Calzetta Luigino, Pistocchini Elena, Ritondo Beatrice Ludovica, Cavalli Francesco, Camardelli Francesca, Rogliani Paola
Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy.
Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
Heliyon. 2022 Jun 22;8(6):e09760. doi: 10.1016/j.heliyon.2022.e09760. eCollection 2022 Jun.
Airway inflammation is crucial in the pathogenesis of many respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma. Current evidence supports the beneficial impact of muscarinic receptor antagonists against airway inflammation from bench-to-bedside. Considering the numerous sampling approaches and the ethical implications required to study inflammation in vivo in patients, the use of pre-clinical models is inevitable. Starting from our recently published systematic review concerning the impact of muscarinic antagonists, we have systematically assessed the current pharmacological models of airway inflammation and provided an overview on the advances in in vitro and ex vivo approaches. The purpose of in vitro models is to recapitulate selected pathophysiological parameters or processes that are crucial to the development of new drugs within a controlled environment. Nevertheless, immortalized cell lines or primary airway cells present major limitations, including the inability to fully replicate the conditions of the corresponding cell types within a whole organism. Induced animal models are extensively used in research in the attempt to replicate a respiratory condition reflective of a human pathological state, although considering animal models with spontaneously occurring respiratory diseases may be more appropriate since most of the clinical features are accompanied by lung pathology resembling that of the human condition. In recent years, three-dimensional organoids have become an alternative to animal experiments, also because animal models are unable to fully mimic the complexity of human pulmonary diseases. Ex vivo studies performed on human isolated airways have a superior translational value compared to in vitro and animal models, as they retain the morphology and the microenvironment of the lung in vivo. In the foreseeable future, greater effort should be undertaken to rely on more physiologically relevant models, that provide translational value into clinic and have a direct impact on patient outcomes.
气道炎症在包括慢性阻塞性肺疾病(COPD)和哮喘在内的许多呼吸系统疾病的发病机制中起着关键作用。目前的证据支持从实验室到临床,毒蕈碱受体拮抗剂对气道炎症具有有益影响。考虑到在患者体内研究炎症所需的众多采样方法和伦理问题,使用临床前模型是不可避免的。从我们最近发表的关于毒蕈碱拮抗剂影响的系统评价开始,我们系统地评估了当前气道炎症的药理模型,并概述了体外和离体方法的进展。体外模型的目的是在可控环境中重现对新药开发至关重要的选定病理生理参数或过程。然而,永生化细胞系或原代气道细胞存在主要局限性,包括无法在整个生物体中完全复制相应细胞类型的条件。诱导动物模型广泛用于研究,试图复制反映人类病理状态的呼吸系统疾病,尽管考虑患有自发性呼吸系统疾病的动物模型可能更合适,因为大多数临床特征都伴有类似于人类疾病的肺部病理。近年来,三维类器官已成为动物实验的替代方法,这也是因为动物模型无法完全模拟人类肺部疾病的复杂性。与体外和动物模型相比,对人类离体气道进行的离体研究具有更高的转化价值,因为它们保留了体内肺的形态和微环境。在可预见的未来,应做出更大努力,依赖更具生理相关性的模型,这些模型可提供临床转化价值并直接影响患者的治疗结果。