Clemons Karl V, Stevens David A
Department of Medicine, Division of Infectious Diseases, Santa Clara Valley Medical Center, San Jose, and Department of Medicine, Division of Infectious Diseases and Geographic Medicine, California Institute for Medical Research, San JoseStanford University, California, Stanford, USA.
Med Mycol. 2006 Sep 1;44(Supplement_1):S119-S126. doi: 10.1080/13693780600871174.
Animal models of aspergillosis, particularly those studied in rodents, are an integral part of antifungal drug development. The capacity to control different variables is beneficial, allowing a well defined model system to be used to address various issues of efficacy with monotherapy, combinations, or immunotherapy. One beneficial aspect of the use of animal models is that they enable us to investigate novel indications of drugs prior to a clinical trial or where a clinical trial is impractical. Included in these types of studies is the testing of potentially preventative vaccines. Animal models also are useful for studying diagnostic assays, as well as pharmacology and toxicity. Thus, because of the ability of the best models to mimic human diseases, and our ability to infect genetically identical cohorts of the same age, sex, co-morbidities and risk factors, with an identical challenge inoculum at the same time, we are able to address issues in vivo that cannot be answered by in vitro tests. We also can have sufficient numbers of subjects for statistical analyses, can vary the severity of infection at will and can choose to terminate the experiments to enable using survival or clearance of residual infection as the efficacy end-point. Are these animal models predictive of clinical efficacy, pharmacology and toxicity of an antifungal drug? No single model should be relied upon, as different models of aspergillosis in mice or other animals sometimes show somewhat different results. However, the accumulated wealth of experience has demonstrated the utility of these models in predicting clinical efficacy, pharmacology and toxicity.
曲霉病动物模型,尤其是在啮齿动物中研究的模型,是抗真菌药物研发的重要组成部分。控制不同变量的能力是有益的,这使得能够使用定义明确的模型系统来解决单药治疗、联合治疗或免疫治疗的各种疗效问题。使用动物模型的一个有益之处在于,它们使我们能够在临床试验之前或临床试验不切实际的情况下研究药物的新适应症。这些类型的研究包括对潜在预防性疫苗的测试。动物模型也可用于研究诊断测定法以及药理学和毒性。因此,由于最佳模型能够模拟人类疾病,并且我们有能力在同一时间用相同的攻击接种物感染年龄、性别、合并症和风险因素相同的基因相同的群体,我们能够解决体外试验无法回答的体内问题。我们也可以有足够数量的受试者进行统计分析,可以随意改变感染的严重程度,并且可以选择终止实验,以便将生存或残余感染的清除作为疗效终点。这些动物模型能否预测抗真菌药物的临床疗效、药理学和毒性?不应依赖单一模型,因为小鼠或其他动物中不同的曲霉病模型有时会显示出略有不同的结果。然而,积累的丰富经验已证明这些模型在预测临床疗效、药理学和毒性方面的实用性。