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Are researchers moving away from animal models as a result of poor clinical translation in the field of stroke? An analysis of opinion papers
BMJ Open Science Pub Date : 2020-02-01 , DOI: 10.1136/bmjos-2019-100041
Pandora Pound 1 , Rebecca Ram 1
Affiliation  

Objectives Despite decades of research using animals to develop pharmaceutical treatments for patients who have had a stroke, few therapeutic options exist. The vast majority of interventions successful in preclinical animal studies have turned out to have no efficacy in humans or to be harmful to humans. In view of this, we explore whether there is evidence of a move away from animal models in this field. Methods We used an innovative methodology, the analysis of opinion papers. Although we took a systematic approach to literature searching and data extraction, this is not a systematic review because the study involves the synthesis of opinions, not research evidence. Data were extracted from retrieved papers in chronological order and analysed qualitatively and descriptively. Results Eighty eligible papers, published between 1979 and 2018, were identified. Most authors were from academic departments of neurology, neuroscience or stroke research. Authors agreed that translational stroke research was in crisis. They held diverse views about the causes of this crisis, most of which did not fundamentally challenge the use of animal models. Some, however, attributed the translational crisis to animal–human species differences and one to a lack of human in vitro models. Most of the proposed solutions involved fine-tuning animal models, but authors disagreed about whether such modifications would improve translation. A minority suggested using human in vitro methods alongside animal models. One proposed focusing only on human in vitro methods. Conclusion Despite recognising that animal models have been unsuccessful in the field of stroke, most researchers exhibited a strong resistance to relinquishing them. Nevertheless, there is an emerging challenge to the use of animal models, in the form of human-focused in vitro approaches. For the sake of stroke patients there is an urgent need to revitalise translational stroke research and explore the evidence for these new approaches.

中文翻译:

由于中风领域临床转化不佳,研究人员是否正在远离动物模型?意见书分析

目标 尽管使用动物为中风患者开发药物治疗已有数十年的研究,但几乎没有治疗选择。绝大多数在临床前动物研究中取得成功的干预措施已证明对人类无效或对人类有害。鉴于此,我们探讨是否有证据表明该领域正在远离动物模型。方法 我们使用了一种创新的方法,即分析意见书。尽管我们对文献检索和数据提取采取了系统的方法,但这不是系统评价,因为该研究涉及观点的综合,而不是研究证据。数据按时间顺序从检索到的论文中提取,并进行定性和描述性分析。结果 1979 年至 2018 年间发表的 80 篇符合条件的论文,被识别。大多数作者来自神经病学、神经科学或中风研究的学术部门。作者一致认为,平移性中风研究处于危机之中。他们对这场危机的起因持有不同的观点,其中大多数并没有从根本上挑战动物模型的使用。然而,有些人将转化危机归因于动物与人类的物种差异,其中之一归因于缺乏人类体外模型。大多数提出的解决方案都涉及微调动物模型,但作者不同意这种修改是否会改善翻译。少数人建议将人类体外方法与动物模型一起使用。有人提议只关注人体体外方法。结论 尽管认识到动物模型在中风领域并不成功,大多数研究人员对放弃它们表现出强烈的抵抗力。然而,以人类为中心的体外方法形式的动物模型的使用面临着新的挑战。为了中风患者,迫切需要振兴转化中风研究并探索这些新方法的证据。
更新日期:2020-02-01
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