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Popovic B, Breed J, Rees DG, Gardener MJ, Vinall LMK, Kemp B, Spooner J, Keen J, Minter R, Uddin F, Colice G, Wilkinson T, Vaughan T, May RD. Structural Characterisation Reveals Mechanism of IL-13-Neutralising Monoclonal Antibody Tralokinumab as Inhibition of Binding to IL-13Rα1 and IL-13Rα2. J Mol Biol 2016; 429:208-219. [PMID: 27956146 DOI: 10.1016/j.jmb.2016.12.005] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/02/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022]
Abstract
Interleukin (IL)-13 is a pleiotropic T helper type 2 cytokine frequently associated with asthma and atopic dermatitis. IL-13-mediated signalling is initiated by binding to IL-13Rα1, which then recruits IL-4Rα to form a heterodimeric receptor complex. IL-13 also binds to IL-13Rα2, considered as either a decoy or a key mediator of fibrosis. IL-13-neutralising antibodies act by preventing IL-13 binding to IL-13Rα1, IL-4Rα and/or IL-13Rα2. Tralokinumab (CAT-354) is an IL-13-neutralising human IgG4 monoclonal antibody that has shown clinical benefit in patients with asthma. To decipher how tralokinumab inhibits the effects of IL-13, we determined the structure of tralokinumab Fab in complex with human IL-13 to 2 Å resolution. The structure analysis reveals that tralokinumab prevents IL-13 from binding to both IL-13Rα1 and IL-13Rα2. This is supported by biochemical ligand-receptor interaction assay data. The tralokinumab epitope is mainly composed of residues in helices D and A of IL-13. It is mostly light chain complementarity-determining regions that are driving paratope interactions; the variable light complementarity-determining region 2 plays a key role by providing residue contacts for a network of hydrogen bonds and a salt bridge in the core of binding. The key residues within the paratope contributing to binding were identified as Asp50, Asp51, Ser30 and Lys31. This study demonstrates that tralokinumab prevents the IL-13 pharmacodynamic effect by binding to IL-13 helices A and D, thus preventing IL-13 from interacting with IL-13Rα1 and IL-13Rα2.
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Wilkinson T, Sculpher MJ, Claxton K, Revill P, Briggs A, Cairns JA, Teerawattananon Y, Asfaw E, Lopert R, Culyer AJ, Walker DG. The International Decision Support Initiative Reference Case for Economic Evaluation: An Aid to Thought. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:921-928. [PMID: 27987641 DOI: 10.1016/j.jval.2016.04.015] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/17/2016] [Accepted: 04/18/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Policymakers in high-, low-, and middle-income countries alike face challenging choices about resource allocation in health. Economic evaluation can be useful in providing decision makers with the best evidence of the anticipated benefits of new investments, as well as their expected opportunity costs-the benefits forgone of the options not chosen. To guide the decisions of health systems effectively, it is important that the methods of economic evaluation are founded on clear principles, are applied systematically, and are appropriate to the decision problems they seek to inform. METHODS The Bill and Melinda Gates Foundation, a major funder of economic evaluations of health technologies in low- and middle-income countries (LMICs), commissioned a "reference case" through the International Decision Support Initiative (iDSI) to guide future evaluations, and improve both the consistency and usefulness to decision makers. RESULTS The iDSI Reference Case draws on previous insights from the World Health Organization, the US Panel on Cost-Effectiveness in Health Care, and the UK National Institute for Health and Care Excellence. Comprising 11 key principles, each accompanied by methodological specifications and reporting standards, the iDSI Reference Case also serves as a means of identifying priorities for methods research, and can be used as a framework for capacity building and technical assistance in LMICs. CONCLUSIONS The iDSI Reference Case is an aid to thought, not a substitute for it, and should not be followed slavishly without regard to context, culture, or history. This article presents the iDSI Reference Case and discusses the rationale, approach, components, and application in LMICs.
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Rigge LA, Coombs NA, Johnson M, Culliford D, Josephs L, Williams N, Thomas M, Wilkinson T. P53 Predicting poor outcomes in COPD patients deemed ‘low risk’ by dose score. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ostridge K, Williams N, Kim V, Bennett M, Harden S, Welch L, Bourne S, Coombs N, Elkington P, Staples K, Wilkinson T. S93 Pulmonary Matrix Metalloproteinases and Small Airways Disease in COPD – The Origins of Airflow Obstruction?: Abstract S93 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rigge LA, Johnson M, Culliford D, Williams N, Josephs L, Thomas M, Wilkinson T. P20 A database approach to DOSE score calculation as a tool to identify ‘at risk’ Chronic Obstructive Pulmonary Disease patients through clinical records. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Richards E, Rafie S, Rafie S, Cohen Landau S, Wilkinson T. Pharmacists' views on California's new law for pharmacy access to contraception: a qualitative study. Contraception 2015. [DOI: 10.1016/j.contraception.2015.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Connolly M, Kerse N, Moyes S, Wilkinson T, Rolleston R, Chong Y, Menzies O, Broad J, Jatrana S, Teh R. 75SERUM TESTOSTERONE LEVELS RELATE TO BOTH FRAILTY AND ADL IN OCTOGENARIAN MALES: LILACS STUDY, NEW ZEALAND. Age Ageing 2015. [DOI: 10.1093/ageing/afv115.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Daniel C, Hickman C, Wilkinson T, Oliana O, Gwinnett D, Trew G, Lavery S. Maximising success rates by improving ICSI technique: which factors affect outcome? Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thomas M, Wilkinson T. Asthma diagnosis in the community--time for a change? Clin Exp Allergy 2015; 44:1206-9. [PMID: 25243811 DOI: 10.1111/cea.12392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Santatiwongchai B, Chantarastapornchit V, Wilkinson T, Thiboonboon K, Rattanavipapong W, Walker DG, Chalkidou K, Teerawattananon Y. Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development. PLoS One 2015; 10:e0123853. [PMID: 25950443 PMCID: PMC4423853 DOI: 10.1371/journal.pone.0123853] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/1969] [Accepted: 07/20/1969] [Indexed: 11/18/2022] Open
Abstract
Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.
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Ostridge K, Williams N, Kim V, Barton A, Wojtas M, Harden S, Aris E, Peeters M, Devaster J, Bourne S, Wilkinson T. P62 Correlation Of Quantitative Chest Ct Measures With Lung Function And Functional Parameters In A Cohort Of Moderate To Very Severe Copd Patients. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Spalluto C, Singhania A, Woelk C, Sanchez-Elsner T, Staples K, Wilkinson T. S129 Inflammatory Cytokines Influence Respiratory Epithelial Anti-viral Immune Responses Via Inducible Epigenetic Control Of Rig1 Expression: A Model Of Early Life Origins Of Asthma? Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ostridge K, Harden S, Elkington P, Staples K, Wilkinson T. P63 Assessment Of Regional Variability In Matrix Metalloproteinase Concentrations By Ct Informed Bronchoalveolar Lavage In Patients With Copd. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jackson J, Kim V, Tuck A, Wootton S, Wilkinson T. S89 Identification Of Potentially Pathogenic Microorganisms By Selected Ion Flow Tube -mass Spectrometry (sift-ms). Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kim V, Williams N, Ostridge K, Barton A, Wojtas M, Aris E, Peeters M, Devaster J, Bourne S, Wilkinson T. S33 Sputum Colour In The Light Of The Health Related Quality Of Life, Airways And Systemic Biomarkers In Exacerbations Of Copd. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Williams N, Ostridge K, Kim V, Barton A, Wojtas M, Harden S, Aris E, Peeters M, Devaster J, Bourne S, Wilkinson T. P153 Stratifying Pneumonic Episodes And Acute Exacerbations In Copd Patients - A Continuum Or Discrete Phenomena? Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Minter RR, Cohen ES, Wang B, Liang M, Vainshtein I, Rees G, Eghobamien L, Harrison P, Sims DA, Matthews C, Wilkinson T, Monk P, Drinkwater C, Fabri L, Nash A, McCourt M, Jermutus L, Roskos L, Anderson IK, Sleeman MA. Protein engineering and preclinical development of a GM-CSF receptor antibody for the treatment of rheumatoid arthritis. Br J Pharmacol 2014; 168:200-11. [PMID: 22913645 DOI: 10.1111/j.1476-5381.2012.02173.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 05/22/2012] [Accepted: 07/16/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE For antibody therapies against receptor targets, in vivo outcomes can be difficult to predict because of target-mediated clearance or antigen 'sink' effects. The purpose of this work was to engineer an antibody to the GM-CSF receptor α (GM-CSFRα) with pharmacological properties optimized for chronic, s.c. treatment of rheumatoid arthritis (RA) patients. EXPERIMENTAL APPROACH We used an in silico model of receptor occupancy to guide the target affinity and a combinatorial phage display approach for affinity maturation. Mechanism of action and internalization assays were performed on the optimized antibody in vitro before refining the modelling predictions of the eventual dosing in man. Finally, in vivo pharmacology studies in cynomolgus monkeys were carried out to inform the predictions and support future clinical development. KEY RESULTS Antibody potency was improved 8600-fold, and the target affinity was reached. The refined model predicted pharmacodynamic effects at doses as low as 1 mg kg(-1) and a study in cynomolgus monkeys confirmed in vivo efficacy at 1 mg kg(-1) dosing. CONCLUSIONS AND IMPLICATIONS This rational approach to antibody drug discovery enabled the isolation of a potent molecule compatible with chronic, s.c. self-administration by RA patients. We believe this general approach enables the development of optimal biopharmaceuticals.
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Akaza H, Kawahara N, Roh JK, Inoue H, Park EC, Lee KS, Kim S, Hayre J, Naidoo B, Wilkinson T, Fukuda T, Jang WI, Nogimori M. Japanese Cancer Association Meeting UICC International Session - What is Cost-effectiveness in Cancer Treatment? Asian Pac J Cancer Prev 2014; 15:3-10. [DOI: 10.7314/apjcp.2014.15.1.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bourne SC, Wilkinson T, Kruk H, Austin K, Watson J, James N. P104 Southampton City: finding the missing millions and reducing admissions through medical intelligence. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Keys A, Wilkinson T, Staples KJ, North M, Pink S, Wilson S, Kilty I, Djukanovic R, Nicholas B. P120 Comparison of cellular inflammation and TLR expression profiles between healthy and COPD subjects. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Uttley P, Wilkinson T, Cassatella P, Wilms J, Pottschmidt K, Hanke M, Böck M. The causal connection between disc and power-law variability in hard state black hole X-ray binaries. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1745-3933.2011.01056.x] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hutchinson C, Hanger C, Wilkinson T, Sainsbury R, Pithie A. Spontaneous spinal infections in older people. Intern Med J 2009; 39:845-8. [DOI: 10.1111/j.1445-5994.2009.02052.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wilkinson T. Norman Daniels. Just Health. Public Health Ethics 2008. [DOI: 10.1093/phe/phn028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hart BJ, Crowther D, Wilkinson T, Biddulph P, Ucci M, Pretlove S, Ridley I, Oreszczyn T. Reproduction and development of laboratory and wild house dust mites (Acari: Pyroglyphidae) and their relationship to the natural dust ecosystem. JOURNAL OF MEDICAL ENTOMOLOGY 2007; 44:568-74. [PMID: 17695009 DOI: 10.1603/0022-2585(2007)44[568:radola]2.0.co;2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Life histories of "wild" house dust mites, Dermatophagoides pteronyssinus (Trouessart) (Acari: Pyroglyphidae), were compared with laboratory cultures by using a diet consisting of skin and dust or a laboratory diet consisting of dried liver and yeast. Under constant conditions of 25 degrees C and 75% RH, fecundity and rate of reproduction were higher in laboratory cultures on both diets compared with wild mites. There were also trends for a shorter prereproductive period and more rapid egg development of laboratory mites compared with wild mites. Overall, there was little effect of diet on either strain of mites at 75% RH. At low RH (64%), fecundity was significantly lower (for both strains on both diets), and there were also trends for longer prereproductive period, reduced rate of reproduction, reduced adult survival, prolonged egg and juvenile development, or a combination compared with 75% RH. Additionally egg and juvenile mortality were significantly higher on the liver and yeast diet. Overall, the skin and dust diet favored both strains of mites at 64% RH. On the liver and yeast diet at 64% RH, wild mite adults performed significantly better than laboratory mites, and egg mortality was lower. These results suggest that laboratory mites have stronger reproduction and development than wild mites, except when under environmental stress and that diet is a significant factor, particularly in suboptimal conditions. This could have important implications for predictive models of house dust mite populations in their natural habitat. Ideally, such models should be developed using data from wild dust mite populations reared on a natural diet.
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Bermingham J, Charles H, Calevero F, Wilkinson T. Comparative analysis of gene expression in an aphid–Buchnera symbiosis: The role of Buchnera in the nutrition of aphid embryos. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.01.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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