Qualification of cardiac troponins for nonclinical use: a regulatory perspective

The US Food and Drug Administration (FDA) Biomarker Qualification Review Team presents its perspective on the recent qualification of cardiac troponins for use in nonclinical safety assessment studies. The goal of this manuscript is to provide greater transparency into the qualification process and factors that were considered in reaching a regulatory decision. This manuscript includes an overview of the data that were submitted and a discussion of the strengths and shortcomings of these data supporting the qualification decision. The cardiac troponin submission is the first literature-based biomarker application to be reviewed by the FDA and insights gained from this experience may aid future submissions and help streamline the characterization and qualification of future biomarkers.

Novel biomarkers of acute kidney toxicity

Novel biomarkers of kidney toxicity are powerful tools not only with respect to their clinical applications but also because of their impact on drug development. These biomarkers can influence the assessment of efficacy of new drugs for kidney diseases as well as the risk management for new drugs. The science behind these novel biomarkers reflects the evolution over the past decade of genomic and proteomic platforms that have transformed the discovery and development of new biomarkers for preclinical and clinical applications in drug development. Several of these biomarkers are in use as transcriptomic biomarkers in animal models as well as translational proteomic biomarkers in animal models and in humans. Their ability to detect kidney damage earlier than is possible with currently accessible biomarkers is being given qualification through regulatory biomarker-qualification programs, which will help establish consensus for their widespread use.

Nonclinical aspects of biopharmaceutical development: discussion of case studies at a PhRMA-FDA workshop

Robust assessments of the nonclinical safety profile of biopharmaceuticals are best developed on a scientifically justified, case-by-case basis, with consideration of the therapeutic molecule, molecular target, and differences/similarities between nonclinical species and humans (ICH S6). Significant experience has been gained in the 10 years ensuing since publication of the ICH S6 guidance. In a PhRMA-FDA-sponsored workshop, "Nonclinical Aspects of Biopharmaceutical Development," industry and US regulatory representatives engaged in exploration of current scientific and regulatory issues relating to the nonclinical development of biopharmaceuticals in order to share scientific learning and experience and to work towards establishing consistency in application of general principles and approaches. The proceedings and discussions of this workshop confirm general alignment of strategy and tactics in development of biopharmaceuticals with regard to such areas as species selection, selection of high doses in toxicology studies, selection of clinical doses, the conduct of developmental and reproductive toxicity (DART) studies, and assessment of carcinogenic potential. However, several important aspects, including, for example, appropriate use of homologues, nonhuman primates, and/or in vitro models in the assessment of risk for potential developmental and carcinogenic effects, were identified as requiring further scientific exploration and discussion.

The transvestite serpent: why do male garter snakes court (some) other males?

In large mating aggregations of red-sided garter snakes, Thamnophis sirtalis parietalis, in Manitoba, male courtship is directed not only to females, but also to other males with female-like skin lipids ('she-males'). We show that 'she-maleness' is an intrinsic property of a male rather than an artefact of lipid transfer from females, and that male-male courtship is very common in the field. She-males were distinctive in terms of appearance (they were heavier than other males and more often covered with mud), behaviour (they were inactive and rarely courted females) and performance (they were slow crawlers, ineffective courters and easily outcompeted by other males in mating trials). 'She-maleness' was not a characteristic of a particular subset of males, as envisaged in previous work; instead, it was a transitory phase that most (perhaps all) male snakes passed through soon after they first emerged from the winter den. Recently emerged males spent their first day or two relatively inactive, while restoring physiological functions (including locomotor performance and courtship ability). Experimental application of female skin lipids on to males dramatically decreased courtship levels of the recipient snakes. Thus, recently emerged males may derive two kinds of benefit from mimicking female skin lipids. First, female mimicry 'switches off' the male's own (energetically expensive) courtship at a time when that courtship would be unproductive. Second, it may disadvantage his rivals by distracting them from females, and increasing their energy expenditure. Copyright 2000 The Association for the Study of Animal Behaviour.

Increasing the power of psychiatric court diversion: a new model of supra-district diversion centre

The object was to develop and evaluate a new concentrated model of psychiatric diversion scheme at the magistrates' court, designed to maximize the potential of such interventions. A one-year prospective study was undertaken of a consecutive series of 264 referrals to the new diversion project at an Inner London magistrates' court, with concurrent examination of police station custody records, magistrates' court returns, hospital admission data and remand prison transfer records for an area with a population of 500,000. The results showed that this one scheme originated 12.8% of all the unrestricted hospital orders in England under section 37 of the Mental Health Act 1983, 4.2% of section 35 orders, and 6.4% of section 48 and 48/49 remand prisoner transfers. Of all arrests in the central London area, 0.46% were referred to the scheme, with 0.28% being admitted. The seriousness of the charge did not have a significant effect on whether or not admission was achieved (p = 0.5365). The new model is a powerful intervention in the assessment and diversion of mentally disordered offenders. Similar supra-district diversion centres may have a role to play in other areas, complementing other local diversion exercises, some of which might better be relocated to the police station.

Combinatorial regulation by promoter and intron 1 regions of the metallothionein SpMTA gene in the sea urchin embryo

The SpMTA metallothionein gene of the sea urchin Strongylocentrotus purpuratus is regulated developmentally, histospecifically, and by heavy-metal induction. The sequenced 5' flank of the gene can be divided into proximal, middle, and distal regions, each containing a pair of metal response elements (MREs). Canonical 7-bp core sequences are present in all except the middle-region MREs c and d, which contain 1-bp mismatches. Metal-induced expression in transgenic blastulae was increased with each consecutive addition of the middle and distal regions to a chimeric reporter gene construct containing the proximal SpMTA promoter region. Reduced metal induction through point mutation of the distal MREs e and f indicated that the MREs themselves were largely responsible for the transcriptional increase. These activities were further enhanced by SpMTA intron 1, but not when a specific interior region of the intron had been deleted. The atypical MREs c and d did not support induction by themselves, i.e., when present alone with mutated proximal MREs a and b. However, in the presence of intron 1, they were able to substitute for the nullified MREs a and b in the promotion of metal-induced expression. This capability suggests, furthermore, that these atypical MREs, in addition to responding to an intron 1 region, participate cooperatively with the canonical proximal MREs.

Low protein catabolic rate and serum albumin correlate with increased mortality and abdominal complications in peritoneal dialysis patients

We retrospectively reviewed 167 consecutive peritoneal dialysis patients with regard to serum albumin (Alb), mortality and abdominal complications. In addition, 25 patients were studied with serial measurements of urea kinetics. The patients were divided into four groups based on their dialysis index (DI) and normalized protein catabolic rate (NPCR) (Table I). 12/167 patients were identified with abdominal catastrophes. Before these complications occurred, the M Alb in this group was 2.67 + 0.24 (compared to age, sex and disease matched controls of 3.55 + .11 P < .05). Six of these patients died from abdominal complications. In the 26 patients with serial urea kinetic studies, 4/11 patients in group IV died (low NPCR and low DI) (P < .05 compared to Group I, II or III). We conclude that urea kinetic modeling is predictive of outcome in those patients with presumed poor nutrition and inadequate dialysis and that abdominal catastrophes are more common in those patients with poor nutrition. Prospective interventional studies should be designed in an attempt to improve the poor outcome in this group of patients.

Structure, spatial, and temporal expression of two sea urchin metallothionein genes, SpMTB1 and SpMTA

The metallothionein-B genes of the sea urchin Strongylocentrotus purpuratus encode a metallothionein (MT) isoform distinguishable from the MTA isoform. The MTB subfamily consists of at least two genes, MTB1 and MTB2, and possibly two to three others. The unique MTB1 and MTA genes have a high degree of identity but diverge in structural detail and expression. Transcripts of the MTA, MTB1, troponin C Spec 1, and CyIIIa actin genes begin simultaneously to accumulate at an early blastula stage. MTB1 mRNA becomes localized in the embryonic gut and oral ectoderm, whereas MTA, Spec 1, and CyIIIa actin mRNAs are spatially restricted to the aboral ectoderm. Several DNA elements are localized at the same positions in the MTB1 and MTA genes: these include respective CATA and TATA boxes, two metal response elements, and three distinct upstream DNA elements that are also present, and in the same order, in the Spec 1 gene promoter. A heptameric sequence, element A, is present at two sites each in the Spec 1 and CyIIIa actin genes, five sites in MTA, but only one site in MTB1. Most strikingly, the first intron of MTA contains elements not found in the MTB1 introns, including a consensus metal response element, an element A, and the P3A site demonstrated in the CyIIIa actin gene to be linked to the regulation of spatial expression.

Structure of an ectodermally expressed sea urchin metallothionein gene and characterization of its metal-responsive region

The metallothionein-A gene in the metallothionein gene family of the sea urchin Strongylocentrotus purpuratus (SpMTA gene) was sequenced and found to contain three coding exons plus a 3' entirely noncoding exon. Putative alpha and beta MT domains were encoded, by its exons 2 and 3, respectively, in reverse of the order in vertebrate metallothionein genes. The SpMTA promoter was characterized through the expression of recombinant constructs containing various portions of the proximal 678-base-pair (bp) 5'-flanking region of the SpMTA gene. Zygotes injected with constructs were cultured to the blastula stage in the presence of a heavy-metal chelator and then incubated in the presence or absence of cadmium. The longest constructs were expressed only when heavy-metal ion was present. Two putative metal-responsive elements (MREs a and b) within 240 bp of the transcription start site resembled mammalian MREs in their critical 8-bp cores (TGCRCNCS) and in their locations relative to each other and to the TATA box. Elimination of activity by site-specific mutations in MREs a and b, separately or in both, identified them as metal regulatory elements. Thus, MRE recognition in this invertebrate resembles that in vertebrates. Upstream sites with single-mismatched MREs neither acted as MREs nor amplified the activity of MREs a and b. The SpMTA, Spec1, and CyIIIa actin genes, which have the same ectodermal specificity, have common DNA elements at relatively similar locations in their promoter regions; however, these elements are insufficient in themselves to promote gene expression.

Psychosis associated with HIV infection

Five cases of psychiatric illness, presenting as functional psychosis, occurring in male homosexuals with human immunodeficiency virus (HIV) infection are described and compared with similar cases in the literature. The association between psychosis and infection with HIV is discussed with particular emphasis on the significance of functional versus organic presentation.

Sea-urchin RNAs displaying differences in developmental regulation and in complementarity to a collagen exon probe

Sea-urchin embryo RNAs of 9 kb and 7 kb hybridise with a collagen-coding probe. The delta Tm of the hybrids indicates a 70% sequence identity between these RNA regions. Both RNAs are localised in the pluteus endomesoderm, but accumulate over different developmental periods: the 9 kb RNA first appears in the blastula and reaches a maximum concentration during the gastrula stages, while the 7 kb RNA is first detected in the gastrula and is at maximal concentration in the pluteus larva. Animalization by transient exposure of the early stage embryo to Zn2+ alters the developmental profile of the 9 kb collagen mRNA in a way that is clearly different from responses of other mRNAs whose accumulations are initiated during the blastula stage (Nemer, M. (1986) Dev. Biol. 114, 214-224).

Synonymous nucleotide substitution rates of beta-tubulin and histone genes conform to high overall genomic rates in rodents but not in sea urchins

Sea urchin and rodent genomes have been posited to evolve rapidly as indicated by divergences in single copy nuclear DNA sequences. We have examined whether the synonymous substitution rates of three highly conserved genes, beta-tubulin, histone H4, and histone H3, adhere to these high genomic substitution rates by comparing sequences between two sea urchins, Strongylocentrotus purpuratus and Lytechinus pictus, and between rodents and humans. Whereas the rate of change between the 3' untranslated regions of the beta-tubulin cDNA of S. purpuratus (Sp-beta 1), sequenced in this study, and of L. pictus (Lp-beta 3) was consistent with the overall rate of change estimated from previous DNA hybridization results between these species, the synonymous substitution rates for the carboxyl domains of these beta-tubulins, as well as for the late histones H4 and H3, were significantly depressed. In contrast, synonymous nucleotide substitution rates between rodents and between rodent and human for the carboxyl domain proper of identical beta-tubulin isotypes and for histone H4 and H3.1 did not differ from the overall rate of change for the rodent genomes. Moreover, an analysis of paralogous human and mouse beta-tubulin sequences supported the conclusion that the synonymous substitution rates in the mouse were higher than those in the human. Differences in constraint on evolutionary change were not evident strictly from the conserved amino acid sequences and base compositions of these genes. Other constraining influences seemed more relevant to the departure of the synonymous substitution rates of the sea urchin beta-tubulin and histone coding regions from the average genomic rate.

Coordinate and selective beta-tubulin gene expression associated with cilium formation in sea urchin embryos

beta-Tubulin mRNAs associated with cilium formation in Strongylocentrotus purpurpatus sea urchin embryos are expressed selectively from a multiple gene family. The accumulations of three beta-tubulin mRNAs (beta 1, beta 2, and beta 3) are temporally coordinated with ciliogenesis during blastula development and with the regeneration of cilia after their amputation. In contrast, another beta-tubulin mRNA, beta 4, is not induced in either case. The zinc-animalized embryo with its exaggerated blastula phenotype forms longer cilia through a protracted period of ciliogenesis, in which the beta-tubulin mRNAs, principally beta 1, accumulate to higher than normal levels. The rate of beta-tubulin transcription per nucleus in the animalized embryo is greater than that of the normal embryo and is not changed through deciliation, although the tubulin mRNAs accumulate to higher levels. However, deciliation raises the beta-tubulin transcription rate in the normal embryo to that in the animalized embryo. Thus, the induction of beta-tubulin mRNA by cilium amputation is regulated transcriptionally in the normal embryo, but post-transcriptionally in the zinc-animalized embryos. Moreover, the beta-tubulin genes that are expressed in association with cilium formation appear to be induced selectively within the framework of ectodermal cell-type specificity.

Developmental and tissue-specific regulation of beta-tubulin gene expression in the embryo of the sea urchin Strongylocentrotus purpuratus

Four beta-tubulin mRNAs in the embryo of the sea urchin Strongylocentrotus purpuratus are transcribed from at least 3 of the 9-12 beta-tubulin genes. A beta 1 tubulin mRNA of 1.8 kb, transcribed from a unique beta 1 gene, is expressed with high specificity in the pluteus ectoderm. Another 1.8-kb mRNA, beta 2, and a 2.5-kb beta 3 mRNA are moderately ectoderm specific. In contrast, a 3.0-kb beta 4 mRNA is highly specific for the endomesoderm tissue fraction. Certain similarities in developmental and tissue-specific expression suggest that these beta-tubulin genes may be related in their mode of regulation to counterparts among the genes for actin, another cytoskeletal protein. Measurements of absolute amounts revealed a distinct developmental profile for each beta-tubulin mRNA. An increase in the total amount of beta-tubulin mRNA in the early blastula was correlated with an increase in transcription rate per nucleus; whereas, later in the mesenchyme blastula stage, the beta-tubulin mRNA level decreased sharply as the rate of beta-tubulin gene transcription on a per embryo basis remained constant. Thus, during development through the blastula stages, there was a switch to a predominantly posttranscriptional regulation of beta-tubulin mRNA expression, probably through a decrease in mRNA stability.