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创新的精神分裂症药物治疗发现筛选模型:一种综合方法。

Innovative screening models for the discovery of new schizophrenia drug therapies: an integrated approach.

机构信息

Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.

出版信息

Expert Opin Drug Discov. 2021 Jul;16(7):791-806. doi: 10.1080/17460441.2021.1877657. Epub 2021 Jan 29.

DOI:10.1080/17460441.2021.1877657
PMID:33467920
Abstract

: Schizophrenia is a severe psychiatric disorder affecting millions worldwide. However, available treatment options do not fully address the disease. Whereas current antipsychotics may control psychotic symptoms, they seem notoriously ineffective in improving negative and cognitive symptoms or in preventing functional decline. As the etiology of schizophrenia eludes us, the development of valid animal models for screening new drug targets appears to be a strenuous task. In this review, the authors present the key concepts that validate animal models of schizophrenia, as well as the different screening approaches for novel schizophrenia treatments. The models covered are either based on major neurotransmitter systems or neurodevelopmental, immune, and genetic approaches. Sadly, due to inertia, research focuses on developing 'anti-psychotics', instead of 'anti-schizophrenia' drugs that would tackle the entire syndrome of schizophrenia. Whereas no perfect model may ever exist, combining different experimental designs may enhance validity, as the over-reliance on a single model is inappropriate. Multi-model approaches incorporating vulnerability, the 'two-hit' hypothesis, and endophenotypes offer a promise for developing new strategies for schizophrenia treatment. Forward and reverse translation between preclinical and clinical research will increase the probability of success and limit failures in drug development.

摘要

精神分裂症是一种严重的精神疾病,影响着全球数百万人。然而,现有的治疗选择并不能完全解决该疾病。虽然目前的抗精神病药物可以控制精神病症状,但它们在改善阴性和认知症状或预防功能下降方面似乎效果不佳。由于我们对精神分裂症的病因仍不清楚,因此开发有效的动物模型来筛选新的药物靶点似乎是一项艰巨的任务。在这篇综述中,作者介绍了验证精神分裂症动物模型的关键概念,以及用于筛选新型精神分裂症治疗方法的不同方法。涵盖的模型要么基于主要的神经递质系统,要么基于神经发育、免疫和遗传方法。可悲的是,由于惰性,研究的重点是开发“抗精神病药”,而不是能够治疗精神分裂症整个综合征的“抗精神分裂症药”。虽然可能永远不会存在完美的模型,但结合不同的实验设计可以提高有效性,因为过度依赖单一模型是不合适的。结合易感性、“双打击”假说和表型的多模型方法为开发新的精神分裂症治疗策略提供了希望。临床前和临床研究之间的正向和逆向翻译将增加成功的可能性,并限制药物开发中的失败。

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