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García-García I, Hernández-González I, Díaz-Machado A, González-Delgado CA, Pérez-Rodríguez S, García-Vega Y, Campos-Mojena R, Tuero-Iglesias ÁD, Valenzuela-Silva CM, Cruz-Ramírez A, Martín-Trujillo A, Santana-Milián H, López-Saura PA, Bello-Rivero I. Pharmacokinetic and pharmacodynamic characterization of a novel formulation containing co-formulated interferons alpha-2b and gamma in healthy male volunteers. BMC Pharmacol Toxicol 2016; 17:58. [PMID: 27923408 PMCID: PMC5142133 DOI: 10.1186/s40360-016-0103-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 11/01/2016] [Indexed: 11/17/2022] Open
Abstract
Background More potent antitumor activity is desired in Interferon (IFN)-treated cancer patients. This could be achieved by combining IFN alpha and IFN gamma. The aim of this work was to characterize the pharmacokinetics and pharmacodynamics of a novel formulation containing a co-formulated combination of IFNs alpha-2b and gamma (CIGB-128-A). Methods A group of nine healthy male subjects received intramuscularly 24.5 × 106 IU of CIGB-128-A. IFN concentrations were evaluated for 48 h. Serum neopterin, beta2-microglobulin (β2M) and 2′–5′ oligoadenylate synthetase (2′–5′ OAS), classical IFN-inducible serum markers, were measured during 192 h by enzyme immunoassay and body temperature was used as pharmacodynamic variable as well. Results Concerning pharmacokinetics, serum IFNs’ profiles were better fitted to a mono-compartmental model with consecutive zero order and first order absorption, one bioavailability value. No interferences by simultaneous administered IFNs were observed in their typical similar systemic profiles. Neopterin and β2M time profiles showed a delay that was efficiently linked to pharmacokinetics by means of a zero order absorption rate constant. Neopterin level was nine-fold higher than initial values, 48 h post-administration, an increment not described before. At this time, mean serum β2M peaked around the double from baseline. Serum concentrations of the enzyme 2′–5′ OAS was still elevated on the 8 day post-injection. The formulation was well tolerated. Most frequent adverse reactions were fever, headache, arthralgia and lymphopenia, mostly mild. Conclusions The administration of co-formulated IFN alpha-2b and IFN gamma likely provides improved pharmacodynamic properties that may be beneficial to treat several malignancies. Trial registration Cuban Public Registry of Clinical Trials RPCEC00000118, May 24, 2011.
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Affiliation(s)
- Idrian García-García
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba
| | | | - Alina Díaz-Machado
- National Center for Toxicology, "Carlos J. Finlay" University Hospital, Havana, Cuba
| | | | - Sonia Pérez-Rodríguez
- National Center for Toxicology, "Carlos J. Finlay" University Hospital, Havana, Cuba
| | - Yanelda García-Vega
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba
| | - Rosario Campos-Mojena
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba
| | - Ángela D Tuero-Iglesias
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba
| | - Carmen M Valenzuela-Silva
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba
| | - Alieski Cruz-Ramírez
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba
| | - Alis Martín-Trujillo
- National Center for Toxicology, "Carlos J. Finlay" University Hospital, Havana, Cuba
| | - Héctor Santana-Milián
- Development Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Pedro A López-Saura
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba
| | - Iraldo Bello-Rivero
- Clinical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 134 b/23 and 25, Cubanacán, Playa, P.O. Box 6332, Havana, Cuba.
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Vinh DC. Cytokine immunomodulation for the treatment of infectious diseases: lessons from primary immunodeficiencies. Expert Rev Clin Immunol 2014; 10:1069-100. [PMID: 24881679 DOI: 10.1586/1744666x.2014.919224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Traditionally, management of infectious diseases focuses on identification of the causative microbe and the use of pathogen-targeted therapy. With increasing antimicrobial resistance, novel approaches are required. One strategy is to modulate those natural host immune responses that critically mediate resistance to specific microbes. Clinically, this host-directed tactic could be used either alone or in combination with antimicrobial therapy. While conceptually attractive, there is potential concern that the pathways governing host resistance to pathogens in animal models may not extrapolate linearly to humans. Targeting these immune processes clinically may precipitate damaging, epiphenomenal responses. The field of Primary Immunodeficiencies focuses on the characterization of humans with inborn errors of immunity. These rare conditions permit the identification of those molecular and cellular processes that are central to human susceptibility to microbes. In efforts to compensate for defective host responses, this field has also provided a wealth of clinical experience in the effective use of cytokines to treat various active infections, while demonstrating their safety. In this review, we provide a historical perspective of the treatment of infectious diseases, evolving from a focus on the microbe, to an understanding of human immunity; we then outline the growing contribution of Primary Immunodeficiencies to the rational use of adjunctive cytokine immunotherapy in the management of infections.
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Affiliation(s)
- Donald C Vinh
- Department of Medicine, Department of Medical Microbiology, Department of Human Genetics, Division of Infectious Diseases, Division of Allergy and Clinical Immunology, McGill University Health Centre - Montreal General Hospital, 1650 Cedar Ave, Rm A5-156, Montreal, Quebec, H3G 1A4, Canada
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García-Vega Y, García-García I, Collazo-Caballero SE, Santely-Pravia EE, Cruz-Ramírez A, Tuero-Iglesias AD, Alfonso-Alvarado C, Cabrera-Placeres M, Castro-Basart N, Duncan-Roberts Y, Carballo-Treto TI, Soto-Matos J, Izquierdo-Toledo Y, Vázquez-Blomquist D, García-Iglesias E, Bello-Rivero I. Pharmacokinetic and pharmacodynamic characterization of a new formulation containing synergistic proportions of interferons alpha-2b and gamma (HeberPAG) in patients with mycosis fungoides: an open-label trial. BMC Pharmacol Toxicol 2012; 13:20. [PMID: 23272809 PMCID: PMC3633053 DOI: 10.1186/2050-6511-13-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 12/21/2012] [Indexed: 11/10/2022] Open
Abstract
Background The synergistic combination of interferon (IFN) alpha-2b and IFN gamma results in more potent in vitro biological effects mediated by both IFNs. The aim of this investigation was to evaluate by first time the pharmacokinetics and pharmacodynamics of this combination in patients with mycosis fungoides. Methods An exploratory, prospective, open-label clinical trial was conducted. Twelve patients, both genders, 18 to 75 years-old, with mycosis fungoides at stages IB to III, were eligible for the study. All of them received intramuscularly a single high dose (23 × 106 IU) of a novel synergistic IFN mixture (HeberPAG®) for pharmacokinetic and pharmacodynamic studies. Serum IFN alpha-2b and IFN gamma concentrations were measured during 96 hours by commercial enzyme immunoassays (EIA) specific for each IFN. Other blood IFN-inducible markers and laboratory variables were used as pharmacodynamics and safety criteria. Results The pharmacokinetic evaluation by EIA yielded a similar pattern for both IFNs that are also in agreement with the well-known described profiles for these molecules when these are administered separately. The average values for main parameters were: Cmax: 263 and 9.3 pg/mL; Tmax: 9.5 and 6.9 h; AUC: 4483 and 87.5 pg.h/mL, half-life (t1/2): 4.9 and 13.4 h; mean residence time (MRT): 13.9 and 13.5 h, for serum IFN alpha-2b and IFN gamma, respectively. The pharmacodynamic variables were strongly stimulated by simultaneous administration of both IFNs: serum neopterin and beta-2 microglobulin levels (β2M), and stimulation of 2’-5’ oligoadenylate synthetase (OAS1) mRNA expression. The most encouraging data was the high increment of serum neopterin, 8.0 ng/mL at 48 h, not been described before for any unmodified or pegylated IFN. Additionally, β2M concentration doubled the pre-dose value at 24–48 hours. For both variables the values remained clearly upper baseline levels at 96 hours. Conclusions HeberPAG®possesses improved pharmacodynamic properties that may be very useful in the oncologic setting. Efficacy trials can be carried out to confirm these findings. Trial registration Registro Público Cubano de Ensayos Clínicos RPCEC00000130
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Saez V, Ramón J, Peniche C, Hardy E. Microencapsulation of Alpha Interferons in Biodegradable Microspheres. J Interferon Cytokine Res 2012; 32:299-311. [DOI: 10.1089/jir.2011.0034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Vivian Saez
- Formulation Development Department, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - José Ramón
- Macromolecular Chemistry Department, Biomaterials Center (BIOMAT), Havana University. Havana, Cuba
| | - Carlos Peniche
- Macromolecular Chemistry Department, Biomaterials Center (BIOMAT), Havana University. Havana, Cuba
| | - Eugenio Hardy
- Institute for Science and Technology of Materials, Havana University, Havana, Cuba
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García-García I, González-Delgado CA, Valenzuela-Silva CM, Díaz-Machado A, Cruz-Díaz M, Nodarse-Cuní H, Pérez-Pérez O, Bermúdez-Badell CH, Ferrero-Bibilonia J, Páez-Meireles R, Bello-Rivero I, Castro-Odio FR, López-Saura PA. Pharmacokinetic and pharmacodynamic comparison of two "pegylated" interferon alpha-2 formulations in healthy male volunteers: a randomized, crossover, double-blind study. BMC Pharmacol 2010; 10:15. [PMID: 21092287 PMCID: PMC3001701 DOI: 10.1186/1471-2210-10-15] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 11/23/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interferon (IFN) alpha conjugation to polyethylene glycol (PEG) results in a better pharmacokinetic profile and efficacy. The aim of this study was to compare the pharmacokinetic, pharmacodynamic and safety properties of a new, locally developed, 40-kDa PEG-IFN alpha-2b preparation with a reference, commercially available PEG-IFN alpha-2a in healthy male volunteers. METHODS A randomized, crossover, double-blind study with a 3-weeks washout period, was done. A single 180 micrograms PEG-IFN alpha-2 dose was administered subcutaneously in both groups. Sixteen apparently healthy male subjects were included. Serum PEG-IFN concentration was measured during 336 hours by an enzyme immunoassay (EIA). Other clinical and laboratory variables were used as pharmacodynamic and safety criteria. RESULTS The pharmacokinetic comparison by EIA yielded a high similitude between the formulations. In spite of a high subject variability, the parameters' mean were very close (in all cases p > 0.05): AUC: 53623 vs. 44311 pg.h/mL; Cmax: 333 vs. 271 pg/mL; Tmax: 54 vs. 55 h; half-life (t1/2): 72.4 vs. 64.8 h; terminal elimination rate (lambda): 0.011 vs. 0.014 h(-1); mean residence time (MRT): 135 vs. 123 h for reference and study preparations, respectively. There were no significant differences with respect to the pharmacodynamic variables either: serum neopterin and beta-2 microglobulin levels, stimulation of 2'5' oligoadenylate synthetase expression, and serum IFN antiviral activity. A strong Spearman's rank order correlation (p < 0.01) between the pharmacokinetic and pharmacodynamic concentration-time curves was observed. Both products caused similar leukocyte counts diminution and had similar safety profiles. The most frequent adverse reactions were leukopenia, fever, thrombocytopenia, transaminases increase and asthenia, mostly mild. CONCLUSIONS Both formulations are fully comparable from the pharmacokinetic, pharmacodynamic, and safety profiles. Efficacy trials can be carried out to confirm clinical similarity.
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