ESTUDIOS
PRECLÍNICOS

Los llamados métodos in vitro implican estudios de laboratorio de células bacterianas, animales o humanas. In vitro significa en latín «Dentro del vaso». El objetivo es:

  1. Observar los procesos naturales o manipular los procesos dentro de las células individuales o entre las células
  2. Conocer cómo un componente (fármaco) influye en el funcionamiento de las células

ESTUDIOS SOBRE ANIMALES

A menudo, pero no siempre, se considera necesario o útil probar un medicamento en animales antes de pasar a los ensayos en humanos. Los ensayos con animales pueden realizarse en organismos pequeños como las moscas, en animales pequeños como los ratones y las ratas o en animales más grandes como los cerdos. El objetivo es:

  1. Probar la seguridad de un fármaco en un organismo vivo sin riesgo de dañar a los humanos.
  2. Medir la eficacia y probar la dosis en un organismo vivo sin riesgo de dañar a los humanos.

ENSAYOS CLÍNICOS

Prueba de tratamiento en humanos.

Fase I. Estos ensayos prueban un tratamiento experimental en un pequeño grupo de personas por primera vez. El propósito es:

1) Evaluar la seguridad del tratamiento
2) Descubrir cuál sería el rango seguro para la dosificación
Identificar efectos secundarios

Fase II. El tratamiento se administra a un grupo más grande de personas para:

1) Obtener datos preliminares sobre la eficacia del tratamiento para una enfermedad o afección en particular.
2) Evaluar más a fondo la seguridad del tratamiento
3) Determinar la mejor dosis

Fase III. El tratamiento se administra a grupos aún más grandes de personas para:

1) Confirmar su efectividad
2) Monitorizar los efectos secundarios
3) Compararlo con los tratamientos de uso común
4) Recopilar información que permitirá que el tratamiento se utilice de forma segura en el mercado

Phase IV. Realizada después de que el tratamiento esté aprobado y esté en el mercado. Recopilar información sobre cómo es la mejor manera de usar un tratamiento y los beneficios y riesgos a largo plazo.
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SNP-single nucleotide polymorphisms

a single-letter spelling difference in a gene. SNPs, pronounced ‘snips’, are common and most don’t change the function of the gene.

 
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at risk

You do not know if you carry the genetic mutation for HD gene 

 
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TFC-total functional capacity

A standardized rating scale for function in HD, used to assess capacity to work, handle finances, perform domestic chores and self-care tasks.
Scores range from 0 to 13, with higher scores indicating better functional capacity. 

 
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Double-blinded

 means that neither the participant nor the clinical trial doctor can choose or know the group the participant is in until the trial is over. This approach helps to prevent bias.

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Open label

A trial in which the patient and doctor know what drug is being used. Open label trials are susceptible to bias through placebo effects.

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Gene therapy

a technique that aims to treat or prevent diseases by modifying a person’s genes. It involves introducing, removing, or changing genetic material (DNA or RNA) within a patient’s cells.

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UHDRS- Unified Huntington Disease Rating Scale

A standardized neurological examination that aims to provide a uniform assessment of the clinical features of HD

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CAG repeat

The stretch of DNA at the beginning of the HD gene, which contains the sequence CAG repeated many times, and is abnormally long in people who will develop HD

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Wild-type

the opposite of ‘mutant’. Wild-type huntingtin, for example, is the ‘normal’, ‘healthy’ protein

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Tolerabilty

How well a person can handle a treatment without having serious or uncomfortable side effects.

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Striatum

Part of the brain that  coordinates multiple aspects of cognition, including both motor and action planning, decision-making, motivation, reinforcement, and reward system.

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Randomized allocation

A type of allocation strategy in which participants are assigned to the arms of a clinical trial by chance.

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Radioligand

a radioactive substance that binds to a specific target in the body, allowing visualization of that target’s distribution and activity

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Protein

Protein builds, maintains, and replaces the tissues in your body. The building blocks of life.

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Premanifest / Prodromal

Prior to onset or diagnosis of movement symptoms.

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Placebo

A placebo is a dummy medicine containing no active ingredients. The placebo effect is a psychological effect that causes people to feel better even if they’re taking a pill that doesn’t work.

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PK - Pharmacokinetics

The movement of drugs through the body

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PD - Pharmacodynamics

The body’s biological response to drugs

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PET scan

Positron emission tomography which produces detailed 3-dimensional images of the inside of the body.

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Neuron

Brain cells that store and transmit information

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MRI

Magentic resonance imaging: A technique using powerful magnetic fields to produce detailed images and visualizes the structure of organs, tissues, and bones 

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mHTT

Mutant huntingtin protein. The protein produced by the faulty HD gene.

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Manifest

after HD diagnosis, or when symptoms are already showing

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Longitudinal study

A study where each participant is looked at several times over a time period – unlike a cross-sectional study, where each participant is looked at only once

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HTT

one abbreviation for the gene that causes Huntington’s disease. The same gene is also called HD and IT-15

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fMRI

functional MRI:As with MRI, a technique using powerful magnetic fields  but focusing on brain function by measuring and mapping changes in blood flow, revealing which areas of the brain are active during specific tasks or cognitive processes

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CSF - cerebrospinal fluid

A clear fluid produced by the brain, which surrounds and supports the brain and spinal cord.

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Efficacy

A measure of whether a treatment works or not

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ASO(Antisense oligonucleotides)

A type of gene silencing treatment in which specially designed DNA molecules are used to switch off a gene

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Biomarker

a test of any kind – including blood tests, thinking tests and brain scans – that can measure or predict the progression of a disease like HD. Biomarkers may make clinical trials of new drugs quicker and more reliable

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BDNF

Brain-derived neurotrophic factor: a growth factor that may be able to protect neurons in HD.

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Allele

one of the two copies of a gene

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Plasma

Liquid component of the blood.

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Gene

The basic unit of heredity passed from parent to child. Genes are made up of sequences of DNA and are arranged, one after another, at specific locations on chromosomes in the nucleus of cells.

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Phase

Clinical trial phases are different stages of research that assess the safety and effectiveness of a new medical treatment or intervention in humans.

Each phase has a specific goal and involves a different number of participants. Generally, there are 4 phases (I-IV), with Phase I focusing on safety and dosage, Phase II on efficacy and side effects, Phase III on comparing the new treatment with standard treatments, and Phase IV on long-term safety monitoring.