Sung Yon K, Yuan Ke, de Jesus Perez Vinicio A
a Division of Pulmonary and Critical Care Medicine, The Vera Moulton Wall Center for Pulmonary Vascular Medicine , Stanford Cardiovascular Institute , Stanford , CA , USA.
Expert Opin Drug Discov. 2016;11(4):407-14. doi: 10.1517/17460441.2016.1153625. Epub 2016 Feb 27.
Pulmonary arterial hypertension (PAH) is a rare disorder associated with abnormally elevated pulmonary pressures that, if untreated, leads to right heart failure and premature death. The goal of drug development for PAH is to develop effective therapies that halt, or ideally, reverse the obliterative vasculopathy that results in vessel loss and obstruction of blood flow to the lungs.
This review summarizes the current approach to candidate discovery in PAH and discusses the currently available drug discovery methods that should be implemented to prioritize targets and obtain a comprehensive pharmacological profile of promising compounds with well-defined mechanisms.
To improve the successful identification of leading drug candidates, it is necessary that traditional pre-clinical studies are combined with drug screening strategies that maximize the characterization of biological activity and identify relevant off-target effects that could hinder the clinical efficacy of the compound when tested in human subjects. A successful drug discovery strategy in PAH will require collaboration of clinician scientists with medicinal chemists and pharmacologists who can identify compounds with an adequate safety profile and biological activity against relevant disease mechanisms.
肺动脉高压(PAH)是一种罕见的疾病,与肺压力异常升高有关,若不治疗,会导致右心衰竭和过早死亡。PAH药物研发的目标是开发有效的疗法,以阻止甚至理想情况下逆转导致血管丧失和肺血流阻塞的闭塞性血管病变。
本综述总结了PAH候选药物发现的当前方法,并讨论了目前可用的药物发现方法,这些方法应被用于确定靶点优先级,并获得具有明确作用机制的有前景化合物的全面药理学特征。
为了提高成功识别领先候选药物的几率,有必要将传统的临床前研究与药物筛选策略相结合,这些策略能最大限度地表征生物活性,并识别可能在人体试验中阻碍化合物临床疗效的相关脱靶效应。PAH成功的药物发现策略将需要临床科学家与药物化学家及药理学家合作,他们能够识别出具有足够安全性和针对相关疾病机制的生物活性的化合物。