Loizzo A, Tebano M T
Laboratorio di Farmacologia, Istituto Superiore di Sanità, Roma.
Recenti Prog Med. 1993 Nov;84(11):786-93.
Basic investigation in industrial laboratories are mainly addressed to widespread diseases. It follows that: 1) basic research is addressed chiefly to the well known and largely diffuse diseases; 2) rare diseases are not usually studied and therefore little chance is given to their physiopathological or therapeutic knowledge. Hence the name of orphan diseases. The aim of this study is to contribute to the stimulation of innovative and applied basic research of orphan diseases and therefore to gradually confine the number of incurable rare diseases. Our proposal upsets the studies undertaken in some foreign countries and Italy on the orphan drugs (e.g. Orphan Drug Act, issued in the USA in 1982) since we suggest starting from a study on disease more than studies on drug. The planning of studies of disease may be undertaken on various points of view (prevalence, clinical features, prognosis, social cost, etc.), while this may be very hard for the drug. Therefore we suggest starting from a study plane, classification and estimation of rare diseases, shared for apparatus. These studies may be undertaken on a vigorous rationale (more than studies on orphan drugs) and therefore they may bring about to the definition of a national (government) planning for addressing consistent financial resources to the study of pathophysiology and therapy (or prevention) of the major orphan diseases. Adequate studies within the European Community may be planned in the near future, since most rare diseases are presumed to have a common distribution within the Community.
工业实验室的基础研究主要针对常见疾病。由此可知:1)基础研究主要针对广为人知且广泛传播的疾病;2)罕见病通常不被研究,因此对其病理生理或治疗知识的了解机会很少。这就是罕见病名称的由来。本研究的目的是促进对罕见病的创新性和应用性基础研究,从而逐渐减少无法治愈的罕见病数量。我们的提议与一些外国和意大利针对孤儿药所开展的研究(例如1982年美国颁布的《孤儿药法案》)相悖,因为我们建议从对疾病的研究而非对药物的研究入手。疾病研究规划可以从多个角度(患病率、临床特征、预后、社会成本等)进行,而药物研究则很难做到这一点。因此,我们建议从一个针对罕见病的研究层面、分类和评估入手,这是大家共同关注的。这些研究可以基于一个有力的理论依据(比孤儿药研究更充分)开展,因此可能促成一项国家(政府)规划的制定,以便将大量财政资源用于主要罕见病的病理生理和治疗(或预防)研究。鉴于大多数罕见病在欧盟内部可能具有共同的分布情况,在不久的将来可以在欧盟内部规划充分的研究。