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Jäckel S, Pipp FC, Emde B, Weigt S, Vigna E, Hanschke B, Kasper L, Siddharta A, Hellmann J, Czasch S, Schmitt MW. l-citrulline: A preclinical safety biomarker for the small intestine in rats and dogs in repeat dose toxicity studies. J Pharmacol Toxicol Methods 2021; 110:107068. [PMID: 33940165 DOI: 10.1016/j.vascn.2021.107068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/22/2021] [Accepted: 04/08/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Gastrointestinal (GI) toxicity is still an issue within drug development, especially for novel oncology drugs. The identification of GI mucosal damage at an early stage with high sensitivity and specificity across preclinical species and humans remains difficult. To date, in preclinical studies, no qualified mechanistic, diagnostic or prognostic biomarkers exist for GI mucosal toxicity. l-citrulline is one of the most promising biomarker candidates used in clinical settings to quantify enterocyte integrity in various small intestinal diseases. l-citrulline is an intermediate metabolic amino acid produced mainly by functional enterocytes of the small intestine, whereby enterocyte loss will cause a drop in circulating l-citrulline. METHODS In several repeat-dose toxicity studies, plasma l-citrulline has been evaluated as a potential safety biomarker for intestinal toxicity in beagle dogs and Wistar (Han) rats treated with different oncological drug candidates in drug development. Clinical observations and body weight determinations were performed during the pretreatment, treatment and treatment-free recovery period as well as toxicokinetic, gross and histopathology examinations. The quantitative determination of plasma l-citrulline levels during the pretreatment (only dogs), treatment and treatment-free recovery period were performed using an HPLC MS/MS assay. In cynomolgus monkeys, the first investigations on baseline l-citrulline levels were performed. RESULTS In dogs, a dose- and exposure-dependent decrease of up to 50% in plasma l-citrulline was seen without histopathological alterations. However, a decrease of more than 50% in comparison to the individual animal pretreatment value of l-citrulline correlated very well with histopathological findings (intestinal crypt necrosis, villus atrophy, enterocyte loss) and clinical signs (bloody faeces and diarrhoea). During a treatment-free recovery period, a trend of increasing levels was observed in dogs. In rats, absolute l-citrulline plasma levels of treated animals decreased compared to the values of the concurrent control group. This decrease also correlated with the histopathological findings in the small intestine (single cell necrosis and mucosa atrophy). Because of a large physiological variation in l-citrulline plasma levels in dogs and rats, a clear cut-off value for absolute l-citrulline levels predictive of intestinal mucosal toxicity was difficult to establish. However, a > 50% decrease in l-citrulline plasma levels during the treatment period strongly correlated with histopathological findings. DISCUSSION Based on the performed analysis, a longitudinal investigation of l-citrulline plasma levels for individual animals in the control and treatment groups is essential and pretreatment values of l-citrulline levels in rodents would be highly informative. Overall, further cross-species comparison (Cynomolgus monkey, mouse) and implementation in clinical trials as exploratory biomarker is essential to foster the hypothesis and to understand completely the clinical relevance of l-citrulline as a small intestine biomarker.
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Affiliation(s)
- Sven Jäckel
- Merck KGaA, Chemical and Preclinical Safety, Darmstadt, Germany.
| | | | - Barbara Emde
- Merck KGaA, Chemical and Preclinical Safety, Darmstadt, Germany
| | - Stefan Weigt
- Merck KGaA, Chemical and Preclinical Safety, Darmstadt, Germany
| | - Enrico Vigna
- Istituto di Ricerche Biomediche "Antoine Marxer" - RBM; Colleretto Giacosa, Italy
| | | | - Lena Kasper
- Merck KGaA, Chemical and Preclinical Safety, Darmstadt, Germany
| | | | - Jürgen Hellmann
- Merck KGaA, Chemical and Preclinical Safety, Darmstadt, Germany
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Jäckel S, Emde B, Lai V, Weigt S, Hanschke B, Kasper L, Siddharta A, Hellmann J, Czasch S, Knippel A, Schmitt MW. L-Citrulline as translational safety biomarker for the small intestine—An update. J Pharmacol Toxicol Methods 2020. [DOI: 10.1016/j.vascn.2020.106863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pfaender S, Helfritz FA, Siddharta A, Todt D, Behrendt P, Heyden J, Riebesehl N, Willmann W, Steinmann J, Münch J, Ciesek S, Steinmann E. Environmental Stability and Infectivity of Hepatitis C Virus (HCV) in Different Human Body Fluids. Front Microbiol 2018; 9:504. [PMID: 29636728 PMCID: PMC5881408 DOI: 10.3389/fmicb.2018.00504] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/05/2018] [Indexed: 12/11/2022] Open
Abstract
Background: Hepatitis C virus (HCV) is a hepatotropic, blood-borne virus, but in up to one-third of infections of the transmission route remained unidentified. Viral genome copies of HCV have been identified in several body fluids, however, non-parental transmission upon exposure to contaminated body fluids seems to be rare. Several body fluids, e.g., tears and saliva, are renowned for their antimicrobial and antiviral properties, nevertheless, HCV stability has never been systematically analyzed in those fluids. Methods: We used state of the art infectious HCV cell culture techniques to investigate the stability of HCV in different body fluids to estimate the potential risk of transmission via patient body fluid material. In addition, we mimicked a potential contamination of HCV in tear fluid and analyzed which impact commercially available contact lens solutions might have in such a scenario. Results: We could demonstrate that HCV remains infectious over several days in body fluids like tears, saliva, semen, and cerebrospinal fluid. Only hydrogen-peroxide contact lens solutions were able to efficiently inactivate HCV in a suspension test. Conclusion: These results indicate that HCV, once it is present in various body fluids of infected patients, remains infective and could potentially contribute to transmission upon direct contact.
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Affiliation(s)
- Stephanie Pfaender
- Institute of Virology and Immunology, Mittelhäusern, Switzerland.,Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Fabian A Helfritz
- Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Anindya Siddharta
- Institute of Experimental Virology, TWINCORE-Centre for Experimental and Clinical Infections Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hanover, Germany
| | - Daniel Todt
- Institute of Experimental Virology, TWINCORE-Centre for Experimental and Clinical Infections Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hanover, Germany.,Department of Molecular and Medical Virology, Ruhr-University Bochum, Bochum, Germany
| | - Patrick Behrendt
- Institute of Experimental Virology, TWINCORE-Centre for Experimental and Clinical Infections Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hanover, Germany.,Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hanover, Germany
| | - Julia Heyden
- Institute of Experimental Virology, TWINCORE-Centre for Experimental and Clinical Infections Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hanover, Germany
| | - Nina Riebesehl
- Institute of Experimental Virology, TWINCORE-Centre for Experimental and Clinical Infections Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hanover, Germany
| | - Wiebke Willmann
- Institute of Experimental Virology, TWINCORE-Centre for Experimental and Clinical Infections Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hanover, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.,Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Medical Private University, Nürnberg Hospital, Nürnberg, Germany
| | - Jan Münch
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Sandra Ciesek
- Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Eike Steinmann
- Institute of Experimental Virology, TWINCORE-Centre for Experimental and Clinical Infections Research, a joint venture between the Hannover Medical School and the Helmholtz Centre for Infection Research, Hanover, Germany.,Department of Molecular and Medical Virology, Ruhr-University Bochum, Bochum, Germany
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Siddharta A, Pfaender S, Vielle NJ, Dijkman R, Friesland M, Becker B, Yang J, Engelmann M, Todt D, Windisch MP, Brill FH, Steinmann J, Steinmann J, Becker S, Alves MP, Pietschmann T, Eickmann M, Thiel V, Steinmann E. Virucidal Activity of World Health Organization-Recommended Formulations Against Enveloped Viruses, Including Zika, Ebola, and Emerging Coronaviruses. J Infect Dis 2017; 215:902-906. [PMID: 28453839 PMCID: PMC5407053 DOI: 10.1093/infdis/jix046] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/15/2017] [Indexed: 12/13/2022] Open
Abstract
The World Health Organization (WHO) published 2 alcohol-based formulations to be used in healthcare settings and for outbreak-associated infections, but inactivation efficacies of these products have not been determined against (re-)emerging viruses. In this study, we evaluated the virucidal activity of these WHO products in a comparative analysis. Zika virus (ZIKV), Ebola virus (EBOV), severe acute respiratory syndrome coronavirus (SARS-CoV), and Middle East respiratory syndrome coronavirus (MERS-CoV) as (re-)emerging viral pathogens and other enveloped viruses could be efficiently inactivated by both WHO formulations, implicating their use in healthcare systems and viral outbreak situations.
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Affiliation(s)
- Anindya Siddharta
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Stephanie Pfaender
- Department of Infectious diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland.,Federal Department of Home Affairs, Institute of Virology and Immunology, Bern and Mittelhäusern, Switzerland
| | - Nathalie Jane Vielle
- Department of Infectious diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Switzerland.,Federal Department of Home Affairs, Institute of Virology and Immunology, Bern and Mittelhäusern, Switzerland
| | - Ronald Dijkman
- Department of Infectious diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland.,Federal Department of Home Affairs, Institute of Virology and Immunology, Bern and Mittelhäusern, Switzerland
| | - Martina Friesland
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Britta Becker
- Dr Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Jaewon Yang
- Applied Molecular Virology, Institut Pasteur Korea, Seongnam, Gyeonggi-do, South Korea
| | - Michael Engelmann
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Daniel Todt
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Marc P Windisch
- Applied Molecular Virology, Institut Pasteur Korea, Seongnam, Gyeonggi-do, South Korea
| | - Florian H Brill
- Dr Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany
| | - Jochen Steinmann
- Dr Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Stephan Becker
- Institute for Virology, Philipps University of Marburg, Germany
| | - Marco P Alves
- Department of Infectious diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland.,Federal Department of Home Affairs, Institute of Virology and Immunology, Bern and Mittelhäusern, Switzerland
| | - Thomas Pietschmann
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - Markus Eickmann
- Institute for Virology, Philipps University of Marburg, Germany
| | - Volker Thiel
- Department of Infectious diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland.,Federal Department of Home Affairs, Institute of Virology and Immunology, Bern and Mittelhäusern, Switzerland
| | - Eike Steinmann
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research, Hannover, Germany
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Siddharta A, Pfaender S, Malassa A, Doerrbecker J, Anggakusuma, Engelmann M, Nugraha B, Steinmann J, Todt D, Vondran FWR, Mateu-Gelabert P, Goffinet C, Steinmann E. Inactivation of HCV and HIV by microwave: a novel approach for prevention of virus transmission among people who inject drugs. Sci Rep 2016; 6:36619. [PMID: 27857152 PMCID: PMC5114683 DOI: 10.1038/srep36619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/17/2016] [Indexed: 01/06/2023] Open
Abstract
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV-1) transmissions among people who inject drugs (PWID) continue to pose a challenging global health problem. Here, we aimed to analyse a universally applicable inactivation procedure, namely microwave irradiation, as a safe and effective method to reduce the risk of viral transmission. The exposure of HCV from different genotypes to microwave irradiation resulted in a significant reduction of viral infectivity. Furthermore, microwave irradiation reduced viral infectivity of HIV-1 and of HCV/HIV-1 suspensions indicating that this inactivation may be effective at preventing co-infections. To translate microwave irradiation as prevention method to used drug preparation equipment, we could further show that HCV as well as HIV-1 infectivity could be abrogated in syringes and filters. This study demonstrates the power of microwave irradiation for the reduction of viral transmission and establishment of this safety strategy could help reduce the transmission of blood-borne viruses.
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Affiliation(s)
- Anindya Siddharta
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Stephanie Pfaender
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Angelina Malassa
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Juliane Doerrbecker
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Anggakusuma
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Michael Engelmann
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Daniel Todt
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Florian W R Vondran
- ReMediES, Department of General, Visceral and Transplantation Surgery, Hannover Medical School, and German Centre for Infection Research, Hannover-Braunschweig, Germany
| | | | - Christine Goffinet
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
| | - Eike Steinmann
- Institute of Experimental Virology, Twincore, Centre for Experimental and Clinical Infection Research; a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI) , Hannover, Germany
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