AstraZeneca, Safety, Health & Environment, Brixham Environmental Laboratory, Freshwater Quarry, Brixham, Devon TQ5 8BA, United Kingdom.
Integr Environ Assess Manag. 2010 Jan;6(1):38-51. doi: 10.1897/IEAM_2009-044.1.
Over recent years, human pharmaceuticals have been detected in the aquatic environment. This, combined with the fact that many are (by design) biologically active compounds, has raised concern about potential impacts in wildlife species. This concern was realized with two high-profile cases of unforeseen environmental impact (i.e., estrogens and diclofenac), which have led to a flurry of work addressing how best to predict such effects in the future. One area in which considerable research effort has been made, partially in response to regulatory requirements, has been on the potential use of preclinical and clinical pharmacological and toxicological data (generated during drug development from nonhuman mammals and humans) to predict possible effects in nontarget, environmentally relevant species: so-called read across. This approach is strengthened by the fact that many physiological systems are conserved between mammals and certain environmentally relevant species. Consequently, knowledge of how a pharmaceutical works (the “mode-of-action,” or MoA) in nonclinical species and humans could assist in the selection of appropriate test species, study designs, and endpoints, in an approach referred to as “intelligent testing.” Here we outline the data available from the human drug development process and suggest how this might be used to design a testing strategy best suited to the specific characteristics of the drug in question. In addition, we review published data that support this type of approach, discuss the potential pitfalls associated with read across, and identify knowledge gaps that require filling to ensure accuracy in the extrapolation of data from preclinical and clinical studies, for use in the environmental risk assessment of human pharmaceuticals.
近年来,人类药物已在水生环境中被检出。由于许多药物(设计初衷)都是具有生物活性的化合物,这引发了人们对野生动物物种可能受到潜在影响的担忧。这一担忧在两个备受瞩目的环境影响意外案例中得到了体现(即雌激素和双氯芬酸),这导致了大量工作致力于研究如何最好地预测未来的此类影响。其中一个投入了大量研究的领域,部分是为了应对监管要求,是在非临床和临床药理学和毒理学数据(在非人类哺乳动物和人类的药物开发过程中产生)的潜在用途上,以预测非目标、与环境相关物种中可能产生的影响:所谓的“外推”。这种方法之所以强大,是因为许多生理系统在哺乳动物和某些与环境相关的物种之间是保守的。因此,了解药物在非临床物种和人类中的作用机制(“作用机制”或 MoA)可以帮助选择适当的测试物种、研究设计和终点,这是一种被称为“智能测试”的方法。在这里,我们概述了人类药物开发过程中可用的数据,并提出了如何利用这些数据来设计最适合所讨论药物特定特征的测试策略。此外,我们还回顾了支持这种方法的已发表数据,讨论了外推相关的潜在陷阱,并确定了需要填补的知识空白,以确保从临床前和临床研究中推断数据的准确性,用于人类药物的环境风险评估。