Noa Rappaport, Bartek Nogal, Kevin Perrott, Vincenzo Domina, Leroy Hood, Nathan D Price
{"title":"Early Detection of Wellness-to-Disease Transitions in the AI Era: Implications for Pharmacology and Toxicology.","authors":"Noa Rappaport, Bartek Nogal, Kevin Perrott, Vincenzo Domina, Leroy Hood, Nathan D Price","doi":"10.1146/annurev-pharmtox-062124-013423","DOIUrl":"10.1146/annurev-pharmtox-062124-013423","url":null,"abstract":"<p><p>Precision medicine demands a shift from static, single-analyte diagnostics toward dynamic, systems-level understanding of health and disease. This review explores how the convergence of systems biology, multiomics, and artificial intelligence (AI) redefines biomarker discovery to drive early disease detection and personalized intervention. We highlight pioneering efforts that use longitudinal, multimodal data to map individual health trajectories and uncover early disease signals. Advances in AI, including machine learning and contextualization using knowledge graphs and digital twins, are accelerating clinical translation by enabling predictive, context-aware analyses. Real-world applications, including omics-informed diagnostics and digital health monitoring, demonstrate the potential of this approach to transform health care from reactive treatment to proactive wellness. These technologies also inform the development of targeted therapeutics that intervene earlier, personalize treatment, and potentially halt or reverse disease progression. We outline challenges, emerging solutions, and future directions that position AI-driven systems biology at the center of next-generation precision health.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"41-64"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Akinleye Akinrinde, Luis Andres Sanchez, Silvia Maglioni, Natascia Ventura
{"title":"<i>Caenorhabditis elegans</i> as a Model System for Environmental Mitotoxicants.","authors":"Akinleye Akinrinde, Luis Andres Sanchez, Silvia Maglioni, Natascia Ventura","doi":"10.1146/annurev-pharmtox-062124-012254","DOIUrl":"10.1146/annurev-pharmtox-062124-012254","url":null,"abstract":"<p><p>Environmental pollutants such as heavy metals, pesticides, and plastic nanoparticles pose significant risks to human, animal, and environmental health. New approach methodologies complying with the 3R principles (replace, reduce, refine) are essential for advancing the molecular basis of pollutant-induced toxicity, thus improving risk assessment, disease prevention, and therapies. Thanks to its remarkable features, the multicellular organism <i>Caenorhabditis elegans</i> offers unique opportunities to meet this goal. Mitochondria, central hubs in cellular homeostasis, are particularly vulnerable to pollutants, orchestrating stress responses that progress to toxicity and disease. <i>C. elegans</i> represents a powerful model to study these effects, offering conserved systems with quantifiable end points. While previous studies have mainly focused on environmental stressors inducing DNA damage, this review explores <i>C. elegans</i>'s end points of relevance for mitotoxicology, highlighting advantages and limitations of the system as an alternative approach for in vivo environmental-induced mitochondrial toxicology and diseases.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"261-284"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dengue Fever Vaccines: Progress and Challenges.","authors":"Alan L Rothman, Heather Friberg","doi":"10.1146/annurev-pharmtox-062124-040711","DOIUrl":"10.1146/annurev-pharmtox-062124-040711","url":null,"abstract":"<p><p>Development of vaccines against dengue has been designated a priority for over 75 years. The completion of Phase III trials and licensing of multiple dengue vaccines have been significant accomplishments of the last 15 years. Despite that progress, a vaccine suitable for broad use has not yet been identified. The scientific challenges of multiple dengue viral serotypes, immune imprinting from previous infections, and immune enhancement of infection and disease remain formidable obstacles to this goal. Further investments in clinical research of natural dengue virus infections and participants in dengue vaccine trials will be needed to enable the development and testing of the next generation of dengue vaccines.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"129-147"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lessons from Glucocorticoids, Metformin, and Dimethyl Fumarate: Could Targeting Immunometabolism Lead to Better Anti-Inflammatory Therapies?","authors":"Victoria A Evans, Luke A J O'Neill","doi":"10.1146/annurev-pharmtox-062624-013520","DOIUrl":"10.1146/annurev-pharmtox-062624-013520","url":null,"abstract":"<p><p>Emerging evidence suggests that alterations in immunometabolism contribute to pathogenesis of inflammatory diseases, providing potential therapeutic targets. Anti-inflammatory drugs such as glucocorticoids, metformin, and dimethyl fumarate (DMF) modulate key immunometabolic pathways. Glucocorticoids boost itaconate production, which exerts anti-inflammatory effects via multiple targets, including by modification of cysteines on inflammatory proteins. Metformin, known for inhibiting gluconeogenesis in type 2 diabetes, also blocks mitochondrial Complex I and increases GDF-15, a regulator of food intake with anti-inflammatory properties, which may explain effects of metformin on inflammation. DMF, like itaconate, modifies cysteines on target proteins, notably KEAP1, leading to Nrf2 activation, which induces antioxidant enzymes and suppresses inflammatory gene expression. These immunometabolic actions suggest that targeting immune cell metabolism could provide new strategies for treating autoimmune diseases. This review explores recent advances in itaconate, GDF-15, and Nrf2 signaling and how harnessing these pathways may lead to novel anti-inflammatory therapies for patients with inflammatory diseases.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"419-440"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sana Qayum, Darlaine Pétrin, Jason C Tanny, Terence E Hébert
{"title":"Gβγ Signaling: Lessons Across the Cellular Multiverse.","authors":"Sana Qayum, Darlaine Pétrin, Jason C Tanny, Terence E Hébert","doi":"10.1146/annurev-pharmtox-062124-033726","DOIUrl":"10.1146/annurev-pharmtox-062124-033726","url":null,"abstract":"<p><p>The eponymous term Gβγ protein has given way to a more nuanced view of 60 different possible combinations of the 5 Gβ and 12 Gγ subunits and their effects on cellular signaling profiles. Beyond this increased appreciation of their diversity per se, we now know that distinct Gβγ combinations may play roles beyond the regulation of cell surface effectors following G protein-coupled receptor activation and release from G protein heterotrimers. Gβγ subunits operate in multiple subcellular compartments. In this review, we focus on Gβγ-mediated events in the endoplasmic reticulum, Golgi apparatus, and mitochondria and particularly highlight Gβγ roles in the nucleus.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"487-500"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shane C Wright, Peter Lindquist, Mette M Rosenkilde, Volker M Lauschke
{"title":"Incretin Signaling Neighborhoods and Adverse Drug Reactions.","authors":"Shane C Wright, Peter Lindquist, Mette M Rosenkilde, Volker M Lauschke","doi":"10.1146/annurev-pharmtox-062124-015046","DOIUrl":"10.1146/annurev-pharmtox-062124-015046","url":null,"abstract":"<p><p>In light of the success of blockbuster drugs for type 2 diabetes and obesity based on the GLP-1 hormone, drugmakers have concentrated their efforts on developing new and improved variations that address the route of administration, dosing, pathway selectivity, or polypharmacology. While some of these modifications have demonstrated improved efficacy in clinical studies and offered exciting opportunities for treating other diseases, drug-induced shifts to the conformational landscape of target receptors may have consequences for side effects. Our review summarizes advances in the understanding of the biochemistry, pharmacogenomics, and molecular pharmacology of incretins and their cognate receptors. We further highlight the current landscape of incretin mimetics and discuss how differences in compartmentalized pathway selectivity affect drug action and outcomes.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"501-518"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Davies Otieno, Francis Williams Ojara, Naomi Richardson, Catriona Waitt, Ping Zhao, Dan Hartman
{"title":"Treating Pregnant and Lactating Women: Insights from Clinical Pharmacology.","authors":"Davies Otieno, Francis Williams Ojara, Naomi Richardson, Catriona Waitt, Ping Zhao, Dan Hartman","doi":"10.1146/annurev-pharmtox-071724-014725","DOIUrl":"10.1146/annurev-pharmtox-071724-014725","url":null,"abstract":"<p><p>Pregnant and lactating women have historically been excluded from clinical trials, limiting data on drug pharmacokinetics, safety, and efficacy in these populations. This knowledge gap stems from complex ethical, historical, and cultural factors, which previously categorized these women as vulnerable rather than protected participants. Recent legislative frameworks, including the FDA Pregnancy and Lactation Labeling Rule, have catalyzed efforts to include these populations in structured research. Quantitative pharmacology approaches using innovations such as physiologically based pharmacokinetic models support optimized trial designs, safer dosing regimens, and ethical research frameworks. Emerging technologies, including artificial intelligence, novel drug delivery mechanisms, and organ-on-chip models, further enhance insights into maternal-fetal drug exposure and drug exposures in breastfeeding infants. Integrating in vitro, ex vivo, in vivo, and clinical data and modeling approaches improves understanding of pregnancy-related physiological changes and their impact on drug outcomes, ultimately enabling appropriate and equitable pharmacotherapy for pregnant and breastfeeding women.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":"66 1","pages":"191-210"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew J Mears, Priya Bandaru, Evan W Neczypor, Min Kwang Byun, Michelle Zhang, Matthew W Gorr, Jorge A Masso-Silva, Laura Barnes, Alexia Perryman, Avnee J Kumar, Jeffrey M Hendel, Ana Lucia Fuentes, Loren E Wold, Laura E Crotty Alexander
{"title":"Multisystem Toxicity of E-Cigarettes in Preclinical and Clinical Studies: Pathophysiologic Effects of E-Cigarette Aerosol Exposures from Head to Toe.","authors":"Matthew J Mears, Priya Bandaru, Evan W Neczypor, Min Kwang Byun, Michelle Zhang, Matthew W Gorr, Jorge A Masso-Silva, Laura Barnes, Alexia Perryman, Avnee J Kumar, Jeffrey M Hendel, Ana Lucia Fuentes, Loren E Wold, Laura E Crotty Alexander","doi":"10.1146/annurev-pharmtox-062124-022856","DOIUrl":"10.1146/annurev-pharmtox-062124-022856","url":null,"abstract":"<p><p>The global population breathes unsafe levels of pollutants. In recent years, electronic cigarettes (e-cigs) have become a significant source of particulate matter (PM), which causes injurious effects across organ systems. E-cig users and bystanders are exposed to concentrated aerosols, commonly called vapor, that we now know can have harmful long-term consequences due to PM and chemicals contained within. E-cigs are diverse in design, and e-liquids vary dramatically, making it difficult to draw broad conclusions from studies of different devices, brands, and flavors. With the rise in popularity of e-cigs, it is important to define the health effects across the body. In this comprehensive review, we dissect and summarize the known organ-specific effects of e-cigs, including underlying molecular mechanisms. Notably, e-cig aerosols broadly cause increased cytokine release and oxidative stress, which are associated with a heightened risk of organ dysfunction. We also highlight ways to minimize harmful e-cig constituents to develop safer products.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"325-352"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"RNA Splicing as a Therapeutic Target in Cancer.","authors":"Alexander M Lewis, Kenyon Weis, Omar Abdel-Wahab","doi":"10.1146/annurev-pharmtox-062124-035809","DOIUrl":"10.1146/annurev-pharmtox-062124-035809","url":null,"abstract":"<p><p>RNA splicing is a nuclear enzymatic process that catalyzes excision of segments of premature messenger RNA (mRNA) and ligation to give rise to mature coding mRNA. Genomic and transcriptomic studies of cancer have revealed that RNA splicing is often dysregulated in cancer due to mutations in genes affecting their splicing in <i>cis</i>, alterations in the components of the splicing machinery in <i>trans</i>, and transcriptional as well as epigenetic alterations that impact cotranscriptional splicing. These observations have motivated a number of efforts to pharmacologically modulate splicing using small molecules that bind, degrade, or modify the RNA splicing machinery as well as oligonucleotides and small molecules that bind mRNA transcripts to modulate their processing. These therapeutic modalities are reviewed here along with early findings from clinical trials evaluating these agents in patients. The vast number of opportunities to alter splicing continues to highlight splicing as an exciting therapeutic target in cancer.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"441-463"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From Fundamental Biology to Toxicology by Way of an Accident.","authors":"Ana M Soto","doi":"10.1146/annurev-pharmtox-071724-100915","DOIUrl":"10.1146/annurev-pharmtox-071724-100915","url":null,"abstract":"<p><p>When I was young and pictured my future, it wasn't a path that could be determined a priori. The world was full of interesting things. Obtaining the qualifications to become a professor and a researcher was the easy part. The rest relied on being in the right place at the right moment and having the intuition to feel the importance of events we were witnessing. This is how I met my mentors and how my scientific partner and I came upon the paradox that caused us to propose the principle of biological inertia. This is also how we discovered that estrogens leached from plasticware were ruining our experiments, and thus we became \"toxicologists by accident.\" Indeed, we were never formally trained in pharmacology or toxicology; however, our discovery that the estrogen nonylphenol leached from plastics made us pioneers of the new field of endocrine disruptors that encompasses endocrinology and toxicology.</p>","PeriodicalId":8057,"journal":{"name":"Annual review of pharmacology and toxicology","volume":" ","pages":"29-40"},"PeriodicalIF":19.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}