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Introduction to the Theme “Pharmacological Individuality: New Insights and Strategies for Personalized and Precise Drug Treatment” 主题“药物个性:个性化和精准药物治疗的新见解和新策略”导论
1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-10-10 DOI: 10.1146/annurev-physiol-090123-010552
Urs A. Meyer, Susan G. Amara, Terrence F. Blaschke, Paul A. Insel
The reviews in Volume 64 of the Annual Review of Pharmacology and Toxicology cover diverse topics. A common theme in many of the reviews is the interindividual variability in the clinical response to drugs. Highlighted areas include emerging developments in pharmacogenomics that can predict the personal risk for drug inefficacy and/or adverse drug reactions. Other reviews focus on the use of circulating biomarkers to define drug metabolism phenotypes and the effect of circadian regulation on drug response. Another emerging technology, digital twins that model individual patients, is used to generate computational simulations of drug effects and identify optimal personalized treatments. Another variable that may affect clinical outcomes, the nocebo response (an adverse reaction to a placebo), complicates clinical trials. These reviews further document that pharmacological individuality is an essential component of the concepts of personalized medicine and precision medicine and will likely have an important impact on patient care. Expected final online publication date for the Annual Review of Pharmacology and Toxicology, Volume 64 is January 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
药理学和毒理学年度评论第64卷的评论涵盖了不同的主题。在许多评论中,一个共同的主题是临床对药物反应的个体差异。重点领域包括药物基因组学的新兴发展,可以预测药物无效和/或药物不良反应的个人风险。其他综述侧重于使用循环生物标志物来定义药物代谢表型和昼夜节律调节对药物反应的影响。另一项新兴技术是数字双胞胎,它可以为单个患者建模,用于生成药物效果的计算模拟,并确定最佳的个性化治疗方案。另一个可能影响临床结果的变量,反安慰剂反应(对安慰剂的不良反应),使临床试验复杂化。这些综述进一步证明,药理学个性是个性化医疗和精准医疗概念的重要组成部分,并可能对患者护理产生重要影响。《药理学和毒理学年度评论》第64卷的最终在线出版日期预计为2024年1月。修订后的估计数请参阅http://www.annualreviews.org/page/journal/pubdates。
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引用次数: 0
Artificial Intelligence and Machine Learning for Lead-to-Candidate Decision-Making and Beyond. 人工智能和机器学习在候选人决策中的应用。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-051921-023255
Douglas McNair

The use of artificial intelligence (AI) and machine learning (ML) in pharmaceutical research and development has to date focused on research: target identification; docking-, fragment-, and motif-based generation of compound libraries; modeling of synthesis feasibility; rank-ordering likely hits according to structural and chemometric similarity to compounds having known activity and affinity to the target(s); optimizing a smaller library for synthesis and high-throughput screening; and combining evidence from screening to support hit-to-lead decisions. Applying AI/ML methods to lead optimization and lead-to-candidate (L2C) decision-making has shown slower progress, especially regarding predicting absorption, distribution, metabolism, excretion, and toxicology properties. The present review surveys reasons why this is so, reports progress that has occurred in recent years, and summarizes some of the issues that remain. Effective AI/ML tools to derisk L2C and later phases of development are important to accelerate the pharmaceutical development process, ameliorate escalating development costs, and achieve greater success rates.

迄今为止,人工智能(AI)和机器学习(ML)在药物研发中的应用主要集中在以下几个方面:目标识别;基于对接、片段和基序的复合库生成;综合可行性建模;根据与已知活性和亲和力的化合物的结构和化学相似性对可能的命中进行排序;优化一个较小的文库用于合成和高通量筛选;并结合筛选的证据来支持热门领导决策。将AI/ML方法应用于先导物优化和候选先导物(L2C)决策的进展较慢,特别是在预测吸收、分布、代谢、排泄和毒理学特性方面。本报告调查了出现这种情况的原因,报告了近年来取得的进展,并总结了仍然存在的一些问题。有效的AI/ML工具来降低L2C和后期开发阶段的风险,对于加速药物开发过程、改善不断上升的开发成本和实现更高的成功率非常重要。
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引用次数: 5
Structures of Leukotriene Biosynthetic Enzymes and Development of New Therapeutics. 白三烯生物合成酶的结构及新疗法的研究进展。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-051921-085014
Jesper Z Haeggström, Marcia E Newcomer

Leukotrienes are potent immune-regulating lipid mediators with patho-genic roles in inflammatory and allergic diseases, particularly asthma. These autacoids also contribute to low-grade inflammation, a hallmark of cardiovascular, neurodegenerative, metabolic, and tumor diseases. Biosynthesis of leukotrienes involves release and oxidative metabolism of arachidonic acid and proceeds via a set of cytosolic and integral membrane enzymes that are typically expressed by cells of the innate immune system. In activated cells, these enzymes traffic and assemble at the endoplasmic and perinuclear membrane, together comprising a biosynthetic complex. Here we describe recent advances in our molecular understanding of the protein components of the leukotriene-synthesizing enzyme machinery and also briefly touch upon the leukotriene receptors. Moreover, we discuss emerging opportunities for pharmacological intervention and development of new therapeutics.

白三烯是一种有效的免疫调节脂质介质,在炎症和过敏性疾病,特别是哮喘中具有致病作用。这些类自身物质也会导致低度炎症,这是心血管、神经退行性、代谢和肿瘤疾病的标志。白三烯的生物合成涉及花生四烯酸的释放和氧化代谢,并通过一组胞质和整体膜酶进行,这些酶通常由先天免疫系统的细胞表达。在活化的细胞中,这些酶在内质膜和核周膜上运输和组装,共同组成生物合成复合物。在这里,我们描述了在白三烯合成酶机制的蛋白质成分的分子理解的最新进展,并简要地谈到了白三烯受体。此外,我们讨论了药理学干预和新疗法发展的新机会。
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引用次数: 7
Pharmacological Induction of Granulocyte Cell Death as Therapeutic Strategy. 药物诱导粒细胞死亡作为治疗策略。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-051921-115130
Thomas Kaufmann, Hans-Uwe Simon

Apoptosis is central for the maintenance of health. In the immune system, apoptosis guarantees proper development of immune cells and shutdown of immune reactions by the coordinated elimination of activated immune cells. Limitation of the life span of granulocytes is important, as overactivation of these cells is associated with chronic inflammation and collateral tissue damage. Consequently, targeted induction of granulocyte apoptosis may be beneficial in the course of respective immune disorders. Anti-inflammatory drugs such as glucocorticoids and monoclonal antibodies against IL-5Rα exert their function in part by triggering eosinophil apoptosis. Agonistic antibodies targeting Siglec-8 or death receptors are tested (pre)clinically. Moreover, a new class of inhibitors targeting antiapoptotic BCL-2 proteins shows great promise for anticancer treatments. Because of their specificity and tolerable side effects, these so-called BH3 mimetics may be worthwhile to evaluate in inflammatory disorders. Here, we review past and recent data on pharmacological apoptosis induction of granulocytes and highlight respective therapeutic potential.

细胞凋亡是维持健康的核心。在免疫系统中,细胞凋亡通过协调消除活化的免疫细胞来保证免疫细胞的正常发育和关闭免疫反应。限制粒细胞的寿命是很重要的,因为这些细胞的过度激活与慢性炎症和附带组织损伤有关。因此,靶向诱导粒细胞凋亡在各自的免疫紊乱过程中可能是有益的。抗炎药物如糖皮质激素和抗IL-5Rα单克隆抗体部分通过触发嗜酸性粒细胞凋亡发挥作用。针对Siglec-8或死亡受体的激动抗体进行临床(预)测试。此外,一类新的靶向抗凋亡BCL-2蛋白的抑制剂显示出抗癌治疗的巨大希望。由于它们的特异性和可耐受的副作用,这些所谓的BH3模拟物可能值得在炎症性疾病中进行评估。在这里,我们回顾了过去和最近的数据在药物诱导粒细胞凋亡和强调各自的治疗潜力。
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引用次数: 2
Fibroblast Growth Factor-Based Pharmacotherapies for the Treatment of Obesity-Related Metabolic Complications. 基于成纤维细胞生长因子的药物疗法治疗肥胖相关代谢并发症。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-032322-093904
Leigang Jin, Ranyao Yang, Leiluo Geng, Aimin Xu

The fibroblast growth factor (FGF) family, which comprises 22 structurally related proteins, plays diverse roles in cell proliferation, differentiation, development, and metabolism. Among them, two classical members (FGF1 and FGF4) and two endocrine members (FGF19 and FGF21) are important regulators of whole-body energy homeostasis, glucose/lipid metabolism, and insulin sensitivity. Preclinical studies have consistently demonstrated the therapeutic benefits of these FGFs for the treatment of obesity, diabetes, dyslipidemia, and nonalcoholic steatohepatitis (NASH). Several genetically engineered FGF19 and FGF21 analogs with improved pharmacodynamic and pharmacokinetic properties have been developed and progressed into various stages of clinical trials. These FGF analogs are effective in alleviating hepatic steatosis, steatohepatitis, and liver fibrosis in biopsy-confirmed NASH patients, whereas their antidiabetic and antiobesity effects are mildand vary greatly in different clinical trials. This review summarizes recent advances in biopharmaceutical development of FGF-based therapies against obesity-related metabolic complications, highlights major challenges in clinical implementation, and discusses possible strategies to overcome these hurdles.

成纤维细胞生长因子(FGF)家族由22种结构相关蛋白组成,在细胞增殖、分化、发育和代谢等方面发挥着多种作用。其中,两个经典成员(FGF1和FGF4)和两个内分泌成员(FGF19和FGF21)是全身能量稳态、糖/脂代谢和胰岛素敏感性的重要调节因子。临床前研究一致证明了这些FGFs在治疗肥胖、糖尿病、血脂异常和非酒精性脂肪性肝炎(NASH)方面的治疗益处。一些基因工程的FGF19和FGF21类似物具有改善的药效学和药代动力学特性,并已开发并进入临床试验的各个阶段。这些FGF类似物可有效缓解活检证实的NASH患者的肝脂肪变性、脂肪性肝炎和肝纤维化,而其抗糖尿病和抗肥胖作用较轻,在不同的临床试验中差异很大。本文综述了基于fgf治疗肥胖相关代谢并发症的生物制药研究的最新进展,强调了临床实施中的主要挑战,并讨论了克服这些障碍的可能策略。
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引用次数: 8
Pharmacological Interventions in Labor and Delivery. 分娩中的药物干预。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-051921-122822
Susan Wray, Sarah Arrowsmith, Andrew Sharp

While there is not a wide range of pregnancy-specific drugs, there are some very specific high-risk areas of obstetric care for which unique pharmacological approaches have been established. In preterm birth, labor induction and augmentation, and the management of postpartum hemorrhage, these pharmacological approaches have become the bedrock in managing some of the most common and problematic areas of antenatal and intrapartum care. In this review, we summarize the existing established and emerging evidence that supports and broadens these pharmacological approaches to obstetric management and its impact on clinical practice. It is clear that existing therapeutics are limited. They have largely been developed from our knowledge of the physiology of the myometrium and act on hormonal receptors and their signaling pathways or on ion channels influencing excitability. Newer drugs in development are mostly refinements of these two approaches, but novel agents from plants and improved formulations are also discussed.

虽然没有广泛的妊娠专用药物,但在一些非常具体的高危产科护理领域,已经建立了独特的药理学方法。在早产,引产和增强,以及产后出血的管理,这些药理学方法已成为管理一些最常见和有问题的产前和产时护理领域的基石。在这篇综述中,我们总结了现有的建立和新兴的证据,支持和扩大这些药理学方法的产科管理及其对临床实践的影响。很明显,现有的治疗方法是有限的。它们在很大程度上是从我们对肌层生理学的了解发展起来的,作用于激素受体及其信号通路或影响兴奋性的离子通道。正在开发的新药大多是对这两种方法的改进,但也讨论了来自植物的新药和改进的配方。
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引用次数: 3
Understanding the Chemical Exposome During Fetal Development and Early Childhood: A Review. 了解胎儿发育和幼儿期化学物质暴露:综述。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-051922-113350
Magdaléna Krausová, Dominik Braun, Tina Buerki-Thurnherr, Claudia Gundacker, Eva Schernhammer, Lukas Wisgrill, Benedikt Warth

Early human life is considered a critical window of susceptibility to external exposures. Infants are exposed to a multitude of environmental factors, collectively referred to as the exposome. The chemical exposome can be summarized as the sum of all xenobiotics that humans are exposed to throughout a lifetime. We review different exposure classes and routes that impact fetal and infant metabolism and the potential toxicological role of mixture effects. We also discuss the progress in human biomonitoring and present possiblemodels for studying maternal-fetal transfer. Data gaps on prenatal and infant exposure to xenobiotic mixtures are identified and include natural biotoxins, in addition to commonly reported synthetic toxicants, to obtain a more holistic assessment of the chemical exposome. We highlight the lack of large-scale studies covering a broad range of xenobiotics. Several recommendations to advance our understanding of the early-life chemical exposome and the subsequent impact on health outcomes are proposed.

人类的早期生活被认为是对外界暴露敏感的关键时期。婴儿暴露于多种环境因素,统称为暴露物。化学物质暴露量可以概括为人类一生中接触到的所有外源性物质的总和。我们回顾了影响胎儿和婴儿代谢的不同暴露类别和途径以及混合效应的潜在毒理学作用。我们还讨论了人类生物监测的进展,并提出了研究母胎移植的可能模型。确定了产前和婴儿接触外源性混合物的数据缺口,除了通常报告的合成毒物外,还包括天然生物毒素,以便对化学品接触进行更全面的评估。我们强调缺乏涵盖广泛的外源性药物的大规模研究。提出了几项建议,以增进我们对生命早期化学接触及其对健康结果的后续影响的理解。
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引用次数: 10
Cognitive Impairment Associated with Schizophrenia: From Pathophysiology to Treatment. 与精神分裂症相关的认知障碍:从病理生理学到治疗。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-051921-093250
Daniel C Javitt

Cognitive impairment is a core feature of schizophrenia and a major contributor to poor functional outcomes. Methods for assessment of cognitive dysfunction in schizophrenia are now well established. In addition, there has been increasing appreciation in recent years of the additional role of social cognitive impairment in driving functional outcomes and of the contributions of sensory-level dysfunction to higher-order impairments. At the neurochemical level, acute administration of N-methyl-d-aspartate receptor (NMDAR) antagonists reproduces the pattern of neurocognitive dysfunction associated with schizophrenia, encouraging the development of treatments targeted at both NMDAR and its interactome. At the local-circuit level, an auditory neurophysiological measure, mismatch negativity, has emerged both as a veridical index of NMDAR dysfunction and excitatory/inhibitory imbalance in schizophrenia and as a critical biomarker for early-stage translational drug development. Although no compounds have yet been approved for treatment of cognitive impairment associated with schizophrenia, several candidates are showing promise in early-phase testing.

认知障碍是精神分裂症的核心特征,也是导致功能不良的主要因素。评估精神分裂症患者认知功能障碍的方法现已得到很好的确立。此外,近年来越来越多的人认识到社会认知障碍在驱动功能结果中的额外作用,以及感觉水平障碍对高阶障碍的贡献。在神经化学水平上,急性给药n -甲基-d-天冬氨酸受体(NMDAR)拮抗剂再现了与精神分裂症相关的神经认知功能障碍模式,鼓励了针对NMDAR及其相互作用组的治疗方法的发展。在局部回路水平上,一种听觉神经生理学测量,失配负性,已经成为精神分裂症NMDAR功能障碍和兴奋/抑制失衡的真实指标,也是早期翻译药物开发的关键生物标志物。虽然目前还没有化合物被批准用于治疗与精神分裂症相关的认知障碍,但一些候选药物在早期测试中显示出希望。
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引用次数: 11
Biased Agonism: Lessons from Studies of Opioid Receptor Agonists. 偏倚激动作用:阿片受体激动剂研究的启示。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-052120-091058
Eamonn Kelly, Alexandra Conibear, Graeme Henderson

In ligand bias different agonist drugs are thought to produce distinct signaling outputs when activating the same receptor. If these signaling outputs mediate therapeutic versus adverse drug effects, then agonists that selectively activate the therapeutic signaling pathway would be extremely beneficial. It has long been thought that μ-opioid receptor agonists that selectively activate G protein- over β-arrestin-dependent signaling pathways would produce effective analgesia without the adverse effects such as respiratory depression. However, more recent data indicate that most of the therapeutic and adverse effects of agonist-induced activation of the μ-opioid receptor are actually mediated by the G protein-dependent signaling pathway, and that a number of drugs described as G protein biased in fact may not be biased, but instead may be low-intrinsic-efficacy agonists. In this review we discuss the current state of the field of bias at the μ-opioid receptor and other opioid receptor subtypes.

在配体偏倚中,当激活同一受体时,不同的激动剂药物被认为产生不同的信号输出。如果这些信号输出介导治疗与不良药物效应,那么选择性激活治疗信号通路的激动剂将是非常有益的。长期以来,人们一直认为μ-阿片受体激动剂可以选择性地激活G蛋白-过β-抑制蛋白依赖的信号通路,从而产生有效的镇痛效果,而不会产生呼吸抑制等副作用。然而,最近的数据表明,大多数激动剂诱导的μ-阿片受体激活的治疗和不良反应实际上是由G蛋白依赖的信号通路介导的,并且一些被描述为G蛋白偏倚的药物实际上可能不是偏倚的,而可能是低内在功效的激动剂。本文综述了μ-阿片受体和其他阿片受体亚型的偏倚研究现状。
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引用次数: 14
Introduction to the Theme "Development of New Drugs: Moving from the Bench to Bedside and Improved Patient Care". 介绍主题“新药的发展:从实验室到床边,改善病人护理”。
IF 12.5 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2023-01-20 DOI: 10.1146/annurev-pharmtox-091222-022612
Terrence F Blaschke, Paul A Insel, Susan G Amara, Urs A Meyer

Investigations in pharmacology and toxicology range from molecular studies to clinical care. Studies in basic and clinical pharmacology and in preclinical and clinical toxicology are all essential in bringing new knowledge and new drugs into clinical use. The 30 reviews in Volume 63 of the Annual Review of Pharmacology and Toxicology explore topics across this spectrum. Examples include "Zebrafish as a Mainstream Model for In Vivo Systems Pharmacology and Toxicology" and "Artificial Intelligence and Machine Learning for Lead-to-Candidate Decision-Making and Beyond." Other reviews discuss components important for drug discovery and development and the use of pharmaceuticals in a variety of diseases. Air pollution continues to increase globally; accordingly, "Air Pollution-Related Neurotoxicity Across the Life Span" is a timely and forward-thinking review. Volume 63 also explores the use of contemporary technologies such as electronic health records, pharmacogenetics, and new drug delivery systems that help enhance and improve the utility of new therapies.

药理学和毒理学的研究范围从分子研究到临床护理。基础药理学和临床药理学、临床前毒理学和临床毒理学的研究是将新知识和新药物应用于临床的必要条件。《药理学和毒理学年度评论》第63卷的30篇评论探讨了这一领域的主题。例子包括“斑马鱼作为体内系统药理学和毒理学的主流模型”和“人工智能和机器学习用于候选人决策及其他方面”。其他评论讨论了药物发现和开发的重要组成部分以及药物在各种疾病中的使用。全球空气污染继续增加;因此,《空气污染与生命周期相关的神经毒性》是一篇及时且具有前瞻性的综述。第63卷还探讨了现代技术的使用,如电子健康记录,药物遗传学和新的药物输送系统,有助于加强和改善新疗法的效用。
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引用次数: 1
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Annual review of pharmacology and toxicology
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