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Ramprasad A, Ezekwe A, Lee BR, Balasubramanian S, Jones BL. The impact of skin color and tone on histamine iontophoresis and Doppler flowmetry measurements as a pharmacodynamic biomarker. Clin Transl Sci 2024; 17:e13777. [PMID: 38511581 PMCID: PMC10955605 DOI: 10.1111/cts.13777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
The phenotypical manifestations of asthma among children are diverse and exhibit varying responses to therapeutic interventions. There is a need to develop objective biomarkers to improve the characterization of allergic and inflammatory responses relevant to asthma to predict therapeutic treatment responses. We have previously investigated histamine iontophoresis with laser Doppler flowmetry (HILD) as a potential surrogate biomarker that characterizes histamine response and may be utilized to guide the treatment of allergic and inflammatory disease. We have identified intra-individual variability of HILD response type among children and adults with asthma and that HILD response type varied in association with racial classification. As laser Doppler flowimetry may be impacted by skin color, we aimed to further validate the HILD method by determining if skin color or tone is associated with observed HILD response type differences. We conducted an observational study utilizing quantification of skin color and tone obtained from photographs of the skin among participants during HILD assessments via the RGB color model. We compared RGB values across racial, ethnic, and HILD response type via the Kruskal-Wallis test and calculated Kendall rank correlation coefficient to evaluate the relationship between RGB composite scores and HILD pharmacodynamic measures. We observed that RGB scores differed among racial groups and histamine response phenotypes (p < 0.05). However, there was a lack of correlation between the RGB composite score and HILD pharmacodynamic measures (r values 0.1, p > 0.05). These findings suggest that skin color may not impact HILD response variations, necessitating further research to understand previously observed differences across identified racial groups.
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Affiliation(s)
- Aarya Ramprasad
- University of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
| | - Adara Ezekwe
- Division of Pediatric Clinical Pharmacology and Therapeutic Innovation and Section of Allergy/Asthma/ImmunologyChildren's Mercy HospitalKansas CityMissouriUSA
| | - Brian R. Lee
- University of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
- Division of Health Services and Outcomes ResearchChildren's Mercy HospitalKansas CityMissouriUSA
| | | | - Bridgette L. Jones
- University of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
- Division of Pediatric Clinical Pharmacology and Therapeutic Innovation and Section of Allergy/Asthma/ImmunologyChildren's Mercy HospitalKansas CityMissouriUSA
- Department of PediatricsUniversity of Missouri‐Kansas City School of MedicineKansas CityMissouriUSA
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Huang Z, Zhang L, Li Y, Yu Y, Shen Y, Sun X, Lou K, Luo H, Meng Z, Li H, Wei Y. Population Pharmacodynamic Models of Risperidone on PANSS Total Scores and Prolactin Levels in Schizophrenia. Pharmaceuticals (Basel) 2024; 17:148. [PMID: 38399363 PMCID: PMC10891722 DOI: 10.3390/ph17020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
Currently, research predominantly focuses on evaluating clinical effects at specific time points while neglecting underlying patterns within the treatment process. This study aims to analyze the dynamic alterations in PANSS total scores and prolactin levels in patients with schizophrenia treated with risperidone, along with the influencing covariates. Using data from an 8-week randomized, double-blind, multicenter clinical trial, a population pharmacodynamic model was established for the PANSS total scores of and prolactin levels in patients treated with risperidone. The base model employed was the Emax model. Covariate selection was conducted using a stepwise forward inclusion and backward elimination approach. A total of 144 patients were included in this analysis, with 807 PANSS total scores and 531 prolactin concentration values. The PANSS total scores of the patients treated with risperidone decreased over time, fitting a proportionally parameterized sigmoid Emax model with covariates including baseline score, course of the disease, gender, plasma calcium ions, and lactate dehydrogenase levels. The increase in prolactin levels conformed to the ordinary Emax model, with covariates encompassing course of the disease, gender, weight, red blood cell count, and triglyceride levels. The impacts of the baseline scores and the course of the disease on the reduction of the PANSS scores, as well as the influence of gender on the elevation of prolactin levels, each exceeded 20%. This study provides valuable quantitative data regarding PANSS total scores and prolactin levels among patients undergoing risperidone treatment across various physiological conditions.
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Affiliation(s)
- Zhiwei Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
| | - Lei Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
| | - Yan Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
| | - Yimin Yu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
| | - Yifeng Shen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
| | - Xiujia Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
| | - Kun Lou
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang 050000, China
| | - Hongmei Luo
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang 050000, China
| | - Zhibin Meng
- CSPC Zhongqi Pharmaceutical Technology (Shijiazhuang) Co., Ltd., Shijiazhuang 050000, China
| | - Huafang Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
- Shanghai Clinical Research Center for Mental Health, Shanghai 200030, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - Yumei Wei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; (Z.H.)
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Henricson J, Sjöberg F, Iredahl F, Strömberg T, Wilhelms D. In vivo dose-response analysis to acetylcholine: pharmacodynamic assessment by polarized reflectance spectroscopy. Sci Rep 2022; 12:6594. [PMID: 35449189 PMCID: PMC9023454 DOI: 10.1038/s41598-022-10617-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022] Open
Abstract
Transdermal iontophoresis offers an in vivo alternative to the strain-gauge model for measurement of vascular function but is limited due to lack of technical solutions for outcome assessment. The aims of this study were to, after measurement by polarized reflectance spectroscopy (PRS), use pharmacodynamic dose–response analysis on responses to different concentrations of acetylcholine (ACh); and to examine the effect of three consecutively administered iontophoretic current pulses. The vascular responses in 15 healthy volunteers to iontophorised ACh (5 concentrations, range 0.0001% to 1%, three consecutive pulses of 0.02 mA for 10 min each) were recorded using PRS. Data were fitted to a four-parameter logistic dose response model and compared. Vascular responses were quantifiable by PRS. Similar pharmacodynamic dose response curves could be generated irrespectively of the ACh concentration. Linearly increasing maximum vasodilatory responses were registered with increasing concentration of ACh. A limited linear dose effect of the concentration of ACh was seen between pulses. Polarized reflectance spectroscopy is well suited for measuring vascular responses to iontophoretically administrated ACh. The results of this study support further development of iontophoresis as a method to study vascular function and pharmacological responses in vivo.
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Affiliation(s)
- Joakim Henricson
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, 58182, Linköping, Sweden. .,Department of Biomedical and Clinical Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
| | - Folke Sjöberg
- Department of Hand, Plastic Surgery, Burns and Intensive Care, Linköping University Hospital, 58182, Linköping, Sweden.,Department of Health, Medicine and Caring Sciences, Division of Community Medicine, Linköping University, Linköping, Sweden
| | - Fredrik Iredahl
- Department of Primary Health Care, Region Östergötland, 58182, Linköping, Sweden.,Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Tomas Strömberg
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Daniel Wilhelms
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, 58182, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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Kumar SS, Liu X, Sherwin CM, Jones BL. The Reliability of Histamine Pharmacodynamic Response Phenotype Classification in Children With Allergic Disease. Front Pharmacol 2020; 11:227. [PMID: 32218731 PMCID: PMC7078102 DOI: 10.3389/fphar.2020.00227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 02/19/2020] [Indexed: 11/30/2022] Open
Abstract
We have identified distinct histamine pharmacodynamic response phenotypes in children with allergic disease utilizing histamine iontophoresis with laser Doppler (HILD). These response phenotypes may be relevant in guiding therapeutic decision making for agents targeting the allergic response pathways. However, the reliability of these response phenotypes has not been assessed. Therefore, we performed HILD in children with allergic rhinitis and/or asthma on two to three separate occasions. HILD response-time data were analyzed in NONMEM using a linked effect PKPD model. Examination of observed vs. classified response phenotypes predicted response plots and the sum of residuals. The intraclass correlation coefficient (ICC) was used to determine the reliability of phenotype classification. Eighty-two percent of children exhibited a reliable histamine response phenotype [intraclass correlation coefficient 0.77 (95% CI 0.44–0.93]. These preliminary results suggest moderate reliability of HILD response phenotype in children. Further exploration is needed to determine contributions to phenotype variability.
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Affiliation(s)
- Shaun S Kumar
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Xiaoxi Liu
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Catherine M Sherwin
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States.,Department of Pediatrics, Dayton Children's Hospital, Wright State University Boonshoft School of Medicine, Dayton, OH, United States
| | - Bridgette L Jones
- Division of Pediatric Pharmacology, Therapeutic Innovation, Children's Mercy Hospital, Kansas City, MO, United States.,Division of Allergy, Asthma, Clinical Immunology, Children's Mercy Hospital, Kansas City, MO, United States.,Department of Pediatrics, University of Missouri, Kansas City, MO, United States
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Gabrielsson J, Andersson R, Jirstrand M, Hjorth S. Dose-Response-Time Data Analysis: An Underexploited Trinity. Pharmacol Rev 2018; 71:89-122. [DOI: 10.1124/pr.118.015750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Jones BL, Sherwin CMT, Liu X, Dai H, Vyhlidal CA. Genetic Variation in the Histamine Production, Response, and Degradation Pathway Is Associated with Histamine Pharmacodynamic Response in Children with Asthma. Front Pharmacol 2017; 7:524. [PMID: 28101058 PMCID: PMC5209333 DOI: 10.3389/fphar.2016.00524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/15/2016] [Indexed: 01/05/2023] Open
Abstract
Introduction: There is growing knowledge of the wide ranging effects of histamine throughout the body therefore it is important to better understand the effects of this amine in patients with asthma. We aimed to explore the association between histamine pharmacodynamic (PD) response and genetic variation in the histamine pathway in children with asthma. Methods: Histamine Iontophoresis with Laser Doppler Monitoring (HILD) was performed in children with asthma and estimates for area under the effect curve (AUEC), maximal response over baseline (Emax), and time of Emax (Tmax) were calculated using non-compartmental analysis and non-linear mixed-effects model with a linked effect PK/PD model. DNA isolation and genotyping were performed among participants to detect known single nucleotide polymorphisms (SNPs) (n = 10) among genes (HDC, HNMT, ABP1, HRH1, HRH4) within the histamine pathway. General linear model was used to identify associations between histamine related genetic variants and measured histamine PD response parameters. Results: Genotyping and HILD response profiles were completed for 163 children. ABP1 47 C/T, ABP1 4107, and HNMT-1639 C/Twere associated with Emax (ABP1 47 CC genotype mean Emax 167.21 vs. CT/TT genotype mean Emax 139.20, p = 0.04; ABP1 4107 CC genotype mean Emax 141.72 vs. CG/GG genotype mean Emax 156.09, p = 0.005; HNMT-1639 CC genotype mean Emax 132.62 vs. CT/TT genotype mean Emax 155.3, p = 0.02). In a stratified analysis among African American children only, ABP1 and HNMT SNPs were also associated with PD response; HRH4 413 CC genotype was associated with lower Emax, p = 0.009. Conclusions: We show for the first time that histamine pathway genetic variation is associated with measureable changes in histamine response in children with asthma. The variability in histamine response and impact of histamine pathway genotype is important to further explore in patients with asthma so as to improve disease phenotyping leading to more personalized treatments.
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Affiliation(s)
- Bridgette L Jones
- Department of Pediatrics University of Missouri-Kansas City, Children's Mercy Hospitals and ClinicsKansas City, MO, USA; Division of Pediatric Pharmacology and Therapeutic Innovation, Children's Mercy Hospitals and ClinicsKansas City, MO, USA; Division of Allergy, Asthma and Clinical Immunology, Children's Mercy Hospitals and ClinicsKansas City, MO, USA; Children's Mercy Hospitals and ClinicsKansas City, MO, USA
| | - Catherine M T Sherwin
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of MedicineSalt Lake City, UT, USA; Department of Pharmacology and Toxicology, University of Utah College of PharmacySalt Lake City, UT, USA; University of Utah College of PharmacySalt Lake City, UT, USA
| | - Xiaoxi Liu
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of MedicineSalt Lake City, UT, USA; Department of Pharmacology and Toxicology, University of Utah College of PharmacySalt Lake City, UT, USA; University of Utah College of PharmacySalt Lake City, UT, USA
| | - Hongying Dai
- Department of Pediatrics University of Missouri-Kansas City, Children's Mercy Hospitals and ClinicsKansas City, MO, USA; Children's Mercy Hospitals and ClinicsKansas City, MO, USA; Division of Health Services and Outcomes Research, Children's Mercy Hospitals and ClinicsKansas City, MO, USA
| | - Carrie A Vyhlidal
- Department of Pediatrics University of Missouri-Kansas City, Children's Mercy Hospitals and ClinicsKansas City, MO, USA; Division of Pediatric Pharmacology and Therapeutic Innovation, Children's Mercy Hospitals and ClinicsKansas City, MO, USA; Children's Mercy Hospitals and ClinicsKansas City, MO, USA
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