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药物重定位:治疗生命垂危疾病和 COVID-19 大流行的新方法和未来前景。

Drug Repositioning: New Approaches and Future Prospects for Life-Debilitating Diseases and the COVID-19 Pandemic Outbreak.

机构信息

School of Science, Monash University, Bandar Sunway, Subang Jaya 47500, Selangor Darul Ehsan, Malaysia.

Tropical Medicine & Biology Platform, Monash University, Subang Jaya 47500, Selangor Darul Ehsan, Malaysia.

出版信息

Viruses. 2020 Sep 22;12(9):1058. doi: 10.3390/v12091058.

Abstract

Traditionally, drug discovery utilises a de novo design approach, which requires high cost and many years of drug development before it reaches the market. Novel drug development does not always account for orphan diseases, which have low demand and hence low-profit margins for drug developers. Recently, drug repositioning has gained recognition as an alternative approach that explores new avenues for pre-existing commercially approved or rejected drugs to treat diseases aside from the intended ones. Drug repositioning results in lower overall developmental expenses and risk assessments, as the efficacy and safety of the original drug have already been well accessed and approved by regulatory authorities. The greatest advantage of drug repositioning is that it breathes new life into the novel, rare, orphan, and resistant diseases, such as Cushing's syndrome, HIV infection, and pandemic outbreaks such as COVID-19. Repositioning existing drugs such as Hydroxychloroquine, Remdesivir, Ivermectin and Baricitinib shows good potential for COVID-19 treatment. This can crucially aid in resolving outbreaks in urgent times of need. This review discusses the past success in drug repositioning, the current technological advancement in the field, drug repositioning for personalised medicine and the ongoing research on newly emerging drugs under consideration for the COVID-19 treatment.

摘要

传统上,药物发现采用从头设计方法,需要高成本和多年的药物开发才能进入市场。新药物开发并不总是考虑孤儿病,因为孤儿病的需求较低,因此药物开发商的利润率也较低。最近,药物重定位已被视为一种替代方法,用于探索已获得商业批准或拒绝的现有药物的新途径,以治疗除预期疾病以外的其他疾病。药物重定位的总体开发费用和风险评估较低,因为原始药物的疗效和安全性已经得到监管机构的充分评估和批准。药物重定位的最大优势在于,它为库欣综合征、艾滋病毒感染和 COVID-19 等新型、罕见、孤儿和耐药疾病注入了新的活力。重新定位现有的药物,如羟氯喹、瑞德西韦、伊维菌素和巴利昔替尼,显示出治疗 COVID-19 的良好潜力。这对于在紧急需要时解决疫情爆发至关重要。本文讨论了药物重定位的过去成功案例、该领域当前的技术进步、个性化医学的药物重定位以及正在研究的新出现药物,这些药物都在考虑用于 COVID-19 治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05c7/7551028/88ee5c73b806/viruses-12-01058-g001.jpg

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