疫情后药物的发现和开发:面临当前和未来的挑战

B. Villoutreix
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Eventually, after years of efforts, true user benefits are noticed. As today artificial intelligence is increasingly over-advertised in drug discovery and development, the Bezdek theory may apply, suggesting that a curious enthusiastic but cautious approach is advisable (Schneider et al., 2020). Related to this is the need of high quality data that are often missing or maintained confidential in health-related research (Scannell and Bosley, 2016; Bender and Cortés-Ciriano, 2021). Nowadays, while fashionable research topics appear unavoidable, decision makers, scientists and patients should keep in mind that hype cycles may turn out to hype bubbles and that such cycles can be detrimental to science (Rinaldi, 2012). In the field of drug discovery and development, several different challenges seem to be awaiting us and the dramatic COVID-19 pandemic could be one catalyst accelerating the changes (Aghila Rani et al., 2021). Among the numerous challenges, some are briefly discussed below. 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引用次数: 5

摘要

药物发现和医学的历史与人类一样古老,据许多历史学家称,早在公元前几千年,中国和印度就首次对一些草药的药用价值进行了评估。事实上,阿育吠陀的实践、传统中药和埃及医学实践的证据早在数千年前就有记载。然后在希腊,希波克拉底开始将医学从艺术转变为科学。两千多年来,各国杰出人才的智力贡献逐渐奠定了科学医学的基础。现代药物的发现始于20世纪末。今天,这一庞大的调查领域的特点是由无数地方、国家和国际公共和私人组织进行的高度复杂、耗时、昂贵(但有利可图)、往往不成功的多学科过程。这些参与者可能有不同的兴趣,有时是出于患者健康以外的考虑。鉴于药物发现和开发作为一个领域的复杂性,任何提高成功几率的尝试都需要谦逊,考虑对立的观点,并摆脱知识孤岛。尽管历史不能总是预言未来,但肯定有一些教训可以从过去吸取。应该避免关于只探索某些特定科学领域的强烈声明,而在大多数情况下,其他学科或其他部门的预算会大幅削减。例如,1999年,有人建议人类基因组计划将在2010年前改变药物发现,到2020年,通过量身定制的疗法(个性化药物)将显著改善患者护理。虽然人类基因组计划可能会改变未来的一切,但向新药的转化是有限的(Joyner和Paneth,2019)。问题显然不在于人类项目本身,而在于它被高估了,人们的期望不现实,人体在健康和疾病状态下的复杂性在很大程度上被低估了。J.Bezdek在1993年提出了一条曲线,显示了技术如何随着时间的推移而发展,并用这种方法分析了计算机药物设计策略(Van Drie,2007)。“Bezdek阶段”通常涉及对不成熟技术的过度反应、炒作的高峰,然后是绝望,因为结果与预期不符。最终,经过多年的努力,真正的用户利益得到了关注。随着今天人工智能在药物发现和开发中越来越被过度宣传,Bezdek理论可能适用,这表明一种好奇、热情但谨慎的方法是可取的(Schneider等人,2020)。与此相关的是对高质量数据的需求,这些数据在健康相关研究中经常缺失或保密(Scannell和Bosley,2016;Bender和Cortés-Ciriano,2021)。如今,虽然时尚的研究主题似乎不可避免,但决策者、科学家和患者应该记住,炒作周期可能会变成炒作泡沫,这种周期可能对科学有害(Rinaldi,2012)。在药物发现和开发领域,似乎有几个不同的挑战在等待我们,新冠肺炎的急剧流行可能是加速变化的催化剂之一(Aghila Rani et al.,2021)。在众多挑战中,以下简要讨论了一些挑战。编辑和审查:墨西哥国立自治大学JoséL Medina Franco
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Post-Pandemic Drug Discovery and Development: Facing Present and Future Challenges
The history of drug discovery and medicine is as ancient as humanity with, according to numerous historians, the first evaluation of the medicinal values of some herbs as early as a few thousand years B.C. in China and in India. Indeed, the practice of Ayurveda, traditional Chinese medicines and the evidence of medicinal practice in Egypt have been documented thousands of years ago. Then in Greece, Hippocrates started to transform medicine from art to science. Intellectual contributions of many great minds from different countries developed over two thousand years gradually established the foundation of scientific medicine. Modern drug discovery started to emerge by the end of the 20th century. Today, this immense field of investigation is characterized by highly complex, time consuming, expensive (yet profitable), often unsuccessful, multidisciplinary processes carried out by a myriad of local, national and international public and private organizations. These players may have divergent interests, and are sometimes driven by concerns other than patients’ health. Given the complexity of drug discovery and development as a field, any attempt to improve the odds of success requires humility, consideration of opposing views and escaping intellectual silos. Although history cannot always foretell the future, there are certainly some lessons to be learned from the past. Strong statements about exploring only some specific scientific areas, with most of the time substantial budget cuts to other disciplines or other departments, should be avoided. For instance, in 1999, it was suggested that the Human Genome Project would transform drug discovery by 2010 and that by 2020 significant improvements in patient care through tailored therapies (personalized medicine) would take place. While the human genome project might change everything in the future, translation to new drugs has been limited (Joyner and Paneth, 2019). The problem is obviously not the human project in itself but the fact that it was oversold, expectations were not realistic and the complexity of the human body in the health and disease states largely underestimated. Along the same line of reasoning but about technologies, J. Bezdek proposed in 1993 a curve showing how technologies tend to progress with time and in silico drug design strategies were analyzed with this approach (Van Drie, 2007). The “Bezdek phases” usually involve an overreaction to immature technology, a peak of hype, followed by despair because the results do not match the expectations. Eventually, after years of efforts, true user benefits are noticed. As today artificial intelligence is increasingly over-advertised in drug discovery and development, the Bezdek theory may apply, suggesting that a curious enthusiastic but cautious approach is advisable (Schneider et al., 2020). Related to this is the need of high quality data that are often missing or maintained confidential in health-related research (Scannell and Bosley, 2016; Bender and Cortés-Ciriano, 2021). Nowadays, while fashionable research topics appear unavoidable, decision makers, scientists and patients should keep in mind that hype cycles may turn out to hype bubbles and that such cycles can be detrimental to science (Rinaldi, 2012). In the field of drug discovery and development, several different challenges seem to be awaiting us and the dramatic COVID-19 pandemic could be one catalyst accelerating the changes (Aghila Rani et al., 2021). Among the numerous challenges, some are briefly discussed below. Edited and reviewed by: José L Medina-Franco, National Autonomous University of Mexico, Mexico
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