The bad taste of medicines: overview of basic research on bitter taste.
The bad taste of medicines: overview of basic research on bitter taste.
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DOI：
10.1016/j.clinthera.2013.06.007
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发表时间：
2013-08
影响因子：
3.2
通讯作者：
Coldwell SE
中科院分区：
文献类型：
--
作者：
Mennella JA;Spector AC;Reed DR;Coldwell SE
许多活性药物成分味道苦，因此儿童以及许多成人都厌恶。将药物封装成丸剂或片剂是成人避免不良味道的有效方法，但对儿童来说却是个问题。许多儿童不能或不会吞咽固体剂型。这篇综述强调了味觉功能的基本原理，特别关注源自动物模型和人类心理物理学研究的苦味科学。我们重点关注编码苦味受体蛋白质的基因组，以及导致味觉功能多维方面的级联事件，强调动物模型在这些发现中发挥的作用。我们还总结了研究成人和儿童苦味的心理物理学方法，强调了成人和儿童之间苦味感知和接受度的相似性和差异的证据，并从动物模型中借鉴了有用的策略。药物通常味道很苦，而且由于儿童比成人对苦味更敏感，这会产生依从性问题。苦味是由刺激味觉受体细胞中的受体产生的，信号在味蕾中进行处理并传递到大脑。然而，我们对如何最好地测量苦味以及如何改善苦味的理解存在许多差距，包括是否在受体和感觉信号水平、中央处理水平或通过掩蔽技术更有效地解决苦味问题。所有测量苦味配体反应性的方法——在动物模型中、通过人类心理物理学或“电子舌头”——都有局限性。味道更好的药物可能会提高儿科对药物治疗的依从性。糖、酸、盐和其他物质可以减少几种药物的苦味，尽管令人愉快的调味剂可能有助于儿童服用某些药物，但它们通常不能有效抑制苦味。儿童心理物理工具的进一步开发将帮助我们更好地了解他们的感官世界。多种测试策略将帮助我们完善评估不同儿科人群接受度和依从性/依从性的方法。涉及动物模型的研究可以对味觉系统进行更具侵入性的操纵，可以阐明机制，最终提供潜在的目标。这些方法与新技术相结合，并以临床研究结果为指导，将有可能找到提高儿科人群药物接受度和依从性的有效方法。
Many active pharmaceutical ingredients taste bitter and thus are aversive to children, as well as many adults. Encapsulation of the medicine in pill or tablet form, an effective method for adults to avoid the unpleasant taste, is problematic for children. Many children cannot or will not swallow solid dosage forms. This review highlights basic principles of gustatory function, with a special focus on the science of bitter taste, derived from studies of animal models and human psychophysics. We focus on the set of genes that encode the proteins that function as bitter receptors, as well as the cascade of events that lead to multidimensional aspects of taste function, highlighting the role that animal models played in these discoveries. We also summarize psychophysical approaches to studying bitter taste in adult and pediatric populations, highlighting evidence of the similarities and differences in bitter taste perception and acceptance between adults and children and drawing on useful strategies from animal models. Medicine often tastes bitter, and because children are more bitter sensitive than are adults, this creates problems with compliance. Bitter arises from stimulating receptors in taste receptor cells, with signals processed in the taste bud and relayed to the brain. However, there are many gaps in our understanding of how best to measure bitterness and how to ameliorate it, including whether it is more efficiently addressed at the level of receptor and sensory signaling, at the level of central processing, or by masking techniques. All methods of measuring responsiveness to bitter ligands—in animal models, through human psychophysics, or with “electronic tongues”—have limitations. Better-tasting medications may enhance pediatric adherence to drug therapy. Sugars, acids, salt, and other substances reduce perceived bitterness of several pharmaceuticals, and although pleasant flavorings may help children consume some medicines, they often are not effective in suppressing bitter tastes. Further development of psychophysical tools for children will help us better understand their sensory worlds. Multiple testing strategies will help us refine methods to assess acceptance and compliance/adherence by various pediatric populations. Research involving animal models, in which the gustatory system can be more invasively manipulated, can elucidate mechanisms, ultimately providing potential targets. These approaches, combined with new technologies and guided by findings from clinical studies, will potentially lead to effective ways to enhance drug acceptance and compliance in pediatric populations.
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