保肝和抗纤维化药物:是时候迈出下一步了。
Hepatoprotective and Anti-fibrotic Agents: It's Time to Take the Next Step.
作者信息
Weiskirchen Ralf
机构信息
Institute of Molecular Pathobiochemistry, Experimental Gene Therapy, and Clinical Chemistry, RWTH University Hospital Aachen Aachen, Germany.
出版信息
Front Pharmacol. 2016 Jan 7;6:303. doi: 10.3389/fphar.2015.00303. eCollection 2015.
Hepatic fibrosis and cirrhosis cause strong human suffering and necessitate a monetary burden worldwide. Therefore, there is an urgent need for the development of therapies. Pre-clinical animal models are indispensable in the drug discovery and development of new anti-fibrotic compounds and are immensely valuable for understanding and proofing the mode of their proposed action. In fibrosis research, inbreed mice and rats are by far the most used species for testing drug efficacy. During the last decades, several hundred or even a thousand different drugs that reproducibly evolve beneficial effects on liver health in respective disease models were identified. However, there are only a few compounds (e.g., GR-MD-02, GM-CT-01) that were translated from bench to bedside. In contrast, the large number of drugs successfully tested in animal studies is repeatedly tested over and over engender findings with similar or identical outcome. This circumstance undermines the 3R (Replacement, Refinement, Reduction) principle of Russell and Burch that was introduced to minimize the suffering of laboratory animals. This ethical framework, however, represents the basis of the new animal welfare regulations in the member states of the European Union. Consequently, the legal authorities in the different countries are halted to foreclose testing of drugs in animals that were successfully tested before. This review provides a synopsis on anti-fibrotic compounds that were tested in classical rodent models. Their mode of action, potential sources and the observed beneficial effects on liver health are discussed. This review attempts to provide a reference compilation for all those involved in the testing of drugs or in the design of new clinical trials targeting hepatic fibrosis.
肝纤维化和肝硬化给人类带来巨大痛苦,在全球范围内造成经济负担。因此,迫切需要开发相关治疗方法。临床前动物模型在新的抗纤维化化合物的药物发现和开发中不可或缺,对于理解和验证其作用模式具有极高价值。在纤维化研究中,近交系小鼠和大鼠是测试药物疗效最常用的物种。在过去几十年里,在各自疾病模型中可重复性地对肝脏健康产生有益作用的数百种甚至上千种不同药物被鉴定出来。然而,只有少数化合物(如GR-MD-02、GM-CT-01)从实验室走向了临床应用。相比之下,大量在动物研究中成功测试的药物被反复测试,却不断得出相似或相同的结果。这种情况违背了罗素和伯奇提出的3R(替代、优化、减少)原则,该原则旨在尽量减少实验动物的痛苦。然而,这一伦理框架是欧盟成员国新的动物福利法规的基础。因此,不同国家的法律当局停止了对之前已成功测试过的药物进行动物实验。本综述概述了在经典啮齿动物模型中测试过的抗纤维化化合物。讨论了它们的作用模式、潜在来源以及对肝脏健康观察到的有益效果。本综述旨在为所有参与药物测试或针对肝纤维化设计新临床试验的人员提供一份参考汇编。