慢性和复杂疾病的不适当建模:如何在预测性、预防性和个性化医学以及转化医学的背景下重新考虑该方法。

IF 6 Q1 MEDICINE, RESEARCH & EXPERIMENTAL The EPMA journal Pub Date : 2019-07-31 eCollection Date: 2019-09-01 DOI:10.1007/s13167-019-00176-z
Soroush Seifirad, Vahid Haghpanah
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引用次数: 20

摘要

临床前研究,如动物模型,是临床研究和后续患者护理的基础。预测性、预防性和个性化医学(PPPM)不仅强调了通过在正确的时间点选择正确的药物、正确的剂量来为患者量身定制的方法,而且还基本上需要通过复杂和最先进的技术来早期识别个体的未列明的病理过程,以便尽早提供有针对性的预防以逆转病理学的表现。这种方法可以通过考虑患者或健康状况不佳的个人的临床、病理、环境和心理社会特征来实现。在这种情况下,对慢性和复杂疾病的不适当建模可能会降低预测潜力,减缓PPPM的发展,从而减缓现代医疗保健的发展。因此,找到我们在综述中提出的问题的解决方案是PPPM和转化医学的共同目标。同时,转化医学和PPPM本质上都需要准确的替代品来建立误导性的动物模型。因此,这项研究旨在为动物模型的有效性提供零星的证据。系统地讨论了当前动物模型的局限性和基于动物模型的药物开发策略。最后,已经提出了各种潜在的代孕者来改变医学研究以及医疗保健领域的不利局面。
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Inappropriate modeling of chronic and complex disorders: How to reconsider the approach in the context of predictive, preventive and personalized medicine, and translational medicine.

Preclinical investigations such as animal modeling make the basis of clinical investigations and subsequently patient care. Predictive, preventive, and personalized medicine (PPPM) not only highlights a patient-tailored approach by choosing the right medication, the right dose at the right time point but it as well essentially requires early identification, by the means of complex and state-of-the-art technologies of unmanifested pathological processes in an individual, in order to deliver targeted prevention early enough to reverse manifestation of a pathology. Such an approach can be achieved by taking into account clinical, pathological, environmental, and psychosocial characteristics of the patients or an individual who has a suboptimal health condition. Inappropriate modeling of chronic and complex disorders, in this context, may diminish the predictive potential and slow down the development of PPPM and consequently modern healthcare. Therefore, it is the common goal of PPPM and translational medicine to find the solution for the problem we present in our review. Both, translational medicine and PPPM in parallel, essentially need accurate surrogates for misleading animal models. This study was therefore undertaken to provide shreds of evidence against the validity of animal models. Limitations of current animal models and drug development strategies based on animal modeling have been systematically discussed. Finally, a variety of potential surrogates have been suggested to change the unfavorable situation in medical research and consequently in healthcare.

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