药物QT间期延长潜在作用非临床研究技术指导原则(国家食药监总局通告2014年第4号) .. ...

2023-3-7 12:35| 发布者: 启疾光| 查看: 960| 评论: 0|来自: 国家药监局

摘要: 本指则适用于中药、天然药物和化学药物。主要是关于评价受试物延迟心室复极化潜在作用的非临床研究策略,以及对非临床研究信息的分析和综合风险性评估。QT间期研究结果可以和其他信息一起,用来阐明药物作用机制,以 ...


(三)追加的研究

药物对心肌动作电位(Action potentialAP)的影响:心脏的正常功能依赖于心肌细胞动作电位的产生和传导。药物引起细胞膜离子通道表达或功能异常是其导致心律失常的重要病理生理基础。因此,在离体心脏标本进行动作电位参数测定,是ICH 推荐的QT间期延长药物安全性评价体系中的重要组成之一。常用于动作电位参数测定的动物离体心脏标本及试验方法见表4,试验中重要的参数项目见表5

记录心肌AP的离体心肌标本

 

动物标本

参考文献

犬蒲肯

野纤维

Terrar, DA et al  Comparison of guinea-pig ventricular myocytes and dog Purkinje fibres for in vitro assessment of drug-induced delayed repolarization J Pharmacol Toxicol Methods, 2007; 56: 171-85

Lightbown ID et al  Towards automation of a valuable preclinical cardiac safety pharmacology assay: Evaluation of the effects of cardiac ion channel blockers on cardiac repolarisation in vitro J Pharmacol Toxicol Methods, 2007;56:194-202

Limberis JT et al The effects of plasma proteins on delayed repolarization in vitro with cisapride, risperidone, and D, L-sotalol J Pharmacol Toxicol Methods, 2007; 56:11-7

兔蒲肯

野纤维

Himmel HM  Suitability of commonly used excipients for electrophysiological in-vitrosafety pharmacology assessment of effects on hERG potassiumcurrent and on rabbit Purkinje fiber action potential J Pharmacol Toxicol Methods, 2007; 56: 145-58

Ducroq J et al  Action potential experiments complete hERG assay and QT-interval measurements in cardiac preclinical studies  J Pharmacol Toxicol Methods, 2007; 159-70

豚鼠心室

肌细胞

Hagiwara T et al A comparative study of the fluoroquinolone antibacterial agents on the action potential duration in guinea pig ventricular myocardia Jpn J Pharmacol, 2001; 87: 231–34

Shuba LM et al Action potentials, contraction, and membrane currents in guinea pig ventricular preparations treated with the antispasmodic agent terodiline JPET, 1999; 290:1417-26

豚鼠心室

乳头肌

Hayashi S et al  QT PRODACT: a multi-site study of in vitro action potential assays on 21 compounds in isolated guinea-pig papillary muscles  J PharmacolSci,2005; 99:423-37

Langendorff离体心脏

Milberg P et al  Proarrhythmia as a class effect of quinolones: increased dispersion of repolarization and triangulation of action potential predict torsades de pointes J Cardiovasc Electrophysiol, 2007; 18:647-54

Clements-Jewery H et al  Actions of flecainide on susceptibility to phase-2 ventricular arrhythmias during infarct evolution in rat isolated perfused hearts  British J Pharmacol, 2006; 147: 468–75

ChengHC and Incardona J  Models of torsades de pointes: effects of FPL64176, DPI201106, dofetilide, and chromanol 293B in isolated rabbit and guinea pig hearts  J Pharmacol Toxicol Methods, 2009; 60: 174-84

冠状动脉灌注兔左心室肌楔形标本

ChenX et al  Use of arterially perfused rabbit ventricular wedge inpredicting arrhythmogenic potentials of drugs J Pharmacol Toxicol Methods, 2006;54: 261-72

Liu T, Brown BS, Wu Y, Antzelevitch C, Kowey PR, Yan GX.Blinded validation of the isolated arterially perfused rabbit ventricular wedge in preclinical assessment of drug-induced proarrhythmias  Heart Rhythm 2006; 3: 948-956

上述研究相关试验建议最大可能执行GLP

 



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