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目前非临床评估滥用和依赖的方法有多好?

How good are current approaches to nonclinical evaluation of abuse and dependence?

机构信息

Porsolt & Partners Pharmacology, Boulogne-Billancourt, France.

出版信息

J Pharmacol Exp Ther. 2011 Mar;336(3):588-95. doi: 10.1124/jpet.110.169979. Epub 2010 Nov 22.

Abstract

Nonclinical assessment of drug abuse and dependence is the subject of several recent regulatory guidelines, which are generally aligned on the methods to be employed. The most direct approach to assessing reinforcing properties of a drug is the self-administration procedure whereby animals can initiate intravenous injections of the test substance, something they readily do with prototypic drugs of abuse. Complications arise because there is no standardized procedure for evaluating substances with differing potencies, reinforcement properties, or pharmacokinetics. Moreover, the choice of training substance, species, and procedural parameters can radically affect the outcome. Apart from the lower cost of rats, primates present several advantages for self-administration studies with similarity to human pharmacokinetics in particular. The most powerful method for assessing similarities between a test substance and a prototypic drug of abuse is the drug discrimination procedure. In contrast to self-administration, drug discrimination is pharmacologically very specific, often reflecting functional activity at receptor level. Dependence is assessed by the occurrence of withdrawal effects on drug discontinuation. Although conceptually simple, interpretation can be complicated by factors such as duration and frequency of administration and observations as well as the choice of end points. Telemetry allows continuous observation of multiple parameters during withdrawal, thereby increasing sensitivity. Presently available tools identify all substances known to cause abuse or dependence, with little risk of false-positives. It remains unclear, however, how predictive these models are with entirely novel substances. Nonetheless, drug abuse/dependence is an area of safety pharmacology where the predictive value of animal models is remarkably high.

摘要

药物滥用和依赖性的非临床评估是最近几个监管指南的主题,这些指南在采用的方法上基本一致。评估药物强化特性最直接的方法是自我给药程序,通过该程序,动物可以自行静脉注射受试物质,它们会欣然对典型的滥用药物这样做。然而,由于没有评估具有不同效力、强化特性或药代动力学的物质的标准化程序,因此出现了一些问题。此外,训练物质、物种和程序参数的选择会极大地影响结果。除了大鼠成本较低之外,灵长类动物在自我给药研究中具有几个优势,特别是在与人药代动力学的相似性方面。评估测试物质与典型滥用药物之间相似性的最有力方法是药物辨别程序。与自我给药不同,药物辨别在药理学上非常特异,通常反映受体水平的功能活性。停药后出现戒断效应可评估依赖性。虽然概念上很简单,但解释可能会受到给药时间和频率以及观察终点的选择等因素的影响。遥测技术允许在戒断期间连续观察多个参数,从而提高了灵敏度。目前可用的工具可以识别所有已知会导致滥用或依赖性的物质,很少出现假阳性的风险。然而,这些模型对于全新的物质的预测能力仍不清楚。尽管如此,药物滥用/依赖性是安全性药理学的一个领域,动物模型的预测价值非常高。

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