全球抗HIV 药物研发进展报告

近年来,艾滋病在世界范围内的迅速传播和蔓延,已严重威胁着人类的健康,且引发了一系列社会问题。报告以Thomson Reuters Cortellis 数据库为数据源,从总体研发态势、研发阶段、作用靶点、研究地区、研发机构、销售情况以及交易合作等角度对全球 抗HIV 药物的研发情况进行多角度、多层次的分析,旨在为我国抗HIV 药物的研发提供参考。     

Scientific R&D: time to revise the rules?

For several decades scientific R&D has been failing communities around the world, especially in developing countries, by not producing an adequate level of benefits (for example, improved health and living standards) and essential public goods (for example, the provision of safe water, sanitation and energy). It is time for a complete overhaul of the R&D process, with a comprehensive review of the mechanisms by which R&D is financed, how and where the work and results are published and disseminated, how the results and knowledge are exploited, and how ownership is decided. This is particularly important for public goods, for which there is often no market or prospect of commercial return or profit.     

Drug discovery and development for neglected parasitic diseases

Diseases caused by tropical parasites affect hundreds of millions of people worldwide but have been largely neglected for drug development because they affect poor people in poor regions of the world. Most of the current drugs used to treat these diseases are decades old and have many limitations, including the emergence of drug resistance. This review will summarize efforts to reinvigorate the drug development pipeline for these diseases, which is driven in large part by support from major philanthropies. The organisms responsible for these diseases have a fascinating biology, and many potential biochemical targets are now apparent. These neglected diseases present unique challenges to drug development that are being addressed by new consortia of scientists from academia and industry.     

Drug discovery for parasitic diseases: powered by technology,enabled by pharmacology,informed by clinical science

While prevention is a bedrock of public health, innovative therapeutics are needed to complement the armamentarium of interventions required to achieve disease control and elimination targets for neglected diseases. Extraordinary advances in drug discovery technologies have occurred over the past decades, along with accumulation of scientific knowledge and experience in pharmacological and clinical sciences that are transforming many aspects of drug R&D across disciplines. We reflect on how these advances have propelled drug discovery for parasitic infections, focusing on malaria, kinetoplastid diseases, and cryptosporidiosis. We also discuss challenges and research priorities to accelerate discovery and development of urgently needed novel antiparasitic drugs.     

“首届中国孤儿药研发论坛”专家观点

对2015 年4 月25 日召开的“首届中国孤儿药研发论坛”的专家报告内容进行归纳总结,旨在为从事罕见病诊断和孤儿药研发工 作的人士提供信息参考。报告内容涉及国内外孤儿药研发现状和前景、中国孤儿药政策和审评状况、罕见病诊断以及中国孤儿药研发的机 会等。     

在我国失效的美国心血管疾病治疗药物的PCT 专利申请数据挖掘

目的：从没有在中国得到保护的美国专利申请或专利中寻找心血管疾病治疗药物研发的思路。方法：对申请日从2005 年1 月1 日至2014 年12 月31 日的美国心血管系统疾病治疗药物PCT 申请进入中国国家阶段后失效的专利申请及专利数据进行整序和分析,依据其在美国本土的法律状态确定其技术含金量。结果：未得到中国专利保护的美国心血管系统疾病治疗药物PCT 申请共174 件,其中170 件申请了美国优先权或进入了美国国家阶段。结论：170 件美国心血管系统疾病治疗药物PCT 申请在美国申请优先权,大多数因美国的优先权临时申请过期而放弃。14 件在美国本土的优先权申请失效,其所含信息量应该相当于公开发表的论文的信息量,23 件在美国本土优先权授权的专利技术具有一定的技术含金量,目前在中国已经进入公知公用领域,经过市场价值评估后可以无偿使用。     

海洋生物技术催生蓝色生物经济

海洋生物技术是20世纪末国际出现的前沿技术,至今发展势头良好,方兴未艾。在全球经济面临转型换代的关键时刻,蓝色经济渐现端倪。探讨了蓝色生物经济的概念和内涵,评述了海洋生物技术研发前沿与重点应用领域,展望了蓝色生物经济的良好市场前景与可持续发展,提出了加快发展我国蓝色生物经济的策略和建议。     

罕见病基因治疗与孤儿药

孤儿药因面向的罕见病患者群小、市场需求低、研发成本高、缺乏政策支持等,其发展面临困境。随着精准医疗概念的提出,基 因治疗因能够从根本出发,给患者提供 “一劳永逸”的治疗,备受关注。基因治疗以单基因罕见病的治疗作为极佳切入点,为孤儿药的 研发带来了新的希望。概述基因治疗针对的疾病对象、实施策略和属性以及基因药物的结构及基因治疗的载体,以血友病的基因治疗为 例回顾罕见病基因治疗的发展,并分析罕见病基因治疗药物研发现状。     

Delivering vaccines to the people who need them most

Thanks to the Global Alliance for Vaccines and Immunization (GAVI), the Vaccine Fund and the Bill & Melinda Gates Foundation, the global health community has made enormous progress in providing already existing vaccines to developing countries. However, there still exists a gap to develop vaccines for which there is no market in the Western world, owing to low economic incentives for the private sector to justify the investments necessary for vaccine development. In many cases, industry has the technologies, but lacks the impetus to direct resources to develop these vaccine products. The present emergency with the Ebola vaccine provides us an excellent example where a vaccine was feasible several years ago, but the global health community waited for a humanitarian disaster to direct efforts and resources to develop this vaccine. In the beginning of 2015, the first large-scale trials of two experimental vaccines against Ebola virus disease have begun in West Africa. During the past few years, several institutions have dedicated efforts to the development of vaccines against diseases present only in low-income countries. These include the International Vaccine Institute, the Novartis Vaccines Institute for Global Health, the Hilleman Institute, the Sabin Vaccine Institute and the Infectious Disease Research Institute. Nevertheless, solving this problem requires a more significant global effort than that currently invested. These efforts include a clear policy, global coordination of funds dedicated to the development of neglected disease and an agreement on regulatory strategies and incentives for the private sector.     

Parasites, people and policy: infectious diseases and the Millennium Development Goals

Here, I briefly review past history and present patterns in the interactions between parasites (defined broadly to include viruses and bacteria along with protozoan, helminth and arthropod parasites) and human populations in developed and developing countries. Against this background, I offer thoughts on current public health initiatives at national and international levels, with particular reference to the Millennium Development Goals. The news is both good and bad: mortality and morbidity from infectious diseases in the developing world are significantly lower than they were 50 years ago, but we should and could be doing better, particularly in relation to neglected tropical diseases.     

Advancing Drug Innovation for Neglected Diseases—Criteria for Lead Progression

The current drug R&D pipeline for most neglected diseases remains weak, and unlikely to support registration of novel drug classes that meet desired target product profiles in the short term. This calls for sustained investment as well as greater emphasis in the risky upstream drug discovery. Access to technologies, resources, and strong management as well as clear compound progression criteria are factors in the successful implementation of any collaborative drug discovery effort. We discuss how some of these factors have impacted drug discovery for tropical diseases within the past four decades, and highlight new opportunities and challenges through the virtual North–South drug discovery network as well as the rationale for greater participation of institutions in developing countries in product innovation. A set of criteria designed to facilitate compound progression from screening hits to drug candidate selection is presented to guide ongoing efforts.     

Plant-derived pharmaceuticals for the developing world

Plant-produced vaccines and therapeutic agents offer enormous potential for providing relief to developing countries by reducing the incidence of infant mortality caused by infectious diseases. Vaccines derived from plants have been demonstrated to effectively elicit an immune response. Biopharmaceuticals produced in plants are inexpensive to produce, require fewer expensive purification steps, and can be stored at ambient temperatures for prolonged periods of time. As a result, plant-produced biopharmaceuticals have the potential to be more accessible to the rural poor. This review describes current progress with respect to plant-produced biopharmaceuticals, with a particular emphasis on those that target developing countries. Specific emphasis is given to recent research on the production of plant-produced vaccines toward human immunodeficiency virus, malaria, tuberculosis, hepatitis B virus, Ebola virus, human papillomavirus, rabies virus and common diarrheal diseases. Production platforms used to express vaccines in plants, including nuclear and chloroplast transformation, and the use of viral expression vectors, are described in this review. The review concludes by outlining the next steps for plant-produced vaccines to achieve their goal of providing safe, efficacious and inexpensive vaccines to the developing world.     

GLOBAL HEALTH IMPACT: A BASIS FOR LABELING AND LICENSING CAMPAIGNS?

Most of the world's health problems afflict poor countries and their poorest inhabitants. There are many reasons why so many people die of poverty‐related causes. One reason is that the poor cannot access many of the existing drugs and technologies they need. Another, is that little of the research and development (R&D) done on new drugs and technologies benefits the poor. There are several proposals on the table that might incentivize pharmaceutical companies to extend access to essential drugs and technologies to the global poor. 1 Still, the problem remains – the poor are suffering and dying from lack of access to essential medicines. So, it is worth considering a new alternative. This paper suggests rating pharmaceutical and biotechnology companies based on how some of their policies impact poor people's health. It argues that it might be possible to leverage a rating system to encourage companies to extend access to essential drugs and technologies to the poor.     

Challenges and opportunities for enhancing biotechnology and technology transfer in developing countries

Biotechnological innovation is gaining increased recognition as an important tool for improving global health. The challenge, however, lies in defining the role of technology transfer to develop therapies for diseases prevalent in developing countries. During the past decade, a large disparity emerged between the developed and developing world in accessing affordable medicines because of the pharmaceutical industry's focus on health areas bearing greatest profits. Discussed herein are several mechanisms that provide partial solutions to this challenge. The Office of Technology Transfer of the US National Institutes of Health has increased its technology licensing pertaining to neglected diseases to partners in developing regions. Establishing partnerships through the transfer of technologies and assisting indigenous institutions build R and D capacity may positively impact policies on protection of intellectual property rights and increase multinational company investments in lesser-developed countries. This will most probably result in the development of more accessible therapies for those in need.     

Renewing Linnaean taxonomy: a proposal to restructure the highest levels of the Natural System

During the last century enormous progress has been made in the understanding of biological diversity, involving a dramatic shift from macroscopic to microscopic organisms. The question now arises as to whether the Natural System introduced by Carl Linnaeus, which has served as the central system for organizing biological diversity, can accommodate the great expansion of diversity that has been discovered. Important discoveries regarding biological diversity have not been fully integrated into a formal, coherent taxonomic system. In addition, because of taxonomic challenges and conflicts, various proposals have been made to abandon key aspects of the Linnaean system. We review the current status of taxonomy of the living world, focussing on groups at the taxonomic level of phylum and above. We summarize the main arguments against and in favour of abandoning aspects of the Linnaean system. Based on these considerations, we conclude that retaining the Linnaean Natural System provides important advantages. We propose a relatively small number of amendments for extending this system, particularly to include the named rank of world (Latin alternative mundis) formally to include non-cellular entities (viruses), and the named rank of empire (Latin alternative imperium) to accommodate the depth of diversity in (unicellular) eukaryotes that has been uncovered. We argue that in the case of both the eukaryotic domain and the viruses the cladistic approach intrinsically fails. However, the resulting semi-cladistic system provides a productive way forward that can help resolve taxonomic challenges. The amendments proposed allow us to: (i) retain named taxonomic levels and the three-domain system, (ii) improve understanding of the main eukaryotic lineages, and (iii) incorporate viruses into the Natural System. Of note, the proposal described herein is intended to serve as the starting point for a broad scientific discussion regarding the modernization of the Linnaean system.     

轮状病毒疫苗研究现状

轮状病毒自上世纪70年代初发现至今,仍是婴幼儿病毒性腹泻最主要的病原体。每年约60万婴幼儿因轮状病毒感染导致严重脱水死亡。轮状病毒疫苗从上世纪90年代初开始研制,至今已有三种疫苗用于预防轮状病毒感染。这三种疫苗均为减毒活疫苗:其中包括单一血清型Rotarix、罗特威和重组5价疫苗RotaTeq。它们已在全球多国使用,有些国家已将其纳入免疫规划。疫苗的使用使人群轮状病毒感染下降,特别是死亡率明显减少。但也出现了一些问题,因此除了减毒活疫苗,也有一些实验室研究其他形式的疫苗,例如重组疫苗、灭活疫苗等。本文主要介绍轮状病毒疫苗的研究现状,为我国轮状病毒疫苗的研究、使用和推广提供一定理论依据。     

R&D Incentives for Neglected Diseases

Neglected diseases are typically characterized as those for which adequate drug treatment is lacking, and the potential return on effort in research and development (R&D), to produce new therapies, is too small for companies to invest significant resources in the field. In recent years various incentives schemes to stimulate R&D by pharmaceutical firms have been considered. Broadly speaking, these can be classified either as ‘push’ or ‘pull’ programs. Hybrid options, that include push and pull incentives, have also become increasingly popular. Supporters and critics of these various incentive schemes have argued in favor of their relative merits and limitations, although the view that no mechanism is a perfect fit for all situations appears to be widely held. For this reason, the debate on the advantages and disadvantages of different approaches has been important for policy decisions, but is dispersed in a variety of sources. With this in mind, the aim of this paper is to contribute to the understanding of the economic determinants behind R&D investments for neglected diseases by comparing the relative strength of different incentive schemes within a simple economic model, based on the assumption of profit maximizing firms. The analysis suggests that co-funded push programs are generally more efficient than pure pull programs. However, by setting appropriate intermediate goals hybrid incentive schemes could further improve efficiency.     

细胞药物的研发现状——细胞药物连载之三

近年来,细胞药物的研究受到了国内外重视。特别是干细胞药物,已成为世界各国竞相研究的热点领域,但各国的干细胞药物绝大多数仍处于研究阶段,全球真正上市的干细胞药物很少。目前正在研发的干细胞药物主要集中在治疗慢性疾病（关节炎、糖尿病和癌症等）和心脏相关疾病（心肌梗死、心脏衰竭等）。一些传统体细胞药物（软骨细胞、心肌细胞、胰岛细胞等）和免疫细胞药物已在临床应用。     

The Scientific Impact of Developing Nations

This paper analyzes science productivity for nine developing countries. Results show that these nations are reducing their science gap, with R&D investments and scientific impact growing at more than double the rate of the developed world. But this “catching up” hides a very uneven picture among these nations, especially on what they are able to generate in terms of impact and output relative to their levels of investment and available resources. Moreover, unlike what one might expect, it is clear that the size of the nations and the relative scale of their R&D investments are not the key drivers of efficiency.     

Challenges and prospects for biomarker research: A current perspective from the developing world

Majority of deaths due to communicable and non-communicable diseases occur in the low and middle-income nations (LMNs), mainly due to the lack of early diagnoses and timely treatments. In such a scenario, biomarkers serve as an indispensible resource that can be used as indicators of biological processes, specific disease conditions or response to therapeutic interventions. Evaluation, diagnosis and management of diseases in developing world by following/extrapolating the findings obtained on the basis of the research work involving only the populations from the developed countries, could often be highly misleading due to existence of diverse patterns of diseases in developing countries compared to the developed world. Biomarker candidates identified from high-throughput integrated omics technologies have promising potential; however, their actual clinical applications are found to be limited, primarily due to the challenges of disease heterogeneity and pre-analytical variability associated with the biomarker discovery pipeline. Additionally, in the developing world, economic crunches, lack of awareness and education, paucity of biorepositories, enormous diversities in socio-epidemiological background, ethnicity, lifestyle, diet, exposure to various environmental risk factors and infectious agents, and ethical and social issues also cumulatively hinder biomarker discovery ventures. Establishment of standard operating procedures, comprehensive data repositories and exchange of scientific findings are crucial for reducing the variability and fragmentation of data. This review highlights the challenges associated with the discovery, validation and translational phases of biomarker research in LMNs with some of their amenable solutions and future prospects. This article is part of a Special Issue entitled: Biomarkers: A Proteomic Challenge.