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Windoloski KA, Janum S, Berg RMG, Olufsen MS. Characterization of differences in immune responses during bolus and continuous infusion endotoxin challenges using mathematical modelling. Exp Physiol 2024; 109:689-710. [PMID: 38466166 PMCID: PMC11061636 DOI: 10.1113/ep091552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/13/2024] [Indexed: 03/12/2024]
Abstract
Endotoxin administration is commonly used to study the inflammatory response, and though traditionally given as a bolus injection, it can be administered as a continuous infusion over multiple hours. Several studies hypothesize that the latter better represents the prolonged and pronounced inflammation observed in conditions like sepsis. Yet very few experimental studies have administered endotoxin using both strategies, leaving significant gaps in determining the underlying mechanisms responsible for their differing immune responses. We used mathematical modelling to analyse cytokine data from two studies administering a 2 ng kg-1 dose of endotoxin, one as a bolus and the other as a continuous infusion over 4 h. Using our model, we simulated the dynamics of mean and subject-specific cytokine responses as well as the response to long-term endotoxin administration. Cytokine measurements revealed that the bolus injection led to significantly higher peaks for interleukin (IL)-8, while IL-10 reaches higher peaks during continuous administration. Moreover, the peak timing of all measured cytokines occurred later with continuous infusion. We identified three model parameters that significantly differed between the two administration methods. Monocyte activation of IL-10 was greater during the continuous infusion, while tumour necrosis factor α $ {\alpha} $ and IL-8 recovery rates were faster for the bolus injection. This suggests that a continuous infusion elicits a stronger, longer-lasting systemic reaction through increased stimulation of monocyte anti-inflammatory mediator production and decreased recovery of pro-inflammatory catalysts. Furthermore, the continuous infusion model exhibited prolonged inflammation with recurrent peaks resolving within 2 days during long-term (20-32 h) endotoxin administration.
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Affiliation(s)
| | - Susanne Janum
- Frederiksberg and Bispebjerg HospitalsFrederiksbergDenmark
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Ronan M. G. Berg
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
- Department of Clinical Physiology and Nuclear Medicine and, Centre for Physical Activity ResearchCopenhagen University HospitalCopenhagenDenmark
- Neurovascular Research LaboratoryUniversity of South WalesPontypriddUK
| | - Mette S. Olufsen
- Department of MathematicsNorth Carolina State UniversityRaleighNorth CarolinaUSA
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Mika B, Pełka M, Tkacz E. Mathematical modeling of the neutrophil production process supported by administration of glycoprotein. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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3
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Cho YK, Irby DJ, Li J, Sborov DW, Mould DR, Badawi M, Dauki A, Lamprecht M, Rosko AE, Fernandez S, Hade EM, Hofmeister CC, Poi M, Phelps MA. Pharmacokinetic-Pharmacodynamic Model of Neutropenia in Patients With Myeloma Receiving High-Dose Melphalan for Autologous Stem Cell Transplant. CPT Pharmacometrics Syst Pharmacol 2018; 7:748-758. [PMID: 30343510 PMCID: PMC6263666 DOI: 10.1002/psp4.12345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
High-dose melphalan (HDM) is part of the conditioning regimen in patients with multiple myeloma (MM) receiving autologous stem cell transplantation (ASCT). However, individual sensitivity to melphalan varies, and many patients experience severe toxicities. Prolonged severe neutropenia is one of the most severe toxicities and contributes to potentially life-threatening infections and failure of ASCT. Granulocyte-colony stimulating factor (G-CSF) is given to stimulate neutrophil proliferation after melphalan administration. The aim of this study was to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model capable of predicting neutrophil kinetics in individual patients with MM undergoing ASCT with high-dose melphalan and G-CSF administration. The extended PK/PD model incorporated several covariates, including G-CSF regimen, stem cell dose, hematocrit, sex, creatinine clearance, p53 fold change, and race. The resulting model explained portions of interindividual variability in melphalan exposure, therapeutic effect, and feedback regulation of G-CSF on neutrophils, thus enabling simulation of various doses and prediction of neutropenia duration.
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Affiliation(s)
- Yu Kyoung Cho
- Division of Pharmaceutics and Pharmaceutical ChemistryCollege of PharmacyThe Ohio State UniversityColumbusOhioUSA
| | - Donald J. Irby
- Division of Pharmaceutics and Pharmaceutical ChemistryCollege of PharmacyThe Ohio State UniversityColumbusOhioUSA
| | - Junan Li
- Division of Pharmaceutics and Pharmaceutical ChemistryCollege of PharmacyThe Ohio State UniversityColumbusOhioUSA
| | - Douglas W. Sborov
- Division of HematologyDepartment of Internal MedicineCollege of MedicineThe Ohio State UniversityColumbusOhioUSA
| | | | - Mohamed Badawi
- Division of Pharmaceutics and Pharmaceutical ChemistryCollege of PharmacyThe Ohio State UniversityColumbusOhioUSA
| | - Anees Dauki
- Division of Pharmaceutics and Pharmaceutical ChemistryCollege of PharmacyThe Ohio State UniversityColumbusOhioUSA
| | - Misty Lamprecht
- Comprehensive Cancer CenterThe Ohio State UniversityColumbusOhioUSA
| | - Ashley E. Rosko
- Division of HematologyDepartment of Internal MedicineCollege of MedicineThe Ohio State UniversityColumbusOhioUSA
- Comprehensive Cancer CenterThe Ohio State UniversityColumbusOhioUSA
| | - Soledad Fernandez
- Comprehensive Cancer CenterThe Ohio State UniversityColumbusOhioUSA
- Center for BiostatisticsDepartment of Biomedical InformaticsCollege of MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Erinn M. Hade
- Center for BiostatisticsDepartment of Biomedical InformaticsCollege of MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Craig C. Hofmeister
- Division of HematologyDepartment of Internal MedicineCollege of MedicineThe Ohio State UniversityColumbusOhioUSA
- Comprehensive Cancer CenterThe Ohio State UniversityColumbusOhioUSA
| | - Ming Poi
- Comprehensive Cancer CenterThe Ohio State UniversityColumbusOhioUSA
- Division of Pharmacy Practice and ScienceCollege of PharmacyThe Ohio State UniversityColumbusOhioUSA
| | - Mitch A. Phelps
- Division of Pharmaceutics and Pharmaceutical ChemistryCollege of PharmacyThe Ohio State UniversityColumbusOhioUSA
- Comprehensive Cancer CenterThe Ohio State UniversityColumbusOhioUSA
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Fornari C, O'Connor LO, Yates JWT, Cheung SYA, Jodrell DI, Mettetal JT, Collins TA. Understanding Hematological Toxicities Using Mathematical Modeling. Clin Pharmacol Ther 2018; 104:644-654. [PMID: 29604045 DOI: 10.1002/cpt.1080] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/09/2018] [Accepted: 03/27/2018] [Indexed: 12/16/2022]
Abstract
Balancing antitumor efficacy with toxicity is a significant challenge, and drug-induced myelosuppression is a common dose-limiting toxicity of cancer treatments. Mathematical modeling has proven to be a powerful ally in this field, scaling results from animal models to humans, and designing optimized treatment regimens. Here we outline existing mathematical approaches for studying bone marrow toxicity, identify gaps in current understanding, and make future recommendations to advance this vital field of safety research further.
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Affiliation(s)
- Chiara Fornari
- Safety and ADME Translational Sciences, Drug Safety and Metabolism, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | | | - James W T Yates
- DMPK, Oncology, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - S Y Amy Cheung
- Quantitative Clinical Pharmacology, Early Clinical Development, IMED Biotech Unit, Cambridge, UK
| | - Duncan I Jodrell
- CRUK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK
| | - Jerome T Mettetal
- Safety and ADME Translational Sciences, Drug Safety and Metabolism, IMED Biotech Unit, AstraZeneca, Boston, Massachusetts, USA
| | - Teresa A Collins
- Safety and ADME Translational Sciences, Drug Safety and Metabolism, IMED Biotech Unit, AstraZeneca, Cambridge, UK
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Bara O, Fliess M, Join C, Day J, Djouadi SM. Toward a model-free feedback control synthesis for treating acute inflammation. J Theor Biol 2018; 448:26-37. [PMID: 29625206 DOI: 10.1016/j.jtbi.2018.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 03/03/2018] [Accepted: 04/02/2018] [Indexed: 01/22/2023]
Abstract
An effective and patient-specific feedback control synthesis for inflammation resolution is still an ongoing research area. A strategy consisting of manipulating a pro and anti-inflammatory mediator is considered here as used in some promising model-based control studies. These earlier studies, unfortunately, suffer from the difficultly of calibration due to the heterogeneity of individual patient responses even under similar initial conditions. We exploit a new model-free control approach and its corresponding "intelligent" controllers for this biomedical problem. A crucial feature of the proposed control problem is as follows: the two most important outputs which must be driven to their respective desired states are sensorless. This difficulty is overcome by assigning suitable reference trajectories to the other two outputs that do have sensors. A mathematical model, via a system of ordinary differential equations, is nevertheless employed as a "virtual" patient for in silico testing. We display several simulation results with respect to the most varied situations, which highlight the effectiveness of our viewpoint.
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Affiliation(s)
- Ouassim Bara
- Department of Electrical Engineering and Computer Science University of Tennessee, Knoxville, TN 37996, USA.
| | - Michel Fliess
- LIX (CNRS, UMR 7161), École polytechnique, Palaiseau 91128, France; AL.I.E.N. (ALgèbre pour Identification & Estimation Numériques) 7 rue Maurice Barrès, Vézelise 54330, France.
| | - Cédric Join
- CRAN (CNRS, UMR 7039), Université de Lorraine BP 239, Vandœuvre-lès-Nancy 54506, France; Projet NON-A, INRIA Lille - Nord-Europe, France; AL.I.E.N. (ALgèbre pour Identification & Estimation Numériques) 7 rue Maurice Barrès, Vézelise 54330, France.
| | - Judy Day
- Department of Mathematics, University of Tennessee, Knoxville, TN 37996, USA.
| | - Seddik M Djouadi
- Department of Electrical Engineering and Computer Science University of Tennessee, Knoxville, TN 37996, USA.
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Sarker JM, Pearce SM, Nelson RP, Kinzer-Ursem TL, Umulis DM, Rundell AE. An Integrative multi-lineage model of variation in leukopoiesis and acute myelogenous leukemia. BMC SYSTEMS BIOLOGY 2017; 11:78. [PMID: 28841879 PMCID: PMC5574150 DOI: 10.1186/s12918-017-0469-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/11/2017] [Indexed: 12/11/2022]
Abstract
Background Acute myelogenous leukemia (AML) progresses uniquely in each patient. However, patients are typically treated with the same types of chemotherapy, despite biological differences that lead to differential responses to treatment. Results Here we present a multi-lineage multi-compartment model of the hematopoietic system that captures patient-to-patient variation in both the concentration and rates of change of hematopoietic cell populations. By constraining the model against clinical hematopoietic cell recovery data derived from patients who have received induction chemotherapy, we identified trends for parameters that must be met by the model; for example, the mitosis rates and the probability of self-renewal of progenitor cells are inversely related. Within the data-consistent models, we found 22,796 parameter sets that meet chemotherapy response criteria. Simulations of these parameter sets display diverse dynamics in the cell populations. To identify large trends in these model outputs, we clustered the simulated cell population dynamics using k-means clustering and identified thirteen ‘representative patient’ dynamics. In each of these patient clusters, we simulated AML and found that clusters with the greatest mitotic capacity experience clinical cancer outcomes more likely to lead to shorter survival times. Conversely, other parameters, including lower death rates or mobilization rates, did not correlate with survival times. Conclusions Using the multi-lineage model of hematopoiesis, we have identified several key features that determine leukocyte homeostasis, including self-renewal probabilities and mitosis rates, but not mobilization rates. Other influential parameters that regulate AML model behavior are responses to cytokines/growth factors produced in peripheral blood that target the probability of self-renewal of neutrophil progenitors. Finally, our model predicts that the mitosis rate of cancer is the most predictive parameter for survival time, followed closely by parameters that affect the self-renewal of cancer stem cells; most current therapies target mitosis rate, but based on our results, we propose that additional therapeutic targeting of self-renewal of cancer stem cells will lead to even higher survival rates. Electronic supplementary material The online version of this article (doi:10.1186/s12918-017-0469-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joyatee M Sarker
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, 47906, IN, USA
| | - Serena M Pearce
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, 47906, IN, USA
| | - Robert P Nelson
- Department of Medicine and Pediatrics, Divisions of Hematology/Oncology, Indiana University School of Medicine, 535 Barnhill Dr., Ste. 473, Indianapolis, 46202, IN, USA
| | - Tamara L Kinzer-Ursem
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, 47906, IN, USA
| | - David M Umulis
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, 47906, IN, USA. .,Ag. and Biological Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, 47906, IN, USA.
| | - Ann E Rundell
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, 47906, IN, USA
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Craig M. Towards Quantitative Systems Pharmacology Models of Chemotherapy-Induced Neutropenia. CPT Pharmacometrics Syst Pharmacol 2017; 6:293-304. [PMID: 28418603 PMCID: PMC5445232 DOI: 10.1002/psp4.12191] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/21/2017] [Accepted: 02/21/2017] [Indexed: 12/22/2022] Open
Abstract
Neutropenia is a serious toxic complication of chemotherapeutic treatment. For years, mathematical models have been developed to better predict hematological outcomes during chemotherapy in both the traditional pharmaceutical sciences and mathematical biology disciplines. An increasing number of quantitative systems pharmacology (QSP) models that combine systems approaches, physiology, and pharmacokinetics/pharmacodynamics have been successfully developed. Here, I detail the shift towards QSP efforts, emphasizing the importance of incorporating systems-level physiological considerations in pharmacometrics.
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Affiliation(s)
- M Craig
- Program for Evolutionary Dynamics, Harvard UniversityCambridgeMassachusettsUSA
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8
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A systematic framework for the design, simulation and optimization of personalized healthcare: Making and healing blood. Comput Chem Eng 2015. [DOI: 10.1016/j.compchemeng.2015.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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9
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Craig M, Humphries AR, Nekka F, Bélair J, Li J, Mackey MC. Neutrophil dynamics during concurrent chemotherapy and G-CSF administration: Mathematical modelling guides dose optimisation to minimise neutropenia. J Theor Biol 2015; 385:77-89. [PMID: 26343861 DOI: 10.1016/j.jtbi.2015.08.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 06/10/2015] [Accepted: 08/20/2015] [Indexed: 11/18/2022]
Abstract
The choice of chemotherapy regimens is often constrained by the patient's tolerance to the side effects of chemotherapeutic agents. This dose-limiting issue is a major concern in dose regimen design, which is typically focused on maximising drug benefits. Chemotherapy-induced neutropenia is one of the most prevalent toxic effects patients experience and frequently threatens the efficient use of chemotherapy. In response, granulocyte colony-stimulating factor (G-CSF) is co-administered during chemotherapy to stimulate neutrophil production, increase neutrophil counts, and hopefully avoid neutropenia. Its clinical use is, however, largely dictated by trial and error processes. Based on up-to-date knowledge and rational considerations, we develop a physiologically realistic model to mathematically characterise the neutrophil production in the bone marrow which we then integrate with pharmacokinetic and pharmacodynamic (PKPD) models of a chemotherapeutic agent and an exogenous form of G-CSF (recombinant human G-CSF, or rhG-CSF). In this work, model parameters represent the average values for a general patient and are extracted from the literature or estimated from available data. The dose effect predicted by the model is confirmed through previously published data. Using our model, we were able to determine clinically relevant dosing regimens that advantageously reduce the number of rhG-CSF administrations compared to original studies while significantly improving the neutropenia status. More particularly, we determine that it could be beneficial to delay the first administration of rhG-CSF to day seven post-chemotherapy and reduce the number of administrations from ten to three or four for a patient undergoing 14-day periodic chemotherapy.
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Affiliation(s)
- Morgan Craig
- Faculté de Pharmacie, Université de Montréal, Montréal, QC, Canada H3C 3J7; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6.
| | - Antony R Humphries
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada H3A 0B9; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Fahima Nekka
- Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Jacques Bélair
- Département de mathématiques et de statistique, Université de Montréal, Montréal, QC, Canada H3C 3J7; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Jun Li
- Faculté de Pharmacie, Université de Montréal, Montréal, QC, Canada H3C 3J7; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Michael C Mackey
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada H3A 0B9; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Departments of Physiology and Physics, McGill University, Montreal, QC, Canada H3G 1Y6.
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