药物再利用治疗脊髓损伤:主要因素和继发并发症的治疗干预进展。

IF 3.1 Q2 PHARMACOLOGY & PHARMACY
Pharmaceutical Medicine Pub Date : 2023-11-01 Epub Date: 2023-09-12 DOI:10.1007/s40290-023-00499-3
Lahanya Guha, Hemant Kumar
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引用次数: 1

摘要

脊髓损伤(SCI)包括许多复杂的机制,如主要细胞死亡途径的参与、脊髓神经元的神经退行性变、谷氨酰胺能传递的过度表达和炎症级联反应,以及不同的合并症,如神经性疼痛、泌尿和性功能障碍、呼吸和心脏衰竭,使其成为全球发病率和死亡率的主要原因之一。皮质类固醇如甲基强的松龙和地塞米松,以及非甾体抗炎药如萘普生、阿司匹林和布洛芬是SCI的一线治疗选择,通过预防炎症和活性氧的作用抑制原发性和继发性进展。然而,它们受到短期有效给药窗口的限制,并且它们的药理作用仅限于与脊髓损伤相关的副作用的症状缓解。尽管损伤后的康复治疗可以使功能恢复,但它们需要很长时间才能显现效果。药物再利用可能是扩大治疗替代品的一种创新方法,利用已经获得世界各地各受尊敬的联邦机构批准的药物。利用药物分子治疗SCI可以消除昂贵和漫长的药物发现过程的需要,并为SCI的新治疗方法铺平道路。这篇综述总结了可根据其安全性和有效性数据重新调整用途的上市药物。我们还讨论了它们的作用机制,并提供了一份正在进行SCI治疗临床试验的重新利用药物清单。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Drug Repurposing for Spinal Cord Injury: Progress Towards Therapeutic Intervention for Primary Factors and Secondary Complications.

Spinal cord injury (SCI) encompasses a plethora of complex mechanisms like the involvement of major cell death pathways, neurodegeneration of spinal cord neurons, overexpression of glutaminergic transmission and inflammation cascade, along with different co-morbidities like neuropathic pain, urinary and sexual dysfunction, respiratory and cardiac failures, making it one of the leading causes of morbidity and mortality globally. Corticosteroids such as methylprednisolone and dexamethasone, and non-steroidal anti-inflammatory drugs such as naproxen, aspirin and ibuprofen are the first-line treatment options for SCI, inhibiting primary and secondary progression by preventing inflammation and action of reactive oxygen species. However, they are constrained by a short effective drug administration window and their pharmacological action being limited to symptomatic relief of the secondary effects related to spinal cord injury only. Although post-injury rehabilitation treatments may enable functional recovery, they take a long time to show results. Drug repurposing might be an innovative method for expanding therapy alternatives, utilising drugs that are already approved by various esteemed federal agencies throughout the world. Reutilising a drug molecule to treat SCI can eliminate the need for expensive and lengthy drug discovery processes and pave the way for new therapeutic approaches in SCI. This review summarises marketed drugs that could be repurposed based on their safety and efficacy data. We also discuss their mechanisms of action and provide a list of repurposed drugs under clinical trials for SCI therapy.

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来源期刊
Pharmaceutical Medicine
Pharmaceutical Medicine PHARMACOLOGY & PHARMACY-
CiteScore
5.10
自引率
4.00%
发文量
36
期刊介绍: Pharmaceutical Medicine is a specialist discipline concerned with medical aspects of the discovery, development, evaluation, registration, regulation, monitoring, marketing, distribution and pricing of medicines, drug-device and drug-diagnostic combinations. The Journal disseminates information to support the community of professionals working in these highly inter-related functions. Key areas include translational medicine, clinical trial design, pharmacovigilance, clinical toxicology, drug regulation, clinical pharmacology, biostatistics and pharmacoeconomics. The Journal includes:Overviews of contentious or emerging issues.Comprehensive narrative reviews that provide an authoritative source of information on topical issues.Systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by PRISMA statement.Original research articles reporting the results of well-designed studies with a strong link to wider areas of clinical research.Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pharmaceutical Medicine may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.
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