Holsapple Michael P, O'Lone Raegan
ILSI Health and Environmental Sciences Institute, Washington, DC 20005-1743, USA.
Toxicol Pathol. 2012;40(2):248-54. doi: 10.1177/0192623311427708. Epub 2012 Jan 17.
Developmental immunotoxicity (DIT) testing is centered around the concern that exposure to immunotoxicants early in development may result in enhanced susceptibility of, or unique or more persistent effects on, the immune system, in comparison to adult exposure. Developmental immunotoxicity has been the focus of numerous workshops and reviews for at least fifteen years. Most of these earlier activities have focused on both environmental chemicals and pharmaceuticals and have concluded that the best approach to DIT is to address the possible impacts of exposure during all of the critical windows of development. This article will emphasize the critical role played by exposure during the juvenile stage of development. This article will also highlight several key issues that distinguish DIT testing of pharmaceuticals. Representatives from the pharmaceutical, biotechnology, academic, and regulatory sectors (both FDA and EMA) were brought together during a two-day workshop in May 2010 to consider the current state of the science of DIT as it pertains to the testing of pharmaceuticals. It is important to emphasize at the onset that there are currently no regulatory guidelines for either drugs or nondrug chemicals specifically focused on assessment of DIT, although some general guidelines are included in both developmental and reproductive toxicity and general immunotoxicology guidance documents.
发育免疫毒性(DIT)测试主要关注的是,与成年期接触相比,在发育早期接触免疫毒素可能会导致免疫系统易感性增强,或产生独特的或更持久的影响。至少十五年来,发育免疫毒性一直是众多研讨会和综述的焦点。这些早期活动大多同时关注环境化学品和药品,并得出结论,DIT的最佳方法是研究在所有关键发育窗口期接触的可能影响。本文将强调发育幼年期接触所起的关键作用。本文还将突出区分药品DIT测试的几个关键问题。2010年5月,来自制药、生物技术、学术和监管部门(美国食品药品监督管理局和欧洲药品管理局)的代表齐聚一堂,举行为期两天的研讨会,审议与药品测试相关的DIT科学现状。必须在一开始就强调,目前尚无专门针对DIT评估的药品或非药品化学品监管指南,不过在发育和生殖毒性以及一般免疫毒理学指南文件中包含了一些通用指南。