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Kang HN, Wadhwa M, Knezevic I, Burns C, Griffiths E. The importance of World Health Organization international reference standards in the product life cycle of biosimilars. Ann N Y Acad Sci 2024. [PMID: 39255512 DOI: 10.1111/nyas.15217] [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] [Indexed: 09/12/2024]
Abstract
Technological advances in analytics, as well as scientific and regulatory knowledge and experience gained from biosimilar development/approvals over the last decade, enabled the World Health Organization (WHO) in 2022 to revise its guidelines on the evaluation of biosimilars. Among the revisions, there is more reliance on analytical and functional aspects to prove similarity (and likely fewer clinical requirements). WHO international reference standards for biosimilars provide additional confidence to regulators looking for evidence- and data-based regulatory convergence in scientific and technical measures of quality attributes. These standards serve as a benchmark for harmonizing the bioactivity or potency of biosimilars, ensuring their future sustainability. This article discusses the availability and role of WHO international reference standards throughout the product life cycle of biosimilars.
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Affiliation(s)
- Hye-Na Kang
- World Health Organization, Access to Medicines and Health Products, Geneva, Switzerland
| | - Meenu Wadhwa
- Medicines and Healthcare products Regulatory Agency, Potters Bar, UK
| | - Ivana Knezevic
- World Health Organization, Access to Medicines and Health Products, Geneva, Switzerland
| | - Chris Burns
- Medicines and Healthcare products Regulatory Agency, Potters Bar, UK
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Valdés-Delgado T, Aguado-Paredes A, Merino-Bohórquez V, Martín-Manzanares J, Alonso MM, Maldonado B, Castro L, Belvis M, Benítez B, Caunedo Á, Calleja MÁ, Argüelles-Arias F. Performance of a New Rapid Point-of-Care Test for Infliximab Levels in Patients with Inflammatory Bowel Disease: A Comparison to ELISA. Dig Dis Sci 2024; 69:228-234. [PMID: 37943382 PMCID: PMC10787688 DOI: 10.1007/s10620-023-08139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/24/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Therapeutic drug monitoring of infliximab levels in patients with inflammatory bowel disease (IBD) optimizes patients' treatment. The reference technique is based on enzyme-linked immunosorbent assay (ELISA) although point of care (POC) assays are being developed. AIMS To assess the performance of a new rapid immunochromatographic POC assay (Promonitor Quick IFX) compared with ELISA technique to measure infliximab levels in patients with IBD. METHODS A prospective, observational, unicentric study was performed on capillary blood samples from patients with IBD before infliximab infusion (trough levels). Infliximab levels and anti-infliximab antibodies were measured using the ELISA technique (Promonitor IFX) and the POC assay. Correlation between both techniques was assessed by Pearson's coefficient. Quantitative differences were evaluated by Bland-Altman analysis. Samples were stratified according to infliximab therapeutic ranges (< 3 μg/mL, 3-8 μg/mL, and > 8 μg/mL). RESULTS A total of 135 experimental samples were assessed. Infliximab levels showed a high correlation between POC and ELISA tests (r = 0.84, P < 0.001). The mean difference between tests was 1.46 μg/mL (P < 0.001), being minimal for concentrations < 8 μg/mL. POC and ELISA assays showed an overall concordance of 87.4%. Most samples were in the same therapeutic range, which lead to equivalent therapeutic decisions. POC and ELISA assays detected the presence of anti-infliximab antibodies in 2.2% and 3.7% of the samples, respectively. CONCLUSIONS POC assay results in blood samples from patients with IBD were comparable to those obtained with the reference ELISA technique. The POC assay could be considered for routine testing based on its ease of use and rapidity.
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Affiliation(s)
- Teresa Valdés-Delgado
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | | | - Vicente Merino-Bohórquez
- Pharmacy Department, Hospital Universitario Virgen Macarena, Seville, Spain
- Faculty of Pharmacy, University of Sevilla, Seville, Spain
| | | | - María Mercedes Alonso
- Nursing, Hospital Virgen Universitario Virgen Macarena y de Sán Lázaro, Seville, Spain
| | - Belén Maldonado
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - Luisa Castro
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - María Belvis
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - Beatriz Benítez
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - Ángel Caunedo
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | | | - Federico Argüelles-Arias
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain.
- Faculty of Medicine, University of Sevilla, Seville, Spain.
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Urbano A, Plaza J, Picado C, de Mora F. Combined analytical assays for the characterization of drugs binding to human IgE: Applicability to omalizumab-bearing biosimilar candidates assessment. Biomed Pharmacother 2023; 169:115848. [PMID: 37976893 DOI: 10.1016/j.biopha.2023.115848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/25/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023] Open
Abstract
Analytical and functional comparison is key for substantiating the level of convergence (essential sameness) or divergence between versions or variants of a given biological medicine. Accordingly, an overlapping biological activity between products meant to be equal probably reflects a highly similar structure and anticipates a comparable pharmacodynamic behavior. We developed an orthogonal approach to compare the human IgE binding features of different lots and versions of Xolair® (omalizumab), an anti-human IgE monoclonal antibody. The IgE binding affinity and kinetics were measured by surface plasmon resonance. Ability to prevent mast cell activity was assessed in vitro and in vivo in mast cell-based models. The variability of monoclonal antibodies with identical amino acid sequences produced either in Chinese hamster ovarian cells or in human HEK293 cells, was compared. Monoclonal antibodies from the two sources exhibited slightly different human IgE binding and neutralizing features. A known variant exhibiting a three amino acid replacement in the Fab region had lower IgE binding affinity than the original omalizumab. The lower binding affinity translated into reduced IgE neutralizing capacity and, in turn, a difference in the ability to prevent mast cell activation in vitro and in vivo. The proposed set of analytical and functional assays was sensitive enough to detect Fab-linked differences between anti-IgE antibody versions exhibiting an identical aminoacid sequence. In addition to add value to the comparative assessment of biosimilar candidates bearing omalizumab, these methods can aid pre-assessments of new anti-IgE agents that aim to improve therapeutic performance.
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Affiliation(s)
- Adrián Urbano
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Judith Plaza
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - César Picado
- Department of Pneumology and Respiratory Allergy, Hospital Clínic, IDIBAPS (Institut d'Investigacions Biomèdiques Agust Pi i Sunyer), Universitat de Barcelona, Barcelona, Spain; CIBERES (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias), Barcelona, Spain
| | - Fernando de Mora
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Lamela-Gómez I, Gonçalves LM, Almeida AJ, Luzardo-Álvarez A. Infliximab microencapsulation: an innovative approach for intra-articular administration of biologics in the management of rheumatoid arthritis-in vitro evaluation. Drug Deliv Transl Res 2023; 13:3030-3058. [PMID: 37294425 PMCID: PMC10624745 DOI: 10.1007/s13346-023-01372-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/10/2023]
Abstract
Microencapsulation of the therapeutical monoclonal antibody infliximab (INF) was investigated as an innovative approach to improve its stability and to achieve formulations with convenient features for intra-articular administration. Ultrasonic atomization (UA), a novel alternative to microencapsulate labile drugs, was compared with the conventional emulsion/evaporation method (Em/Ev) using biodegradable polymers, specifically Polyactive® 1000PEOT70PBT30 [poly(ethylene-oxide-terephthalate)/poly(butylene-terephthalate); PEOT-PBT] and its polymeric blends with poly-(D, L-lactide-co-glycolide) (PLGA) RG502 and RG503 (PEOT-PBT:PLGA; 65:35). Six different formulations of spherical core-shell microcapsules were successfully developed and characterized. The UA method achieved a significantly higher encapsulation efficiency (69.7-80.25%) than Em/Ev (17.3-23.0%). Mean particle size, strongly determined by the microencapsulation method and to a lesser extent by polymeric composition, ranged from 26.6 to 49.9 µm for UA and 1.5-2.1 µm for Em/Ev. All formulations demonstrated sustained INF release in vitro for up to 24 days, with release rates modulated by polymeric composition and microencapsulation technique. Both methods preserved INF biological activity, with microencapsulated INF showing higher efficacy than commercial formulations at comparable doses regarding bioactive tumor necrosis factor-alpha (TNF-α) neutralization according to WEHI-13VAR bioassay. Microparticles' biocompatibility and extensive internalization by THP-1-derived macrophages was demonstrated. Furthermore, high in vitro anti-inflammatory activity was achieved after treatment of THP-1 cells with INF-loaded microcapsules, significatively reducing in vitro production of TNF-α and interleucine-6 (Il-6).
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Affiliation(s)
- Iván Lamela-Gómez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Sciences, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15706, Santiago de Compostela, Spain
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisbon, Portugal
| | - Lídia M Gonçalves
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisbon, Portugal
| | - António J Almeida
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisbon, Portugal
| | - Asteria Luzardo-Álvarez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Sciences, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain.
- Health Research Institute of Santiago de Compostela (IDIS), 15706, Santiago de Compostela, Spain.
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Jia H, Harikumar P, Atkinson E, Rigsby P, Wadhwa M. The First WHO International Standard for Harmonizing the Biological Activity of Bevacizumab. Biomolecules 2021; 11:1610. [PMID: 34827607 PMCID: PMC8615914 DOI: 10.3390/biom11111610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 11/22/2022] Open
Abstract
Several Bevacizumab products are approved for clinical use, with many others in late-stage clinical development worldwide. To aid the harmonization of potency assessment across different Bevacizumab products, the first World Health Organization (WHO) International Standard (IS) for Bevacizumab has been developed. Two preparations of a Bevacizumab candidate and comparator were assessed for their ability to neutralize and bind vascular endothelial growth factor (VEGF) using different bioassays and binding assays in an international collaborative study. Relative potency estimates were similar across different assays for the comparator or the duplicate-coded candidate sample. Variability in relative potency estimates was reduced when the candidate standard was used for calculation compared with various in-house reference standards, enabling harmonization in bioactivity evaluations. The results demonstrated that the candidate standard is suitable to serve as an IS for Bevacizumab, with assigned unitages for VEGF neutralization and VEGF binding activity. This standard coded 18/210 was established by the WHO Expert Committee on Biological Standardization, which is intended to support the calibration of secondary standards for product development and lifecycle management. The availability of IS 18/210 will help facilitate the global harmonization of potency evaluation to ensure patient access to Bevacizumab products with consistent safety, quality and efficacy.
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Affiliation(s)
- Haiyan Jia
- Division of Biotherapeutics, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (P.H.); (M.W.)
| | - Parvathy Harikumar
- Division of Biotherapeutics, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (P.H.); (M.W.)
| | - Eleanor Atkinson
- Division of Technology Development and Infrastructure, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (E.A.); (P.R.)
| | - Peter Rigsby
- Division of Technology Development and Infrastructure, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (E.A.); (P.R.)
| | - Meenu Wadhwa
- Division of Biotherapeutics, National Institute for Biological Standards and Control, Hertfordshire EN6 3QG, UK; (P.H.); (M.W.)
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Patel S, Wadhwa M. Therapeutic use of specific tumour necrosis factor inhibitors in inflammatory diseases including COVID-19. Biomed Pharmacother 2021; 140:111785. [PMID: 34126316 PMCID: PMC8162906 DOI: 10.1016/j.biopha.2021.111785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has caused significant devastation globally. Despite the development of several vaccines, with uncertainty around global uptake and vaccine efficacy, the need for effective therapeutic agents remains. Increased levels of cytokines including tumour necrosis factor are significant in the pathogenesis of COVID-19 and associated with poor outcomes including ventilator requirement and mortality. Repurposing tumour necrosis factor blocker therapy used in conditions such as rheumatoid arthritis and inflammatory bowel disease seems promising, with early feasibility data showing a reduction in circulation of pro-inflammatory cytokines and encouraging the evaluation of such interventions in preventing disease progression and clinical deterioration in patients with COVID-19. Here, we examine the biological activities of tumour necrosis factor inhibitors indicative of their potential in COVID-19 and briefly outline the randomised control trials assessing their benefit-risk profile in COVID-19 therapy.
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Affiliation(s)
- Serena Patel
- Downing College, Regent Street, Cambridge CB2 1DQ, UK; Ipswich Hospital, Heath Road, Ipswich IP4 5PD, UK
| | - Meenu Wadhwa
- NIBSC, MHRA, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK.
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Wadhwa M, Bird C, Atkinson E, Cludts I, Rigsby P. The First WHO International Standard for Adalimumab: Dual Role in Bioactivity and Therapeutic Drug Monitoring. Front Immunol 2021; 12:636420. [PMID: 33936049 PMCID: PMC8082443 DOI: 10.3389/fimmu.2021.636420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
The expanded availability of adalimumab products continues to widen patient access and reduce costs with substantial benefit to healthcare systems. However, the long-term success of these medicines is highly dependent on maintaining consistency in quality, safety and efficacy while minimizing any risk of divergence during life-cycle management. In recognition of this need and demand from global manufacturers, the World Health Organization (WHO) Expert Committee on Biological standardization established the WHO 1st International standard (IS) for Adalimumab (coded 17/236) in October 2019 with a defined unitage ascribed to each of the individual bioactivities evaluated in the study namely, TNF-α binding, TNF-α neutralization, complement dependent cytotoxicity and antibody-dependent cellular cytotoxicity. For development of the IS, two candidate standards were manufactured as per WHO recommendations. Analysis of extensive datasets generated by testing of a common set of samples including the candidate standards by multiple stakeholders including regulatory agencies using their own qualified assays in a large international collaborative study showed comparable biological activity for the tested candidates for the different activities. Use of a common standard significantly decreased the variability of bioassays and improved agreement in potency estimates. Data from this study clearly supports the utility of the IS as an important tool for assuring analytical assay performance, for bioassay calibration and validation, for identifying and controlling changes in bioactivity during life-cycle management and for global harmonization of adalimumab products. In addition, in a separate multi-center study which included involvement of hospital and clinical diagnostic laboratories, the suitability of the adalimumab IS for therapeutic drug monitoring assays was examined by analysis of data from testing of a common blind coded panel of adalimumab spiked serum samples representative of the clinical scenario along with the IS and in-house standards in diverse immunoassays/platforms. Both commercially available and in-house assays that are routinely used for assessing adalimumab trough levels were included. Excellent agreement in estimates for adalimumab content in the spiked samples was observed regardless of the standard or the method with inter-laboratory variability also similar regardless of the standard employed. This data, for the first time, provides support for the extended applicability of the IS in assays in use for therapeutic drug monitoring based on the mass content of the IS. The adalimumab IS, in fulfilling clinical demand, can help toward standardizing and harmonizing clinical monitoring assays for informed clinical decisions and/or personalized treatment strategies for better patient outcomes. Collectively, a significant role for the adalimumab IS in assuring the quality, safety and efficacy of adalimumab products globally is envisaged.
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Affiliation(s)
- Meenu Wadhwa
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Chris Bird
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Eleanor Atkinson
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Isabelle Cludts
- Biotherapeutics Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
| | - Peter Rigsby
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom
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8
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Prior S, Metcalfe C, Hufton SE, Wadhwa M, Schneider CK, Burns C. Maintaining 'standards' for biosimilar monoclonal antibodies. Nat Biotechnol 2021; 39:276-280. [PMID: 33664522 DOI: 10.1038/s41587-021-00848-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Sandra Prior
- National Institute for Biological Standards and Control (NIBSC), South Mimms, United Kingdom.
| | - Clive Metcalfe
- National Institute for Biological Standards and Control (NIBSC), South Mimms, United Kingdom
| | - Simon E Hufton
- National Institute for Biological Standards and Control (NIBSC), South Mimms, United Kingdom
| | - Meenu Wadhwa
- National Institute for Biological Standards and Control (NIBSC), South Mimms, United Kingdom
| | - Christian K Schneider
- National Institute for Biological Standards and Control (NIBSC), South Mimms, United Kingdom.,Twincore Centre, Hannover Medical School, Hannover, Germany
| | - Chris Burns
- National Institute for Biological Standards and Control (NIBSC), South Mimms, United Kingdom
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Bielsky MC, Cook A, Wallington A, Exley A, Kauser S, Hay JL, Both L, Brown D. Streamlined approval of biosimilars: moving on from the confirmatory efficacy trial. Drug Discov Today 2020; 25:S1359-6446(20)30343-3. [PMID: 32916269 DOI: 10.1016/j.drudis.2020.09.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/23/2020] [Accepted: 09/03/2020] [Indexed: 12/21/2022]
Abstract
Licensing of biosimilars is essential to promote patient access to 21st-century biological medicines. Regulatory approval of biosimilars is based on the totality of evidence from a head-to-head comparison with reference products (RPs). A clinical efficacy trial is usually required, but this is increasingly questioned. Based on a thorough review of biosimilar applications in the European Union (EU), we conclude that in-depth knowledge of the reference product, allied with high-performing analytical tools, largely predicts clinical comparability, subject to confirmation by a comparative pharmacokinetic (PK) trial. We provide a blueprint for a biosimilar pathway that reduces the need for clinical efficacy trials in exceptional cases, together with qualifying criteria and requirements for streamlined assessment to expedite wider access to affordable biological medicines.
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Affiliation(s)
| | - Anne Cook
- Medicines & Healthcare Products Regulatory Agency, 10SC Canary Wharf, E14 4PU, London, UK
| | - Andrea Wallington
- Medicines & Healthcare Products Regulatory Agency, 10SC Canary Wharf, E14 4PU, London, UK
| | - Andrew Exley
- Medicines & Healthcare Products Regulatory Agency, 10SC Canary Wharf, E14 4PU, London, UK
| | - Shahin Kauser
- Medicines & Healthcare Products Regulatory Agency, 10SC Canary Wharf, E14 4PU, London, UK
| | - Justin L Hay
- Medicines & Healthcare Products Regulatory Agency, 10SC Canary Wharf, E14 4PU, London, UK
| | - Leonard Both
- Medicines & Healthcare Products Regulatory Agency, 10SC Canary Wharf, E14 4PU, London, UK
| | - David Brown
- Medicines & Healthcare Products Regulatory Agency, 10SC Canary Wharf, E14 4PU, London, UK
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Núñez-Sánchez MA, Colom J, Walsh L, Buttimer C, Bolocan AS, Pang R, Gahan CGM, Hill C. Characterizing Phage-Host Interactions in a Simplified Human Intestinal Barrier Model. Microorganisms 2020; 8:E1374. [PMID: 32906839 PMCID: PMC7563437 DOI: 10.3390/microorganisms8091374] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 12/24/2022] Open
Abstract
An intestinal epithelium model able to produce mucus was developed to provide an environment suitable for testing the therapeutic activity of gut bacteriophages. We show that Enterococcus faecalis adheres more effectively in the presence of mucus, can invade the intestinal epithelia and is able to translocate after damaging tight junctions. Furthermore, Enterococcus phage vB_EfaM_A2 (a member of Herelleviridae that possesses virion associated immunoglobin domains) was found to translocate through the epithelium in the presence and absence of its host bacteria. Phage A2 protected eukaryotic cells by reducing mortality and maintaining the structure of the cell layer structure. We suggest the mammalian cell model utilized within this study as an adaptable in vitro model that can be employed to enable a better understanding of phage-bacteria interactions and the protective impact of phage therapy relating to the intestinal epithelium.
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Affiliation(s)
- María A. Núñez-Sánchez
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
| | - Joan Colom
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
| | - Lauren Walsh
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
| | - Colin Buttimer
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
| | - Andrei Sorin Bolocan
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
| | - Rory Pang
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
| | - Cormac G. M. Gahan
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
- School of Microbiology, University College Cork, T12 YN60 Cork, Ireland
- School of Pharmacy, University College Cork, T12 YN60 Cork, Ireland
| | - Colin Hill
- APC Microbiome Ireland, Bioscience institute, University College Cork, T12 YT20 Cork, Ireland; (M.A.N.-S.); (J.C.); (L.W.); (C.B.); (A.S.B.); (R.P.); (C.G.M.G.)
- School of Microbiology, University College Cork, T12 YN60 Cork, Ireland
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Wadhwa M, Kang HN, Jivapaisarnpong T, Andalucia LR, Blades CDRZ, Casas Levano M, Chang W, Chew JY, Chilufya MB, Chirachanakul P, Cho HG, Cho YO, Choi KM, Chong S, Chua HM, Farahani AV, Gencoglu M, Ghobrial MRW, Guha P, Gutierrez Lugo MT, Ha SB, Habahbeh S, Hamel H, Hong Y, Iarutkin A, Jang H, Jayachandran R, Jivapaisarnpong T, Kang HN, Kim DY, Kim GH, Kim Y, Kwon HS, Larsen J, Lee AH, Lee J, Medvedeva K, Munkombwe Z, Oh I, Park J, Park J, Putri DE, Rodgers J, Ryu S, Savkina M, Schreitmueller T, Semeniuk O, Seo M, Shin YI, Shin J, Srivastava S, Song H, Song S, Tavares Neto J, Wadhwa M, Yamaguchi T, Youn HJD, Yun M. WHO implementation workshop on guidelines on procedures and data requirements for changes to approved biotherapeutic products, Seoul, Republic of Korea, 25-26 June 2019. Biologicals 2020; 65:50-59. [PMID: 31959504 DOI: 10.1016/j.biologicals.2019.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022] Open
Abstract
The first global workshop on implementation of the WHO guidelines on procedures and data requirements for changes to approved biotherapeutic products adopted by the WHO Expert Committee in 2018 was held in June 2019. The workshop participants recognized that the principles based on sound science and the potential for risk, as described in the WHO Guidelines on post-approval changes, which constitute the global standard for product life-cycle management are providing clarity and helping national regulatory authorities in establishing guidance while improving time-lines for an efficient regulation of products. Consequently, the regulatory situation for post-approval changes and guideline implementation is changing but there is a disparity between different countries. While the guidelines are gradually being implemented in some countries and also being considered in other countries, the need for regional workshops and further training on post-approval changes was a common theme reiterated by many participants. Given the complexities relating to post-approval changes in different regions/countries, there was a clear understanding among all participants that an efficient approach for product life-cycle management at a national level is needed to ensure faster availability of high standard, safe and efficacious medicines to patients as per the World Health Assembly Resolution 67.21.
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Affiliation(s)
- Meenu Wadhwa
- National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom.
| | - Hye-Na Kang
- World Health Organization, Avenue Appia 20, CH-1211, Geneva, Switzerland.
| | - Teeranart Jivapaisarnpong
- National Biopharmaceutical Facility, King Mongkut's University of Technology Thonburi, Bangkhuntian, Bangkok, 10150, Thailand.
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- International MSD International GmbH, Singapore
| | | | | | - Mary Casas Levano
- General Directorate of Medicines Supplies and Drugs (DIGEMID), San Miguel, Peru
| | | | | | | | | | | | | | - Kyung Min Choi
- Ministry of Food and Drug Safety (MFDS), Republic of Korea
| | | | | | | | - Mumun Gencoglu
- International Federation of Pharmaceutical Manufacturers Association, Switzerland
| | | | | | | | | | | | | | | | - Aleksei Iarutkin
- Federal Service for Surveillance in Healthcare (Roszdravnadzor), Russian Federation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Desi Eka Putri
- National Agency of Drug and Food Control (NADFC), Indonesia
| | | | | | - Maria Savkina
- The FSBI "SCEEMP of the Ministry of Health of the Russian Federation, Russian Federation
| | | | | | | | | | | | | | - HyeonHo Song
- ILDONG Pharmaceutical Co., Ltd, Republic of Korea
| | | | | | - Meenu Wadhwa
- National Institute for Biological Standards and Control, United Kingdom
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Cowper B, Hockley J, Partridge K, Ferguson J, Rigsby P, Burns C. The first World Health Organization International Standard for in vitro biological activity of darbepoetin. Biologicals 2020; 63:33-38. [DOI: 10.1016/j.biologicals.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022] Open
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