Q面J
◇Invited1.uavi6,w◇
Chinese
d34-1206/R.ISSN
2007
Phm蜥‘:;.1
ainPhannaeolTher
Society
1009-2501
E-mail:ccpl%@21cn.。∞
Oct;12(10)1081一10昭
Quantitativepharmacology
translationalresearch
in
a
environment
JeffreySBarrett
Laboratoryfor
aepi玩PK/PD。Clinical
of
TheChildren’5Hospital
University
Philadelphia;Pediatrics执舯唰,School
19104,USA
de.
Pharmacology&TherapeuticsDivision,
ofMedwine,
ofPennsylvania,Phihddphia,PA
is
AB鳓【RACr剐3ribed
as
Translationalresearch
generally
thetreatmentNeuroAIDSisusedtoillustratetheapplica・tionofquantitativepharmacologysearch
in,a
translational
re。
theapplicationofbasic
or
sciencediscoveriesto
or
thetreamaent
preventionofdisease
on
injury.Itsvalue
paradigm.
isusuallydeterminedbased
atory
or
thelikelihoodthatG—xp]or-
Call
developmentalresearch
yieldeffectivethem.
pies.Whilethepharmaceuticalindustryhasevdvedinto
a
AcCederesearchisan
importantcomponent
inthe
highlyspecializedsector
engaged
intranslational
community
Ie・
discoveryanddevelopmentofrlewmolecularentities.ⅡketheirindustrialandregulatOryfists
are
search,theacademicmedicalresearchhas
colle鹕,ues.acad鲥cscien-
a
similarlyembracedthisparadigmlargelythmnghthemoti-vationoftheNationalInstituteof
engagedinrespondingtoehansinsevolved
R&Dland—
Health(N珊)via
its
scapewhichdemandsbothefficiencyandinnovation.Theconceptoftranslationalresearchhasdecade
over
Roadmapinitiative.耵leClinicalandTranslationalSci.
enoA,Award(㈣)has
iOilswhich
Call
thepast
createdopportunitiesforinstitut.
and
haslikewisebeen
defined
the
inmanyways.A
providethemultidisciplinaryenvironment
reasonabledefinitionwould
be
applicationofbasic
requiredtoengagesuchresearch.Akeycomponentofthescientificdiscoveriesintoclinicallygermanefindingsand,simultaneously,the
generation
of
scientific
IIl口哩e
CrI姒and
all
elementofboththeNIHRoadmapandthePathisthebridgingofbenchandbedside
questions
m~Critical
based蚰clillicalobservatio璐[1。.A
lucidunder.
re・
scienceviaquantitativepharmacologicrelationships.,11leinfrastructureof
standing
can
befoundintheutilizationoftranslational
areas
the啪versity
of
Pennsylvania(Penn)/
CrSAishighlighted
searchmethodologiesinspecifictherapeuticoncology‘2’3l,nephrology‘4|,
such
as
Children’sHospitalofrelativeto
Philadelphhpain【5】’and
and
cognitive
de.
both
researchandeducationalobjectives
eflse
reliant
clinewithaging。6,j.Thehistorical
parallelcontextto
uponquantitativepharmacology.A
study.NⅡ{-
be
considered
when
discussingthegenesisoftranslational
smallPhRMAwerecont-
sponsoredreseawhprogramexploringNKlrantagonismfor
researchisthatwhilebigand
endingwithdiminishingpipelinesdespite
CorrespondenceAuthorandAddress:JeffreyS.Barrett,HID,FcP
improvements
a
in
bb0咖for
sion
AppliedPK/PD,Clinical
Plmrmacology&'l姗tics
Dt私l巾mllt
highthroughputscreeningandotherdiscovery・-basedinno・-
Divi-
vation¥.acad洲c
to
medical
centers
wereat
lossforhow
era
田mChildren’BHospitalofPhiladelphia
connectthebasicsciencesinthepost—genoIIlic
to
‰University
of
Pennsylvania
MedicalSchool,Pediatrics
clinicalresearcherswhohadheardofseldomvisited.Atthe戤Hne
the‘‘bench”but
had
AbramsonResearchCenter,Rm916H3615CivicCenterBIvdPhiladelphia,PA19104
time。their
and
governingregula-
roadma—
torycounterpartscraftedthecriticalpt引initiativesfromtheFDAdress
path…and
E-mail.-bm-mtj@email.chop.edu
Pholle;267426-5479
Fax:215-590-7544
NIHrespectivelytoad—
forresoh—
these咖oenls
and
providesuggestions
・1082・
tion.Atthecore
oftheseproposalsisa
clearrequestforthecreation
of
interdisciplinaryteams
thatwilldefine
quantitativerelationshipsbridgingdiscoveryanddevelop・mentalscienceandchallenging
hypotheses
regarding
basic
andchnicalpharmacology,facilitatingnovelexperimental
designsand
aiding
indrugdevelopmentdecisionmaking
ingeneral-"quantitativepharmacology”forlackof
a
better
2
NmRoADML心AND
THECLDⅡCAL
AND
TRANSLAT飘)N
SCmNCEAWARD
(CTSA)
Academicresearchisfundedbya
varietyofmecha—
nisms
including
thepublicandprivatesectors
withthe
major
investment
comingfromthe
NationalInstituteof
Health(NIH)which
will
use
muchofits
projected¥28.
6billion2(107budgettofundbiomedicalresearchintheUnitedStates[9|.The
structure
oftheNIHiscomposed
primarilyofdisease・-specificinstitutionswhichhashistori・-callycreated
a
compartmentalized
focus
on
disease
11e—
search;countertonewparadigmswhichencouragemul-tidisciplinaryteamsandthebasic・・to-appliedresearchcon・-
tinuumin
general.The
NIHRoadmapinitiative(http://
nihroadmap.nih.gov)seeks
toresolvethisinfrastructure
barrierand
a
ailnstoacoele玎ltena璐lati彻alDesearch[10J.
Itsmaingoalis“toidentifymajor
opportunitiesandgaps
inbiomedicalresearch
that
no
singleinstituteat
NIH
couldtackle
alone.’’The
roadmap
covers
threemain
themes:
*
“NowPathwaystoDiscovery”:tostimulatethede.velopmentofnovelapproachestounravel
thecom—
plexityofbiologicsystemsandtheirregulation.
*
“ResearchTeamsoftheFuture”:toreducethecul.turalandadministrativeb舢TieIBthatofteninlpederesearch
and
invoke
all
era
inwhichscientists
can
;cooperatein
new
anddifferentways.
*
“Re—engineering
theClinicalResearchEnterprise”:to
fundfacilities,re¥ources,orbothtobolsterelini.ealandtranslationalresearch.
Anoutgrowthoftheroadmapinitiativeisa
newpro-
gramthatfunds
institutionalClinicalandTranslational
Science
Awards(CTSAs).Through
this
mechanism(ht.tp:I/grants.nih.govlgrantslguidelnotice—files/NOT-RM一
05-013.h叫),applicants
mayproposetransformtiveef-forts
appropriate
totheirown
institutions.The
CISAswill
advancetheassemblyofinstitutionalacademic“homes’’
providingintegratedintellectualandphysical
re¥o嘲for
theconduct
of
original
clinical
andtranslationalsci-
enCe【11,12].
Itisexpectedthatthedevelopmentoftheseenviron-
mentswill,overtime,enhancethediscipline,provide
much-needededucationalprograms,contributetothe
growthofwell—structuredandwell—recognized
career
path-
ways,andprovide
a
researchenvironmentthatismore
nimble,conduciveto,andresponsivetothedemandsofmoderntranslationalandclinicalresearch.Toallowinsti—
tutions
to
buildaninnovativeandintegratedprogram,the
NIHhasaskedapplicantstoconsolidateGeneralClinicalResearch
Centers(GCRCs),T32andK12programs,andotherre¥ourcesas
appropriate.These
reflources
may
be
augmentedbysubstantialNIHRoadmapfundingredirect-
edfromotherinitiativesandtargetedtotheCTSApro—gram,withtheNationalCenterforResearchResources.astheleadNIHentity.Recently,theNIHawarded
a
con—
sortiumof12institutions(http://www.hen".nih.gov/
ncrrprog/madmap/CTSA一9-2006.asp)thefirstfundingthroughtheCISAprogramtotalingj5108millionthefirst
year.Theawards黜for
5yearsandtheprogramitself
willeventuallyreplacetheGCRCs[13].
0F咖。ADEI脚A3
咖P】盼州,C印匝DREN’SC瞰
II(熔P】呲Oneoftheinitial12CTSArecipientswasthePenn
and
itspartnerinstitutions,theChildren’sHospitalof
Philadelphia(CHOP),theWistar
InstituteandtheUni-
versityoftheSciencesinPhiladelphia.Theirapplication
includedparticipationfromthe
SchoolsofMedicine,
Nursing,Dentistry,Education,ArtsandSciences,Vet-eIiIlary,EngineeringandAppliedSciences,theAnnen—bergSchoolof
Communications,and
theWhartonBusi-
ness
SchoolwithinPenncombinedwithcolleaguesfrom
externalpartnershipsintonovel,interdisciplinary・struc-
tures
andprograms.PennandCHOP.together诵Ⅱ1their
partnerinstitutionsinclude
a
laI琴ecriticalIlm鹪ofsenior
facultyaccomplishedinthetranslationofa
diversearmy
oftherapeutic
modalities—small
molecules,proteins,
genes,vaccines—intotheclinicaldomain.Togetherthey
have
a
remarkabletrainingrecord—more
NIHsupported
拓ailliJlggrantsthananyotherinstitution,thela增estreed—icalsciencetrainingprograminthecountryandmultiple
・1083・
junior
facultyholdingKawards.Theyalsohavetwowellofnewmedicinesiswellappreciated
and
pervasiveinin-
establishedNIHfundedGCRCs诵tIlpotentialtobridgethepediatricsents
a
dustry.academiaandtheregulatorycommunityt1引.Fig2
contains
a
adultinterface.Finally,thegrouprepm—schematicofthepmposedbythePenn/CHOP
educational
program
singlegeographiccampusfacilitatingtheengage-supported
CTSA.TheITMAThad
mentof
chemists,engineers,statisticians,nurses,veteri—
sha-
proposedthen踟le“TranslationalMedicineandTherapeu-
tics'’toembracethe
narians,dentists,pharmacists,policymakersandprojectionofbasicdisciplinesinto
ofdevelopingnovel
pemandexpertsinconmmrcializationwithbiomedicalsci.theehnicaldomainwiththe
objective
entists,epidemiologistsand
7111e
Penn/CHOP
physicians.
plan
involves
a
therapeutics.Suchindividualswouldbetrainedinthede.
velopmentandfromcellular
transformational
commitmentbytheinstitutionsinvolvedto(a)collaborateandsupporttherecruitmentsandpmgramsinthefieldofclinicalandtranslational
projectionof.mechanismbasedbiomarkersandmodelsystemstoguiderationaldosese.
to
1ection.Furthermore,theywouldbetrained
emerging
use
applythe
research;(b)devote
substantial
andbioinformatic
as
analysisofoutputfrom
and
space(wetand
tional
dry
laboratories)to
clinicalandtransla-
ex.
technologies,such
pmteomies,metabolomics
research;and(c)foster
thetrails—institutionalgenomics,toselectbetweendiversemoleculesdirectedat
a
pausionofthe“academichome”ofthisenterprise—the
InstituteforTranslationalMedicineandTherapeutics(IT.
singulartarget.WhiletheKMAS
core
willprovidefunc-
tionalsupportofquantitativepharmacologyactivities,a
MAT)topermitdevelopmentofnewcenters.coresandPharmacometricTrainingUnitwillprovideeducationaltrainingresources
inadditionto
and
interdisciplinarypmgramsofresearchandeducation.Anpreviouslycreatedpro-
on
importantgoalforthePenn/CHOPplanisthedevelop・
mentoffocusedstrategicallianceswiththeFDA
gramsintranslationalmedicine.Initially,amodule
tracer
and
the
kinetics,pharmacokineties,andcompartmental
modeling
a
and
core
phammeeutiealandcomputingindustries.Besidesthesealliances,theengagementofBioAdvanee(http://www.bioadvanee.com),astatefundedentity
pharmaeometricrequirementeleetivelyasdegree
in
a
willbe
offeredas
a
Translational
Therapeuticstrackand
or
a
charged稍tll‰一
as-
standalonecourse
componentinother
teringthedevelopmentofthelifesciencesinsoutheasternPennsylvaniahasalsobeensecured.BioAdvancewillsistinproviding
resolll℃e
courses
administeredvia1TMATin
support
ofthe
CTSA.PhRMAandFDAstaffwillparticipate,bothas
fbftlle
acc,ess
oftraineesbased
facultyparticipantsandassitesforrotationsiteforCTSA
students.BioAdvancewillfacilitateregionalizationofeesstothisprogram.
ac—
withprimaryappointmentsinregional
institutionstothese
educationalinstrumentsandwillalsosupportthedevelop-
mentofand
regionalization
ofacces,a5to
bioinformatieslshowsthe
4
platformsdevelopedthroughthevarious
cores
C融~.Fig
CASEsTUDY:NKlr
ANI'AGoNISM
IN
centers
whichcomprise1TMATwiththeassociated
NEURoAⅡ烬
whichwillservicetheTranslationalResearchCen.
An
exampleofthe
integrationofthe
all
quantitative
ter.’nlesupportofquantitativepharmacologypracticewillbeprovidedby
pharmacologyapproachappliedtotionalresearchinitiativefortstoexplore
can
academictransla—
tlleⅪ垤AS(KineticModelingandSimula-beillustratedwithrecentel-
totreatNeu—
tion)Core(http://www.reed.upenn.edulkmasl)whichWill(a)aidinthedevelopmentofdrugassays;(b)pm—
moteandassistintheperformanceoftracerkineticstud—
NKlreceptorantagonism
mAIDS.nis
projectisfundedbytheNationalInstitutes
ofAllergyandInfectioustionalInstitutesofMental
Disease(NIAID)andHealth(NIMH)of
seekstoestablish
theNa—the
a
ies;(c)developnovelapproaches
to
kineticdataanalys-
kineticmodel.
Nm
mul-
is;(d)providePK,PK/PD,and
tracer
program(PAR-03—138)which
ing;and(e)developeducationalmodulesinphannacoki-neticsandtiltcerkineticstopopulatetheeducationaliniti-
ativespursuedwithintheCTSA.
AcentralmissionofITMAThas
beeneducation.
tidisciplinaryresearchanddevelopmentprogramtargetedtowardthediscovery,developmentandevaluationofinno—vativetherapiesforHIVinfection(http://grants.nih.gov/
grants/guide/pa-files/PAR一03—138.html).%e
goaloftheprogramisto
overall
’nledeficiencyofhumancapitalintranslationalresearch.particularlywithrespectto’thedevelopmentandevaluation
andtechnicalprogress
supportandacceleratescientificinnon—traditionalandtraditional
.・
1084・
drug-basedtherapiesthatexploitnovelviralandcellulartargetsofimportanceinHIVinfection.Abenchmarkfora
SUCCesSfUlprogramisthedevelopmentof
a
newtreatment
concept
that
call
beintroduced
to
clinicalpractice.Theabilityofneurokinin・1receptor(NK—lR)antagoniststotargetthesubstanceP(SP)receptordemonstratingantivi-ralandimmunomodulatoryeffects[15—17]renew
therapeutictargetwiththepotentialtointerrupt
a
pathway
criticaltoHIVreplication【18,19‘.ThegoalofthisspecificIntegratedPreclinical/ClinicalProgram(IPCP)istoiden—tify
an
NK-IRantagonistthatis:(a)active
a8
ananti—HIVagenttIlrougIlinteractionwithchemokine/cytokinereceptom(Project1);(b)specific
forchemokineandG-
proteincoupledreceptors(Project2);(c)safefor
nile
in
SIV・-infectednon・-humanprimatesandprovidesproofof
concept
related
to
antiviral,immunomodulatory,and
neu—
robehavioraleffects(Project3);and(d)safeinhumansandhaspositiveimmunomodulatoryeffects(Project4).
Allprojectscontributetounderstandingthebasicvirolog—ie,molecularandcellularimmunologic
mechanismsof
SP,NK一1R
antagonists,and
HIV/SIVinfection.
AkeyelementintheIPCPistheintegrationofmod—
and
simulation
s£m硒es
to
supportthe
valjous
projects
as
wellasinformtheadministrativecore.Specifi—
cally,computationaltechniquesale
employedtochallengethe“drnggabililty”of
the
candidateagents.Insilico
ADMEtechniques
are
usedaspartoftherankingcriteria
bywhichwewillprioritizetheadvancementofselected
agents.Theapproach
enablesthecalculationofmolecular
descriptomandpredictionofdrug-likeness
data
using2D
structures,andwithouttheneedforspecial
computationalchemistryknowledge.Aspharumeology
and
biology/mechanismdata
ale
generated
forthevariousagents(Projects
1
and2),thegenemlizability
of
QSAR
QSPK
relationshipsforthiscompoundclasswill
be
explored.Fig3illustratestheintegrationofquantitative
pharmacologyapplication
acroK¥projects
forthisIPCP.
TheNKlRprojectisdependenton
two
primarypro—
pathways:(1)examine
theextenttowhichtheRantagonist
aprepitantis
a
suitableagentforART
in
NeuroAIDS
patientsbased
on
exlx挎ure—-re・・
criteriaconstructedfromits
presumed
actionsand
(2)examinethecorrelationbetweenaprepitantpreclinical
pharmacology,druggabilitycriteriaandPK/PDrelation-shipstogeneralizeandultimatelyranksuitablehack-up
compounds.Within
thefirstpathwaythereis
a
progres—
sionofexperiments,predefinedcriteriaforstageadvance-
mentanddecision
trees
thatguidetheoverallprogression.
These
ar;e
facilitatedbymodelingandsimUlationexercises
permittingscenariotestingforsubsequentexperimentsandtestingof
assumptions
fundamentaltokeyassumptionsfor
theoverallprogram.OneoftheessentialbridgesinthisIF-CPisthe
suitabilityofan
SIV
pharmacology/disease
modeltopredict
success
outcomesinHIV.Intheseries
ofexperimentsthathasensued,thePK/PDofaprepitantmSIV—infectedanimalshavebeencharacterizedandusedin
conjunctionwith
relevantdatafromchemotherapy--in-・
duced
nausea
andvomiting(CmV)patients
to
buildsim-
ulationmodelsthatprojectresponse
inHIV-・infectedpa--
tients.The
use
ofmodelingandsimulation
to
advance
compoundprogressionofantiretroviralagentsrecentlyice—
viewedbyBarrett[驯contains
a
morethoroughdescription
ofthis
case
study.
5CONCIjUSIoN
Itisclearthatacademicmedicalcenterswillbe
all
importantplayerin
the
evolving
R&Dparadigms
which
willguidethediscoveryof
new
molecularentitiesinthe
yearstocome.Translationalresearchisan
approachthat
reliesheavily
on
theinteractionbetweenbasicand
clinical
scientistsandtheappropriatecommunicationofideas,hy・
pothesesandexperimentaldesigns
toevaluatediseasetherapies.,11leconceptof
quantitativephanmeology
is.in
essence,a
communication
platformbywhichtranslational
researchcanbediscussedand
in
which
h.ssumptions,
modelsandsimulations
are
integrated
intodecision.mak.
ingtools.ItisalsoclearthattherecenteffortsoftheFDAandNIHreflecttherecognitionthatthisskillsetisin
short
supplyandwillrequirededicatedprogramstotrainfuture
generationsofscientiststhat
conduct
translational
re-
search.
A删眦。EDE^诬Ⅳ巧:Dr.Barrett’5
effortissup—
byNlHGrant’s.P01饕MH076388andtU54
#R尺0235f订.0】
clingmolecularand
gressionNKItherapy
portedsponse
・1085・
../厂
r,
、
’;
(
Tf.anslational
I啪m…edica吲l
In酬for肾m
t.cs
蕞慕豫衙藩商赢≥
甑t
5
ResearchCenter
)
!。ging‘C,en¨,J}、灌
ChemicalBiologyInTI.anslation
PersonalizedMedicine
inT『翟nslation
惑。N.
1.|
I’
:
CENTER
TransIationaIResearchcenter
ASSoClATEDCoRES
圆圈圃
匣匝习匹习
~∥||K;/
Figure1InstituteforTranslaiionalMedicineandTherapeutics(ITMAT)Centersproposedwithinthe
Penll/CHOPCTSAgrantandthenewcoressupportingtheTranslationalResearchCenter.TheKMAS(KineticModelingandSimulation)corewillprovidetechnologicexpertiseforintegrationofquantitativepharmacologyintothetranslationalresearchparadigm.TRL=TranslationalResearchLaboratories,SDAB=StudyDesignandBiostatistics
TATCO=TranslationalandClinicalTrialOrganization
.
E一,IDS、]i:@
CCS=ClinicalCoreServices
OHSAP=O伍ceofHumanSubiectAdvocacy&Protection
RNC=ResearchNurseCore
IDS=InvestigationalDrugService
KMAS=Kinetics.ModelingandSimulation
・
1086・
Chin
JClinPham——mcolTher2007Oct;12(10)
Figure2ThePenn/CHOPeducationalprogramproposedfortheCTSAtargetsthefullspectrumofpotentialandexistingtrainees,fromundergraduatestograduatestudents,fellows,andfaculty.Asindividualsrequiredifferentlevelsandtypesoftrainingateachstageoftheiracademicdevelopment,multipleoptionsprovidedforexposuretotranslationalresearchrangingfrompreview/awareness
courses
are
to
certification,
mastersanddoctoraldegreeprograms.
・
1087・
Quantitation/M&STasks
Literatureandexperimentalpriori;:
・80%InhibitionofHWBaIstraininmonocy慷derivedmacrophages(io・6H1
‘AssumeexPOsuretargetsimilartoinvitro
activity?target
Translational肋rkflow
HypothesesbyStage
・DoesthestructuresuggestN3MEpropertieswhichconsistentwith"druggable”agents?
・isthecompound”active。intherangeofconcentraUonswhich
wouldbe
trough瞻concent怕Uon~
100—500ng/mL.
・Hetabolized
primadlybyCYP3A4;minor
metabolismby“P1A2andcYp2C19.・Enzymeinductionreducestheexposure
foIlowingchronicadministraUon.・ProteinbiridIng一95%;F
9-13hr
w
.
pharmacologically
achievable?
・Isthereevidenceofsynergywith
thevariousexperimentalagentsandmarketedanUrotrovirals?
・WhatistheQSARbetweenCCR5
andNKlreceptors?
60"6S%;HaIf-life:
・Moderatevariabili~inClearanceandVolume
0fdistribuUon
・Staged
first-orderinput
explainsabsomuon
・Isthe
monkey
the
areasonable
l‘a1I‘|2
——斗
presumedNKlr
mechanism(s)ofaction?
mode}for
・Canthe
extrapolated
SW/monkeymodelbe
tothehumanP“PD
behavior(neourocogn砌ve,
antirotroviral,etc)?
・Can
theSIv/monkeymodeIbe
tothehumanHⅣ
disease?
extrapolated
・Canactivitybedemonstratedat
thedoseandduraUonoftherapynegotiatedwithFDA?・Doesthe
.S..1.m....u..1.a...U...o..n....M...o..d...e..1..R...e..s..u...1.t.s.:
・Therapeuticwindowlikelysusceptibleto
・Inductionmay
variationin
response
suggestiveofresD0nder/non-responderpartitiongiventhe
。small・Is
interactions,adherence
bemanageable
・ARV/doselikelyexceedsofCINVdose
samplesize?
thePK/PDadequatelydefinedsuchthatdoseextrapolaUoncanbemadereliably?
・isthereSU仟icientcorrelaUon
betweenQSAPaandtherankingsuggestaback-up
apropt口nc,
・IsthereatherapeuticresponseforNeuroAIDSbasedonthe
aprepitantPhaseIbtrialthatcanbetargetedfromearlier
compoundtocriteriato
T■_M
(preclinical)data?
^啊■-●岫:一●■一一_I■_
CINV=chemotherapy-inducednauseaandvomitingSIV=simianimmunodeficiencyvirusARV=antiretroviral
Figure
3An
example
ofquantitative
pharmacologicalprinciplesapplied
totranslationalresearch:
Relationshipswithaprepitantfrominvitrodata,invivodatainanimals,andinvivodatainCINVpatientsused
to
predictHIV-infectedpatientresponseandNeuroAIDsdiseaseprogression.
・1088・
new
vision[J].Nr,w,1J
Med,2005;353:162l一1623.
and
12
1
ZerllouniEA,Al、rir瞩B.Climcalawards:aframework1.0rRes,2006;148:4—5.
a
tramlafionalscienoe
晰AK.Transitional
ogy,1999;116:1285.Opm
research:whati8
it[jJ?Gastroen咖l—
13
rationalresearchagenda[J].Traml
2
R舶eⅡR,MonzoM,0’B憎teA,砑以.TramlafionalOl'lCOg.
enomics:towardrationaltherapeutic
Kai∞rJ.Biomedicine.N】时funds
a
down’hom嘴’f撕transla.
d础ion-making[J].Curr
fional陀Bearch[J].science,2006;314:237.
14
DauphineeD,MartinJB.BreakirlgdowntIlethe
Oneol,20吆;14:171一179.
GJ,SigmanCC,GreenwaldP.Cancerehemopreven-
walls:thou曲tson
3Keloff
scb【盯幽p
0f
mtegration[J].Acad
Med,2000;75:881—
fion:progress2088.4
and删∞lJJ.EIlr
886.15
HoWZ,CnaanA,“YH,d以.Su]粥taneePmodttlateshu.mallblood
immunoddlciencyvirusIeplicationin
humanpenpher.1
JCancer,1999;35:203l一
Hum瞄曲.Tmnsladonal
mediei∞andtIleNationalInsfitutesof
Healtllroadmap:steepgraclesandClnMed,2005;146:51—54.
’
to咖伽scun,鹄[J].J
Lab
monoeyte-&fivedmacmphag瞄[J].AIDSllesHumRet—
P麟一
rovimses,1996;12:195—198.
5
Mao
J.Transitionalpainresearch:晡dgingtllegapbetween
16Ho
WZ,hiJP,UY,甜af.ⅧV
basic卸delimcalre=e,lreh[J].Pain,2002;97:183—187.
6
BrownSC,ParkI)C.Theoreticalmodel80fcogniive
pressioninhumanilnnllme—618.
eells[J].眦B
in
enhanc∞substance
J,2002;16:616
agingand
imptcafiomfortranslationalresearchiIlmedicine[J].Gemntol—o西st,2003;43:57—67.
7
17场JP,HoWz,ZlumGX,税以.subs咖Pantagonist(CP-
96.345)inhibits
HIV-l酬ication
NailAead
humanmoflonuclo_.,alr
CI)阴,US
Foodand
DmgAdministration.IllnOvllIJonandstag-
On
pllagoc归[J].Proc
sci吣~,2001;98:3970—
substanceP
nation:Challenge锄dopportunity
medicinalproducts|S8
thecritical
p讪to
new
1.2004.
ZerhouniE.Nedicine.711leNIH302:63—72.
R0蛳[J].science,2003;
andopportu-
18叫鹪SD,Ho
levels19
3975.
in阱i瓶ectedmen[J].AIDs,200l;15:2043—2045.
J,PerkimD0,髓以.Stress-associated
WZ,Gettes
DR,甜以.Eh砷ed
EvansDL,Lef℃Ilmlm
9
I_osealzo
J.TtleNIHbudgetandthe缸tureofbiomedieal陀.
Engl
reduetiomofcvtoto菇cT
search[J].N
10
norignm鹤iII708.1l
JMed,2006;354:1665—1667.
20
船)吼l栅mtic
543—550.Barrett
lymphoc舾锄dnaturalkillereelsirI
HⅣi如lon[JJ.AmJPsycIlia何,1995;152:
c伽咖und
progression0fanti|etroviral
H,Marin砒E,Marin池F1VI.0bslacles
trans舢onal
research[J].Nat
Med,20Q5;ll:705—
JS.Faclimfing
agentsvia
modelllg卸dsimuladon[J].JNettroimmunePhar—
Ze由ourliEA.Translationaland
clillical∞ier妒time
for
llmcol。20I昕;2:58—71.
a
转化型研究中的定量药理学
摘要转化型研究一般是指将基础科学发现应用到治疗或预防疾病或损伤,其价值通常是基于探索或
品药物管理局的关键路径计划中的一个元素就是通
过定量药理学研究桥接基础与临床科学。美国宾夕法尼亚大学/费城儿童医院临床和转化型研究相对
发展可产生有效疗法的可能性。当今的制药工业已发展成为一个从事转化型研究的高度专业化行业,在美国国立卫生研究院的倡议及激励下,医学科研
队伍同样接受了这一模式。临床和转化型研究奖的
突出,两项研究和教育目标均依赖于定量药理学。美国国立卫生研究院所赞助的一项旨在探索神经激
肽l受体拮抗用于治疗神经性爱滋病的研究案例,
设立可以为能从事此类研究机构所需的多学科环境创造机会。临床和转化型研究奖的一个关键组成部分以及美国国立卫生研究院的工作路线图和美国食
正是用来说明运用定量药理进行转化型研究的范
例。
Q面J
◇Invited1.uavi6,w◇
Chinese
d34-1206/R.ISSN
2007
Phm蜥‘:;.1
ainPhannaeolTher
Society
1009-2501
E-mail:ccpl%@21cn.。∞
Oct;12(10)1081一10昭
Quantitativepharmacology
translationalresearch
in
a
environment
JeffreySBarrett
Laboratoryfor
aepi玩PK/PD。Clinical
of
TheChildren’5Hospital
University
Philadelphia;Pediatrics执舯唰,School
19104,USA
de.
Pharmacology&TherapeuticsDivision,
ofMedwine,
ofPennsylvania,Phihddphia,PA
is
AB鳓【RACr剐3ribed
as
Translationalresearch
generally
thetreatmentNeuroAIDSisusedtoillustratetheapplica・tionofquantitativepharmacologysearch
in,a
translational
re。
theapplicationofbasic
or
sciencediscoveriesto
or
thetreamaent
preventionofdisease
on
injury.Itsvalue
paradigm.
isusuallydeterminedbased
atory
or
thelikelihoodthatG—xp]or-
Call
developmentalresearch
yieldeffectivethem.
pies.Whilethepharmaceuticalindustryhasevdvedinto
a
AcCederesearchisan
importantcomponent
inthe
highlyspecializedsector
engaged
intranslational
community
Ie・
discoveryanddevelopmentofrlewmolecularentities.ⅡketheirindustrialandregulatOryfists
are
search,theacademicmedicalresearchhas
colle鹕,ues.acad鲥cscien-
a
similarlyembracedthisparadigmlargelythmnghthemoti-vationoftheNationalInstituteof
engagedinrespondingtoehansinsevolved
R&Dland—
Health(N珊)via
its
scapewhichdemandsbothefficiencyandinnovation.Theconceptoftranslationalresearchhasdecade
over
Roadmapinitiative.耵leClinicalandTranslationalSci.
enoA,Award(㈣)has
iOilswhich
Call
thepast
createdopportunitiesforinstitut.
and
haslikewisebeen
defined
the
inmanyways.A
providethemultidisciplinaryenvironment
reasonabledefinitionwould
be
applicationofbasic
requiredtoengagesuchresearch.Akeycomponentofthescientificdiscoveriesintoclinicallygermanefindingsand,simultaneously,the
generation
of
scientific
IIl口哩e
CrI姒and
all
elementofboththeNIHRoadmapandthePathisthebridgingofbenchandbedside
questions
m~Critical
based蚰clillicalobservatio璐[1。.A
lucidunder.
re・
scienceviaquantitativepharmacologicrelationships.,11leinfrastructureof
standing
can
befoundintheutilizationoftranslational
areas
the啪versity
of
Pennsylvania(Penn)/
CrSAishighlighted
searchmethodologiesinspecifictherapeuticoncology‘2’3l,nephrology‘4|,
such
as
Children’sHospitalofrelativeto
Philadelphhpain【5】’and
and
cognitive
de.
both
researchandeducationalobjectives
eflse
reliant
clinewithaging。6,j.Thehistorical
parallelcontextto
uponquantitativepharmacology.A
study.NⅡ{-
be
considered
when
discussingthegenesisoftranslational
smallPhRMAwerecont-
sponsoredreseawhprogramexploringNKlrantagonismfor
researchisthatwhilebigand
endingwithdiminishingpipelinesdespite
CorrespondenceAuthorandAddress:JeffreyS.Barrett,HID,FcP
improvements
a
in
bb0咖for
sion
AppliedPK/PD,Clinical
Plmrmacology&'l姗tics
Dt私l巾mllt
highthroughputscreeningandotherdiscovery・-basedinno・-
Divi-
vation¥.acad洲c
to
medical
centers
wereat
lossforhow
era
田mChildren’BHospitalofPhiladelphia
connectthebasicsciencesinthepost—genoIIlic
to
‰University
of
Pennsylvania
MedicalSchool,Pediatrics
clinicalresearcherswhohadheardofseldomvisited.Atthe戤Hne
the‘‘bench”but
had
AbramsonResearchCenter,Rm916H3615CivicCenterBIvdPhiladelphia,PA19104
time。their
and
governingregula-
roadma—
torycounterpartscraftedthecriticalpt引initiativesfromtheFDAdress
path…and
E-mail.-bm-mtj@email.chop.edu
Pholle;267426-5479
Fax:215-590-7544
NIHrespectivelytoad—
forresoh—
these咖oenls
and
providesuggestions
・1082・
tion.Atthecore
oftheseproposalsisa
clearrequestforthecreation
of
interdisciplinaryteams
thatwilldefine
quantitativerelationshipsbridgingdiscoveryanddevelop・mentalscienceandchallenging
hypotheses
regarding
basic
andchnicalpharmacology,facilitatingnovelexperimental
designsand
aiding
indrugdevelopmentdecisionmaking
ingeneral-"quantitativepharmacology”forlackof
a
better
2
NmRoADML心AND
THECLDⅡCAL
AND
TRANSLAT飘)N
SCmNCEAWARD
(CTSA)
Academicresearchisfundedbya
varietyofmecha—
nisms
including
thepublicandprivatesectors
withthe
major
investment
comingfromthe
NationalInstituteof
Health(NIH)which
will
use
muchofits
projected¥28.
6billion2(107budgettofundbiomedicalresearchintheUnitedStates[9|.The
structure
oftheNIHiscomposed
primarilyofdisease・-specificinstitutionswhichhashistori・-callycreated
a
compartmentalized
focus
on
disease
11e—
search;countertonewparadigmswhichencouragemul-tidisciplinaryteamsandthebasic・・to-appliedresearchcon・-
tinuumin
general.The
NIHRoadmapinitiative(http://
nihroadmap.nih.gov)seeks
toresolvethisinfrastructure
barrierand
a
ailnstoacoele玎ltena璐lati彻alDesearch[10J.
Itsmaingoalis“toidentifymajor
opportunitiesandgaps
inbiomedicalresearch
that
no
singleinstituteat
NIH
couldtackle
alone.’’The
roadmap
covers
threemain
themes:
*
“NowPathwaystoDiscovery”:tostimulatethede.velopmentofnovelapproachestounravel
thecom—
plexityofbiologicsystemsandtheirregulation.
*
“ResearchTeamsoftheFuture”:toreducethecul.turalandadministrativeb舢TieIBthatofteninlpederesearch
and
invoke
all
era
inwhichscientists
can
;cooperatein
new
anddifferentways.
*
“Re—engineering
theClinicalResearchEnterprise”:to
fundfacilities,re¥ources,orbothtobolsterelini.ealandtranslationalresearch.
Anoutgrowthoftheroadmapinitiativeisa
newpro-
gramthatfunds
institutionalClinicalandTranslational
Science
Awards(CTSAs).Through
this
mechanism(ht.tp:I/grants.nih.govlgrantslguidelnotice—files/NOT-RM一
05-013.h叫),applicants
mayproposetransformtiveef-forts
appropriate
totheirown
institutions.The
CISAswill
advancetheassemblyofinstitutionalacademic“homes’’
providingintegratedintellectualandphysical
re¥o嘲for
theconduct
of
original
clinical
andtranslationalsci-
enCe【11,12].
Itisexpectedthatthedevelopmentoftheseenviron-
mentswill,overtime,enhancethediscipline,provide
much-needededucationalprograms,contributetothe
growthofwell—structuredandwell—recognized
career
path-
ways,andprovide
a
researchenvironmentthatismore
nimble,conduciveto,andresponsivetothedemandsofmoderntranslationalandclinicalresearch.Toallowinsti—
tutions
to
buildaninnovativeandintegratedprogram,the
NIHhasaskedapplicantstoconsolidateGeneralClinicalResearch
Centers(GCRCs),T32andK12programs,andotherre¥ourcesas
appropriate.These
reflources
may
be
augmentedbysubstantialNIHRoadmapfundingredirect-
edfromotherinitiativesandtargetedtotheCTSApro—gram,withtheNationalCenterforResearchResources.astheleadNIHentity.Recently,theNIHawarded
a
con—
sortiumof12institutions(http://www.hen".nih.gov/
ncrrprog/madmap/CTSA一9-2006.asp)thefirstfundingthroughtheCISAprogramtotalingj5108millionthefirst
year.Theawards黜for
5yearsandtheprogramitself
willeventuallyreplacetheGCRCs[13].
0F咖。ADEI脚A3
咖P】盼州,C印匝DREN’SC瞰
II(熔P】呲Oneoftheinitial12CTSArecipientswasthePenn
and
itspartnerinstitutions,theChildren’sHospitalof
Philadelphia(CHOP),theWistar
InstituteandtheUni-
versityoftheSciencesinPhiladelphia.Theirapplication
includedparticipationfromthe
SchoolsofMedicine,
Nursing,Dentistry,Education,ArtsandSciences,Vet-eIiIlary,EngineeringandAppliedSciences,theAnnen—bergSchoolof
Communications,and
theWhartonBusi-
ness
SchoolwithinPenncombinedwithcolleaguesfrom
externalpartnershipsintonovel,interdisciplinary・struc-
tures
andprograms.PennandCHOP.together诵Ⅱ1their
partnerinstitutionsinclude
a
laI琴ecriticalIlm鹪ofsenior
facultyaccomplishedinthetranslationofa
diversearmy
oftherapeutic
modalities—small
molecules,proteins,
genes,vaccines—intotheclinicaldomain.Togetherthey
have
a
remarkabletrainingrecord—more
NIHsupported
拓ailliJlggrantsthananyotherinstitution,thela增estreed—icalsciencetrainingprograminthecountryandmultiple
・1083・
junior
facultyholdingKawards.Theyalsohavetwowellofnewmedicinesiswellappreciated
and
pervasiveinin-
establishedNIHfundedGCRCs诵tIlpotentialtobridgethepediatricsents
a
dustry.academiaandtheregulatorycommunityt1引.Fig2
contains
a
adultinterface.Finally,thegrouprepm—schematicofthepmposedbythePenn/CHOP
educational
program
singlegeographiccampusfacilitatingtheengage-supported
CTSA.TheITMAThad
mentof
chemists,engineers,statisticians,nurses,veteri—
sha-
proposedthen踟le“TranslationalMedicineandTherapeu-
tics'’toembracethe
narians,dentists,pharmacists,policymakersandprojectionofbasicdisciplinesinto
ofdevelopingnovel
pemandexpertsinconmmrcializationwithbiomedicalsci.theehnicaldomainwiththe
objective
entists,epidemiologistsand
7111e
Penn/CHOP
physicians.
plan
involves
a
therapeutics.Suchindividualswouldbetrainedinthede.
velopmentandfromcellular
transformational
commitmentbytheinstitutionsinvolvedto(a)collaborateandsupporttherecruitmentsandpmgramsinthefieldofclinicalandtranslational
projectionof.mechanismbasedbiomarkersandmodelsystemstoguiderationaldosese.
to
1ection.Furthermore,theywouldbetrained
emerging
use
applythe
research;(b)devote
substantial
andbioinformatic
as
analysisofoutputfrom
and
space(wetand
tional
dry
laboratories)to
clinicalandtransla-
ex.
technologies,such
pmteomies,metabolomics
research;and(c)foster
thetrails—institutionalgenomics,toselectbetweendiversemoleculesdirectedat
a
pausionofthe“academichome”ofthisenterprise—the
InstituteforTranslationalMedicineandTherapeutics(IT.
singulartarget.WhiletheKMAS
core
willprovidefunc-
tionalsupportofquantitativepharmacologyactivities,a
MAT)topermitdevelopmentofnewcenters.coresandPharmacometricTrainingUnitwillprovideeducationaltrainingresources
inadditionto
and
interdisciplinarypmgramsofresearchandeducation.Anpreviouslycreatedpro-
on
importantgoalforthePenn/CHOPplanisthedevelop・
mentoffocusedstrategicallianceswiththeFDA
gramsintranslationalmedicine.Initially,amodule
tracer
and
the
kinetics,pharmacokineties,andcompartmental
modeling
a
and
core
phammeeutiealandcomputingindustries.Besidesthesealliances,theengagementofBioAdvanee(http://www.bioadvanee.com),astatefundedentity
pharmaeometricrequirementeleetivelyasdegree
in
a
willbe
offeredas
a
Translational
Therapeuticstrackand
or
a
charged稍tll‰一
as-
standalonecourse
componentinother
teringthedevelopmentofthelifesciencesinsoutheasternPennsylvaniahasalsobeensecured.BioAdvancewillsistinproviding
resolll℃e
courses
administeredvia1TMATin
support
ofthe
CTSA.PhRMAandFDAstaffwillparticipate,bothas
fbftlle
acc,ess
oftraineesbased
facultyparticipantsandassitesforrotationsiteforCTSA
students.BioAdvancewillfacilitateregionalizationofeesstothisprogram.
ac—
withprimaryappointmentsinregional
institutionstothese
educationalinstrumentsandwillalsosupportthedevelop-
mentofand
regionalization
ofacces,a5to
bioinformatieslshowsthe
4
platformsdevelopedthroughthevarious
cores
C融~.Fig
CASEsTUDY:NKlr
ANI'AGoNISM
IN
centers
whichcomprise1TMATwiththeassociated
NEURoAⅡ烬
whichwillservicetheTranslationalResearchCen.
An
exampleofthe
integrationofthe
all
quantitative
ter.’nlesupportofquantitativepharmacologypracticewillbeprovidedby
pharmacologyapproachappliedtotionalresearchinitiativefortstoexplore
can
academictransla—
tlleⅪ垤AS(KineticModelingandSimula-beillustratedwithrecentel-
totreatNeu—
tion)Core(http://www.reed.upenn.edulkmasl)whichWill(a)aidinthedevelopmentofdrugassays;(b)pm—
moteandassistintheperformanceoftracerkineticstud—
NKlreceptorantagonism
mAIDS.nis
projectisfundedbytheNationalInstitutes
ofAllergyandInfectioustionalInstitutesofMental
Disease(NIAID)andHealth(NIMH)of
seekstoestablish
theNa—the
a
ies;(c)developnovelapproaches
to
kineticdataanalys-
kineticmodel.
Nm
mul-
is;(d)providePK,PK/PD,and
tracer
program(PAR-03—138)which
ing;and(e)developeducationalmodulesinphannacoki-neticsandtiltcerkineticstopopulatetheeducationaliniti-
ativespursuedwithintheCTSA.
AcentralmissionofITMAThas
beeneducation.
tidisciplinaryresearchanddevelopmentprogramtargetedtowardthediscovery,developmentandevaluationofinno—vativetherapiesforHIVinfection(http://grants.nih.gov/
grants/guide/pa-files/PAR一03—138.html).%e
goaloftheprogramisto
overall
’nledeficiencyofhumancapitalintranslationalresearch.particularlywithrespectto’thedevelopmentandevaluation
andtechnicalprogress
supportandacceleratescientificinnon—traditionalandtraditional
.・
1084・
drug-basedtherapiesthatexploitnovelviralandcellulartargetsofimportanceinHIVinfection.Abenchmarkfora
SUCCesSfUlprogramisthedevelopmentof
a
newtreatment
concept
that
call
beintroduced
to
clinicalpractice.Theabilityofneurokinin・1receptor(NK—lR)antagoniststotargetthesubstanceP(SP)receptordemonstratingantivi-ralandimmunomodulatoryeffects[15—17]renew
therapeutictargetwiththepotentialtointerrupt
a
pathway
criticaltoHIVreplication【18,19‘.ThegoalofthisspecificIntegratedPreclinical/ClinicalProgram(IPCP)istoiden—tify
an
NK-IRantagonistthatis:(a)active
a8
ananti—HIVagenttIlrougIlinteractionwithchemokine/cytokinereceptom(Project1);(b)specific
forchemokineandG-
proteincoupledreceptors(Project2);(c)safefor
nile
in
SIV・-infectednon・-humanprimatesandprovidesproofof
concept
related
to
antiviral,immunomodulatory,and
neu—
robehavioraleffects(Project3);and(d)safeinhumansandhaspositiveimmunomodulatoryeffects(Project4).
Allprojectscontributetounderstandingthebasicvirolog—ie,molecularandcellularimmunologic
mechanismsof
SP,NK一1R
antagonists,and
HIV/SIVinfection.
AkeyelementintheIPCPistheintegrationofmod—
and
simulation
s£m硒es
to
supportthe
valjous
projects
as
wellasinformtheadministrativecore.Specifi—
cally,computationaltechniquesale
employedtochallengethe“drnggabililty”of
the
candidateagents.Insilico
ADMEtechniques
are
usedaspartoftherankingcriteria
bywhichwewillprioritizetheadvancementofselected
agents.Theapproach
enablesthecalculationofmolecular
descriptomandpredictionofdrug-likeness
data
using2D
structures,andwithouttheneedforspecial
computationalchemistryknowledge.Aspharumeology
and
biology/mechanismdata
ale
generated
forthevariousagents(Projects
1
and2),thegenemlizability
of
QSAR
QSPK
relationshipsforthiscompoundclasswill
be
explored.Fig3illustratestheintegrationofquantitative
pharmacologyapplication
acroK¥projects
forthisIPCP.
TheNKlRprojectisdependenton
two
primarypro—
pathways:(1)examine
theextenttowhichtheRantagonist
aprepitantis
a
suitableagentforART
in
NeuroAIDS
patientsbased
on
exlx挎ure—-re・・
criteriaconstructedfromits
presumed
actionsand
(2)examinethecorrelationbetweenaprepitantpreclinical
pharmacology,druggabilitycriteriaandPK/PDrelation-shipstogeneralizeandultimatelyranksuitablehack-up
compounds.Within
thefirstpathwaythereis
a
progres—
sionofexperiments,predefinedcriteriaforstageadvance-
mentanddecision
trees
thatguidetheoverallprogression.
These
ar;e
facilitatedbymodelingandsimUlationexercises
permittingscenariotestingforsubsequentexperimentsandtestingof
assumptions
fundamentaltokeyassumptionsfor
theoverallprogram.OneoftheessentialbridgesinthisIF-CPisthe
suitabilityofan
SIV
pharmacology/disease
modeltopredict
success
outcomesinHIV.Intheseries
ofexperimentsthathasensued,thePK/PDofaprepitantmSIV—infectedanimalshavebeencharacterizedandusedin
conjunctionwith
relevantdatafromchemotherapy--in-・
duced
nausea
andvomiting(CmV)patients
to
buildsim-
ulationmodelsthatprojectresponse
inHIV-・infectedpa--
tients.The
use
ofmodelingandsimulation
to
advance
compoundprogressionofantiretroviralagentsrecentlyice—
viewedbyBarrett[驯contains
a
morethoroughdescription
ofthis
case
study.
5CONCIjUSIoN
Itisclearthatacademicmedicalcenterswillbe
all
importantplayerin
the
evolving
R&Dparadigms
which
willguidethediscoveryof
new
molecularentitiesinthe
yearstocome.Translationalresearchisan
approachthat
reliesheavily
on
theinteractionbetweenbasicand
clinical
scientistsandtheappropriatecommunicationofideas,hy・
pothesesandexperimentaldesigns
toevaluatediseasetherapies.,11leconceptof
quantitativephanmeology
is.in
essence,a
communication
platformbywhichtranslational
researchcanbediscussedand
in
which
h.ssumptions,
modelsandsimulations
are
integrated
intodecision.mak.
ingtools.ItisalsoclearthattherecenteffortsoftheFDAandNIHreflecttherecognitionthatthisskillsetisin
short
supplyandwillrequirededicatedprogramstotrainfuture
generationsofscientiststhat
conduct
translational
re-
search.
A删眦。EDE^诬Ⅳ巧:Dr.Barrett’5
effortissup—
byNlHGrant’s.P01饕MH076388andtU54
#R尺0235f订.0】
clingmolecularand
gressionNKItherapy
portedsponse
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圆圈圃
匣匝习匹习
~∥||K;/
Figure1InstituteforTranslaiionalMedicineandTherapeutics(ITMAT)Centersproposedwithinthe
Penll/CHOPCTSAgrantandthenewcoressupportingtheTranslationalResearchCenter.TheKMAS(KineticModelingandSimulation)corewillprovidetechnologicexpertiseforintegrationofquantitativepharmacologyintothetranslationalresearchparadigm.TRL=TranslationalResearchLaboratories,SDAB=StudyDesignandBiostatistics
TATCO=TranslationalandClinicalTrialOrganization
.
E一,IDS、]i:@
CCS=ClinicalCoreServices
OHSAP=O伍ceofHumanSubiectAdvocacy&Protection
RNC=ResearchNurseCore
IDS=InvestigationalDrugService
KMAS=Kinetics.ModelingandSimulation
・
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Chin
JClinPham——mcolTher2007Oct;12(10)
Figure2ThePenn/CHOPeducationalprogramproposedfortheCTSAtargetsthefullspectrumofpotentialandexistingtrainees,fromundergraduatestograduatestudents,fellows,andfaculty.Asindividualsrequiredifferentlevelsandtypesoftrainingateachstageoftheiracademicdevelopment,multipleoptionsprovidedforexposuretotranslationalresearchrangingfrompreview/awareness
courses
are
to
certification,
mastersanddoctoraldegreeprograms.
・
1087・
Quantitation/M&STasks
Literatureandexperimentalpriori;:
・80%InhibitionofHWBaIstraininmonocy慷derivedmacrophages(io・6H1
‘AssumeexPOsuretargetsimilartoinvitro
activity?target
Translational肋rkflow
HypothesesbyStage
・DoesthestructuresuggestN3MEpropertieswhichconsistentwith"druggable”agents?
・isthecompound”active。intherangeofconcentraUonswhich
wouldbe
trough瞻concent怕Uon~
100—500ng/mL.
・Hetabolized
primadlybyCYP3A4;minor
metabolismby“P1A2andcYp2C19.・Enzymeinductionreducestheexposure
foIlowingchronicadministraUon.・ProteinbiridIng一95%;F
9-13hr
w
.
pharmacologically
achievable?
・Isthereevidenceofsynergywith
thevariousexperimentalagentsandmarketedanUrotrovirals?
・WhatistheQSARbetweenCCR5
andNKlreceptors?
60"6S%;HaIf-life:
・Moderatevariabili~inClearanceandVolume
0fdistribuUon
・Staged
first-orderinput
explainsabsomuon
・Isthe
monkey
the
areasonable
l‘a1I‘|2
——斗
presumedNKlr
mechanism(s)ofaction?
mode}for
・Canthe
extrapolated
SW/monkeymodelbe
tothehumanP“PD
behavior(neourocogn砌ve,
antirotroviral,etc)?
・Can
theSIv/monkeymodeIbe
tothehumanHⅣ
disease?
extrapolated
・Canactivitybedemonstratedat
thedoseandduraUonoftherapynegotiatedwithFDA?・Doesthe
.S..1.m....u..1.a...U...o..n....M...o..d...e..1..R...e..s..u...1.t.s.:
・Therapeuticwindowlikelysusceptibleto
・Inductionmay
variationin
response
suggestiveofresD0nder/non-responderpartitiongiventhe
。small・Is
interactions,adherence
bemanageable
・ARV/doselikelyexceedsofCINVdose
samplesize?
thePK/PDadequatelydefinedsuchthatdoseextrapolaUoncanbemadereliably?
・isthereSU仟icientcorrelaUon
betweenQSAPaandtherankingsuggestaback-up
apropt口nc,
・IsthereatherapeuticresponseforNeuroAIDSbasedonthe
aprepitantPhaseIbtrialthatcanbetargetedfromearlier
compoundtocriteriato
T■_M
(preclinical)data?
^啊■-●岫:一●■一一_I■_
CINV=chemotherapy-inducednauseaandvomitingSIV=simianimmunodeficiencyvirusARV=antiretroviral
Figure
3An
example
ofquantitative
pharmacologicalprinciplesapplied
totranslationalresearch:
Relationshipswithaprepitantfrominvitrodata,invivodatainanimals,andinvivodatainCINVpatientsused
to
predictHIV-infectedpatientresponseandNeuroAIDsdiseaseprogression.
・1088・
new
vision[J].Nr,w,1J
Med,2005;353:162l一1623.
and
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1
ZerllouniEA,Al、rir瞩B.Climcalawards:aframework1.0rRes,2006;148:4—5.
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晰AK.Transitional
ogy,1999;116:1285.Opm
research:whati8
it[jJ?Gastroen咖l—
13
rationalresearchagenda[J].Traml
2
R舶eⅡR,MonzoM,0’B憎teA,砑以.TramlafionalOl'lCOg.
enomics:towardrationaltherapeutic
Kai∞rJ.Biomedicine.N】时funds
a
down’hom嘴’f撕transla.
d础ion-making[J].Curr
fional陀Bearch[J].science,2006;314:237.
14
DauphineeD,MartinJB.BreakirlgdowntIlethe
Oneol,20吆;14:171一179.
GJ,SigmanCC,GreenwaldP.Cancerehemopreven-
walls:thou曲tson
3Keloff
scb【盯幽p
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mtegration[J].Acad
Med,2000;75:881—
fion:progress2088.4
and删∞lJJ.EIlr
886.15
HoWZ,CnaanA,“YH,d以.Su]粥taneePmodttlateshu.mallblood
immunoddlciencyvirusIeplicationin
humanpenpher.1
JCancer,1999;35:203l一
Hum瞄曲.Tmnsladonal
mediei∞andtIleNationalInsfitutesof
Healtllroadmap:steepgraclesandClnMed,2005;146:51—54.
’
to咖伽scun,鹄[J].J
Lab
monoeyte-&fivedmacmphag瞄[J].AIDSllesHumRet—
P麟一
rovimses,1996;12:195—198.
5
Mao
J.Transitionalpainresearch:晡dgingtllegapbetween
16Ho
WZ,hiJP,UY,甜af.ⅧV
basic卸delimcalre=e,lreh[J].Pain,2002;97:183—187.
6
BrownSC,ParkI)C.Theoreticalmodel80fcogniive
pressioninhumanilnnllme—618.
eells[J].眦B
in
enhanc∞substance
J,2002;16:616
agingand
imptcafiomfortranslationalresearchiIlmedicine[J].Gemntol—o西st,2003;43:57—67.
7
17场JP,HoWz,ZlumGX,税以.subs咖Pantagonist(CP-
96.345)inhibits
HIV-l酬ication
NailAead
humanmoflonuclo_.,alr
CI)阴,US
Foodand
DmgAdministration.IllnOvllIJonandstag-
On
pllagoc归[J].Proc
sci吣~,2001;98:3970—
substanceP
nation:Challenge锄dopportunity
medicinalproducts|S8
thecritical
p讪to
new
1.2004.
ZerhouniE.Nedicine.711leNIH302:63—72.
R0蛳[J].science,2003;
andopportu-
18叫鹪SD,Ho
levels19
3975.
in阱i瓶ectedmen[J].AIDs,200l;15:2043—2045.
J,PerkimD0,髓以.Stress-associated
WZ,Gettes
DR,甜以.Eh砷ed
EvansDL,Lef℃Ilmlm
9
I_osealzo
J.TtleNIHbudgetandthe缸tureofbiomedieal陀.
Engl
reduetiomofcvtoto菇cT
search[J].N
10
norignm鹤iII708.1l
JMed,2006;354:1665—1667.
20
船)吼l栅mtic
543—550.Barrett
lymphoc舾锄dnaturalkillereelsirI
HⅣi如lon[JJ.AmJPsycIlia何,1995;152:
c伽咖und
progression0fanti|etroviral
H,Marin砒E,Marin池F1VI.0bslacles
trans舢onal
research[J].Nat
Med,20Q5;ll:705—
JS.Faclimfing
agentsvia
modelllg卸dsimuladon[J].JNettroimmunePhar—
Ze由ourliEA.Translationaland
clillical∞ier妒time
for
llmcol。20I昕;2:58—71.
a
转化型研究中的定量药理学
摘要转化型研究一般是指将基础科学发现应用到治疗或预防疾病或损伤,其价值通常是基于探索或
品药物管理局的关键路径计划中的一个元素就是通
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队伍同样接受了这一模式。临床和转化型研究奖的
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肽l受体拮抗用于治疗神经性爱滋病的研究案例,
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正是用来说明运用定量药理进行转化型研究的范
例。