Medical Scientist Training Program, Baylor College of Medicine, Houston, TX, USA.
Division of Allergy & Immunology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Allergy. 2018 Feb;73(2):313-322. doi: 10.1111/all.13305. Epub 2017 Oct 9.
Allergy and atopic asthma have continued to become more prevalent in modern society despite the advent of new treatments, representing a major global health problem. Common medications such as antihistamines and steroids can have undesirable long-term side-effects and lack efficacy in some resistant patients. Biologic medications are increasingly given to treatment-resistant patients, but they can represent high costs, complex dosing and management, and are not widely available around the world. The field needs new, cheap, and convenient treatment options in order to bring better symptom relief to patients. Beyond continued research and development of new drugs, a focus on drug repurposing could alleviate this problem by repositioning effective and safe small-molecule drugs from other fields of medicine and applying them toward the treatment for asthma and allergy. Herein, preclinical models, case reports, and clinical trials of drug repurposing efficacy in allergic disease are reviewed. Novel drugs are also proposed for repositioning based on their mechanism of action to treat asthma and allergy. Overall, drug repurposing could become increasingly important as a way of advancing allergy and atopic asthma therapy, filling a need in treatment of patients today.
尽管出现了新的治疗方法,过敏和特应性哮喘在现代社会仍持续变得更为普遍,这代表了一个主要的全球健康问题。常见的药物,如抗组胺药和类固醇,可能会产生不良的长期副作用,并且在一些耐药患者中疗效不佳。生物药物越来越多地用于治疗耐药患者,但它们可能代表着高昂的成本、复杂的剂量和管理,并且在全球范围内并不广泛可用。为了给患者带来更好的症状缓解,该领域需要新的、廉价且方便的治疗选择。除了继续研究和开发新药外,通过重新定位来自医学其他领域的有效且安全的小分子药物,并将其应用于哮喘和过敏的治疗,药物再利用也可以缓解这一问题。本文综述了药物再利用在过敏性疾病中的临床前模型、病例报告和临床试验的疗效。还根据治疗哮喘和过敏的作用机制提出了重新定位新型药物的建议。总的来说,药物再利用可能会变得越来越重要,成为推进过敏和特应性哮喘治疗的一种方式,满足当前患者的治疗需求。