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神经病理性疼痛精准医学中的转化问题。

Translational issues in precision medicine in neuropathic pain.

作者信息

Dickenson Anthony H, Patel Ryan

机构信息

Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.

出版信息

Can J Pain. 2020 Jan 23;4(1):30-38. doi: 10.1080/24740527.2020.1720502. eCollection 2020.

Abstract

Neuropathic pain remains poorly treated, with most new drugs falling through the translational gap. The traditional model of bench-to-bedside research has relied on identifying new mechanisms/targets in animal models and then developing clinical applications. Several have advocated bridging the translational gap by beginning with clinical observations and back-translating to animal models for further investigation of mechanisms. There is good evidence that phenotyping of patients through quantitative sensory testing can lead to improved treatment selection and hence improved patient outcomes. This practice has been widely adopted in clinical investigations, but its application in preclinical research is not mainstream. In this review, we retrospectively examine our historical rodent data sets with the aim of reconsidering drug effects on sensory neuronal endpoints, their alignment with clinical observations, and how these might guide future clinical studies.

摘要

神经性疼痛的治疗效果仍然不佳,大多数新药都未能跨越转化差距。传统的从实验室到临床的研究模式依赖于在动物模型中识别新机制/靶点,然后开发临床应用。一些人主张通过从临床观察开始,再逆向转化到动物模型以进一步研究机制来弥合转化差距。有充分证据表明,通过定量感觉测试对患者进行表型分析可以改善治疗选择,从而改善患者预后。这种做法在临床研究中已被广泛采用,但其在临床前研究中的应用并不主流。在本综述中,我们回顾性地检查了我们以往的啮齿动物数据集,目的是重新考虑药物对感觉神经元终点的影响、它们与临床观察结果的一致性,以及这些如何指导未来的临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/622c/7951163/e62693f8849b/UCJP_A_1720502_F0001_OC.jpg

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