IBD Drug Discovery and Development Unit, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
IBD Drug Discovery and Development Unit, F. Widjaja Foundation Inflammatory Bowel and Immunbiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Expert Opin Drug Discov. 2021 May;16(5):567-577. doi: 10.1080/17460441.2021.1851185. Epub 2020 Dec 17.
: Advancing new therapies from discovery to development usually requires proof-of-concept in animal models to justify the costs of continuing the program. While animal models are useful for understanding the mechanism of action (MOA) of a target, limitations of many published colitis models restrict their value to predict clinical efficacy.: The authors focused their literature search on published studies of chronic animal models used to evaluate the pre-clinical efficacy of therapeutic molecules subsequently evaluated in clinical trials for UC. The UC therapies evaluated were anti-α4β7, anti-IL13, anti-IL12p40, and anti-IL23p19. The models of chronic colitis evaluating these molecules were: 1a-/-, chronic dextran sulfate sodium (DSS), chronic 2,4,6-trinitrobenzene sulfonic acid (TNBS), and the T cell transfer model.: While some models provide insight into target MOA in UC, none is consistently superior in predicting efficacy. Evaluation of multiple models, with varying mechanisms of colitis induction, is needed to understand potential drug efficacy. Additional models of greater complexity, reflecting the disease chronicity/heterogeneity seen in humans, are needed. Although helpful in prioritizing targets, animal models alone will likely not improve outcomes of UC clinical trials. Transformational changes to clinical efficacy will likely only occur when precision medicine approaches are employed.
推进新疗法从发现到开发通常需要在动物模型中证明概念验证,以证明继续该项目的成本是合理的。虽然动物模型对于了解目标的作用机制(MOA)很有用,但许多已发表的结肠炎模型的局限性限制了它们预测临床疗效的价值。
作者将文献检索重点放在已发表的慢性动物模型研究上,这些模型用于评估随后在临床试验中评估的 UC 治疗分子的临床前疗效。评估的 UC 治疗方法包括抗-α4β7、抗-IL13、抗-IL12p40 和抗-IL23p19。评估这些分子的慢性结肠炎模型包括:1a-/-、慢性葡聚糖硫酸钠(DSS)、慢性 2,4,6-三硝基苯磺酸(TNBS)和 T 细胞转移模型。
虽然有些模型提供了对 UC 中目标 MOA 的深入了解,但没有一种模型在预测疗效方面始终具有优势。需要评估具有不同结肠炎诱导机制的多种模型,以了解潜在药物的疗效。需要更复杂的额外模型,反映人类中所见疾病的慢性/异质性。尽管有助于确定目标的优先级,但仅凭动物模型不太可能改善 UC 临床试验的结果。只有当采用精准医学方法时,才可能发生临床疗效的变革性变化。