Insmed Incorporated, Bridgewater, New Jersey, USA.
J Aerosol Med Pulm Drug Deliv. 2024 Oct;37(5):241-283. doi: 10.1089/jamp.2024.0016.
The Sugen 5416/hypoxia (Su/Hx) rat model of pulmonary arterial hypertension (PAH) demonstrates most of the distinguishing features of PAH in humans, including increased wall thickness and obstruction of the small pulmonary arteries along with plexiform lesion formation. Recently, significant advancement has been made describing the epidemiology, genomics, biochemistry, physiology, and pharmacology in Su/Hx challenge in rats. For example, there are differences in the overall reactivity to Su/Hx challenge in different rat strains and only female rats respond to estrogen treatments. These conditions are also encountered in human subjects with PAH. Also, there is a good translation in both the biochemical and metabolic pathways in the pulmonary vasculature and right heart between Su/Hx rats and humans, particularly during the transition from the adaptive to the nonadaptive phase of right heart failure. Noninvasive techniques such as echocardiography and magnetic resonance imaging have recently been used to evaluate the progression of the pulmonary vascular and cardiac hemodynamics, which are important parameters to monitor the efficacy of drug treatment over time. From a pharmacological perspective, most of the compounds approved clinically for the treatment of PAH are efficacious in Su/Hx rats. Several compounds that show efficacy in Su/Hx rats have advanced into phase II/phase III studies in humans with positive results. Results from these drug trials, if successful, will provide additional treatment options for patients with PAH and will also further validate the excellent translation that currently exists between Su/Hx rats and the human PAH condition.
苏根 5416/缺氧(Su/Hx)肺动脉高压(PAH)大鼠模型显示出人类 PAH 的大多数特征,包括小肺动脉壁增厚和阻塞以及丛状病变形成。最近,在 Su/Hx 对大鼠的挑战中,在描述流行病学、基因组学、生物化学、生理学和药理学方面取得了重大进展。例如,不同大鼠品系对 Su/Hx 挑战的总体反应性存在差异,只有雌性大鼠对雌激素治疗有反应。这些情况也发生在人类 PAH 患者中。此外,Su/Hx 大鼠和人类之间的肺血管和右心的生化和代谢途径都有很好的转化,特别是在从右心衰竭的适应性阶段向非适应性阶段过渡时。超声心动图和磁共振成像等非侵入性技术最近已被用于评估肺血管和心脏血液动力学的进展,这是监测药物治疗随时间推移的疗效的重要参数。从药理学的角度来看,临床上批准用于治疗 PAH 的大多数化合物在 Su/Hx 大鼠中都有效。几种在 Su/Hx 大鼠中显示疗效的化合物已进入 II/III 期临床试验,结果为阳性。如果这些药物试验成功,将为 PAH 患者提供更多的治疗选择,也将进一步验证 Su/Hx 大鼠与人类 PAH 状况之间目前存在的出色转化。