Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA 02139, United States.
Department of Mechanical Engineering, Stevens Institute of Technology, New Jersey, 07030, United States.
Curr Pharm Des. 2018;24(45):5471-5486. doi: 10.2174/1381612825666190308150055.
To reduce the required capital and time investment in the development of new pharmaceutical agents, there is an urgent need for preclinical drug testing models that are predictive of drug response in human tissues or organs. Despite tremendous advancements and rigorous multistage screening of drug candidates involving computational models, traditional cell culture platforms, animal models and most recently humanized animals, there is still a large deficit in our ability to predict drug response in patient groups and overall attrition rates from phase 1 through phase 4 of clinical studies remain well above 90%. Organ-on-a-chip (OOC) platforms have proven potential in providing tremendous flexibility and robustness in drug screening and development by employing engineering techniques and materials. More importantly, in recent years, there is a clear upward trend in studies that utilize human-induced pluripotent stem cell (hiPSC) to develop personalized tissue or organ models. Additionally, integrated multiple organs on the single chip with increasingly more sophisticated representation of absorption, distribution, metabolism, excretion and toxicity (ADMET) process are being utilized to better understand drug interaction mechanisms in the human body and thus showing great potential to better predict drug efficacy and safety. In this review, we summarize these advances, highlighting studies that took the next step to clinical trials and research areas with the utmost potential and discuss the role of the OOCs in the overall drug discovery process at a preclinical and clinical stage, as well as outline remaining challenges.
为了减少新药研发的资金和时间投入,我们迫切需要能够预测药物在人体组织或器官中反应的临床前药物测试模型。尽管在涉及计算模型、传统细胞培养平台、动物模型以及最近的人源化动物的药物候选物的严格多阶段筛选方面取得了巨大进展,但我们在预测患者群体中药物反应的能力方面仍存在很大差距,从临床研究的 1 期到 4 期,总体淘汰率仍远高于 90%。器官芯片 (OOC) 平台通过采用工程技术和材料,在药物筛选和开发方面显示出巨大的灵活性和稳健性。更重要的是,近年来,利用人诱导多能干细胞 (hiPSC) 开发个性化组织或器官模型的研究呈明显上升趋势。此外,越来越多的具有更复杂吸收、分布、代谢、排泄和毒性 (ADMET) 过程的多个器官被集成到单个芯片上,以更好地理解药物在人体中的相互作用机制,从而显示出更好地预测药物疗效和安全性的巨大潜力。在这篇综述中,我们总结了这些进展,重点介绍了那些将研究推进到临床试验的研究,并讨论了 OOC 在临床前和临床阶段整体药物发现过程中的作用,以及概述了尚存的挑战。