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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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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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van den Anker J, Reed MD, Allegaert K, Kearns GL. Developmental Changes in Pharmacokinetics and Pharmacodynamics. J Clin Pharmacol 2018; 58 Suppl 10:S10-S25. [DOI: 10.1002/jcph.1284] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 06/21/2018] [Indexed: 12/22/2022]
Affiliation(s)
- John van den Anker
- Division of Clinical Pharmacology; Children's National Health System; Washington DC USA
- Division of Paediatric Pharmacology and Pharmacometrics; University of Basel Children's Hospital; Basel Switzerland
- Intensive Care and Department of Pediatric Surgery; Erasmus Medical Center-Sophia Children's Hospital; Rotterdam the Netherlands
| | - Michael D. Reed
- Emeritus Professor of Pediatrics; School of Medicine; Case Western Reserve University; Cleveland OH USA
| | - Karel Allegaert
- Intensive Care and Department of Pediatric Surgery; Erasmus Medical Center-Sophia Children's Hospital; Rotterdam the Netherlands
- Department of Pediatrics; Division of Neonatology; Erasmus Medical Center-Sophia Children's Hospital; Rotterdam the Netherlands
- Department of Development and Regeneration; KU Leuven; Leuven Belgium
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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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Population pharmacokinetic/pharmacodynamic modeling of histamine response measured by histamine iontophoresis laser Doppler. J Pharmacokinet Pharmacodyn 2016; 43:385-93. [PMID: 27307292 DOI: 10.1007/s10928-016-9478-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022]
Abstract
The epicutaneous histamine (EH) test is the current gold standard method for the clinical evaluation of allergic conditions. However, the EH method is limited in providing an objective and qualitative assessment of histamine pharmacodynamic response. The histamine iontophoresis with laser Doppler (HILD) monitoring method, an alternative method, allows a fixed dose of histamine to be delivered and provides an objective, continuous, and dynamic measurement of histamine epicutaneous response in children and adults. However, due to the high sampling frequency (up to 40 Hz), the output files are usually too cumbersome to be directly used for further analysis. In this study, we developed an averaging algorithm that efficiently reduces the HILD data in size. The reduced data was further analyzed and a population linked effect pharmacokinetic/pharmacodynamic (PK/PD) model was developed to describe the local histamine response. The model consisted of a one-compartment PK model and a direct-response fractional maximum effect (Emax) model. The parameter estimates were obtained as follows: absorption rate constant (ka), 0.094/min; absorption lag time (Tlag), 2.72 min; partitioning clearance from local depot to systemic circulation (CLpar), 0.0006 L/min; baseline effect (E0), 13.1 flux unit; Emax, 13.4; concentration at half maximum effect (EC50) 31.1 mg/L. Covariate analysis indicated that age and race had significant influence on Tlag and EC50, respectively.
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Jones BL, Kearns G, Neville KA, Sherwin CMT, Spigarelli MMG, Leeder JS. Variability of histamine pharmacodynamic response in children with allergic rhinitis. J Clin Pharmacol 2013; 53:731-7. [PMID: 23681823 DOI: 10.1002/jcph.93] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 04/09/2013] [Indexed: 11/05/2022]
Abstract
Histamine iontophoresis with laser Doppler monitoring (HILD) is a robust and dynamic surrogate for histamine microvasculature response. We characterized histamine pharmacodynamics in children using HILD. HILD was performed in 54 children with allergic rhinitis. A non-compartmental analysis and non-linear mixed-effects model with a linked effect PK/PD model was used to provide estimates for area under the effect curve (AUEC), maximal response over baseline (EffmaxNT), and time of EffmaxNT (Tmax). Data were placed in sub-groups by visualization of time vs. response relationships. ANOVA and regression analyses were used for sub-group comparisons. Three histamine response phenotypes were identified. One group demonstrated a hyper-responsive phenotype (higher Tmax, EffmaxNt and AUEC, P < .01). AUEC and EffmaxNT were more strongly associated in this group (r(2) = 0.86) than the entire cohort (r(2) = 0.64). These data demonstrate a hyper-responsive histamine phenotype via HILD. This finding is important to future pharmacologic studies of antihistamines.
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Affiliation(s)
- Bridgette L Jones
- Department of Paediatrics, University of Missouri, Kansas City, MO 64108, USA.
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Goldman J, Becker ML, Jones B, Clements M, Leeder JS. Development of biomarkers to optimize pediatric patient management: what makes children different? Biomark Med 2012; 5:781-94. [PMID: 22103612 DOI: 10.2217/bmm.11.96] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Despite the frequent utilization of biomarkers in medical practice, there is a relative paucity of information regarding validated pediatric biomarkers. Frequently, biomarkers found to be efficacious in adults are extrapolated to the pediatric clinical setting without considering that the pathogenesis of many diseases is distinctly different in children, and ontogeny directly influences disease evolution and therapeutic response in children. New and innovative approaches are necessary to provide reliable, validated biomarkers that can be used to improve and advance pediatric medical care.
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Affiliation(s)
- Jennifer Goldman
- Division of Clinical Pharmacology & Medical Toxicology, Children's Mercy Hospitals & Clinics & University of Missouri-Kansas City, Kansas City, MO, USA
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Mahé G, Humeau-Heurtier A, Durand S, Leftheriotis G, Abraham P. Assessment of Skin Microvascular Function and Dysfunction With Laser Speckle Contrast Imaging. Circ Cardiovasc Imaging 2012; 5:155-63. [DOI: 10.1161/circimaging.111.970418] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Guillaume Mahé
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Anne Humeau-Heurtier
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Sylvain Durand
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Georges Leftheriotis
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Pierre Abraham
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
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Kearns GL. Beyond biomarkers: an opportunity to address the 'pharmacodynamic gap' in pediatric drug development. Biomark Med 2011; 4:783-6. [PMID: 21133695 DOI: 10.2217/bmm.10.106] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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