差异。性别、种族、气质和遗传因素也会导致个体在疼痛敏感性和对镇痛药的反应方面存在差异。基于个体过去的疼痛经历，疼痛测量量表在不同个体间的使用方式可能有所不同。我们建议在临床试验中使用个体反应者分析，以便更好地检测不同患者群体及亚组中的镇痛活性，并确定导致个体差异的分子遗传机制。
