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Immunoregulation of Liver Fibrosis: New Opportunities for Antifibrotic Therapy 肝纤维化的免疫调节:抗纤维化疗法的新机遇
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-11 DOI: 10.1146/annurev-pharmtox-020524-012013
Helene Gilgenkrantz, Rola Al Sayegh, Sophie Lotersztajn
Liver fibrosis develops in response to chronic liver injury and is characterized by a sustained inflammatory response that leads to excessive collagen deposition by myofibroblasts. The fibrogenic response is governed by the release of inflammatory mediators from innate, adaptive, and innate-like lymphoid cells and from nonprofessional immune cells (i.e., epithelial cells, hepatic myofibroblasts, and liver sinusoidal endothelial cells). Upon removal of the underlying cause, liver fibrosis can resolve via activation of specific immune cell subsets. Despite major advances in the understanding of fibrosis pathogenesis, there is still no approved antifibrotic therapy. This review summarizes our current knowledge of the immune cell landscape and the inflammatory mechanisms underlying liver fibrosis progression and regression. We discuss how reprogramming immune cell phenotype, in particular through targeting selective inflammatory pathways or modulating cell-intrinsic metabolism, may be translated into antifibrogenic therapies.
肝纤维化是对慢性肝损伤的反应,其特点是持续的炎症反应导致肌成纤维细胞过度沉积胶原蛋白。纤维化反应受先天性、适应性和类先天性淋巴细胞以及非专业免疫细胞(即上皮细胞、肝肌成纤维细胞和肝窦内皮细胞)释放的炎症介质控制。在消除潜在病因后,肝纤维化可通过激活特定的免疫细胞亚群而缓解。尽管人们对肝纤维化发病机制的认识取得了重大进展,但目前仍没有获得批准的抗肝纤维化疗法。本综述总结了我们目前对免疫细胞格局以及肝纤维化进展和消退背后的炎症机制的认识。我们将讨论如何重新规划免疫细胞表型,特别是通过靶向选择性炎症通路或调节细胞内在代谢,将其转化为抗纤维化疗法。
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引用次数: 0
Gut Microbiota–Related Biomarkers in Immuno-Oncology 免疫肿瘤学中与肠道微生物群相关的生物标记物
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-11 DOI: 10.1146/annurev-pharmtox-061124-102218
Carolina Alves Costa Silva, Marine Fidelle, Andrew A. Almonte, Lisa Derosa, Laurence Zitvogel
Carcinogenesis is associated with the emergence of protracted intestinal dysbiosis and metabolic changes. Increasing evidence shows that gut microbiota–related biomarkers and microbiota-centered interventions are promising strategies to overcome resistance to immunotherapy. However, current standard methods for evaluating gut microbiota composition are cost- and time-consuming. The development of routine diagnostic tools for intestinal barrier alterations and dysbiosis constitutes a critical unmet medical need that can guide routine treatment and microbiota-centered intervention decisions in patients with cancer. In this review, we explore the influence of gut microbiota on cancer immunotherapy and highlight gut-associated biomarkers that have the potential to be transformed into simple diagnostic tools, thus guiding standard treatment decisions in the field of immuno-oncology. Mechanistic insights toward leveraging the complex relationship between cancer immunosurveillance, gut microbiota, and metabolism open exciting opportunities for developing novel biomarkers in immuno-oncology.
癌症的发生与长期肠道菌群失调和代谢变化有关。越来越多的证据表明,肠道微生物群相关生物标志物和以微生物群为中心的干预措施是克服免疫疗法耐药性的有效策略。然而,目前评估肠道微生物群组成的标准方法既费钱又费时。开发肠道屏障改变和菌群失调的常规诊断工具是一项关键的未满足医疗需求,可为癌症患者的常规治疗和以微生物群为中心的干预决策提供指导。在这篇综述中,我们探讨了肠道微生物群对癌症免疫疗法的影响,并重点介绍了有可能转化为简单诊断工具的肠道相关生物标志物,从而指导免疫肿瘤学领域的标准治疗决策。利用癌症免疫监视、肠道微生物群和新陈代谢之间的复杂关系的机制研究为开发免疫肿瘤学中的新型生物标记物提供了令人兴奋的机会。
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引用次数: 0
Treating Sickle Cell Disease: Gene Therapy Approaches 治疗镰状细胞病:基因治疗方法
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-11 DOI: 10.1146/annurev-pharmtox-022124-022000
Marina Cavazzana, Alice Corsia, Megane Brusson, Annarita Miccio, Michaela Semeraro
Sickle cell disease (SCD) is a hereditary blood disorder characterized by the presence of abnormal hemoglobin molecules and thus distortion (sickling) of the red blood cells. SCD causes chronic pain and organ damage and shortens life expectancy. Gene therapy emerges as a potentially curative approach for people with SCD who lack a matched sibling donor for hematopoietic stem cell transplantation. Here, we review recent progress in gene therapy for SCD and focus on innovative technologies that target the genetic roots of the disease. We also review the challenges associated with gene therapy, including oncogenic risks, and the need for refined delivery methods. Despite these hurdles, the rapidly evolving landscape of gene therapy for SCD raises hope for a paradigm shift in the treatment of this debilitating disease. As research progresses, a deeper understanding of the molecular mechanisms involved and continuous improvements in gene-editing technologies promise to bring gene therapy for SCD closer to mainstream clinical application, offering a transformative, curative option for patients with this genetic disorder.
镰状细胞病(SCD)是一种遗传性血液疾病,其特点是血红蛋白分子异常,从而导致红细胞变形(镰状细胞病)。SCD 会导致慢性疼痛和器官损伤,并缩短预期寿命。对于缺乏匹配的同胞造血干细胞移植供体的 SCD 患者来说,基因疗法是一种潜在的治疗方法。在此,我们回顾了基因疗法治疗 SCD 的最新进展,并重点介绍了针对疾病遗传根源的创新技术。我们还回顾了与基因治疗相关的挑战,包括致癌风险和改进给药方法的必要性。尽管存在这些障碍,但快速发展的 SCD 基因疗法为这种使人衰弱的疾病的治疗模式转变带来了希望。随着研究的进展,对相关分子机制的深入了解以及基因编辑技术的不断改进有望使 SCD 基因疗法更接近主流临床应用,为这种遗传性疾病患者提供一种变革性的治疗选择。
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引用次数: 0
Weight Loss Blockbuster Development: A Role for Unimolecular Polypharmacology 减肥大片的开发:单分子多药理学的作用
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-11 DOI: 10.1146/annurev-pharmtox-061324-011832
Qingtong Zhou, Guanyi Li, Kaini Hang, Jie Li, Dehua Yang, Ming-Wei Wang
Obesity and type 2 diabetes mellitus (T2DM) impact more than 2.5 billion adults worldwide, necessitating innovative therapeutic approaches. Unimolecular polypharmacology, which involves designing single molecules to target multiple receptors or pathways simultaneously, has revolutionized treatment strategies. Blockbuster drugs such as tirzepatide and retatrutide have shown unprecedented success in managing obesity and T2DM, demonstrating superior efficacy compared to conventional single agonists. Tirzepatide, in particular, has garnered tremendous attention for its remarkable effectiveness in promoting weight loss and improving glycemic control, while offering additional cardiovascular and renal benefits. Despite their promises, such therapeutic agents also face challenges that include gastrointestinal side effects, patient compliance issues, and body weight rebound after cessation of the treatment. Nonetheless, the development of these therapies marks a significant leap forward, underscoring the transformative potential of unimolecular polypharmacology in addressing metabolic diseases and paving the way for future innovations in personalized medicine.
肥胖症和 2 型糖尿病(T2DM)影响着全球超过 25 亿成年人,因此需要创新的治疗方法。单分子多药理学(Unimolecular polypharmacology)涉及设计单分子同时靶向多个受体或通路,它彻底改变了治疗策略。诸如替扎帕肽(tirzepatide)和雷他鲁肽(retatrutide)等大片药物在治疗肥胖症和 T2DM 方面取得了前所未有的成功,与传统的单一激动剂相比,疗效更加显著。尤其是替哌肽,它在促进减肥和改善血糖控制方面效果显著,同时还能为心血管和肾脏带来额外的益处,因此受到了极大的关注。尽管这类治疗药物前景广阔,但也面临着一些挑战,包括胃肠道副作用、患者依从性问题以及停止治疗后体重反弹等。不过,这些疗法的开发标志着一个重大飞跃,凸显了单分子多药理学在解决代谢性疾病方面的变革潜力,并为未来个性化医学的创新铺平了道路。
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引用次数: 0
Pollution of Soil by Pharmaceuticals: Implications for Metazoan and Environmental Health. 药物对土壤的污染:对元虫和环境健康的影响。
IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-03 DOI: 10.1146/annurev-pharmtox-030124-111214
Chubin Zhang, Leon P Barron, Stephen R Stürzenbaum

The use of pharmaceuticals has grown substantially and their consequential release via wastewaters poses a potential threat to aquatic and terrestrial environments. While transportation prediction models for aquatic environments are well established, they cannot be universally extrapolated to terrestrial systems. Pharmaceuticals and their metabolites are, for example, readily detected in the excreta of terrestrial organisms (including humans). Furthermore, the trophic transfer of pharmaceuticals to and from food webs is often overlooked, which in turn highlights a public health concern and emphasizes the pressing need to elucidate how today's potpourri of pharmaceuticals affect the terrestrial system, their biophysical behaviors, and their interactions with soil metazoans. This review explores the existing knowledge base of pharmaceutical exposure sources, mobility, persistence, (bio)availability, (bio)accumulation, (bio)magnification, and trophic transfer of pharmaceuticals through the soil and terrestrial food chains.

药物的使用量大幅增加,因此通过废水排放的药物对水生和陆地环境构成了潜在威胁。虽然针对水生环境的迁移预测模型已经成熟,但并不能普遍推广到陆地系统。例如,在陆地生物(包括人类)的排泄物中很容易检测到药物及其代谢物。此外,药物在食物网之间的营养转移往往被忽视,这反过来又凸显了公共健康问题,并强调了阐明当今各种药物如何影响陆地系统、其生物物理行为以及与土壤中的元古宙的相互作用的迫切需要。本综述探讨了有关药物暴露源、流动性、持久性、(生物)可用性、(生物)积累、(生物)放大以及药物通过土壤和陆地食物链进行营养转移的现有知识基础。
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引用次数: 0
Opportunities for Microphysiological Systems in Toxicity Testing of New Drug Modalities. 微观生理学系统在新药毒性测试中的机遇。
IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-09-03 DOI: 10.1146/annurev-pharmtox-061724-080621
Tengku Ibrahim Maulana, Nienke R Wevers, Theodora Kristoforus, Morgan Chandler, Henriette L Lanz, Jos Joore, Paul Vulto, Remi Villenave, Stefan Kustermann, Peter Loskill, Kristin M Bircsak

New drug modalities offer life-saving benefits for patients through access to previously undruggable targets. Yet these modalities pose a challenge for the pharmaceutical industry, as side effects are complex, unpredictable, and often uniquely human. With animal studies having limited predictive value due to translatability challenges, the pharmaceutical industry seeks out new approach methodologies. Microphysiological systems (MPS) offer important features that enable complex toxicological processes to be modeled in vitro such as (a) an adjustable complexity of cellular components, including immune components; (b) a modifiable tissue architecture; (c) integration and monitoring of dynamic mechanisms; and (d) a multiorgan connection. Here we review MPS studies in the context of four clinical adverse events triggered by new drug modalities: peripheral neuropathy, thrombocytopenia, immune-mediated hepatotoxicity, and cytokine release syndrome. We conclude that while the use of MPS for testing new drug modality-induced toxicities is still in its infancy, we see strong potential going forward.

新的药物治疗模式可用于以前无法治疗的靶点,为患者带来救命的好处。然而,这些模式给制药业带来了挑战,因为副作用是复杂的、不可预测的,而且往往是人类独有的。由于可转化性的挑战,动物研究的预测价值有限,因此制药业正在寻求新的方法。微观生理学系统(MPS)具有重要的特点,可在体外模拟复杂的毒理学过程,例如:(a)可调整细胞成分(包括免疫成分)的复杂性;(b)可修改的组织结构;(c)动态机制的整合与监测;以及(d)多器官连接。在此,我们结合新药模式引发的四种临床不良事件回顾了 MPS 研究:周围神经病变、血小板减少症、免疫介导的肝毒性和细胞因子释放综合征。我们的结论是,虽然使用 MPS 检测新药模式引发的毒性仍处于起步阶段,但我们看到了未来的巨大潜力。
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引用次数: 0
PROTACs as Therapeutic Modalities for Drug Discovery in Castration-Resistant Prostate Cancer. PROTACs 作为阉割耐药前列腺癌药物发现的治疗模式。
IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-08 DOI: 10.1146/annurev-pharmtox-030624-110238
Ling-Yu Wang, Chiu-Lien Hung, Tsan-Chun Wang, Hung-Chih Hsu, Hsing-Jien Kung, Kwang-Huei Lin

Castration-resistant prostate cancer (CRPC) presents significant challenges in clinical management due to its resistance to conventional androgen receptor (AR)-targeting therapies. The advent of proteolysis targeting chimeras (PROTACs) has revolutionized cancer therapy by enabling the targeted degradation of key molecular players implicated in CRPC progression. In this review we discuss the developments of PROTACs for CRPC treatment, focusing on AR and other CRPC-associated regulators. We provide an overview of the strategic trends in AR PROTAC development from the aspect of targeting site selection and preclinical antitumor evaluation, as well as updates on AR degraders in clinical applications. Additionally, we briefly address the current status of selective AR degrader development. Furthermore, we review new developments in PROTACs as potential CRPC treatment paradigms, highlighting those targeting chromatin modulators BRD4, EZH2, and SWI/SNF; transcription regulator SMAD3; and kinases CDK9 and PIM1. Given the molecular targets shared between CRPC and neuroendocrine prostate cancer (NEPC), we also discuss the potential of PROTACs in addressing NEPC.

阉割耐药前列腺癌(CRPC)对传统的雄激素受体(AR)靶向疗法产生耐药性,给临床治疗带来了巨大挑战。蛋白水解靶向嵌合体(PROTACs)的出现使癌症治疗发生了革命性的变化,它可以靶向降解与 CRPC 进展有关的关键分子角色。在本综述中,我们将讨论 PROTACs 用于 CRPC 治疗的发展情况,重点关注 AR 和其他 CRPC 相关调节因子。我们从靶点选择和临床前抗肿瘤评估方面概述了 AR PROTAC 开发的战略趋势,以及 AR 降解剂在临床应用中的最新情况。此外,我们还简要介绍了选择性 AR 降解剂的开发现状。此外,我们还回顾了作为潜在 CRPC 治疗范例的 PROTACs 的新进展,重点介绍了针对染色质调节剂 BRD4、EZH2 和 SWI/SNF;转录调节剂 SMAD3;以及激酶 CDK9 和 PIM1 的 PROTACs。鉴于 CRPC 和神经内分泌性前列腺癌 (NEPC) 具有共同的分子靶点,我们还讨论了 PROTACs 在治疗 NEPC 方面的潜力。
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引用次数: 0
Pharma[e]cology: How the Gut Microbiome Contributes to Variations in Drug Response. 制药学:肠道微生物组如何导致药物反应的变化。
IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-06 DOI: 10.1146/annurev-pharmtox-022724-100847
Kai R Trepka, Christine A Olson, Vaibhav Upadhyay, Chen Zhang, Peter J Turnbaugh

Drugs represent our first, and sometimes last, line of defense for many diseases, yet despite decades of research we still do not fully understand why a given drug works in one patient and fails in the next. The human gut microbiome is one of the missing puzzle pieces, due to its ability to parallel and extend host pathways for drug metabolism, along with more complex host-microbiome interactions. Herein, we focus on the well-established links between the gut microbiome and drugs for heart disease and cancer, plus emerging data on neurological disease. We highlight the interdisciplinary methods that are available and how they can be used to address major remaining knowledge gaps, including the consequences of microbial drug metabolism for treatment outcomes. Continued progress in this area promises fundamental biological insights into humans and their associated microbial communities and strategies for leveraging the microbiome to improve the practice of medicine.

药物是我们治疗许多疾病的第一道防线,有时也是最后一道防线,然而,尽管进行了几十年的研究,我们仍然不能完全理解为什么某种药物在一个病人身上起作用,而在另一个病人身上却失效。人类肠道微生物组是缺失的拼图之一,因为它能够平行并扩展宿主的药物代谢途径,以及更复杂的宿主-微生物组相互作用。在此,我们将重点关注肠道微生物组与治疗心脏病和癌症的药物之间已确立的联系,以及有关神经系统疾病的新兴数据。我们将重点介绍现有的跨学科方法,以及如何利用这些方法来解决剩余的主要知识空白,包括微生物药物代谢对治疗效果的影响。该领域的持续进展有望为人类及其相关微生物群落提供基本的生物学见解,并为利用微生物组改善医疗实践提供策略。
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引用次数: 0
What Structural Biology Tells Us About the Mode of Action and Detection of Toxicants. 结构生物学告诉我们毒物的作用方式和检测方法。
IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-06 DOI: 10.1146/annurev-pharmtox-061724-080642
Albane le Maire, William Bourguet

The study of the adverse effects of chemical substances on living organisms is an old and intense field of research. However, toxicological and environmental health sciences have long been dominated by descriptive approaches that enable associations or correlations but relatively few robust causal links and molecular mechanisms. Recent achievements have shown that structural biology approaches can bring this added value to the field. By providing atomic-level information, structural biology is a powerful tool to decipher the mechanisms by which toxicants bind to and alter the normal function of essential cell components, causing adverse effects. Here, using endocrine-disrupting chemicals as illustrative examples, we describe recent advances in the structure-based understanding of their modes of action and how this knowledge can be exploited to develop computational tools aimed at predicting properties of large collections of compounds.

研究化学物质对生物体的不良影响是一个古老而又紧张的研究领域。然而,长期以来,毒理学和环境健康科学一直以描述性方法为主,这些方法能够提供关联或相关性,但相对较少提供可靠的因果联系和分子机制。最近的成就表明,结构生物学方法可以为这一领域带来附加值。通过提供原子级别的信息,结构生物学是一种强大的工具,可用于破译毒物与细胞基本成分结合并改变其正常功能从而造成不良影响的机制。在此,我们将以干扰内分泌的化学物质为例,介绍基于结构了解其作用模式的最新进展,以及如何利用这些知识开发旨在预测大量化合物特性的计算工具。
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引用次数: 0
Trichloroethylene: An Update on an Environmental Contaminant with Multiple Health Effects. 三氯乙烯:一种对健康有多重影响的环境污染物的最新情况。
IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-02 DOI: 10.1146/annurev-pharmtox-022724-120525
Lawrence H Lash

The halogenated solvent trichloroethylene (TCE) has had many uses in medicine, construction, consumer products, and the military. Many of these uses have been discontinued or restricted due to its toxicity, which affects multiple target organs and includes both acute, high-dose toxicity and chronic, low-dose toxicity that also encompass several cancers. US and international agencies have conducted risk and hazard assessments for TCE, with comprehensive publications coming out in the last 10-15 years. Accordingly, the focus of this article is to review recently published data since that time (i.e., 2014) that clarify unsettled questions or provide additional insights into the metabolism and mechanisms of toxicity of TCE in several target organs. Besides metabolism, the review focuses on the kidneys, liver, immune system, nervous system, cardiovascular and pulmonary systems, the search for biomarkers, and recent analyses of human cancer risk and incidence from TCE exposure.

卤代溶剂三氯乙烯(TCE)在医药、建筑、消费品和军事领域有许多用途。三氯乙烯的毒性影响多个靶器官,包括急性、高剂量毒性和慢性、低剂量毒性,其中慢性、低剂量毒性还包括多种癌症。美国和国际机构对三氯乙烷进行了风险和危害评估,并在过去 10-15 年间发表了全面的出版物。因此,本文的重点是回顾自那时(即 2014 年)以来最新发表的数据,这些数据澄清了一些悬而未决的问题,或提供了有关三氯乙烷在多个靶器官中的代谢和毒性机制的更多见解。除新陈代谢外,本文还重点关注肾脏、肝脏、免疫系统、神经系统、心血管和肺部系统、生物标志物的寻找,以及最近对接触三氯乙烯导致的人类癌症风险和发病率的分析。
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引用次数: 0
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Annual review of pharmacology and toxicology
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