基于自然环境中优选药物的毒性和生态毒理风险研究

在如今超过1 500种在用原料药中，环境中发现几率明确和对环境影响明确的原料药所占比例很小。由于很难监管所有在用原料药，众多先前的研究提议将原料药按照受关注程度排序，从而可以将研究资源集中于那些最受瞩目的药物。然而这些研究都存在局限性，本文从之前优先性方法的实践经验出发，提出了一种更为全面的原料药排序方法。该方法基于对水生生物、土壤生物、鸟类、野生哺乳动物和人类的风险，综合考虑了食物链顶端存在的生态毒理学研究终点和由这些治疗性药物作用机制带来的非顶端效果。对于在英国社区以及医院设置中使用的146种活性药物的分析可以更为详细地说明该方法的运用。根据这一方法，我们将16种化合物列为优先考虑的药物。这些药物包括了抗生素、抗抑郁药、抗炎药、抗糖尿病药、抗肥胖药、雌激素类化合物以及相关的代谢产物。我们建议这种优先性方法在将来可以更广泛地应用于世界上不同的地区。
精选自Jiahua Guo, Chris J. Sinclair, Katherine Selby, Alistair B.A. Boxall. Toxicological and ecotoxicological risk based prioritisation of pharmaceuticals in the natural environment. Environmental Toxicology and Chemistry: Volume 35, Issue 7, pages 1550–1559, July 2016. DOI: 10.1002/etc.3319
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Toxicological and ecotoxicological risk based prioritisation of pharmaceuticals in the natural environment

Around 1,500 active pharmaceutical ingredients are currently in use, however the environmental occurrence and impacts of only a small proportion of these has been investigated. Recognising that it would be impractical to monitor and assess all pharmaceuticals that are in use, a number of previous studies have proposed the use of prioritisation approaches to identify substances of most concern so that resources can be focused on these. All of these previous approaches suffer from limitations. Here, we draw on experience from previous prioritisation exercisea and present a holistic approach for prioritising pharmaceuticals in the environment in terms of risks to aquatic and soil organisms, avian and mammalian wildlife and humans. The approach considers both apical ecotoxicological endpoints as well as potential non-apical effects related to the therapeutic mode of action. Application of the approach is illustrated for 146 active pharmaceuticals that are either used in the community or in hospital settings in the United Kingdom. Using the approach sixteen compounds were identified as a potential priority. These substances include compounds belonging to the antibiotic, antidepressant, anti-inflammatory, antidiabetic, antiobesity and estrogen classes as well as associated metabolites. We recommend that in the future, the prioritisation approach be applied more broadly around the different regions of the World.
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