Tashiro Jun, Rubio Gustavo A, Limper Andrew H, Williams Kurt, Elliot Sharon J, Ninou Ioanna, Aidinis Vassilis, Tzouvelekis Argyrios, Glassberg Marilyn K
Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.
Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States.
Front Med (Lausanne). 2017 Jul 28;4:118. doi: 10.3389/fmed.2017.00118. eCollection 2017.
Large multicenter clinical trials have led to two recently approved drugs for patients with idiopathic pulmonary fibrosis (IPF); yet, both of these therapies only slow disease progression and do not provide a definitive cure. Traditionally, preclinical trials have utilized mouse models of bleomycin (BLM)-induced pulmonary fibrosis-though several limitations prevent direct translation to human IPF. Spontaneous pulmonary fibrosis occurs in other animal species, including dogs, horses, donkeys, and cats. While the fibrotic lungs of these animals share many characteristics with lungs of patients with IPF, current veterinary classifications of fibrotic lung disease are not entirely equivalent. Additional studies that profile these examples of spontaneous fibroses in animals for similarities to human IPF should prove useful for both human and animal investigators. In the meantime, studies of BLM-induced fibrosis in aged male mice remain the most clinically relevant model for preclinical study for human IPF. Addressing issues such as time course of treatment, animal size and characteristics, clinically irrelevant treatment endpoints, and reproducibility of therapeutic outcomes will improve the current status of preclinical studies. Elucidating the mechanisms responsible for the development of fibrosis and disrepair associated with aging through a collaborative approach between researchers will promote the development of models that more accurately represent the realm of interstitial lung diseases in humans.
大型多中心临床试验已带来两种最近获批用于特发性肺纤维化(IPF)患者的药物;然而,这两种疗法都只能减缓疾病进展,无法实现彻底治愈。传统上,临床前试验使用博来霉素(BLM)诱导的肺纤维化小鼠模型——尽管存在一些局限性,阻碍了其直接转化为人类IPF模型。自发性肺纤维化发生在其他动物物种中,包括狗、马、驴和猫。虽然这些动物的纤维化肺与IPF患者的肺有许多共同特征,但目前兽医对纤维化肺病的分类并不完全等同。对动物自发性纤维化实例与人类IPF的相似性进行更多研究,对人类和动物研究人员都应是有用的。与此同时,对老年雄性小鼠进行的BLM诱导纤维化研究仍是人类IPF临床前研究中最具临床相关性的模型。解决诸如治疗时间进程、动物大小和特征、临床无关的治疗终点以及治疗结果的可重复性等问题,将改善临床前研究的现状。通过研究人员之间的合作方法,阐明与衰老相关的纤维化和肺组织损伤发展的机制,将促进开发更准确代表人类间质性肺病领域的模型。