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Siska W, Schultze AE, Ennulat D, Biddle K, Logan M, Adedeji AO, Arndt T, Aulbach A. Scientific and Regulatory Policy Committee Points to Consider: Integration of Clinical Pathology Data With Anatomic Pathology Data in Nonclinical Toxicology Studies. Vet Clin Pathol 2022; 51:311-329. [PMID: 35975895 DOI: 10.1111/vcp.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022]
Abstract
Integrating clinical pathology data with anatomic pathology data is a common practice when reporting findings in the context of nonclinical toxicity studies and aids in understanding and communicating the nonclinical safety profile of test articles in development. Appropriate pathology data integration requires knowledge of analyte and tissue biology, species differences, methods of specimen acquisition and analysis, study procedures, and an understanding of the potential causes and effects of a variety of pathophysiologic processes. Neglecting these factors can lead to inappropriate data integration or a missed opportunity to enhance understanding and communication of observed changes. In such cases, nonclinical safety information relevant to human safety risk assessment may be misrepresented or misunderstood. This "Points to Consider" manuscript presents general concepts regarding pathology data integration in nonclinical studies, considerations for avoiding potential oversights and errors in data integration, and focused discussion on topics relevant to data integration for several key organ systems, including liver, kidney, and cardiovascular systems.
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Affiliation(s)
| | | | | | | | | | | | - Tara Arndt
- Labcorp Drug Development, Madison, Wisconsin, USA
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Siska W, Schultze AE, Ennulat D, Biddle K, Logan M, Adedeji AO, Arndt T, Aulbach AD. Scientific and Regulatory Policy Committee Points to Consider: Integration of Clinical Pathology Data With Anatomic Pathology Data in Nonclinical Toxicology Studies. Toxicol Pathol 2022; 50:808-826. [DOI: 10.1177/01926233221108887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article is temporarily under embargo.
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Affiliation(s)
| | | | | | | | | | | | - Tara Arndt
- Labcorp Drug Development, Madison, Wisconsin, USA
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Chorley BN, Ellinger-Ziegelbauer H, Tackett M, Simutis FJ, Harrill AH, McDuffie J, Atabakhsh E, Nassirpour R, Whiteley LO, Léonard JF, Carswell GK, Harpur E, Chen CL, Gautier JC. Urinary miRNA Biomarkers of Drug-Induced Kidney Injury and Their Site Specificity Within the Nephron. Toxicol Sci 2021; 180:1-16. [PMID: 33367795 PMCID: PMC7916737 DOI: 10.1093/toxsci/kfaa181] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Drug-induced kidney injury (DIKI) is a major concern in both drug development and clinical practice. There is an unmet need for biomarkers of glomerular damage and more distal renal injury in the loop of Henle and the collecting duct (CD). A cross-laboratory program to identify and characterize urinary microRNA (miRNA) patterns reflecting tissue- or pathology-specific DIKI was conducted. The overall goal was to propose miRNA biomarker candidates for DIKI that could supplement information provided by protein kidney biomarkers in urine. Rats were treated with nephrotoxicants causing injury to distinct nephron segments: the glomerulus, proximal tubule, thick ascending limb (TAL) of the loop of Henle and CD. Meta-analysis identified miR-192-5p as a potential proximal tubule-specific urinary miRNA candidate. This result was supported by data obtained in laser capture microdissection nephron segments showing that miR-192-5p expression was enriched in the proximal tubule. Discriminative miRNAs including miR-221-3p and -222-3p were increased in urine from rats treated with TAL versus proximal tubule toxicants in accordance with their expression localization in the kidney. Urinary miR-210-3p increased up to 40-fold upon treatment with TAL toxicants and was also enriched in laser capture microdissection samples containing TAL and/or CD versus proximal tubule. miR-23a-3p was enriched in the glomerulus and was increased in urine from rats treated with doxorubicin, a glomerular toxicant, but not with toxicants affecting other nephron segments. Taken together these results suggest that urinary miRNA panels sourced from specific nephron regions may be useful to discriminate the pathology of toxicant-induced lesions in the kidney, thereby contributing to DIKI biomarker development needs for industry, clinical, and regulatory use.
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Affiliation(s)
- Brian N Chorley
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, USA
| | | | | | - Frank J Simutis
- Bristol-Myers Squibb Company, New Brunswick, New Jersey 08901, USA
| | - Alison H Harrill
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709, USA
| | - James McDuffie
- Janssen Research & Development, LLC, San Diego, California 92121, USA
| | | | - Rounak Nassirpour
- Pfizer Drug Safety Research and Development, Cambridge, Massachusetts 02139, USA
| | - Laurence O Whiteley
- Pfizer Drug Safety Research and Development, Cambridge, Massachusetts 02139, USA
| | | | - Gleta K Carswell
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, USA
| | - Ernie Harpur
- Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Connie L Chen
- Health and Environmental Sciences Institute, Washington, District of Columbia 20005, USA
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Xu X, Zhu R, Ying J, Zhao M, Wu X, Cao G, Wang K. Nephrotoxicity of Herbal Medicine and Its Prevention. Front Pharmacol 2020; 11:569551. [PMID: 33178019 PMCID: PMC7593559 DOI: 10.3389/fphar.2020.569551] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/14/2020] [Indexed: 01/31/2023] Open
Abstract
Herbal medicine (HM) has been widely used to treat diseases for thousands of years and has greatly contributed to the health of human beings. Many new drugs have been developed from HM, such as artemisinin. However, artemisinin has adverse effects, such as renal toxicity. In 1993, a study conducted in Belgium reported for the first time that the root extracts of Aristolochia obliqua S. M. Hwang led to progressive interstitial renal fibrosis. The nephrotoxicity of HM has attracted worldwide attention. More than 100 kinds of HM induce renal toxicity, including some herbs, animal HMs, and minerals. This paper aimed to summarize the HM compounds that cause nephrotoxicity, the mechanisms underlying the toxicity of these compounds, biomarkers of renal injury, and prevention strategies. These findings provide a basis for follow-up studies on the prevention and treatment of HM nephrotoxicity.
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Affiliation(s)
- Xiaofen Xu
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ruyi Zhu
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jialiang Ying
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Mengting Zhao
- School of Pharmacy, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xin Wu
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Gang Cao
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Kuilong Wang
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
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Fujiwara K, Yamamoto Y, Saita T, Matsufuji S. Metabolism and disposition of oseltamivir (OS) in rats, determined by immunohistochemistry with monospecific antibody for OS or its active metabolite oseltamivir carboxylate (OC): A possibility of transporters dividing the drugs' excretion into the bile and kidney. Pharmacol Res Perspect 2020; 8:e00597. [PMID: 32489006 PMCID: PMC7266928 DOI: 10.1002/prp2.597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/12/2020] [Accepted: 04/15/2020] [Indexed: 01/19/2023] Open
Abstract
Among any drugs, no comparative pharmacological study on how prodrug and its active metabolite behave in animal bodies is available. Immunohistochemistry (IHCs) using newly prepared two monoclonal antibodies, AOS‐96 and AOC‐160, monospecific for oseltamivir (OS) and its metabolite oseltamivir carboxylate (OC) were developed, simultaneously detecting the uptake or excretion of OS and OC in the intestine, liver, and kidney of rats to which OS was orally administered. In the intestine, IHC for OS revealed OS highly distributed to the absorptive epithelia with heavily stained cytoplasmic small granules (CSGs). IHC for OC showed that OC also distributed highly in the epithelia, but without CSGs, suggesting that OS was partly converted to OC in the cells. In the liver, OS distributed in the hepatocytes and on their bile capillaries, as well as on the lumina from the bile capillaries to the interlobular bile ducts. OC distributed in the whole cell of the hepatocytes, but without CSGs nor on any lumina through the interlobular bile ducts. In the kidney, a few levels of OS distributed in the cytoplasm of almost all the renal tubule cells, but they contained numerous CSGs. In contrast, OC distributed highly in the proximal tubules, but very slightly in the lower renal tubules of the nephrons. Thus, it was concluded that the two drugs behave in completely different ways in rat bodies. This paper also discusses a possibility of the correlation of OS or OC levels in tissue cells with their known transporters.
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Affiliation(s)
- Kunio Fujiwara
- Department of Applied Life Science, Faculty of Biotechnology and Life Science, Sojo University, Kumamoto, Japan
| | - Yutaro Yamamoto
- Department of Applied Life Science, Faculty of Biotechnology and Life Science, Sojo University, Kumamoto, Japan
| | - Tetsuya Saita
- Department of Applied Life Science, Faculty of Biotechnology and Life Science, Sojo University, Kumamoto, Japan
| | - Senya Matsufuji
- Department of Molecular Biology, The Jikei University School of Medicine, Tokyo, Japan
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Phillips JA, Grandhi TSP, Davis M, Gautier JC, Hariparsad N, Keller D, Sura R, Van Vleet TR. A pharmaceutical industry perspective on microphysiological kidney systems for evaluation of safety for new therapies. LAB ON A CHIP 2020; 20:468-476. [PMID: 31989145 DOI: 10.1039/c9lc00925f] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The human kidney contains approximately one million nephrons. As the functional unit of the kidney, the nephron affords an opportunity to approximate the kidney at a microphysiological scale. Recent emergence of physiologically accurate human tissue models has radically advanced the possibilities of mimicking organ biology and multi-organ combinations in vitro. Anatomically, the nephron is one of the most complex, sequentially integrated microfluidic units in the body making the miniaturized microfluidic systems excellent candidates for capturing the kidney biology in vitro. While these models are promising, there are a number of considerations for practical implementation into a drug development paradigm. Opportunities for pharmaceutical industry applications of new MPS models often start with drug safety testing. As such, the intent of this article is to focus on safety and ADME applications. This article reviews biological functions of the kidney and options for characterizing known roles in nephrotoxicity. The concept of "context-of-use" is introduced as a framework for describing and verifying the specific features of an MPS platform for use in drug development. Overall, we present a perspective on key attributes of microphysiological kidney models, which the pharmaceutical industry could leverage to improve confident safety and ADME evaluations of experimental therapies.
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Affiliation(s)
| | - Taraka Sai Pavan Grandhi
- The Genomics Institute of the Novartis Research Foundation, 10675 John J Hopkins Drive, San Diego, CA 92121, USA
| | - Myrtle Davis
- Bristol-Myers Squibb Company, Province Line Road, Princeton, New Jersey 08648, USA
| | | | | | - Douglas Keller
- Sanofi US, 55 Corporate Drive, Bridgewater, NJ 08807, USA
| | - Radhakrishna Sura
- Preclinical Safety, AbbVie, 1 Waukegan Rd, N Chicago, IL 60064, USA.
| | - Terry R Van Vleet
- Preclinical Safety, AbbVie, 1 Waukegan Rd, N Chicago, IL 60064, USA.
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Obajdin J, Cotter M, Snelling S, Dremier S, De Ron P, Fleurance R, Valentin JP, Nogueira da Costa A, Gryshkova V. Fatty-Acid Binding Protein 4 (FABP4) as a Potential Preclinical Biomarker of Drug-Induced Kidney Injury. Toxicol Sci 2019; 166:441-450. [PMID: 30215792 DOI: 10.1093/toxsci/kfy204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Identification of improved translatable biomarkers of nephrotoxicity is an unmet safety biomarker need. Fatty-acid-binding protein 4 (FABP4) was previously found to be associated with clinical renal dysfunction and was proposed as a biomarker of glomerular damage. The aim of this study was to evaluate FABP4 as a potential preclinical biomarker of drug-induced kidney injury (DIKI). Han-Wistar rats were dosed with cisplatin [2.5 mg/kg, single, intraperitoneally (i.p.)], puromycin (10 mg/kg, daily, i.p.) or N-phenylanthranylic acid [NPAA, 500 mg/kg, daily, per os (p.o.)] over a 28-day period to induce proximal tubule, glomerular or collecting duct injury, respectively. An increase in urinary FABP4 levels was observed on days 1 and 3 after NPAA treatment and on days 14, 21, and 28 after puromycin treatment, whereas cisplatin treatment had no effect. No significant changes were reported for plasma levels of FABP4 after any treatment. Interestingly, immunohistochemical analysis showed a marked decrease in FABP4 expression in the loop of Henle on day 7 after NPAA treatment and a complete loss of FABP4 expression on day 14 after puromycin treatment. The magnitude of increase in FABP4 urinary levels in response to NPAA and puromycin was higher than for established preclinical biomarkers serum creatinine, clusterin, or cystatin C. Our results suggest that FABP4 has the potential for preclinical application as a biomarker of DIKI.
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Affiliation(s)
- Jana Obajdin
- Department of Development Science, Investigative Toxicology.,Centre for Stem Cells & Regenerative Medicine King's College London, Tower Wing Guy's Campus Great Maze Pond London SE1 9RT, UK
| | - Mabel Cotter
- Department of Development Science, Investigative Toxicology.,Safety & Environmental Assurance Centre, Unilever U.K., Unilever House, Blackfriars, London EC4Y 0DY, UK
| | - Sara Snelling
- Department of Development Science, Investigative Toxicology.,Immunology, Abzena, Babraham Research Campus, Cambridge CB22 3AT, UK
| | - Sarah Dremier
- Department of Development Science, Investigative Toxicology.,Ogeda SA, 47 Rue Adrienne Bolland, Gosselies, Belgium 6041, Sarah Dremier
| | | | | | | | - André Nogueira da Costa
- Department of Translational Medicine, Experimental Medicine and Diagnostics, UCB Biopharma SPRL, Chemin du Foriest 1, B-1420 Braine L'Alleud, Belgium
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Glineur SF, Hanon E, Dremier S, Snelling S, Berteau C, De Ron P, Nogueira da Costa A. Assessment of a Urinary Kidney MicroRNA Panel as Potential Nephron Segment-Specific Biomarkers of Subacute Renal Toxicity in Preclinical Rat Models. Toxicol Sci 2019; 166:409-419. [PMID: 30169741 DOI: 10.1093/toxsci/kfy213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Drug-induced kidney injury (DIKI) remains a significant concern during drug development. Whereas FDA-endorsed urinary protein biomarkers encounter limitations including the lack of translatability, there is a considerable interest surrounding the application of microRNAs (miRNAs) in the renal biomarker space. Current knowledge about the value of these novel biomarkers for subacute preclinical rodent studies is still sparse. In this work, Wistar rats were treated with three nephrotoxic compounds-cisplatin (CIS, proximal tubule, 2.5 mg/kg, intraperitoneal [i.p.]), puromycin (PUR, glomerulus, 20/10 mg/kg, i.p.) and N-phenylanthranylic acid (NPAA, collecting ducts, 500 mg/kg, per os)-for up to 28 days to evaluate the performance of a panel of 68 urinary miRNAs as potential nephron segment-specific biomarkers. Out of these 68 kidney injury associated-miRNAs, our selection strategy ultimately revealed rno-miR-34c-5p significantly dysregulated after CIS single administration, and rno-miR-335 and rno-miR-155-5p significantly dysregulated after PUR treatment. In contrast, NPAA daily administration strongly altered the expression profile of 28 miRNAs, with rno-miR-210-3p displaying the most robust changes. A thorough evaluation showed that these miRNA candidates could complement urinary protein biomarkers to detect CIS- or PUR-induced kidney injury in a subacute setting, with a mechanistic (based on rno-miR-34c-5p) and/or a kidney injury detection potential. Our results also provide the first evidence that urinary miRNAs could enhance the detection of collecting duct damage. Overall, these data improve our understanding of the utility of urinary miRNAs as DIKI biomarkers in a subacute DIKI preclinical setting and support the value of using urinary biomarker panels comprising proteins and miRNAs.
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Affiliation(s)
- Stéphanie F Glineur
- Investigative Toxicology, Development Science, UCB Biopharma SPRL, B-1420 Braine L'Alleud, Belgium.,Medvet, AML Lab BVBA, E. Vloorstraat 9, B-2020 Antwerpen, Belgium
| | - Etienne Hanon
- Bio Data Analysis, New Medicines Therapeutics, UCB Biopharma SPRL, B-1420 Braine L'Alleud, Belgium
| | - Sarah Dremier
- Investigative Toxicology, Development Science, UCB Biopharma SPRL, B-1420 Braine L'Alleud, Belgium.,Head HTS & In Vitro Pharmacology, Ogeda SA, 47 Rue Adrienne Bolland, 6041 Gosselies, Belgium
| | - Sara Snelling
- Investigative Toxicology, Development Science, UCB Biopharma SPRL, B-1420 Braine L'Alleud, Belgium.,Immunology, Abzena, Babraham Research Campus, Cambridge CB22 3AT, UK
| | - Caroline Berteau
- Investigative Toxicology, Development Science, UCB Biopharma SPRL, B-1420 Braine L'Alleud, Belgium.,School of Medicine, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, LS9 7FT, UK
| | - Pierrette De Ron
- Investigative Toxicology, Development Science, UCB Biopharma SPRL, B-1420 Braine L'Alleud, Belgium
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Gryshkova V, Cotter M, McGhan P, Obajdin J, Fleurance R, da Costa AN. Phosphoprotein expression profiles in rat kidney injury: Source for potential mechanistic biomarkers. J Cell Mol Med 2019; 23:2251-2255. [PMID: 30636369 PMCID: PMC6378196 DOI: 10.1111/jcmm.14103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/11/2018] [Accepted: 11/27/2018] [Indexed: 12/26/2022] Open
Affiliation(s)
- Vitalina Gryshkova
- Investigative Toxicology, Development Science, UCB Biopharma SPRL, Braine L'Alleud, Belgium
| | - Mabel Cotter
- Safety & Environmental Assurance Centre, Unilever U.K., London, UK
| | - Portia McGhan
- MRC Institute of Genetics & Molecular Medicine, The University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - Jana Obajdin
- Centre for Stem Cells & Regenerative Medicine King's College London, London, UK
| | - Renaud Fleurance
- Investigative Toxicology, Development Science, UCB Biopharma SPRL, Braine L'Alleud, Belgium
| | - Andre Nogueira da Costa
- Experimental Medicine and Diagnostics, Translational Medicine, UCB Biopharma SPRL, Braine L'Alleud, Belgium
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Abstract
Renal tubule lesions often prove troublesome for toxicologic pathologists because of the diverse nature and interrelated cell types within the kidney and the presence of spontaneous lesions with overlapping morphologies similar to those induced by renal toxicants. Although there are a number of guidance documents available citing straightforward diagnostic criteria of tubule lesions for the pathologist to refer to, most are presented without further advice on the when to or to the why and the why not of diagnosing one lesion over another. Documents presenting diagnostic perspectives and recommendations derived from an author’s experience are limited since guidance documents are generally based on descriptive observations. In this Regulatory Forum opinion piece, the authors attempt to dispel confusing renal tubule lesion terminology in laboratory animal species by suggesting histological advice on the recognition and interpretation of these complex entities.
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Affiliation(s)
- John Curtis Seely
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina, USA
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Abstract
Nonclinical safety pharmacology and toxicology testing of drug candidates assess the potential adverse effects caused by the drug in relation to its intended use in humans. Hazards related to a drug have to be identified and the potential risks at the intended exposure have to be evaluated in comparison to the potential benefit of the drug. Preclinical safety is thus an integral part of drug discovery and drug development. It still causes significant attrition during drug development.Therefore, there is a need for smart selection of drug candidates in drug discovery including screening of important safety endpoints. In the recent years,there was significant progress in computational and in vitro technology allowing in silico assessment as well as high-throughput screening of some endpoints at very early stages of discovery. Despite all this progress, in vivo evaluation of drug candidates is still an important part to safety testing. The chapter provides an overview on the most important areas of nonclinical safety screening during drug discovery of small molecules.
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Ennulat D, Adler S. Recent Successes in the Identification, Development, and Qualification of Translational Biomarkers. Toxicol Pathol 2014; 43:62-9. [DOI: 10.1177/0192623314554840] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The development of novel safety or efficacy biomarkers has increasingly been used to improve safety monitoring and minimize attrition during drug development; however, for new biomarkers, the failure rate can equal or exceed that of new chemical entities. Drug-induced kidney injury is recognized to occur throughout the drug development process, with histopathology considered to be the gold standard for preclinical toxicologic screening. Renal biomarkers used clinically are primarily biomarkers of renal function and are considered insensitive for the detection of drug-induced kidney injury during first-in-man studies, particularly for compounds known to induce renal injury in preclinical species. Recent efforts by public–private partnerships have led to unprecedented success in the identification, development, and qualification of several new translatable biomarkers of kidney injury in the rat. To optimize the chance of success in current and future biomarker efforts in preclinical species and man, selection and development of biomarkers should emphasize biological considerations including marker variability and biology in both health and disease. The research to support the qualification of novel renal safety markers for routine use in the clinical setting is currently underway, and results from this work are greatly anticipated.
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Affiliation(s)
| | - Scott Adler
- AstraZeneca Research & Development, Wilmington, Delaware, USA
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Brott DA, Adler SH, Arani R, Lovick SC, Pinches M, Furlong ST. Characterization of renal biomarkers for use in clinical trials: biomarker evaluation in healthy volunteers. DRUG DESIGN DEVELOPMENT AND THERAPY 2014; 8:227-37. [PMID: 24611000 PMCID: PMC3928457 DOI: 10.2147/dddt.s54956] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Several preclinical urinary biomarkers have been qualified and accepted by the health authorities (US Food and Drug Administration, European Medicines Agency, and Pharmaceuticals and Medical Devices Agency) for detecting drug-induced kidney injury during preclinical toxicologic testing. Validated human assays for many of these biomarkers have become commercially available, and this study was designed to characterize some of the novel clinical renal biomarkers. The objective of this study was to evaluate clinical renal biomarkers in a typical Phase I healthy volunteer population to determine confidence intervals (pilot reference intervals), intersubject and intrasubject variability, effects of food intake, effect of sex, and vendor assay comparisons. METHODS Spot urine samples from 20 male and 19 female healthy volunteers collected on multiple days were analyzed using single analyte and multiplex assays. The following analytes were measured: α-1-microglobulin, β-2-microglobulin, calbindin, clusterin, connective tissue growth factor, creatinine, cystatin C, glutathione S-transferase-α, kidney injury marker-1, microalbumin, N-acetyl-β-(D) glucosaminidase, neutrophil gelatinase-associated lipocalin, osteopontin, Tamm-Horsfall urinary glycoprotein, tissue inhibitor of metalloproteinase 1, trefoil factor 3, and vascular endothelial growth factor. RESULTS Confidence intervals were determined from the single analyte and multiplex assays. Intersubject and intrasubject variability ranged from 38% to 299% and from 29% to 82% for biomarker concentration, and from 24% to 331% and from 10% to 67% for biomarker concentration normalized to creatinine, respectively. There was no major effect of food intake or sex. Single analyte and multiplex assays correlated with r (2)≥0.700 for five of six biomarkers when evaluating biomarker concentration, but for only two biomarkers when evaluating concentration normalized to creatinine. CONCLUSION Confidence intervals as well as intersubject and intrasubject variability were determined for novel clinical renal biomarkers/assays, which should be considered for evaluation in the next steps of the qualification process.
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Affiliation(s)
- David A Brott
- Translational Patient Safety and Enabling Sciences, AstraZeneca Pharmaceuticals, Wilmington, DE, USA
| | - Scott H Adler
- Translational Patient Safety and Enabling Sciences, AstraZeneca Pharmaceuticals, Wilmington, DE, USA
| | - Ramin Arani
- AstraZeneca Pharmaceuticals, Wilmington, DE, USA
| | | | - Mark Pinches
- Global Safety Assessment, AstraZeneca Pharmaceuticals, Macclesfield, Cheshire, UK
| | - Stephen T Furlong
- Translational Patient Safety and Enabling Sciences, AstraZeneca Pharmaceuticals, Wilmington, DE, USA
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Vlasakova K, Erdos Z, Troth SP, McNulty K, Chapeau-Campredon V, Mokrzycki N, Muniappa N, Gu YZ, Holder D, Bailey WJ, Sistare FD, Glaab WE. Evaluation of the Relative Performance of 12 Urinary Biomarkers for Renal Safety Across 22 Rat Sensitivity and Specificity Studies. Toxicol Sci 2013; 138:3-20. [DOI: 10.1093/toxsci/kft330] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Rouse RL, Stewart SR, Thompson KL, Zhang J. Kidney Injury Biomarkers in Hypertensive, Diabetic, and Nephropathy Rat Models Treated with Contrast Media. Toxicol Pathol 2012; 41:662-80. [DOI: 10.1177/0192623312464122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Contrast-induced nephropathy (CIN) refers to a decline in renal function following exposure to iodinated contrast media (CM). The present study was initiated to explore the role of known human risk factors (spontaneous hypertension, diabetes, protein-losing nephropathy) on CIN development in rodent models and to determine the effect of CM administration on kidney injury biomarkers in the face of preexisting kidney injury. Spontaneously hypertensive rats (hypertension), streptozotocin-treated Sprague Dawley rats (diabetes), and Dahl salt-sensitive rats (protein-losing nephropathy) were given single intravenous injections of the nonionic, low osmolar contrast medium, iohexol. Blood urea nitrogen (BUN), serum creatinine (sCr), and urinary biomarkers; albumin, lipocalin 2 (Lcn-2), osteopontin (Opn), kidney injury molecule 1 (Kim-1), renal papillary antigen 1 (Rpa-1), α-glutathione S-transferase (α-Gst), µ-glutathione S-transferase (µ-Gst), and beta-2 microglobulin (β2m) were measured in disease models and appropriate controls to determine the response of these biomarkers to CM administration. Each disease model produced elevated biomarkers of kidney injury without CM. Preexisting histopathology was exacerbated by CM but little or no significant increases in biomarkers were observed. When 1.5-fold or greater sCr increases from pre-CM were used to define true positives, receiver–operating characteristic curve analysis of biomarker performance showed sCr was the best predictor of CIN across disease models. β2m, Lcn-2, and BUN were the best predictors of histopathology defined kidney injury.
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Affiliation(s)
- Rodney L. Rouse
- Division of Drug Safety Research, Office of Testing and Research, Office of Pharmaceutical Science, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sharron R. Stewart
- Division of Drug Safety Research, Office of Testing and Research, Office of Pharmaceutical Science, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Karol L. Thompson
- Division of Drug Safety Research, Office of Testing and Research, Office of Pharmaceutical Science, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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