Vliegenthart A D Bastiaan, Antoine Daniel J, Dear James W
Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh.
MRC Centre for Drug Safety Science, Department of Molecular & Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Br J Clin Pharmacol. 2015 Sep;80(3):351-62. doi: 10.1111/bcp.12699. Epub 2015 Jul 29.
Paracetamol (acetaminophen) overdose is one of the most common causes of acute liver injury in the Western world. To improve patient care and reduce pressure on already stretched health care providers new biomarkers are needed that identify or exclude liver injury soon after an overdose of paracetamol is ingested. This review highlights the current state of paracetamol poisoning management and how novel biomarkers could improve patient care and save healthcare providers money. Based on the widely used concept of defining a target product profile, a target biomarker profile is proposed that identifies desirable and acceptable key properties for a biomarker in development to enable the improved treatment of this patient population. The current biomarker candidates, with improved hepatic specificity and based on the fundamental mechanistic basis of paracetamol-induced liver injury, are reviewed and their performance compared with our target profile.
对乙酰氨基酚过量是西方世界急性肝损伤最常见的原因之一。为改善患者护理并减轻本就不堪重负的医疗服务提供者的压力，需要新的生物标志物，以便在摄入过量对乙酰氨基酚后不久就能识别或排除肝损伤。本综述重点介绍了对乙酰氨基酚中毒管理的现状，以及新型生物标志物如何改善患者护理并为医疗服务提供者节省资金。基于广泛使用的定义目标产品概况的概念，提出了一个目标生物标志物概况，该概况确定了正在开发的生物标志物的理想和可接受的关键特性，以改善对这一患者群体的治疗。本文回顾了目前具有更高肝脏特异性且基于对乙酰氨基酚诱导肝损伤基本机制的生物标志物候选物，并将它们的性能与我们的目标概况进行了比较。
