Aetiopathogenetic Architecture for Pharmaceutical Development (Using Gout as a Case Study)

INTRODUCTION. A holistic understanding of the physiological and biochemical pathways involved in pathogenesis is needed both for doctors diagnosing and treating patients and for drug developers. The accumulated knowledge in medicine and related fields, combined with the rapid development of digital tools, enables simulating the response systems of the body under normal and pathological conditions at a qualitatively new level. Being able to perform such simulations will lead to creating a digital architecture of body conditions, with interconnected links in the chain of pathogenesis being the focal points for researchers advancing medicines from early development to clinical trials.

AIM. This study aimed to review existing approaches that could form a foundation for constructing an aetiopathogenetic architecture of pathological conditions and diseases that would serve as a framework for targeted drug development.

DISCUSSION. Using gout as a case study, the authors demonstrated the necessity and possibility of developing a three-dimensional aetiopathogenetic architecture of pathological conditions and diseases that would be based on the hierarchical relationships of pathological processes at different biological organisation levels. The study identified key applications for the aetiopathogenetic architecture. In medicine, the aetiopathogenetic architecture could be used in data-driven individual diagnostics and personalised pharmacotherapy. In pharmaceutics, the aetiopathogenetic architecture could provide a platform for investigating pharmacodynamics, from screening candidate compounds to applying targeted and multitargeted approaches in pharmaceutical development. The authors used the aetiopathogenetic architecture of gout as a case study to discuss the logic behind designing studies of medicines.

CONCLUSIONS. The article proposes a methodology for constructing an aetiopathogenetic architecture reflecting cause-and-effect relationships of different significance to the development of pathological conditions and diseases. The aetiopathogenetic approach should become an integrative framework for all stages of the development and use of novel medicines, as well as a basis for expanding the indications for existing medicines. New opportunities are arising for the development of aetiopathogenetic models of varying complexity that can be used in projects ranging from drug design at the molecular level to pathophysiological modelling at the organismal level.

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