药物开发中的DILI预测:现在和未来
1Faculty of Pharmacy, University of Toronto, Toronto, ON, USA.
Expert opinion on drug metabolism & toxicology
|April 20, 2025
概括
药物诱导的异常性肝损伤 (iDILI) 查需要更好的生物标志物. 新的生物标志物应该关注免疫反应,而不是直接的药物毒性,以提高药物开发安全性.
科学领域:
- 药物诱导的肝损伤是由药物引起的.
- 免疫学 免疫学 免疫学
- 发现生物标志物的发现.
背景情况:
- 药物诱导的奇异性肝损伤 (iDILI) 对患者健康和药物开发构成重大风险.
- 目前针对iDILI风险的查方法是不够的.
- 了解iDILI的基本机制对于开发有效的预测工具至关重要.
研究的目的:
- 审查iDILI的一般机制.
- 评估目前查iDILI风险的方法.
- 探索新的生物标志物的潜力,以预测iDILI.
主要方法:
- 审查关于iDILI机制和查的现有文献.
- 探索免疫系统参与iDILI病变的探索.
- 基于细胞反应的潜在生物标志物的识别.
主要成果:
- iDILI主要是由适应性免疫反应驱动的,特别是CD8+细胞毒性T细胞,而不是直接的药物毒性.
- 实验室中细胞毒性测定不能准确地反映iDILI机制.
- 天生的免疫反应,包括抗原呈现细胞激活和肝细胞释放的损伤相关分子模式分子 (DAMPs),对于启动iDILI至关重要.
结论:
- 对iDILI风险的生物标志物应基于免疫介导的损伤机制.
- 肝细胞的反应,DAMP的释放 (特别是在细胞外囊泡中) 和抗原呈现细胞的激活是新型iDILI生物标记物的有希望的候选者.
- 开发基于机制的生物标志物将提高药物开发的安全性,并减少患者的发病率.
相关概念视频
Drug Discovery: Overview
10.3K
Drug discovery is a multifaceted process involving extensive screening, testing, and optimization of lead compounds to identify potential new drugs for therapeutic use. It combines several approaches, including screening large numbers of natural products, chemical modification of known active molecules, identification of new drug targets, and rational design based on biological mechanisms and drug-receptor structure. These approaches are carried out in both academic research laboratories and...
10.3K
Clinical Trials: Overview
4.7K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
4.7K
Preclinical Development: Overview
4.8K
Preclinical development consists of a series of tests that ensure the safety and efficacy of a new therapeutic compound before it is tested in humans. There are four main phases to this process. First, safety pharmacology tests are conducted to ensure the drug does not produce any acutely harmful effects. These tests examine parameters such as bronchoconstriction, cardiac dysrhythmias, blood pressure changes, and ataxia. Next, preliminary toxicological testing is performed to determine the...
4.8K
Structure-Activity Relationships and Drug Design
1.9K
Drug design is a dynamic field that involves discovering and developing new medications based on specific biological targets. This process heavily relies on structure-activity relationships (SAR) and quantitative structure-activity relationships (QSAR) to guide the design and optimization of efficient drugs.
SAR studies the intricate relationship between a drug's chemical structure and biological activity. It focuses on understanding how modifications to a drug's structure can influence...
SAR studies the intricate relationship between a drug's chemical structure and biological activity. It focuses on understanding how modifications to a drug's structure can influence...
1.9K
Pharmacokinetic–Pharmacodynamic Relationship: Problems
127
The empirical approach to drug therapy optimization relies on correlating pharmacological response with administered dosage. Such an approach can be costly, time-consuming, and often yields poor correlation due to variables like formulation factors and drug elimination characteristics. A more precise approach correlates response with plasma drug concentration or the amount of drug in the body, rather than dosage. This is achieved through pharmacokinetic-pharmacodynamic (PK/PD) modeling, which...
127
Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions
97
PK–PD modeling has significantly influenced FDA regulatory decisions, particularly drug approval, dosage optimization, and labeling. These models integrate pharmacokinetics (PK) and pharmacodynamics (PD) to predict drug behavior and effects, aiding in optimizing dosing regimens and enhancing the probability of clinical trial success.One notable example is Nesiritide (Natrecor®), a recombinant human brain natriuretic peptide for treating acute decompensated congestive heart failure...
97


