Departments of Surgery and Anesthesiology; David Geffen School of Medicine at UCLA; Los Angeles, CA USA.
Virulence. 2014 Jan 1;5(1):143-53. doi: 10.4161/viru.26083. Epub 2013 Aug 19.
Sepsis remains a common, serious, and heterogeneous clinical entity that is difficult to define adequately. Despite its importance as a public health problem, efforts to develop and gain regulatory approval for a specific therapeutic agent for the adjuvant treatment of sepsis have been remarkably unsuccessful. One step in the critical pathway for the development of a new agent for adjuvant treatment of sepsis is evaluation in an appropriate animal model of the human condition. Unfortunately, the animal models that have been used for this purpose have often yielded misleading findings. It is likely that there are multiple reasons for the discrepancies between the results obtained in tests of pharmacological agents in animal models of sepsis and the outcomes of human clinical trials. One of important reason may be that the changes in gene expression, which are triggered by trauma or infection, are different in mice, a commonly used species for preclinical testing, and humans. Additionally, many species, including mice and baboons, are remarkably resistant to the toxic effects of bacterial lipopolysaccharide, whereas humans are exquisitely sensitive. New approaches toward the use of animals for sepsis research are being investigated. But, at present, results from preclinical studies of new therapeutic agents for sepsis must be viewed with a degree of skepticism.
脓毒症仍然是一种常见、严重且具有异质性的临床病症,难以充分定义。尽管它是一个公共卫生问题,但开发和获得监管部门批准用于脓毒症辅助治疗的特定治疗药物的努力却非常不成功。开发新的脓毒症辅助治疗药物的关键途径之一是在适当的人类疾病动物模型中进行评估。不幸的是,为此目的而使用的动物模型往往产生误导性的结果。在脓毒症动物模型中测试药理药物的结果与人类临床试验的结果之间存在差异,可能有多个原因。一个重要的原因可能是,创伤或感染引发的基因表达变化在小鼠(常用于临床前测试的物种)和人类之间存在差异。此外,许多物种,包括小鼠和狒狒,对细菌脂多糖的毒性作用具有很强的抵抗力,而人类则非常敏感。目前正在研究用于脓毒症研究的动物的新方法。但是,目前,必须对脓毒症新治疗药物的临床前研究结果持一定程度的怀疑态度。