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GSK-3抑制剂与牙齿修复:伦理分析

GSK-3 Inhibitors and Tooth Repair: An Ethical Analysis.

作者信息

Hostiuc Sorin, Perlea Paula, Marinescu Mihai, Dogaroiu Catalin, Drima Eduard

机构信息

Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

University of Medicine and Pharmacy, Galaţi, Romania.

出版信息

Front Pharmacol. 2019 Jan 7;9:1495. doi: 10.3389/fphar.2018.01495. eCollection 2018.

Abstract

Tideglusib, a GSK-3 inhibitor, was initially tested for the treatment of Alzheimer's disease. However, a recent report has suggested its potential off-label use for the treatment of dental cavities. Even if this effect is not yet confirmed, this off-label use can have significant public/dental health consequences, mainly because of the large number of patients with cavities. The purpose of this mini-review is to perform an ethical analysis of the use of Tideglusib in dentistry. The ethical analysis identified three main areas in which ethical breaches could be significant: 1) respect for the autonomy of the patient, 2) issues raised by horizontal shifts in the translational research process, and 3) the conflict between dental beneficence and general non-maleficence. In conclusion, the use of Tideglusib in dentistry should respect the same strict ethical and regulatory criteria from clinical medicine. A translation of the potential risks should be done only after large-scale, phase-III/IV clinical trials, explicitly designed to test the usefulness of this drug in dental medicine.

摘要

Tideglusib是一种糖原合成酶激酶-3(GSK-3)抑制剂,最初被用于阿尔茨海默病的治疗测试。然而,最近有报告表明其可能存在用于治疗龋齿的未获批准的用法。即便这种效果尚未得到证实,但这种未获批准的用法可能会对公众/口腔健康产生重大影响,主要原因在于患龋齿的患者数量众多。本小型综述的目的是对Tideglusib在牙科领域的应用进行伦理分析。伦理分析确定了三个可能存在重大伦理违规行为的主要领域:1)对患者自主性的尊重;2)转化研究过程中横向转移引发的问题;3)牙科领域的有益性与一般无害性之间的冲突。总之,Tideglusib在牙科领域的应用应遵循与临床医学相同严格的伦理和监管标准。只有在专门设计用于测试该药物在牙科医学中有效性的大规模III/IV期临床试验之后,才应进行潜在风险的说明。

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