这篇综述探讨了药理学中协同作用的概念,强调其在通过不同作用机制的药物组合优化治疗结果方面的重要性。Synergy,定义为根据特定的预测模型,大于单个试剂引起的预期累加效应的效应,提供了一种有希望的方法来提高治疗效果,同时最大限度地减少不良事件。协同研究的历史演变,从古代文明到现代药理学,强调了正在进行的理解和利用协同互动的探索。关键概念,如浓度-响应曲线,加性效应,并详细讨论了预测模型,强调在整个转化药物开发过程中需要准确的评估方法。虽然存在用于协同分析的各种数学模型,选择合适的模型和软件工具仍然是一个挑战,需要仔细考虑实验设计和数据解释。此外,这篇综述阐述了协同评估中的实际考虑,包括临床前和临床方法,作用机制,和统计分析。优化协同作用需要注意浓度/剂量比,目标站点定位,和药物管理的时机,确保在工作台上检测到的联合治疗的益处可转化为临床实践。总的来说,该审查提倡采用系统的方法来评估协同作用,结合稳健的统计分析,有效和简化的预测模型,以及学术机构等关键部门的合作努力,制药公司,和监管机构。通过克服关键挑战并最大限度地发挥治疗潜力,药物开发中的有效协同作用评估有望促进患者护理。意义声明将具有不同作用机制的药物用于协同相互作用优化治疗功效和安全性。对协同作用的准确解释需要识别预期的累加效应。尽管有创新的模型来预测累加效应,药物相互作用研究缺乏共识,阻碍了从台到床的联合疗法的发展。科学之间的合作,工业,监管对于推进联合疗法的发展至关重要,确保预测模型在临床环境中的严格应用。
This review explores the concept of synergy in pharmacology, emphasizing its importance in optimizing treatment outcomes through the combination of drugs with different mechanisms of action. Synergy, defined as an effect greater than the expected additive effect elicited by individual agents according to specific predictive models, offers a promising approach to enhance therapeutic efficacy while minimizing adverse events. The historical evolution of synergy research, from ancient civilizations to modern pharmacology, highlights the ongoing quest to understand and harness synergistic interactions. Key concepts such as concentration-response curves, additive effects, and predictive models are discussed in detail, emphasizing the need for accurate assessment methods throughout translational drug development. While various mathematical models exist for synergy analysis, selecting the appropriate model and software tools remains a challenge, necessitating careful consideration of experimental design and data interpretation. Furthermore, this review addresses practical considerations in synergy assessment, including preclinical and clinical approaches, mechanism of action, and statistical analysis. Optimizing synergy requires attention to concentration/dose ratios, target site localization, and timing of drug administration, ensuring that the benefits of combination therapy detected at bench-side are translatable into clinical practice. Overall, the review advocates for a systematic approach to synergy assessment, incorporating robust statistical analysis, effective and simplified predictive models, and collaborative efforts across pivotal sectors such as academic institutions, pharmaceutical companies, and regulatory agencies. By overcoming critical challenges and maximizing therapeutic potential, effective synergy assessment in drug development holds promise for advancing patient care. Significance Statement Combining drugs with different mechanisms of action for synergistic interactions optimizes treatment efficacy and safety. Accurate interpretation of synergy requires the identification of the expected additive effect. Despite innovative models to predict the additive effect, consensus in drug interaction research is lacking, hindering the bench-to-bedside development of combination therapies. Collaboration among science, industry, and regulation is crucial for advancing combination therapy development, ensuring rigorous application of predictive models in clinical settings.