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Chen L, Zhao Z, Diarimalala RO, Chen Z, Wang Y, Zhan T, Zhao Y, Ma C, Wang X, Zhao C, Xiao Z, Hu K, Wu P. Tris-Functionalized Polyoxotungstovanadate-Mediated Antitumor Efficacy Involves Multiple Cell Death Pathways. Chem Biodivers 2024; 21:e202301898. [PMID: 38369765 DOI: 10.1002/cbdv.202301898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/27/2023] [Accepted: 02/17/2024] [Indexed: 02/20/2024]
Abstract
Polyoxometalates (POMs) are promising inorganic drug candidates for cancer chemotherapy. They are becoming attractive because of their easy accessibility and low cost. Herein, we report the synthesis and antitumor activity studies of four Lindqvist-type POMs with mixed-addenda atoms Na2[V4W2O16{(OCH2)3CR}] (R=-CH2OH, -CH3, -CH2CH3) and (Bu4N)2[V3W3{(OCH2)3CH2OOCCH2CH3}]. Compared with the current clinical applied antitumor drug 5-fluorouracil (5-FU) or Gemcitabine, analysis of MTT/CCK-8 assay, colony formation and wound healing assay revealed that the {V4W2} POMs had acceptable cytotoxicity in normal cells (293T) and significant inhibitory effects on cell proliferation and migration in three human tumor cell lines: human lung carcinoma cells (A549), human cervical carcinoma cells (HeLa), and human breast cancer cells (MCF-7). Interestingly, among the POMs analyzed, the therapeutic index (TI) of the {V4W2} POM with R= -CH2OH was relatively the most satisfactory. Thus, it was subsequently used for further studies. Flow cytometry analysis showed it prompted cellular apoptosis rate. qRT-PCR and Western blotting analysis indicated that multiple cell death pathways were activated including apoptosis, autophagy, necroptosis and pyroptosis during the POM-mediated antitumor process. In conclusion, our study shows that the polyoxotungstovanadate has great potential to be developed into a broad-spectrum antitumor chemotherapeutic drug.
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Affiliation(s)
- Lihong Chen
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Zijia Zhao
- Sino-German Biomedical Center, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Rominah Onintsoa Diarimalala
- Sino-German Biomedical Center, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Zhongwei Chen
- Sino-German Biomedical Center, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Yu Wang
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Taozhu Zhan
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Yanchao Zhao
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Chunhui Ma
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Xingyue Wang
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Chenqi Zhao
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Zicheng Xiao
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Kanghong Hu
- Sino-German Biomedical Center, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education & Hubei Province), Hubei University of Technology, Wuhan, 430068, Hubei, PR China
| | - Pingfan Wu
- Institute of POM-based Materials, New Materials and Green Manufacturing Talent Introduction and Innovation Demonstration Base, School of Materials and Chemical Engineering, Hubei University of Technology, Wuhan, 430068, Hubei, PR China
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Ibrahim AA, Nsairat H, Al-Sulaibi M, El-Tanani M, Jaber AM, Lafi Z, Barakat R, Abuarqoub DA, Mahmoud IS, Obare SO, Aljabali AAA, Alkilany AM, Alshaer W. Doxorubicin conjugates: a practical approach for its cardiotoxicity alleviation. Expert Opin Drug Deliv 2024; 21:399-422. [PMID: 38623735 DOI: 10.1080/17425247.2024.2343882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/04/2023] [Accepted: 02/29/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Doxorubicin (DOX) emerges as a cornerstone in the arsenal of potent chemotherapeutic agents. Yet, the clinical deployment of DOX is tarnished by its proclivity to induce severe cardiotoxic effects, culminating in heart failure and other consequential morbidities. In response, a panoply of strategies has undergone rigorous exploration over recent decades, all aimed at attenuating DOX's cardiotoxic impact. The advent of encapsulating DOX within lipidic or polymeric nanocarriers has yielded a dual triumph, augmenting DOX's therapeutic efficacy while mitigating its deleterious side effects. AREAS COVERED Recent strides have spotlighted the emergence of DOX conjugates as particularly auspicious avenues for ameliorating DOX-induced cardiotoxicity. These conjugates entail the fusion of DOX through physical or chemical bonds with diminutive natural or synthetic moieties, polymers, biomolecules, and nanoparticles. This spectrum encompasses interventions that impinge upon DOX's cardiotoxic mechanism, modulate cellular uptake and localization, confer antioxidative properties, or refine cellular targeting. EXPERT OPINION The endorsement of DOX conjugates as a compelling stratagem to mitigate DOX-induced cardiotoxicity resounds from this exegesis, amplifying safety margins and the therapeutic profile of this venerated chemotherapeutic agent. Within this ambit, DOX conjugates stand as a beacon of promise in the perpetual pursuit of refining chemotherapy-induced cardiac compromise.
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Affiliation(s)
- Abed Alqader Ibrahim
- Department of Nanoscience, Joint School of Nanoscience and Nanoengineering, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Hamdi Nsairat
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Mazen Al-Sulaibi
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Mohamed El-Tanani
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
- College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Areej M Jaber
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Zainab Lafi
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Rahmeh Barakat
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Duaa Azmi Abuarqoub
- Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
- Cell Therapy Center, The University of Jordan, Amman, Jordan
| | - Ismail Sami Mahmoud
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Sherine O Obare
- Department of Nanoscience, Joint School of Nanoscience and Nanoengineering, University of North Carolina at Greensboro, Greensboro, NC, USA
- Department of Nanoengineering, Joint School of Nanoscience and Nanoengineering, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - Alaa A A Aljabali
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Yarmouk University, Irbid, Jordan
| | | | - Walhan Alshaer
- Cell Therapy Center, The University of Jordan, Amman, Jordan
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Sun T, Vander Heiden JA, Gao X, Yin J, Uttarwar S, Liang WC, Jia G, Yadav R, Huang Z, Mitra M, Halpern W, Bender HS, Brightbill HD, Wu Y, Lupardus P, Ramalingam T, Arron JR. Isoform-selective TGF-β3 inhibition for systemic sclerosis. Med 2024; 5:132-147.e7. [PMID: 38272035 DOI: 10.1016/j.medj.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/01/2023] [Revised: 11/03/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Transforming growth factor β (TGF-β) is implicated as a key mediator of pathological fibrosis, but its pleiotropic activity in a range of homeostatic functions presents challenges to its safe and effective therapeutic targeting. There are three isoforms of TGF-β, TGF-β1, TGF-β2, and TGF-β3, which bind to a common receptor complex composed of TGF-βR1 and TGF-βR2 to induce similar intracellular signals in vitro. We have recently shown that the cellular expression patterns and activation thresholds of TGF-β2 and TGF-β3 are distinct from those of TGF-β1 and that selective short-term TGF-β2 and TGF-β3 inhibition can attenuate fibrosis in vivo without promoting excessive inflammation. Isoform-selective inhibition of TGF-β may therefore provide a therapeutic opportunity for patients with chronic fibrotic disorders. METHODS Transcriptomic profiling of skin biopsies from patients with systemic sclerosis (SSc) from multiple clinical trials was performed to evaluate the role of TGF-β3 in this disease. Antibody humanization, biochemical characterization, crystallization, and pre-clinical experiments were performed to further characterize an anti-TGF-β3 antibody. FINDINGS In the skin of patients with SSc, TGF-β3 expression is uniquely correlated with biomarkers of TGF-β signaling and disease severity. Crystallographic studies establish a structural basis for selective TGF-β3 inhibition with a potent and selective monoclonal antibody that attenuates fibrosis effectively in vivo at clinically translatable exposures. Toxicology studies suggest that, as opposed to pan-TGF-β inhibitors, this anti-TGF-β3 antibody has a favorable safety profile for chronic administration. CONCLUSION We establish a rationale for targeting TGF-β3 in SSc with a favorable therapeutic index. FUNDING This study was funded by Genentech, Inc.
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Affiliation(s)
- Tianhe Sun
- Department of Immunology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA.
| | - Jason A Vander Heiden
- Department of OMNI Bioinformatics, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Xia Gao
- Department of Biomarker Discovery OMNI, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Jianping Yin
- Department of Structural Biology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Salil Uttarwar
- Department of OMNI Bioinformatics, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Wei-Ching Liang
- Department of Antibody Engineering, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Guiquan Jia
- Department of Biomarker Discovery OMNI, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Rajbharan Yadav
- Department of Preclinical and Translational Pharmacokinetics, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Zhiyu Huang
- Department of Translational Immunology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Mayurranjan Mitra
- Department of DevSci Safety Assessment, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Wendy Halpern
- Department of DevSci SA Pathology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Hannah S Bender
- Department of Pathology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Hans D Brightbill
- Department of Translational Immunology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Yan Wu
- Department of Antibody Engineering, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Patrick Lupardus
- Department of Structural Biology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Thirumalai Ramalingam
- Department of Biomarker Discovery OMNI, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Joseph R Arron
- Department of Immunology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA.
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Freitas CS, Pereira PR, Cardoso RV, Pauli FP, Ribeiro RCB, Da Silva FDC, Ferreira VF, Paschoalin VMF. Antimicrobial and wound healing potential of naphthoquinones encapsulated in nanochitosan. Front Bioeng Biotechnol 2024; 11:1284630. [PMID: 38239922 PMCID: PMC10794614 DOI: 10.3389/fbioe.2023.1284630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction: The use of chitosan in pharmaceutical formulations is an advantageous approach due to this compound intrinsic biodegradability and biocompatibility, as well as ready availability and low polymer cost. Methods: Herein, the naphthoquinones 3- chloromethylene-menadione (NQ1) and 2,3-dichloro-1,4-naphthoquinone (NQ2) were nanoencapsulated into chitosan (CNP) by the ionotropic gelatinization technique and characterized by DLS, FTIR, SEM, TGA and DSC, and their release profiles evaluated. The antimicrobial and wound healing activities were investigated. Results and Discussion: Homogeneous chitosan nanocapsulses of about 193 nm and Z potential ranging from +30.6 to +33.1 mV loaded with NQ1 (CNP-NQ1) or NQ2 (CNPQNQ2). With nanoencapsulation efficiencies of ≥ 96%, the solubility of naphthoquinones in aqueous environments was improved, making them suitable for biological system applications. The encapsulated naphthoquinones displayed a controlled release of approximately 80% for CNP-NQ1 and 90% for CNP-NQ2 over an 8 h period at 36°C. Both CNP-NQ1 and CNP-NQ2 retained the already established free naphthoquinone antimicrobial activity against two Staphylococcus aureus strains, Staphylococcus epidermidis, Streptococcus pyogenes and Pseudomonas aeruginosa. Although presenting low toxicity to healthy human cells, only CNP-NQ1 displayed therapeutic indices above 100 for S. aureus and S. epidermidis and above 27 for S. pyogenes and P. aeruginosa, allowing for safe use in human tissues. Furthermore, CNP-NQ1 did not impair the migration of human fibroblast cells in scratch assays, adding promising wound healing properties to this formulation. These findings emphasize that CNP-NQ1 may be useful in protecting injured skin tissue from bacterial contamination, avoiding skin infections not only by reducing bacterial loads but also by accelerating the healing process until complete dermal tissue recovery.
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Affiliation(s)
- Cyntia Silva Freitas
- Advanced Analysis Laboratory in Biochemistry and Molecular Biology, Department of Biochemistry, Chemistry Institute, Federal University of Rio De Janeiro, Programa de Pós-Graduação em Ciência de Alimentos, Rio de Janeiro, Brazil
| | - Patricia Ribeiro Pereira
- Advanced Analysis Laboratory in Biochemistry and Molecular Biology, Department of Biochemistry, Chemistry Institute, Federal University of Rio De Janeiro, Programa de Pós-Graduação em Ciência de Alimentos, Rio de Janeiro, Brazil
- Department of Biochemistry, Chemistry Institute, Federal University of Rio De Janeiro, Programa de Pós-Graduação em Química, Rio de Janeiro, Brazil
| | - Raiane Vieira Cardoso
- Advanced Analysis Laboratory in Biochemistry and Molecular Biology, Department of Biochemistry, Chemistry Institute, Federal University of Rio De Janeiro, Programa de Pós-Graduação em Ciência de Alimentos, Rio de Janeiro, Brazil
| | - Fernanda Petzold Pauli
- Applied Organic Synthesis Laboratory, Department of Organic Chemistry, Chemistry Institute, Federal Fluminense University, Niterói, Brazil
| | - Ruan Carlos Busquet Ribeiro
- Applied Organic Synthesis Laboratory, Department of Organic Chemistry, Chemistry Institute, Federal Fluminense University, Niterói, Brazil
| | - Fernando De Carvalho Da Silva
- Applied Organic Synthesis Laboratory, Department of Organic Chemistry, Chemistry Institute, Federal Fluminense University, Niterói, Brazil
| | - Vitor Francisco Ferreira
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Federal Fluminense University, Niterói, Brazil
| | - Vania Margaret Flosi Paschoalin
- Advanced Analysis Laboratory in Biochemistry and Molecular Biology, Department of Biochemistry, Chemistry Institute, Federal University of Rio De Janeiro, Programa de Pós-Graduação em Ciência de Alimentos, Rio de Janeiro, Brazil
- Department of Biochemistry, Chemistry Institute, Federal University of Rio De Janeiro, Programa de Pós-Graduação em Química, Rio de Janeiro, Brazil
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Li R, Dere E, Kwong M, Fei M, Dave R, Masih S, Wang J, McNamara E, Huang H, Liang WC, Schutt L, Kamath AV, Ovacik MA. A Bispecific Modeling Framework Enables the Prediction of Efficacy, Toxicity, and Optimal Molecular Design of Bispecific Antibodies Targeting MerTK. AAPS J 2024; 26:11. [PMID: 38167740 DOI: 10.1208/s12248-023-00881-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/22/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
Inhibiting MerTK on macrophages is a promising therapeutic strategy for augmenting anti-tumor immunity. However, blocking MerTK on retinal pigment epithelial cells (RPEs) results in retinal toxicity. Bispecific antibodies (bsAbs) containing an anti-MerTK therapeutic and anti-PD-L1 targeting arm were developed to reduce drug binding to MerTK on RPEs, since PD-L1 is overexpressed on macrophages but not RPEs. In this study, we present a modeling framework using in vitro receptor occupancy (RO) and pharmacokinetics (PK) data to predict efficacy, toxicity, and therapeutic index (TI) of anti-MerTK bsAbs. We first used simulations and in vitro RO data of anti-MerTK monospecific antibody (msAb) to estimate the required MerTK RO for in vivo efficacy and toxicity. Using these estimated RO thresholds, we employed our model to predict the efficacious and toxic doses for anti-MerTK bsAbs with varying affinities for MerTK. Our model predicted the highest TI for the anti-MerTK/PD-L1 bsAb with an attenuated MerTK binding arm, which was consistent with in vivo efficacy and toxicity observations. Subsequently, we used the model, in combination with sensitivity analysis and parameter scans, to suggest an optimal molecular design of anti-MerTK bsAb with the highest predicted TI in humans. Our prediction revealed that this optimized anti-MerTK bsAb should contain a MerTK therapeutic arm with relatively low affinity, along with a high affinity targeting arm that can bind to a low abundance target with slow turnover rate. Overall, these results demonstrated that our modeling framework can guide the rational design of bsAbs.
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Affiliation(s)
- Ran Li
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc., 1 DNA Way, South San Francisco, California, 94080, USA.
| | - Edward Dere
- Safety Assessment, Genentech Inc., South San Francisco, California, 94080, USA
| | - Mandy Kwong
- Biochemical and Cellular Pharmacology, Genentech Inc., South San Francisco, California, 94080, USA
| | - Mingjian Fei
- Molecular Oncology, Genentech Inc, South San Francisco, California, 94080, USA
| | - Rutwij Dave
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc., 1 DNA Way, South San Francisco, California, 94080, USA
| | - Shabkhaiz Masih
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc., 1 DNA Way, South San Francisco, California, 94080, USA
| | - Joy Wang
- Molecular Oncology, Genentech Inc, South San Francisco, California, 94080, USA
| | - Erin McNamara
- Molecular Oncology, Genentech Inc, South San Francisco, California, 94080, USA
| | - Haochu Huang
- Molecular Oncology, Genentech Inc, South San Francisco, California, 94080, USA
| | - Wei-Ching Liang
- Antibody Engineering, Genentech Inc, South San Francisco, California, 94080, USA
| | - Leah Schutt
- Safety Assessment, Genentech Inc., South San Francisco, California, 94080, USA
| | - Amrita V Kamath
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc., 1 DNA Way, South San Francisco, California, 94080, USA
| | - Meric A Ovacik
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc., 1 DNA Way, South San Francisco, California, 94080, USA.
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Rinscheid A, Gäble A, Wienand G, Pfob C, Dierks A, Kircher M, Trepel M, Weckermann D, Lapa C, Bundschuh RA. An Intrapatient Dosimetry Comparison of 177Lu-rhPSMA-10.1 and 177Lu-PSMA-I&T in Patients with Metastatic Castration-Resistant Prostate Cancer. J Nucl Med 2023; 64:1918-1924. [PMID: 37770108 DOI: 10.2967/jnumed.123.265970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/02/2023] [Revised: 09/07/2023] [Indexed: 10/03/2023] Open
Abstract
As the use of radioligand therapy moves earlier in the prostate cancer timeline, minimizing the absorbed dose to normal organs while maintaining high tumor radiation doses becomes more clinically important because of the longer life expectancy of patients. We performed an intrapatient comparison of pretherapeutic dosimetry with the novel radiohybrid prostate-specific membrane antigen-targeting radiopharmaceutical 177Lu-rhPSMA-10.1, along with 177Lu-PSMA-I&T, in patients with metastatic castration-resistant prostate cancer. Methods: Four consecutive patients with advanced histologically proven metastatic castration-resistant prostate cancer who were scheduled for radioligand therapy were evaluated. Before undergoing therapy, each patient received 1.06 ± 0.05 GBq of 177Lu-rhPSMA-10.1 and 1.09 ± 0.02 GBq of 177Lu-PSMA-I&T at least 7 d apart. For dosimetric assessment, whole-body planar scintigraphy was performed after 5 min, 4 h, 1 d, 2 d, and 7 d. In addition, SPECT/CT images were acquired over the thorax and the abdomen, 4 h, 1 d, 2 d, and 7 d after injection. Dosimetry of the whole body and salivary glands was based on the evaluation of the counts in whole-body planar imaging. Dosimetry of the kidneys, liver, spleen, bone marrow, and tumor lesions (≤4 per patient) was based on the activity in volumes drawn on SPECT/CT images. Doses were calculated using OLINDA/EXM version 1.0. The therapeutic index (TI), or ratio between mean dose of the metastases and mean dose of the kidneys, was calculated for each patient. Results: We found the dose to the kidneys to be higher with 177Lu-rhPSMA-10.1 than with 177Lu-PSMA-I&T (0.68 ± 0.30 vs. 0.46 ± 0.10 mGy/MBq); however, 177Lu-rhPSMA-10.1 delivered an average of a 3.3 times (range, 1.2-8.3 times) higher absorbed radiation dose to individual tumor lesions. Consequently, intraindividual comparison revealed a 1.1-3.1 times higher TI for 177Lu-rhPSMA-10.1 than for 177Lu-PSMA-I&T in all evaluated patients. The effective whole-body dose was 0.038 ± 0.008 mSv/MBq for 177Lu-rhPSMA-10.1 and 0.022 ± 0.005 mSv/MBq for 177Lu-PSMA-I&T. Conclusion: Using 177Lu-rhPSMA-10.1 can significantly increase the tumor-absorbed dose and improve the TI compared with 177Lu-PSMA-I&T. An improved TI gives the flexibility to maximize tumor-absorbed doses up to a predefined renal dose limit or, in earlier disease, to reduce the radiation exposure to the kidney while still achieving an effective tumor dose. The function of at-risk organs such as the kidneys is being assessed in a prospective clinical trial.
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Affiliation(s)
- Andreas Rinscheid
- Department of Medical Physics and Radiation Protection, University Hospital Augsburg, Augsburg, Germany
| | - Alexander Gäble
- Department of Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Georgine Wienand
- Department of Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Christian Pfob
- Department of Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Alexander Dierks
- Department of Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Malte Kircher
- Department of Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Martin Trepel
- Division of Oncology, Department of Internal Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany; and
| | - Dorothea Weckermann
- Department of Urology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Constantin Lapa
- Department of Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany;
| | - Ralph A Bundschuh
- Department of Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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OuYang H, Tang Y, Yang F, Ren X, Yang J, Cao H, Yin Y. Platelet-rich plasma for the treatment of diabetic foot ulcer: a systematic review. Front Endocrinol (Lausanne) 2023; 14:1256081. [PMID: 38169990 PMCID: PMC10760804 DOI: 10.3389/fendo.2023.1256081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024] Open
Abstract
Background With the increasing incidence of diabetes, diabetic foot ulcer(DFU) has become one of the most common and serious complications in people with diabetes. DFU is associated with significant morbidity and mortality, and can also result in significant economic, social and public health burdens. Due to peripheral neuropathy, peripheral vascular disease, hyperglycemic environment, inflammatory disorders and other factors, the healing of DFU is impaired or delayed, resulting in the formation of diabetic chronic refractory ulcer. Because of these pathological abnormalities in DFU, it may be difficult to promote wound healing with conventional therapies or antibiotics, whereas platelet-rich plasma(PRP) can promote wound healing by releasing various bioactive molecules stored in platelets, making it more promising than traditional antibiotics. Therefore, the purpose of this systematic review is to summarize and analyze the efficacy of PRP in the treatment of DFU. Methods A literature search was undertaken in PubMed, CNKI, EMB-ASE, the Cochrane Library, the WanFang Database and the WeiPu Database by computer. Included controlled studies evaluating the efficacy of PRP in the treatment of diabetic foot ulcers. The data extraction and assessment are on the basis of PRISMA. Results Twenty studies were evaluated, and nineteen measures for the evaluation of the efficacy of PRP in DFU treatment were introduced by eliminating relevant duplicate measures. The efficacy measures that were repeated in various studies mainly included the rate of complete ulcer healing, the percentage of ulcer area reduction, the time required for ulcer healing, wound complications (including infection rate, amputation rate, and degree of amputation), the rate of ulcer recurrence, and the cost and duration of hospitalization for DFU, as well as subsequent survival and quality of life scores. One of the most important indicators were healing rate, ulcer area reduction and healing time. The meta-analysis found that PRP was significantly improve the healing rate(OR = 4.37, 95% CI 3.02-6.33, P < 0.001) and shorten the healing time(MD = -3.21, 95% CI -3.83 to -2.59,P < 0.001)of patients with DFU when compared to the conventional treatment, but there was no significant difference in reducing the of ulcer area(MD = 5.67, 95% CI -0.77 to 12.11,P =0.08>0.05 ). Conclusion The application of PRP to DFU can improve ulcer healing rate and shorten ulcer healing time, but more clinical data are needed to clarify some efficacy measures. At the same time, a standardized preparation process for PRP is essential.
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Affiliation(s)
- Hong OuYang
- Geriatric Diseases Institute of Chengdu, Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Yi Tang
- Geriatric Diseases Institute of Chengdu, Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Fan Yang
- Geriatric Diseases Institute of Chengdu, Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Xin Ren
- Geriatric Diseases Institute of Chengdu, Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Jing Yang
- Geriatric Diseases Institute of Chengdu, Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Hongyi Cao
- Geriatric Diseases Institute of Chengdu, Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China
| | - Yifan Yin
- Department of Nephrology, Chengdu Third People’s Hospital, Chengdu, China
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8
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Bolosov IA, Panteleev PV, Sychev SV, Khokhlova VA, Safronova VN, Toropygin IY, Kombarova TI, Korobova OV, Pereskokova ES, Borzilov AI, Ovchinnikova TV, Balandin SV. Design of Protegrin-1 Analogs with Improved Antibacterial Selectivity. Pharmaceutics 2023; 15:2047. [PMID: 37631261 PMCID: PMC10458893 DOI: 10.3390/pharmaceutics15082047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Protegrin-1 (PG-1) is a cationic β-hairpin pore-forming antimicrobial peptide having a membranolytic mechanism of action. It possesses in vitro a potent antimicrobial activity against a panel of clinically relevant MDR ESKAPE pathogens. However, its extremely high hemolytic activity and cytotoxicity toward mammalian cells prevent the further development of the protegrin-based antibiotic for systemic administration. In this study, we rationally modulated the PG-1 charge and hydrophobicity by substituting selected residues in the central β-sheet region of PG-1 to design its analogs, which retain a high antimicrobial activity but have a reduced toxicity toward mammalian cells. In this work, eight PG-1 analogs with single amino acid substitutions and five analogs with double substitutions were obtained. These analogs were produced as thioredoxin fusions in Escherichia coli. It was shown that a significant reduction in hemolytic activity without any loss of antimicrobial activity could be achieved by a single amino acid substitution, V16R in the C-terminal β-strand, which is responsible for the PG-1 oligomerization. As the result, a selective analog with a ≥30-fold improved therapeutic index was obtained. FTIR spectroscopy analysis of analog, [V16R], revealed that the peptide is unable to form oligomeric structures in a membrane-mimicking environment, in contrast to wild-type PG-1. Analog [V16R] showed a reasonable efficacy in septicemia infection mice model as a systemic antibiotic and could be considered as a promising lead for further drug design.
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Affiliation(s)
- Ilia A. Bolosov
- M. M. Shemyakin & Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, the Russian Academy of Sciences, 117997 Moscow, Russia; (I.A.B.); (P.V.P.); (T.V.O.)
| | - Pavel V. Panteleev
- M. M. Shemyakin & Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, the Russian Academy of Sciences, 117997 Moscow, Russia; (I.A.B.); (P.V.P.); (T.V.O.)
| | - Sergei V. Sychev
- M. M. Shemyakin & Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, the Russian Academy of Sciences, 117997 Moscow, Russia; (I.A.B.); (P.V.P.); (T.V.O.)
| | - Veronika A. Khokhlova
- M. M. Shemyakin & Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, the Russian Academy of Sciences, 117997 Moscow, Russia; (I.A.B.); (P.V.P.); (T.V.O.)
| | - Victoria N. Safronova
- M. M. Shemyakin & Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, the Russian Academy of Sciences, 117997 Moscow, Russia; (I.A.B.); (P.V.P.); (T.V.O.)
| | - Ilia Yu. Toropygin
- V. N. Orekhovich Research Institute of Biomedical Chemistry, 119121 Moscow, Russia
| | - Tatiana I. Kombarova
- State Research Center for Applied Microbiology & Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Olga V. Korobova
- State Research Center for Applied Microbiology & Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Eugenia S. Pereskokova
- State Research Center for Applied Microbiology & Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Alexander I. Borzilov
- State Research Center for Applied Microbiology & Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Tatiana V. Ovchinnikova
- M. M. Shemyakin & Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, the Russian Academy of Sciences, 117997 Moscow, Russia; (I.A.B.); (P.V.P.); (T.V.O.)
- Department of Biotechnology, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Sergey V. Balandin
- M. M. Shemyakin & Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, the Russian Academy of Sciences, 117997 Moscow, Russia; (I.A.B.); (P.V.P.); (T.V.O.)
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9
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Abstract
The commentary by Colombo and Rich recently published in Cancer Cell provides a timely and comprehensive review of the clinical maximum tolerated doses (MTDs) of antibody-drug conjugates (ADCs) and their corresponding small molecules/chemotherapies. The authors identified similarities between their MTDs and therefore question the historic assumptions made for ADCs, namely, that they increase the MTDs of their corresponding cytotoxic molecules. However, the authors did not address the superior anti-tumor responses of ADCs compared to their corresponding chemotherapies, as reported in clinical trials. In this point of view, we propose a revised model wherein the anti-tumor activities of ADCs and consequently their therapeutic indexes (TIs) are not solely associated with changes not only in their MTDs but also in their minimal effective doses (MEDs). In addition, when using an exposure-based TI calculation method, the superior anti-tumor activities of ADCs relative to their corresponding chemotherapy can readily be explained. We discussed the clinical and preclinical data in support of lower MEDs of ADCs and generated a revised graph illustrating the TI improvements of ADCs vs chemotherapy more accurately. We believe that our revised model can provide a blueprint for future improvements in protein engineering and chemical engineering of toxins to further advance ADC research and development.
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Affiliation(s)
- Hans-Peter Gerber
- Department of Research and Development, Codeable Therapeutics, Palo Alto, CA, USA
| | - Sanjeev Gangwar
- Department of Research and Development, Codeable Therapeutics, Palo Alto, CA, USA
| | - Alison Betts
- Department of DMPK & Modeling, Applied BioMath, Concord, MA, USA
- Department of DMPK & Modeling, Preclinical & Translational Sciences, Takeda Pharmaceutical Company Limited, Cambridge, MA, USA
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10
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Li L, Wang S, Zhou W. Balance Cell Apoptosis and Pyroptosis of Caspase-3-Activating Chemotherapy for Better Antitumor Therapy. Cancers (Basel) 2022; 15. [PMID: 36612023 DOI: 10.3390/cancers15010026] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Chemotherapy is a standard treatment modality in clinic that exerts an antitumor effect via the activation of the caspase-3 pathway, inducing cell death. While a number of chemotherapeutic drugs have been developed to combat various types of tumors, severe side effects have been their common limitation, due to the nonspecific drug biodistribution, bringing significant pain to cancer patients. Recently, scientists found that, besides apoptosis, chemotherapy could also cause cell pyroptosis, both of which have great influence on the therapeutic index. For example, cell apoptosis is, generally, regarded as the main mechanism of killing tumor cells, while cell pyroptosis in tumors promotes treatment efficacy, but in normal tissue results in toxicity. Therefore, significant research efforts have been paid to exploring the rational modulation mode of cell death induced by chemotherapy. This critical review aims to summarize recent progress in the field, focusing on how to balance cell apoptosis and pyroptosis for better tumor chemotherapy. We first reviewed the mechanisms of chemotherapy-induced cell apoptosis and pyroptosis, in which the activated caspase-3 is the key signaling molecule for regulating both types of cell deaths. Then, we systematically discussed the rationale and methods of switching apoptosis to pyroptosis for enhanced antitumor efficacy, as well as the blockage of pyroptosis to decrease side effects. To balance cell pyroptosis in tumor and normal tissues, the level of GSDME expression and tumor-targeting drug delivery are two important factors. Finally, we proposed potential future research directions, which may provide guidance for researchers in the field.
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11
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Jun SY, Kim DS, Kim YS. Expanding the Therapeutic Window of EGFR-Targeted PE24 Immunotoxin for EGFR-Overexpressing Cancers by Tailoring the EGFR Binding Affinity. Int J Mol Sci 2022; 23. [PMID: 36555466 DOI: 10.3390/ijms232415820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/23/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Immunotoxins (ITs), which are toxin-fused tumor antigen-specific antibody chimeric proteins, have been developed to selectively kill targeted cancer cells. The epidermal growth factor receptor (EGFR) is an attractive target for the development of anti-EGFR ITs against solid tumors due to its overexpression on the cell surface of various solid tumors. However, the low basal level expression of EGFR in normal tissue cells can cause undesirable on-target/off-tumor toxicity and reduce the therapeutic window of anti-EGFR ITs. Here, based on an anti-EGFR monobody with cross-reactivity to both human and murine EGFR, we developed a strategy to tailor the anti-EGFR affinity of the monobody-based ITs carrying a 24-kDa fragment of Pseudomonas exotoxin A (PE24), termed ER-PE24, to distinguish tumors that overexpress EGFR from normal tissues. Five variants of ER-PE24 were generated with different EGFR affinities (KD ≈ 0.24 nM to 104 nM), showing comparable binding activity for both human and murine EGFR. ER/0.2-PE24 with the highest affinity (KD ≈ 0.24 nM) exhibited a narrow therapeutic window of 19 pM to 93 pM, whereas ER/21-PE24 with an intermediate affinity (KD ≈ 21 nM) showed a much broader therapeutic window of 73 pM to 1.5 nM in in vitro cytotoxic assays using tumor model cell lines. In EGFR-overexpressing tumor xenograft mouse models, the maximum tolerated dose (MTD) of intravenous injection of ER/21-PE24 was found to be 0.4 mg/kg, which was fourfold higher than the MTD (0.1 mg/kg) of ER/0.2-PE24. Our study provides a strategy for the development of IT targeting tumor overexpressed antigens with basal expression in broad normal tissues by tailoring tumor antigen affinities.
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12
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Cappiello F, Casciaro B, Loffredo MR, Puglisi E, Lin Q, Yang D, Conte G, d’Angelo I, Ungaro F, Ferrera L, Barbieri R, Cresti L, Pini A, Di YP, Mangoni ML. Pulmonary Safety Profile of Esc Peptides and Esc-Peptide-Loaded Poly(lactide-co-glycolide) Nanoparticles: A Promising Therapeutic Approach for Local Treatment of Lung Infectious Diseases. Pharmaceutics 2022; 14:2297. [PMID: 36365116 PMCID: PMC9697339 DOI: 10.3390/pharmaceutics14112297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 07/30/2023] Open
Abstract
In recent years, we have discovered Esc(1-21) and its diastereomer (Esc peptides) as valuable candidates for the treatment of Pseudomonas lung infection, especially in patients with cystic fibrosis (CF). Furthermore, engineered poly(lactide-co-glycolide) (PLGA) nanoparticles (NPs) were revealed to be a promising pulmonary delivery system of antimicrobial peptides. However, the "ad hoc" development of novel therapeutics requires consideration of their stability, tolerability, and safety. Hence, by means of electrophysiology experiments and preclinical studies on healthy mice, we demonstrated that neither Esc peptides or Esc-peptide-loaded PLGA NPs significantly affect the integrity of the lung epithelium, nor change the global gene expression profile of lungs of treated animals compared to those of vehicle-treated animals. Noteworthy, the Esc diastereomer endowed with the highest antimicrobial activity did not provoke any pulmonary pro-inflammatory response, even at a concentration 15-fold higher than the efficacy dosage 24 h after administration in the free or encapsulated form. The therapeutic index was ≥70, and the peptide was found to remain available in the bronchoalveolar lavage of mice, after two days of incubation. Overall, these studies should open an avenue for a new up-and-coming pharmacological approach, likely based on inhalable peptide-loaded NPs, to address CF lung disease.
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Affiliation(s)
- Floriana Cappiello
- Department of Biochemical Sciences, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Sapienza University of Rome, 00185 Rome, Italy
| | - Bruno Casciaro
- Department of Biochemical Sciences, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Rosa Loffredo
- Department of Biochemical Sciences, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Sapienza University of Rome, 00185 Rome, Italy
| | - Elena Puglisi
- Department of Biochemical Sciences, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Sapienza University of Rome, 00185 Rome, Italy
| | - Qiao Lin
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Dandan Yang
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Gemma Conte
- Department of Pharmacy, University of Napoli Federico II, 80131 Napoli, Italy
| | - Ivana d’Angelo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Francesca Ungaro
- Department of Pharmacy, University of Napoli Federico II, 80131 Napoli, Italy
| | - Loretta Ferrera
- U.O.C. Genetica Medica, IRCCS, Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Raffaella Barbieri
- Biophysic Institute, Consiglio Nazionale delle Ricerche (CNR), 16149 Genoa, Italy
| | - Laura Cresti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Alessandro Pini
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Yuanpu Peter Di
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Maria Luisa Mangoni
- Department of Biochemical Sciences, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Sapienza University of Rome, 00185 Rome, Italy
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13
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Abstract
Despite the numerous scientific and technological advances made within the last decade the attrition rates for new drug discovery remain as high as 95% for anticancer drugs. Recent drug development has been in part guided by Lipinski’s Rule of 5 (Ro5) even though many approved drugs do not comply to these rules. With Covid-19 vaccine development strategy dramatically accelerating drug development perhaps it is timely to question the generic drug development process itself to find a more efficient, cost effective, and successful approach. It is widely believed that drugs permeate cells via two methods: phospholipid bilayer diffusion and carrier mediated transporters. However, emerging evidence suggests that carrier mediated transport may be the primary mechanism of drug uptake and not diffusion as long believed. Computational biology increasingly assists drug design to achieve desirable absorption, distribution, metabolism, elimination and toxicity (ADMET) properties. Perfecting drug entry into target cells as a prerequisite to intracellular drug action is a logical and compelling route and is expected to reduce drug attrition rates, particularly gaining favour amongst chronic lifelong therapeutics. Novel drug development is rapidly expanding from the utilisation of beyond the rule of five (bRo5) to pulsatile drug delivery systems and fragment based drug design. Utilising transporters as drug targets and advocating bRo5 molecules may be the solution to increasing drug specificity, reducing dosage and toxicity and thus revolutionising drug development. This review explores the development of cell surface transporter exploitation in drug development and the relationship with improved therapeutic index.
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Affiliation(s)
- Natasha Carmichael
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Philip J R Day
- School of Biological Sciences and Manchester Institute of Biotechnology, The University of Manchester, Manchester, United Kingdom.,Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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14
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Moghaddasi L, Reid P, Bezak E, Marcu LG. Radiobiological and Treatment-Related Aspects of Spatially Fractionated Radiotherapy. Int J Mol Sci 2022; 23:3366. [PMID: 35328787 PMCID: PMC8954016 DOI: 10.3390/ijms23063366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/13/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
The continuously evolving field of radiotherapy aims to devise and implement techniques that allow for greater tumour control and better sparing of critical organs. Investigations into the complexity of tumour radiobiology confirmed the high heterogeneity of tumours as being responsible for the often poor treatment outcome. Hypoxic subvolumes, a subpopulation of cancer stem cells, as well as the inherent or acquired radioresistance define tumour aggressiveness and metastatic potential, which remain a therapeutic challenge. Non-conventional irradiation techniques, such as spatially fractionated radiotherapy, have been developed to tackle some of these challenges and to offer a high therapeutic index when treating radioresistant tumours. The goal of this article was to highlight the current knowledge on the molecular and radiobiological mechanisms behind spatially fractionated radiotherapy and to present the up-to-date preclinical and clinical evidence towards the therapeutic potential of this technique involving both photon and proton beams.
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Affiliation(s)
- Leyla Moghaddasi
- Department of Medical Physics, Austin Health, Ballarat, VIC 3350, Australia;
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5001, Australia;
| | - Paul Reid
- Radiation Health, Environment Protection Authority, Adelaide, SA 5000, Australia;
| | - Eva Bezak
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5001, Australia;
- Cancer Research Institute, University of South Australia, Adelaide, SA 5001, Australia
| | - Loredana G. Marcu
- Cancer Research Institute, University of South Australia, Adelaide, SA 5001, Australia
- Faculty of Informatics and Science, University of Oradea, 1 Universitatii Str., 410087 Oradea, Romania
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15
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Shah JC, Hong J. Model for Long Acting Injectables (Depot Formulation) Based on Pharmacokinetics and Physical Chemical Properties. AAPS J 2022; 24:44. [PMID: 35298711 DOI: 10.1208/s12248-022-00695-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
The objective was to develop a model to a priori identify the most suitable depot technology for a candidate based upon its therapeutic index (TI), pharmacokinetics (PK), and physical chemical properties. A depot map of release rates needed to achieve target PK in TI against release rates predicted based on intrinsic dissolution rate (IDR) and particle size (PS) clearly identified three zones: (a) products and candidates around the line of identity for which suspension is the appropriate depot technology, (b) area to the right of line of identity in which depot candidates would require a controlled release technology such as PLGA microspheres since in vivo release rate needed for PK in TI is significantly lower than predicted based on IDR and PS, and (c) area to the left of the line of identity where IDR is not sufficient to achieve target in vivo release rate for PK in TI and hence enhanced dissolution is needed such as with nanoparticles. Dose-solubility technology map of approved depot products and candidates showed clusters of products around a depot technology such as suspensions and microspheres, for drugs with high dose/low solubility and low dose/high solubility compounds, respectively. Novel PK-based computational tool showed how all combinations of depot doses and release rate constants for a candidate can be calculated to achieve plasma levels within the TI bounded by minimum effective and minimum toxic concentrations (MEC and MTC). The PK predictions for several drugs such as estradiol, risperidone, medroxyprogesterone acetate (MPA), and ziprasidone showed how these predictions can guide scientists to target specific depot doses and release rates into the depot formulation. In parallel, IDR of depot compounds clearly showed differentiation of compounds by successful depot technologies to achieve target dose and duration. For drugs with IDR between 0.1 and 1 mg/h/cm2, aqueous suspension has successfully delivered depot PK profile, while for candidates with IDRs greater than 1 mg/h/cm2, controlled release technology such as microsphere or in situ gel was required. The framework, prediction tools, and depot map will reduce the need for semi-empirical formulation work and preclinical studies to design depot formulations. Graphical Abstract.
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Affiliation(s)
- Jaymin C Shah
- Pharmaceutical Sciences Small Molecule, Pfizer Worldwide Research, Development and Medical, 441 Eastern Point Road, Groton, Connecticut, 06340, USA.
| | - Jinyang Hong
- Pharmaceutical Sciences Small Molecule, Pfizer Worldwide Research, Development and Medical, 441 Eastern Point Road, Groton, Connecticut, 06340, USA
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16
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Kim H, Huang Y, Zhao N, Wang YH, Sakhamuri S, Chopra S, Hooshdaran N, Sriram R, Aggarwal R, Evans MJ. In Vivo Profiling with 18F-YJH08 Reveals Diverse Tissue Patterns of Antagonist/Glucocorticoid Receptor Interactions. Mol Pharm 2022; 19:704-709. [PMID: 35049307 DOI: 10.1021/acs.molpharmaceut.1c00833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Demonstrating target engagement in vivo is an important milestone in drug development, both to establish on target, on tissue interactions but also to identify potentially undesirable off tissue binding. The glucocorticoid receptor (GR) is a long-studied yet vexing drug target that has recently re-emerged as a potential druggable driver of many solid tumor types including breast and prostate cancer, and several antagonists are currently in early phase clinical trials. Since GR is also ubiquitously expressed in normal tissues, understanding antagonist/GR interactions in normal tissues and tumor is crucial to defining a therapeutic index. Herein, we demonstrate that the GR radioligand 18F-YJH08 can map drug/GR engagement in vivo. Profiling target engagement in vivo showed that the GR antagonists RU486 (mifepristone) and CORT125281 engaged GR in fewer normal tissues compared to ORIC-101 or the agonist dexamethasone. Furthermore, 18F-YJH08 detected GR in human prostate cancer tumor models and measured receptor binding by RU486. In summary, these data show for the first time that antagonist/GR interactions can be measured in vivo with 18F-YJH08, a finding with clinical relevance as GR antagonists and 11C-YJH08 are currently in clinical trials.
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Affiliation(s)
- Hyunjung Kim
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States
| | - Yangjie Huang
- Fujian Engineering Research Center of New Chinese lacquer Material, Ocean College, Minjiang University, Fuzhou 350108, People's Republic of China
| | - Ning Zhao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States
| | - Yung-Hua Wang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States
| | - Sasank Sakhamuri
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States
| | - Shalini Chopra
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States
| | - Nima Hooshdaran
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States
| | - Rahul Aggarwal
- Department of Medicine, University of California, San Francisco, San Francisco, California 94158, United States.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California 94158, United States
| | - Michael J Evans
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California 94158, United States.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California 94158, United States.,Department of Pharmaceutical Chemistry, University of California, San Francisco San Francisco, California 94158, United States
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17
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Matsuda Y, Seki T, Yamada K, Ooba Y, Takahashi K, Fujii T, Kawaguchi S, Narita T, Nakayama A, Kitahara Y, Mendelsohn BA, Okuzumi T. Chemical Site-Specific Conjugation Platform to Improve the Pharmacokinetics and Therapeutic Index of Antibody-Drug Conjugates. Mol Pharm 2021; 18:4058-4066. [PMID: 34579528 DOI: 10.1021/acs.molpharmaceut.1c00473] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To overcome a lack of selectivity during the chemical modification of native non-engineered antibodies, we have developed a technology platform termed "AJICAP" for the site-specific chemical conjugation of antibodies through the use of a class of IgG Fc-affinity reagents. To date, a limited number of antibody-drug conjugates (ADCs) have been synthesized via this approach, and no toxicological study was reported. Herein, we describe the compatibility and robustness of AJICAP technology, which enabled the synthesis of a wide variety of ADCs. A stability assessment of a thiol-modified antibody synthesized by AJICAP technology indicated no appreciable increase in aggregation or decomposition upon prolonged storage, indicating that the unexpectedly stable thiol intermediate has a great potential intermediate for payload or linker screening or large-scale manufacturing. Payload conjugation with this stable thiol intermediate generated several AJICAP-ADCs. In vivo xenograft studies indicated that the AJICAP-ADCs displayed significant tumor inhibition comparable to benchmark ADC Kadcyla. Furthermore, a rat pharmacokinetic analysis and toxicology study indicated an increase in the maximum tolerated dose, demonstrating an expansion of the AJICAP-ADC therapeutic index, compared with stochastic conjugation technology. This is the first report of the therapeutic index estimation of site-specific ADCs produced by utilizing Fc affinity reagent conjugation. The described site-specific conjugation technology is a powerful platform to enable next-generation ADCs through reduced heterogeneity and enhanced therapeutic index.
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Affiliation(s)
- Yutaka Matsuda
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan.,Ajinomoto Bio-Pharma Services, 11040 Roselle Street, San Diego, California 92121, United States
| | - Takuya Seki
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Kei Yamada
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Yuri Ooba
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Kazutoshi Takahashi
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Tomohiro Fujii
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Sayaka Kawaguchi
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Takahiro Narita
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Akira Nakayama
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Yoshiro Kitahara
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
| | - Brian A Mendelsohn
- Ajinomoto Bio-Pharma Services, 11040 Roselle Street, San Diego, California 92121, United States
| | - Tatsuya Okuzumi
- Ajinomoto Co., Inc., 1-1, Suzuki-Cho, Kawasaki-Ku, Kawasaki-Shi, Kanagawa 210-8681, Japan
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18
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Ri M, Kumagai K, Namikawa K, Atsumi S, Hayami M, Makuuchi R, Ida S, Ohashi M, Sano T, Nunobe S. Is proximal gastrectomy indicated for locally advanced cancer in the upper third of the stomach? Ann Gastroenterol Surg 2021; 5:767-775. [PMID: 34755008 PMCID: PMC8560615 DOI: 10.1002/ags3.12486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/07/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023] Open
Abstract
AIM To treat upper third gastric cancer, proximal gastrectomy (PG), a function-preserving procedure, is recommended for early lesions when at least half the distal stomach can be preserved, while total gastrectomy (TG) is standard for locally advanced lesions. Oncological feasibility, when applying PG for such lesions, remains unknown. METHODS We reviewed patients undergoing TG for clinical (c) T2-T4 upper third gastric cancer between 2006 and 2015. Preoperative tumor locations were further classified into the cardia, fornix, and gastric body based on endoscopic findings. The metastatic rate and therapeutic value index for lymph node (LN) dissection were determined, and characteristics of patients with distal LN (No. 4d, 5, and 6) metastasis (DLNM) were reviewed. In addition, patients with pathological tumor invasion to the middle third (M) region were investigated. RESULTS We studied 167 patients. There were 8 (4.8%) with DLNM and 41 (24.6%) with pathological tumor invasion to the M region. As to regional stations, therapeutic indices for LN dissection at stations No. 4d, 5, 6, and 12a were zero or extremely low. No DLNM was detected in cT2 lesions or cT3/T4 lesions located within the cardia and/or the fornix. In addition, none of the lesions located within the cardia and/or the fornix by preoperative endoscopy extended to the M region in the pathological specimen. CONCLUSIONS For upper third gastric cancer, PG without No. 12a dissection might be acceptable for cT2-T4 lesions located within the cardia and/or the fornix when considering the risk of DLNM and cancer-positivity in the distal stump.
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Affiliation(s)
- Motonari Ri
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Koshi Kumagai
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Ken Namikawa
- Department of GastroenterologyCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Shinichiro Atsumi
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Masaru Hayami
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Rie Makuuchi
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Satoshi Ida
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Manabu Ohashi
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Takeshi Sano
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Souya Nunobe
- Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
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Vasquez G, Migawa MT, Wan WB, Low A, Tanowitz M, Swayze EE, Seth PP. Evaluation of Phosphorus and Non-Phosphorus Neutral Oligonucleotide Backbones for Enhancing Therapeutic Index of Gapmer Antisense Oligonucleotides. Nucleic Acid Ther 2021; 32:40-50. [PMID: 34698585 DOI: 10.1089/nat.2021.0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The phosphorothioate (PS) linkage in an essential component of therapeutic oligonucleotides. PS in the DNA region of gapmer antisense oligonucleotides (ASOs) supports RNaseH1 activity and enhances nuclease stability. PS also promotes binding to plasma, cell surface, and intracellular proteins, which facilitates tissue distribution, cellular uptake, and endosomal escape of PS ASOs. We recently showed that site-specific replacement of PS in the DNA gap with methoxylpropyl phosphonate (MOP) linkages can enhance the therapeutic index of gapmer ASOs. In this article, we explored 18 phosphorus- and non-phosphorus-based neutral backbone modifications to determine the structure-activity relationship of neutral linkages for enhancing therapeutic index. Replacing MOP with other alkyl phosphonate and phosphotriester linkages enhanced therapeutic index, but these linkages were susceptible to chemical degradation during oligonucleotide deprotection from solid supports following synthesis. Replacing MOP with non-phosphorus linkages resulted in improved chemical stability, but these linkages were introduced into ASOs as nucleotide dimers, which limits their versatility. Overall, linkages such as isopropyl and isobutyl phosphonates and O-isopropyl and O-tetrahydrofuranosyl phosphotriesters, formacetal, and C3-amide showed improved activity in mice relative to MOP. Our data suggest that site-specific incorporation of any neutral backbone linkage can improve therapeutic index, but the size, hydrophobicity, and RNA-binding affinity of the linkage influence ASO activity.
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Affiliation(s)
- Guillermo Vasquez
- Department of Medicinal Chemistry, Ionis Pharmaceuticals, Carlsbad, California, USA
| | - Michael T Migawa
- Department of Medicinal Chemistry, Ionis Pharmaceuticals, Carlsbad, California, USA
| | - W Brad Wan
- Department of Medicinal Chemistry, Ionis Pharmaceuticals, Carlsbad, California, USA
| | - Audrey Low
- Department of Medicinal Chemistry, Ionis Pharmaceuticals, Carlsbad, California, USA
| | - Michael Tanowitz
- Department of Medicinal Chemistry, Ionis Pharmaceuticals, Carlsbad, California, USA
| | - Eric E Swayze
- Department of Medicinal Chemistry, Ionis Pharmaceuticals, Carlsbad, California, USA
| | - Punit P Seth
- Department of Medicinal Chemistry, Ionis Pharmaceuticals, Carlsbad, California, USA
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20
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Surnar B, Shah AS, Guin S, Kolishetti N, Fornoni A, Dhar S. Blending of Designer Synthetic Polymers to a Dual Targeted Nanoformulation for SARS-CoV-2 Associated Kidney Damage. Biomacromolecules 2021; 22:4244-4250. [PMID: 34492195 PMCID: PMC8442611 DOI: 10.1021/acs.biomac.1c00799] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/09/2021] [Indexed: 11/28/2022]
Abstract
As the COVID-19 pandemic has continued to spread, studies have shown that hospitalized COVID-19 patients are at significant risk for developing acute kidney injury (AKI), which can cause increased morbidity, the need for dialysis treatment, chronic kidney diseases, and even death. In this paper, we present a proof-of-concept study for the utilization of combination therapeutic-loaded dual-targeted biodegradable nanoparticles (NPs) to treat concurrent AKI and COVID-19 in patients by delivering the therapeutics across the gut epithelial barrier and to the kidney, in order to lower the viral load as well as reduce the symptoms of AKI. Despite recent vaccination efforts and the end of the COVID-19 pandemic in sight, problems related to the long-term effects of COVID-19 will continue to persist, including impacts on patients suffering from AKI and other chronic renal conditions. Therefore, the dual-targeted blended polymeric NP developed in this study to treat concurrent COVID-19 infection and AKI is a useful proof-of-concept nanoplatform for future treatments of these complications.
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Affiliation(s)
- Bapurao Surnar
- Department of Biochemistry and Molecular Biology, Leonard M. Miller School of Medicine, University of Miami, 1011 NW 15 Street, Miami, FL 33136
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, 1011 NW 15 Street, Miami, FL 33136
| | - Anuj S. Shah
- Department of Biochemistry and Molecular Biology, Leonard M. Miller School of Medicine, University of Miami, 1011 NW 15 Street, Miami, FL 33136
| | - Subham Guin
- Department of Biochemistry and Molecular Biology, Leonard M. Miller School of Medicine, University of Miami, 1011 NW 15 Street, Miami, FL 33136
| | - Nagesh Kolishetti
- Department of Immunology and Nano-Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199
| | - Alessia Fornoni
- Katz Family Division of Nephrology and Hypertension, Department of Medicine University of Miami Miller School of Medicine, Miami, FL 33136
- Peggy and Harold Katz Family Drug Discovery Center, Department of Medicine University of Miami Miller School of Medicine, Miami, FL 33136
| | - Shanta Dhar
- Department of Biochemistry and Molecular Biology, Leonard M. Miller School of Medicine, University of Miami, 1011 NW 15 Street, Miami, FL 33136
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, 1011 NW 15 Street, Miami, FL 33136
- Department of Chemistry, University of Miami, 1301 Memorial Drive, Coral Gables, Florida 33146, United States
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21
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Li M, Zhang Q, Yang K. Role of MRI-Based Functional Imaging in Improving the Therapeutic Index of Radiotherapy in Cancer Treatment. Front Oncol 2021; 11:645177. [PMID: 34513659 PMCID: PMC8429950 DOI: 10.3389/fonc.2021.645177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/22/2020] [Accepted: 07/30/2021] [Indexed: 02/05/2023] Open
Abstract
Advances in radiation technology, such as intensity-modulated radiation therapy (IMRT), have largely enabled a biological dose escalation of the target volume (TV) and reduce the dose to adjacent tissues or organs at risk (OARs). However, the risk of radiation-induced injury increases as more radiation dose utilized during radiation therapy (RT), which predominantly limits further increases in TV dose distribution and reduces the local control rate. Thus, the accurate target delineation is crucial. Recently, technological improvements for precise target delineation have obtained more attention in the field of RT. The addition of functional imaging to RT can provide a more accurate anatomy of the tumor and normal tissues (such as location and size), along with biological information that aids to optimize the therapeutic index (TI) of RT. In this review, we discuss the application of some common MRI-based functional imaging techniques in clinical practice. In addition, we summarize the main challenges and prospects of these imaging technologies, expecting more inspiring developments and more productive research paths in the near future.
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Affiliation(s)
- Mei Li
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qin Zhang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Kaixuan Yang
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
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22
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Abstract
Introduction: Plasma protein binding (PPB) remains a controversial topic in drug discovery and development. Fraction unbound (fu) is a critical parameter that needs to be measured accurately, because it has significant impacts on the predictions of drug-drug interactions (DDI), estimations of therapeutic indices (TI), and developments of PK/PD relationships. However, it is generally not advisable to change PPB through structural modifications, because PPB on its own has little relevance for in vivo efficacy.Areas covered: PPB fundamentals are discussed including the three main classes of drug binding proteins (i.e., albumin, alpha1-acid glycoprotein, and lipoproteins) and their physicochemical properties, in vivo half-life, and synthesis rate. State-of-the-art methodologies for PPB are highlighted. Applications of PPB in drug discovery and development are presented.Expert opinion: PPB is an old topic in pharmacokinetics, but there are still many misconceptions. Improving the accuracy of PPB for highly bound compounds is an ongoing effort in the field with high priority. As the field continues to generate high quality data, the regulatory agencies will increase their confidence in our ability to accurately measure PPB of highly bound compounds, and experimental fu values below 0.01 will more likely be used for DDI predictions in the future.
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Affiliation(s)
- Li Di
- Pharmacokinetics, Dynamics and Metabolism, Pfizer Worldwide Research and Development, Groton, CT, US
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23
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Abstract
The popularity of antibody drug conjugates (ADCs) has increased in recent years, mainly due to their unrivalled efficacy and specificity over chemotherapy agents. The success of the ADC is partly based on the stability and successful cleavage of selective linkers for the delivery of the payload. The current research focuses on overcoming intrinsic shortcomings that impact the successful development of ADCs. This review summarizes marketed and recently approved ADCs, compares the features of various linker designs and payloads commonly used for ADC conjugation, and outlines cancer specific ADCs that are currently in late-stage clinical trials for the treatment of cancer. In addition, it addresses the issues surrounding drug resistance and strategies to overcome resistance, the impact of a narrow therapeutic index on treatment outcomes, the impact of drug-antibody ratio (DAR) and hydrophobicity on ADC clearance and protein aggregation.
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Affiliation(s)
| | - Veysel Kayser
- Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
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24
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Cruz-Ramírez OU, Valenzuela-Salas LM, Blanco-Salazar A, Rodríguez-Arenas JA, Mier-Maldonado PA, García-Ramos JC, Bogdanchikova N, Pestryakov A, Toledano-Magaña Y. Antitumor Activity against Human Colorectal Adenocarcinoma of Silver Nanoparticles: Influence of [Ag]/[PVP] Ratio. Pharmaceutics 2021; 13:1000. [PMID: 34371692 PMCID: PMC8308985 DOI: 10.3390/pharmaceutics13071000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
Silver nanoparticles (AgNPs) not only have shown remarkable results as antimicrobial and antiviral agents but also as antitumor agents. This work reports the complete characterization of five polyvinylpyrrolidone-coated AgNP (PVP-AgNP) formulations, their cytotoxic activity against human colon tumor cells (HCT-15), their cytotoxic effect on primary mouse cultures, and their lethal dose on BALB/c mice. The evaluated AgNP formulations have a composition within the ranges Ag: 1.14-1.32% w/w, PVP: 19.6-24.5% and H2O: 74.2-79.2% with predominant spherical shape within an average size range of 16-30 nm according to transmission electron microscopy (TEM). All formulations assessed increase mitochondrial ROS concentration and induce apoptosis as the leading death pathway on HCT-15 cells. Except for AgNP1, the growth inhibition potency of AgNP formulations of human colon tumor cancer cells (HCT-15) is 34.5 times higher than carboplatin, one of the first-line chemotherapy agents. Nevertheless, 5-10% of necrotic events, even at the lower concentration evaluated, were observed. The cytotoxic selectivity was confirmed by evaluating the cytotoxic effect on aorta, spleen, heart, liver, and kidney primary cultures from BALB/c mice. Despite the cytotoxic effects observed in vitro, the lethal dose and histopathological analysis showed the low toxicity of these formulations (all of them on Category 4 of the Globally Harmonized System of Classification and Labelling of Chemicals) and minor damage observed on analyzed organs. The results provide an additional example of the rational design of safety nanomaterials with antitumor potency and urge further experiments to complete the preclinical studies for these AgNP formulations.
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Affiliation(s)
- Omar Ulises Cruz-Ramírez
- Centro de Nanociencias y Nanotecnología, Universidad Nacional Autónoma de México, Ensenada 22860, Mexico; (O.U.C.-R.); (N.B.)
| | - Lucía Margarita Valenzuela-Salas
- Facultad de Ciencias de la Salud Unidad Valle de las Palmas, Universidad Autónoma de Baja California, Tijuana 22260, Mexico; (L.M.V.-S.); (P.A.M.-M.)
| | - Alberto Blanco-Salazar
- Programa de Maestría y Doctorado en Ciencias e Ingeniería, Facultad de Ciencias, Universidad Autónoma de Baja California, Ensenada 22860, Mexico; (A.B.-S.); (J.A.R.-A.)
- Escuela de Ciencias de la Salud Unidad Valle Dorado, Universidad Autónoma de Baja California, Ensenada 22890, Mexico
| | - José Antonio Rodríguez-Arenas
- Programa de Maestría y Doctorado en Ciencias e Ingeniería, Facultad de Ciencias, Universidad Autónoma de Baja California, Ensenada 22860, Mexico; (A.B.-S.); (J.A.R.-A.)
- Escuela de Ciencias de la Salud Unidad Valle Dorado, Universidad Autónoma de Baja California, Ensenada 22890, Mexico
| | - Paris A. Mier-Maldonado
- Facultad de Ciencias de la Salud Unidad Valle de las Palmas, Universidad Autónoma de Baja California, Tijuana 22260, Mexico; (L.M.V.-S.); (P.A.M.-M.)
| | - Juan Carlos García-Ramos
- Escuela de Ciencias de la Salud Unidad Valle Dorado, Universidad Autónoma de Baja California, Ensenada 22890, Mexico
| | - Nina Bogdanchikova
- Centro de Nanociencias y Nanotecnología, Universidad Nacional Autónoma de México, Ensenada 22860, Mexico; (O.U.C.-R.); (N.B.)
| | - Alexey Pestryakov
- Research School of Chemistry & Applied Biomedical Sciences, National Research Tomsk Polytechnic University, 634050 Tomsk, Russia;
| | - Yanis Toledano-Magaña
- Escuela de Ciencias de la Salud Unidad Valle Dorado, Universidad Autónoma de Baja California, Ensenada 22890, Mexico
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Jaisser F, Tan X, Chi S, Liu J, Wang P, Bush M, Benn V, Yang YF, Zhang J. The Non-Steroidal Mineralocorticoid Receptor Antagonist KBP-5074 Limits Albuminuria and has Improved Therapeutic Index Compared With Eplerenone in a Rat Model With Mineralocorticoid-Induced Renal Injury. Front Pharmacol 2021; 12:604928. [PMID: 34248613 PMCID: PMC8264204 DOI: 10.3389/fphar.2021.604928] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 09/10/2020] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
The therapeutic indices (TIs) and efficacy of the non-steroidal mineralocorticoid receptor antagonist (MRA) KBP-5074 and steroidal MRA eplerenone were evaluated in a uninephrectomized Sprague Dawley rat model of aldosterone-mediated renal disease. In two parallel studies, rats were placed on a high-salt diet and received aldosterone by osmotic mini-pump infusion over the course of 27 days. The urinary albumin-to-creatinine ratio (UACR) was evaluated after 7, 14, and 26 days of treatment. Serum K+ was evaluated after 14 and 27 days of treatment. Urinary Na+, urinary K+, and urinary Na+/K+ ratio were evaluated after 7, 14, and 26 days of treatment. The TI was calculated for each drug as the ratio of the concentration of drug producing 50% of maximum effect (EC50) for increasing serum K+ to the EC50 for lowering UACR. The TIs were 24.5 for KBP-5074 and 0.620 for eplerenone, resulting in a 39-fold improved TI for KBP-5074 compared with eplerenone. Aldosterone treatment increased UACR, decreased serum K+, and decreased urinary Na+ relative to sham-operated controls that did not receive aldosterone infusion in both studies, validating the aldosterone/salt renal injury model. KBP-5074 prevented the increase in UACR at 0.5, 1.5, and 5 mg/kg BID while eplerenone did so only at the two highest doses of 50 and 450 mg/kg BID. Both KBP-5074 and eplerenone blunted the reduction in serum K+ seen in the aldosterone treatment group, with significant increases in serum K+ at the high doses only (5 mg/kg and 450 mg/kg BID, respectively). Additionally, the urinary Na+ and Na+/K+ ratio significantly increased at the middle and high doses of KBP-5074, but only at the highest dose of eplerenone. These results showed increased TI and efficacy for KBP-5074 compared with eplerenone over a wider therapeutic window.
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Affiliation(s)
- Frédéric Jaisser
- INSERM UMRS1138, Sorbonne Université, Université de Paris, Centre de Recherche des Cordeliers, Paris, France
| | | | | | | | - Ping Wang
- KBP BioSciences Co., Ltd., Shandong, China
| | - Mark Bush
- Nuventra Inc., Durham, NC, United States
| | - Vincent Benn
- KBP BioSciences USA Inc., Princeton, NJ, United States
| | - Y Fred Yang
- KBP BioSciences USA Inc., Princeton, NJ, United States
| | - Jay Zhang
- KBP BioSciences USA Inc., Princeton, NJ, United States
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26
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Ramchuran EJ, Pérez-Guillén I, Bester LA, Khan R, Albericio F, Viñas M, de la Torre BG. Super-Cationic Peptide Dendrimers-Synthesis and Evaluation as Antimicrobial Agents. Antibiotics (Basel) 2021; 10:695. [PMID: 34200662 PMCID: PMC8228121 DOI: 10.3390/antibiotics10060695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
Microbial infections are a major public health concern. Antimicrobial peptides (AMPs) have been demonstrated to be a plausible alternative to the current arsenal of drugs that has become inefficient due to multidrug resistance. Herein we describe a new AMP family, namely the super-cationic peptide dendrimers (SCPDs). Although all members of the series exert some antibacterial activity, we propose that special attention should be given to (KLK)2KLLKLL-NH2 (G1KLK-L2KL2), which shows selectivity for Gram-negative bacteria and virtually no cytotoxicity in HepG2 and HEK293. These results reinforce the validity of the SCPD family as a valuable class of AMP and support G1KLK-L2KL2 as a strong lead candidate for the future development of an antibacterial agent against Gram-negative bacteria.
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Affiliation(s)
- Estelle J. Ramchuran
- Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (E.J.R.); (L.A.B.)
- Peptide Sciences Laboratory, School of Chemistry and Physics, University of KwaZulu-Natal, University Road, Westville, Durban 4001, South Africa
| | - Isabel Pérez-Guillén
- Lab Molecular Microbiology & Antimicrobials, Department of Pathology and Experimental Therapeutics, Medical School-IDIBELL, University of Barcelona, Hospitalet, 08907 Barcelona, Spain;
| | - Linda A. Bester
- Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (E.J.R.); (L.A.B.)
| | - René Khan
- Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban 4001, South Africa;
| | - Fernando Albericio
- Peptide Sciences Laboratory, School of Chemistry and Physics, University of KwaZulu-Natal, University Road, Westville, Durban 4001, South Africa
- Institute for Advanced Chemistry of Catalonia (IQAC-CSIC), 08034 Barcelona, Spain
- CIBER-BBN, Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Department of Organic Chemistry, University of Barcelona, 08028 Barcelona, Spain
| | - Miguel Viñas
- Lab Molecular Microbiology & Antimicrobials, Department of Pathology and Experimental Therapeutics, Medical School-IDIBELL, University of Barcelona, Hospitalet, 08907 Barcelona, Spain;
| | - Beatriz G. de la Torre
- KRISP, College of Health Sciences, University of KwaZulu-Natal, Westville, Durban 4001, South Africa
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Chrząszcz M, Miazga-Karska M, Klimek K, Granica S, Tchórzewska D, Ginalska G, Szewczyk K. Extracts from Cephalaria Uralensis (Murray) Roem. & Schult. and Cephalaria Gigantea (Ledeb.) Bobrov as Potential Agents for Treatment of Acne Vulgaris: Chemical Characterization and In Vitro Biological Evaluation. Antioxidants (Basel) 2020; 9:E796. [PMID: 32859126 PMCID: PMC7555732 DOI: 10.3390/antiox9090796] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/20/2020] [Revised: 08/16/2020] [Accepted: 08/20/2020] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to compare the chemical composition, as well as antioxidant, anti-inflammatory, antiacne, and cytotoxic activites of various extracts of Cephalaria gigantea and C. uralensis. It is worth underlining that we are the first to characterize the composition and evaluate the biological properties of extracts from Cephalaria gigantea and C. uralensis. Thus, the LC-DAD-MS3 analysis revealed the presence of 41 natural products in studied extracts. The 5-O-caffeoylquinic acid, isoorinetin, and swertiajaponin were the main detected compounds. Among the tested samples, ethanol extract of the aerial parts of C. uralensis (CUE) possessed the most suitable biological properties. It exhibited moderate ability to scavenge free radicals and good capacity to inhibit cyclooxygenase-1, as well as cyclooxygenase-2. Moreover, CUE possessed moderate antibacterial activity against all tested bacterial strains (S. aureus, S. epidermidis, and P. acnes), and importantly, it was non-toxic towards normal skin fibroblasts. Taking into account the value of calculated therapeutic index (>10), it is worth noting that CUE can be subjected to in vivo study. Thus, CUE constitutes a very promising antiacne agent.
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Affiliation(s)
- Małgorzata Chrząszcz
- Department of Pharmaceutical Botany, Medical University of Lublin, 1 Chodźki Str., 20-093 Lublin, Poland;
| | - Małgorzata Miazga-Karska
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 1 Chodźki Str., 20-093 Lublin, Poland; (M.M.-K.); (K.K.); (G.G.)
| | - Katarzyna Klimek
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 1 Chodźki Str., 20-093 Lublin, Poland; (M.M.-K.); (K.K.); (G.G.)
| | - Sebastian Granica
- Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Dorota Tchórzewska
- Department of Plant Anatomy and Cytology, Maria Curie-Skłodowska University, Akademicka 19, 20-033 Lublin, Poland;
| | - Grażyna Ginalska
- Department of Biochemistry and Biotechnology, Medical University of Lublin, 1 Chodźki Str., 20-093 Lublin, Poland; (M.M.-K.); (K.K.); (G.G.)
| | - Katarzyna Szewczyk
- Department of Pharmaceutical Botany, Medical University of Lublin, 1 Chodźki Str., 20-093 Lublin, Poland;
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28
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Azuma E, Choda N, Odaki M, Yano Y, Matsuzaki K. Improvement of Therapeutic Index by the Combination of Enhanced Peptide Cationicity and Proline Introduction. ACS Infect Dis 2020; 6:2271-2278. [PMID: 32786298 DOI: 10.1021/acsinfecdis.0c00387] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Antimicrobial peptides (AMPs) are promising candidates for new therapeutics to combat the emergence of an increasing number of multidrug-resistant pathogens. However, a major obstacle to the systemic application of AMPs is their possible toxicity. In this study, we improved the therapeutic index of the typical AMP F5W-magainin 2 by simultaneously introducing positive charges (+9-+10) and Pro residues. The former and latter contributed to enhanced antimicrobial activity and reduced cytotoxicity, respectively. The results were sensitive to the positions of Pro substitution. The antimicrobial mechanism was considered to involve both membrane permeabilization and DNA binding. The latter was affected by the peptide charge but not the presence of Pro. The neutralization of lipopolysaccharides, another important role of AMPs, was not very sensitive to either the peptide charge or Pro introduction. This strategy using intrinsic amino acids is also promising from the viewpoints of the economic mass production of AMPs and safety of metabolized peptides.
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Affiliation(s)
- Erika Azuma
- Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Naoki Choda
- Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Mayu Odaki
- Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Yoshiaki Yano
- Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Katsumi Matsuzaki
- Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
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Juretić D, Golemac A, Strand DE, Chung K, Ilić N, Goić-Barišić I, Pellay FX. The Spectrum of Design Solutions for Improving the Activity-Selectivity Product of Peptide Antibiotics against Multidrug-Resistant Bacteria and Prostate Cancer PC-3 Cells. Molecules 2020; 25:E3526. [PMID: 32752241 DOI: 10.3390/molecules25153526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/24/2022] Open
Abstract
The link between the antimicrobial and anticancer activity of peptides has long been studied, and the number of peptides identified with both activities has recently increased considerably. In this work, we hypothesized that designed peptides with a wide spectrum of selective antimicrobial activity will also have anticancer activity, and tested this hypothesis with newly designed peptides. The spectrum of peptides, used as partial or full design templates, ranged from cell-penetrating peptides and putative bacteriocin to those from the simplest animals (placozoans) and the Chordata phylum (anurans). We applied custom computational tools to predict amino acid substitutions, conferring the increased product of bacteriostatic activity and selectivity. Experiments confirmed that better overall performance was achieved with respect to that of initial templates. Nine of our synthesized helical peptides had excellent bactericidal activity against both standard and multidrug-resistant bacteria. These peptides were then compared to a known anticancer peptide polybia-MP1, for their ability to kill prostate cancer cells and dermal primary fibroblasts. The therapeutic index was higher for seven of our peptides, and anticancer activity stronger for all of them. In conclusion, the peptides that we designed for selective antimicrobial activity also have promising potential for anticancer applications.
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30
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Malik R, Corrales C, Linsenmeier M, Alalami H, Sepanj N, Bitan G. Examination of SOD1 aggregation modulators and their effect on SOD1 enzymatic activity as a proxy for potential toxicity. FASEB J 2020; 34:11957-11969. [PMID: 32701214 DOI: 10.1096/fj.202000948r] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 01/08/2023]
Abstract
Small-molecule inhibitors of abnormal protein self-assembly are promising candidates for developing therapy against proteinopathies. Such compounds have been examined primarily as inhibitors of amyloid β-protein (Aβ), whereas testing of inhibitors of other amyloidogenic proteins has lagged behind. An important issue with screening compound libraries is that although an inhibitor suitable for therapy must be both effective and nontoxic, typical screening focuses on efficacy, whereas safety typically is tested at a later stage using cells and/or animals. In addition, typical thioflavin T (ThT)-fluorescence-based screens use the final fluorescence value as a readout, potentially missing important kinetic information. Here, we examined potential inhibitors of superoxide dismutase 1 (SOD1) using ThT-fluorescence including the different phases of fluorescence change and added a parallel screen of SOD1 activity as a potential proxy for compound toxicity. Some compounds previously reported to inhibit other amyloidogenic proteins also inhibited SOD1 aggregation at low micromolar concentrations, whereas others were ineffective. Analysis of the lag phase and exponential slope added important information that could help exclude false-positive or false-negative results. SOD1 was highly resistant to inhibition of its activity, and therefore, did not have the necessary sensitivity to serve as a proxy for examining potential toxicity.
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Affiliation(s)
- Ravinder Malik
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Christian Corrales
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Miriam Linsenmeier
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Huda Alalami
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Niki Sepanj
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Gal Bitan
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA.,Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.,Molecular Biology Institute, University of California at Los Angeles, Los Angeles, CA, USA
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31
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Murugesan S, Gowramma B, Lakshmanan K, Reddy Karri VVS, Radhakrishnan A. Oral Modified Drug Release Solid Dosage Form with Special Reference to Design; An Overview. Curr Drug Res Rev 2020; 12:16-25. [PMID: 31755398 DOI: 10.2174/2589977511666191121094520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 11/22/2022]
Abstract
Oral drug delivery is the most widely utilized route of administration among all the routes that have been explored for systemic delivery of drugs via pharmaceutical products of different dosage form and this oral route provides maximum active surface area among all drug delivery system for administration of various drugs. The attractiveness of these dosage forms is due to awareness of toxicity and ineffectiveness of drugs when administered by oral conventional method in the form of tablets and capsules. Usually, conventional dosage form produces wide range of fluctuation in drug concentration in the bloodstream and tissues with consequent undesirable toxicity and poor efficiency. The maintenance of concentration of drug in plasma within therapeutic index is very critical for effective treatment. These factors as well as factors such as repetitive dosing and unpredictable absorption lead to the concept of oral modified drug delivery systems like Sustained release, prolonged release, modified release, extended release. These formulations are used to identify drug delivery systems that are designed to achieve or extend therapeutic effect by continuously releasing medication over an extended period of time after administration of a single dose. This review describes the basic information regarding modified release dosage form like designed to release their medication in controlled manner, criteria for selecting modified release dosage form and factors influencing the dosage and release pattern.
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Affiliation(s)
- Senthilkumar Murugesan
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, Ooty, Nilgiris, Tamil Nadu, India
| | - Byran Gowramma
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, Ooty, Nilgiris, Tamil Nadu, India
| | - Kaviarasan Lakshmanan
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, Ooty, Nilgiris, Tamil Nadu, India
| | | | - Arun Radhakrishnan
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgiris, Tamil Nadu, India
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32
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Daley-Yates P, Brealey N, Thomas S, Austin D, Shabbir S, Harrison T, Singh D, Barnes N. Therapeutic index of inhaled corticosteroids in asthma: A dose-response comparison on airway hyperresponsiveness and adrenal axis suppression. Br J Clin Pharmacol 2020; 87:483-493. [PMID: 32484940 PMCID: PMC9328361 DOI: 10.1111/bcp.14406] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 01/17/2020] [Revised: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 12/01/2022] Open
Abstract
Aims To compare the airway potency, systemic activity and therapeutic index of three inhaled corticosteroids that differ in glucocorticoid receptor binding affinity, physicochemical and pharmacokinetic properties. Methods This escalating‐dose, placebo‐controlled, cross‐over study randomised adults with asthma to 1 or 2 treatment periods with ≥25 days washout in‐between. Each treatment period comprised five 7‐day dose escalations (μg/d): fluticasone furoate (FF; 25 → 100 → 200 → 400 → 800), fluticasone propionate (FP; 50 → 200 → 500 → 1000 → 2000), budesonide (BUD; 100 → 400 → 800 → 1600 → 3200) or placebo. Airway hyperresponsiveness to adenosine‐5'‐monophosphate (AMP PC20) was assessed on day 8. Plasma cortisol was assessed on day 1 (predose baseline) and from pre‐PM dose on day 6 to pre‐PM dose day 7 (24‐h weighted mean). Results Fifty‐four subjects were randomised. FF showed greater airway potency than FP and BUD (AMP PC20 dose at which 50% of the maximum effect is achieved [ED50] values: 48.52, 1081.27 and 1467.36 μg/d, respectively). Systemic activity (cortisol suppression) ED50 values were 899.99, 1986.05 and 1927.42 μg/d, respectively. The therapeutic index (ED50 cortisol suppression/ED50 AMP PC20) was wider for FF (18.55) than FP (1.84) and BUD (1.31). FF 100 μg/d and 200 μg/d were both comparable in terms of airway potency with high doses of FP (≥1000 μg twice daily [BID]) and BUD (≥1500 μg/BID). The systemic activity of FF 100 μg/d and 200 μg/d (cortisol suppression: 7.41% and 14.28%, respectively) was comparable with low doses of FP (100 μg/BID and 250 μg/BID) and BUD (100 μg/BID and 200 μg/BID). Conclusion This study provides evidence that FF can provide more protection against airway hyperresponsiveness, with less systemic activity, than FP or BUD. This suggests that all inhaled corticosteroids are not therapeutically similar and may differ in their therapeutic index. (203162; NCT02991859).
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Affiliation(s)
- Peter Daley-Yates
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline plc, Uxbridge, UK
| | - Noushin Brealey
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline plc, Uxbridge, UK
| | - Sebin Thomas
- Biostatistics and Programming, GlaxoSmithKline plc, Bangalore, India
| | - Daren Austin
- Clinical Pharmacology and Experimental Medicine, GlaxoSmithKline plc, Uxbridge, UK
| | - Shaila Shabbir
- Medicines Research Centre, GlaxoSmithKline plc, Stevenage, UK
| | - Tim Harrison
- Respiratory Research Unit, Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Dave Singh
- Medicines Evaluation Unit, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - Neil Barnes
- Global Medical Franchise, GlaxoSmithKline plc, Brentford, UK.,William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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33
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Affiliation(s)
- Peter Buchwald
- Diabetes Research Institute and Department of Molecular and Cellular Pharmacology, Miller School of Medicine, University of Miami , Miami, FL, USA
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34
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Drechsel A, Helm J, Ehrlich H, Pantovic S, Bornstein SR, Bechmann N. Anti-Tumor Activity vs. Normal Cell Toxicity: Therapeutic Potential of the Bromotyrosines Aerothionin and Homoaerothionin In Vitro. Mar Drugs 2020; 18:E236. [PMID: 32369901 DOI: 10.3390/md18050236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/20/2022] Open
Abstract
Novel strategies to treat cancer effectively without adverse effects on the surrounding normal tissue are urgently needed. Marine sponges provide a natural and renewable source of promising anti-tumor agents. Here, we investigated the anti-tumor activity of Aerothionin and Homoaerothionin, two bromotyrosines isolated from the marine demosponge Aplysina cavernicola, on two mouse pheochromocytoma cells, MPC and MTT. To determine the therapeutic window of these metabolites, we furthermore explored their cytotoxicity on cells of the normal tissue. Both metabolites diminished the viability of the pheochromocytoma cell lines significantly from a concentration of 25 µM under normoxic and hypoxic conditions. Treatment of MPC cells leads moreover to a reduction in the number of proliferating cells. To confirm the anti-tumor activity of these bromotyrosines, 3D-pheochromocytoma cell spheroids were treated with 10 µM of either Aerothionin or Homoaerothionin, resulting in a significant reduction or even complete inhibition of the spheroid growth. Both metabolites reduced viability of normal endothelial cells to a comparable extent at higher micromolar concentration, while the viability of fibroblasts was increased. Our in vitro results show promise for the application of Aerothionin and Homoaerothionin as anti-tumor agents against pheochromocytomas and suggest acceptable toxicity on normal tissue cells.
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35
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Tyson RJ, Park CC, Powell JR, Patterson JH, Weiner D, Watkins PB, Gonzalez D. Precision Dosing Priority Criteria: Drug, Disease, and Patient Population Variables. Front Pharmacol 2020; 11:420. [PMID: 32390828 PMCID: PMC7188913 DOI: 10.3389/fphar.2020.00420] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 11/12/2019] [Accepted: 03/19/2020] [Indexed: 12/12/2022] Open
Abstract
The administered dose of a drug modulates whether patients will experience optimal effectiveness, toxicity including death, or no effect at all. Dosing is particularly important for diseases and/or drugs where the drug can decrease severe morbidity or prolong life. Likewise, dosing is important where the drug can cause death or severe morbidity. Since we believe there are many examples where more precise dosing could benefit patients, it is worthwhile to consider how to prioritize drug–disease targets. One key consideration is the quality of information available from which more precise dosing recommendations can be constructed. When a new more precise dosing scheme is created and differs significantly from the approved label, it is important to consider the level of proof necessary to either change the label and/or change clinical practice. The cost and effort needed to provide this proof should also be considered in prioritizing drug–disease precision dosing targets. Although precision dosing is being promoted and has great promise, it is underutilized in many drugs and disease states. Therefore, we believe it is important to consider how more precise dosing is going to be delivered to high priority patients in a timely manner. If better dosing schemes do not change clinical practice resulting in better patient outcomes, then what is the use? This review paper discusses variables to consider when prioritizing precision dosing candidates while highlighting key examples of precision dosing that have been successfully used to improve patient care.
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Affiliation(s)
- Rachel J Tyson
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Christine C Park
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - J Robert Powell
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - J Herbert Patterson
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Daniel Weiner
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Paul B Watkins
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Institute for Drug Safety Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Daniel Gonzalez
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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36
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Sahara K, Tsilimigras DI, Maithel SK, Abbott DE, Poultsides GA, Hatzaras I, Fields RC, Weiss M, Scoggins C, Isom CA, Idrees K, Shen P, Endo I, Pawlik TM. Survival benefit of lymphadenectomy for gallbladder cancer based on the therapeutic index: An analysis of the US extrahepatic biliary malignancy consortium. J Surg Oncol 2020; 121:503-510. [PMID: 31907941 PMCID: PMC9292425 DOI: 10.1002/jso.25825] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND The survival benefit of lymphadenectomy among patients with gallbladder cancer (GBC) remains poorly understood. METHODS Patients who underwent resection for GBC between 2000 and 2015 were identified from a US multi-institutional database. The therapeutic index (LNM rate multiplied by 3-year overall survival [OS]) was determined to assess the survival benefit of lymphadenectomy. RESULTS Among 449 patients, less than half had LNM (N = 183, 40.8%). The median number of evaluated and metastatic lymph nodes (LNs) was 3 (interquartile range [IQR]: 1-6) and 1 (IQR: 0-1), respectively. 3-year OS among patients with LNM in the entire cohort was 26.8%. The therapeutic index was lower among patients with T4 (5.9) or T1 (6.0) tumors as well as carbohydrate antigen (CA19-9) ≥200 UI/mL (6.0). Of note, a therapeutic index difference ≥10 was noted relative to CA19-9 (<200: 18.7 vs ≥200: 6.0), American Joint Committee on Cancer T Stage (T1: 6.0 vs T2: 17.8 vs T4: 5.9) and number of LNs examined (1-2: 6.9 vs ≥6: 16.9). Concomitant common bile duct resection was not associated with a higher therapeutic index among patients with either T2 or T3 disease. CONCLUSION Certain clinicopathological factors including T1 or T4 tumor and CA19-9 ≥200 UI/mL were associated with a low therapeutic index. Resection of six or more LNs was associated with a meaningful therapeutic index benefit among patients with LNM.
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Affiliation(s)
- Kota Sahara
- Division of Surgical Oncology, Department of SurgeryThe Ohio State University Wexner Medical Center and James Comprehensive Cancer CenterColumbusOhio,Department of Gastroenterological SurgeryYokohama City University School of MedicineYokohamaJapan
| | - Diamantis I. Tsilimigras
- Division of Surgical Oncology, Department of SurgeryThe Ohio State University Wexner Medical Center and James Comprehensive Cancer CenterColumbusOhio
| | - Shishir K. Maithel
- Division of Surgical Oncology, Department of Surgery, Winship Cancer InstituteEmory UniversityAtlantaGeorgia
| | - Daniel E. Abbott
- Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsin
| | | | | | - Ryan C. Fields
- Department of SurgeryWashington University School of MedicineSt LouisMissouri
| | - Matthew Weiss
- Department of SurgeryJohns Hopkins HospitalBaltimoreMaryland
| | - Charles Scoggins
- Division of Surgical Oncology, Department of SurgeryUniversity of LouisvilleLouisvilleKentucky
| | - Chelsea A. Isom
- Division of Surgical Oncology, Department of SurgeryVanderbilt University Medical CenterNashvilleTennessee
| | - Kamran Idrees
- Division of Surgical Oncology, Department of SurgeryVanderbilt University Medical CenterNashvilleTennessee
| | - Perry Shen
- Department of SurgeryWake Forest UniversityWinston‐SalemNorth Carolina
| | - Itaru Endo
- Department of Gastroenterological SurgeryYokohama City University School of MedicineYokohamaJapan
| | - Timothy M. Pawlik
- Division of Surgical Oncology, Department of SurgeryThe Ohio State University Wexner Medical Center and James Comprehensive Cancer CenterColumbusOhio
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Williams DN, Saar JS, Bleicher V, Rau S, Lienkamp K, Rosenzweig Z. Poly(oxanorbornene)-Coated CdTe Quantum Dots as Antibacterial Agents. ACS Appl Bio Mater 2020; 3:1097-1104. [PMID: 33215080 DOI: 10.1021/acsabm.9b01045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In this study, synthetic mimics of antimicrobial peptides based on poly(oxanorbornene) molecules (or PONs) were used to coat CdTe quantum dots (QDs). These PONs-CdTe QDs were investigated for their activity against Escherichia coli, a bacterium with antibiotic resistant strains. At the same time, the antibacterial activity of the PONs-CdTe QDs was compared to the antibacterial activity of free PONs and free CdTe QDs. The observed antibacterial activity of the PONs-CdTe QDs was additive and concentration dependent. The conjugates had a significantly lower minimum inhibitory concentration (MIC) than the free PONs and QDs, particularly for PONs-CdTe QDs which contained PONs of high amine density. The maximum activity of PONs-CdTe QDs was not realized by conjugating PONs with the highest intrinsic antibacterial activity (i.e., the lowest MIC in solution as free PONs), indicating that the mechanism of action for free PONs and PONs-CdTe QDs is different. Equally important, conjugating PONs to CdTe QDs decreased their hemolytic activity against red blood cells compared to free PONs, lending to higher therapeutic indices against E. coli. This could potentially enable the use of higher, and therefore more effective, PONs-QDs concentrations when addressing bacterial contamination, without concerns of adverse impacts on mammalian cells and organisms.
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Affiliation(s)
| | | | | | - Sibylle Rau
- Faculty of Medicine, Albert-Ludwigs-Universität, Freiburg, Germany
| | | | - Zeev Rosenzweig
- University of Maryland, Baltimore County, Baltimore, Maryland
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38
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Fan Y, Mansoor N, Ahmad T, Wu ZX, Khan RA, Czejka M, Sharib S, Ahmed M, Chen ZS, Yang DH. Enzyme and Transporter Kinetics for CPT-11 (Irinotecan) and SN-38: An Insight on Tumor Tissue Compartment Pharmacokinetics Using PBPK. Recent Pat Anticancer Drug Discov 2020; 14:177-186. [PMID: 30760193 DOI: 10.2174/1574892814666190212164356] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/29/2019] [Accepted: 02/08/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Computational tools are becoming more and more powerful and comprehensive as compared to past decades in facilitating pharmaceutical, pharmacological and clinical practice. Anticancer agents are used either as monotherapy or in combination therapy to treat malignant conditions of the body. A single antineoplastic agent may be used in different types of malignancies at different doses according to the stage of the disease. OBJECTIVE To study the behavior of CPT-11 (Irinotecan) and its metabolite SN-38 in tumor tissue compartment through the Whole Body-Physiologically Pharmacokinetics (WB-PBPK) and to determine the activity of metabolic enzymes and transporters participating in the disposition of CPT-11 and SN-38 working in their physiological environment inside the human body. METHODS Whole body PBPK approach is used to determine the activity of different metabolic enzymes and transporters involved in the disposition of CPT-11 and its active metabolite, SN-38. The concentrations and pharmacokinetic parameters of the parent compound and its metabolite administered at clinically applicable dose via the intravenous route in the tumor tissue are predicted using this approach. RESULTS The activity rate constants of metabolic enzymes and transporters of CPT-11 are derived at their natural anatomic locations. Concentration-time curves of CPT-11 and SN-38 with their 5th to 95th percentage range are achieved at the tumor tissue level. Mean tumor tissue pharmacokinetics of both compounds are determined in a population of 100 individuals. CONCLUSION Tumor tissue concentration-time curves of CPT-11 and SN-38 can be determined via PBPK modeling. Rate constants of enzymes and transporters can be shown for healthy and tumor bearing individuals. The results will throw light on the effective concentration of active compound at its target tissue at the clinically applied IV dose.
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Affiliation(s)
- Yingfang Fan
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, 8000 Utopia Parkway, NY 11439, United States
| | - Najia Mansoor
- Department of Pharmacology, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Tasneem Ahmad
- Pharma Professional Service, Karachi 75270, Pakistan
| | - Zhuo X Wu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, 8000 Utopia Parkway, NY 11439, United States
| | - Rafeeq A Khan
- Department of Pharmacology, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Martin Czejka
- Department of Clinical Pharmacy and Diagnostics, University of Vienna, A-1090 Vienna, Austria
| | - Syed Sharib
- Pharma Professional Service, Karachi 75270, Pakistan
| | - Mansoor Ahmed
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi 75270, Pakistan
| | - Zhe S Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, 8000 Utopia Parkway, NY 11439, United States
| | - Dong H Yang
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, 8000 Utopia Parkway, NY 11439, United States
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Miano TA, Flesch JD, Feng R, Forker CM, Brown M, Oyster M, Kalman L, Rushefski M, Cantu E, Porteus M, Yang W, Localio AR, Diamond JM, Christie JD, Shashaty MGS. Early Tacrolimus Concentrations After Lung Transplant Are Predicted by Combined Clinical and Genetic Factors and Associated With Acute Kidney Injury. Clin Pharmacol Ther 2020; 107:462-470. [PMID: 31513279 PMCID: PMC6980920 DOI: 10.1002/cpt.1629] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/25/2019] [Indexed: 12/13/2022]
Abstract
Tacrolimus exhibits unpredictable pharmacokinetics (PKs) after lung transplant, partly explained by cytochrome P450 (CYP)-enzyme polymorphisms. However, whether exposure variability during the immediate postoperative period affects outcomes is unknown, and pharmacogenetic dosing may be limited by residual PK variability. We estimated adjusted associations between early postoperative tacrolimus concentrations and acute kidney injury (AKI) and acute cellular rejection (ACR), and identified clinical and pharmacogenetic factors that explain postoperative tacrolimus concentration variability in 484 lung transplant patients. Increasing tacrolimus concentration was associated with higher AKI risk (hazard ratio (HR) 1.54; 95% confidence interval (CI) 1.20-1.96 per 5-mg/dL); and increasing AKI severity (odds ratio 1.29; 95% CI 1.04-1.60 per 5-mg/dL), but not ACR (HR 1.02; 95% CI 0.73-1.42). A model with clinical and pharmacogenetic factors explained 42% of concentration variance compared with 19% for pharmacogenetic factors only. Early tacrolimus exposure was independently associated with AKI after lung transplantation, but not ACR. Clinical factors accounted for substantial residual tacrolimus concentration variability not explained by CYP-enzyme polymorphisms.
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Affiliation(s)
- Todd A. Miano
- Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania
| | - Judd D. Flesch
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Rui Feng
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania
| | - Caitlin M. Forker
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Melanie Brown
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Michelle Oyster
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Laurel Kalman
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Melanie Rushefski
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Edward Cantu
- Division of Cardiovascular Surgery, Perelman School of Medicine at the University of Pennsylvania
| | - Mary Porteus
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Wei Yang
- Center for Pharmacoepidemiology Research and Training, Perelman School of Medicine at the University of Pennsylvania
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania
| | - A. Russel Localio
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania
| | - Joshua M. Diamond
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Jason D. Christie
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
| | - Michael G. S. Shashaty
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania
- Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania
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Wang Y, Battseren B, Yin W, Lin Y, Zhou L, Yang F, Wang Y, Sun L, Lu J. Predictive and prognostic value of prognostic nutritional index for locally advanced breast cancer. Gland Surg 2019; 8:618-626. [PMID: 32042668 DOI: 10.21037/gs.2019.10.08] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The prognostic nutritional index (PNI) is an indicator of nutritional immune status. Recently, the PNI has been found to be significantly associated with the clinical outcome of various solid tumors. Few patients with newly diagnosed breast cancer are in a state of malnutrition. In contrast, breast cancer is usually an overnutrition-related disease. This study aimed to explore the relationship of an excessively high PNI with sensitivity to neoadjuvant therapy and the prognosis of patients with locally advanced breast cancer. Methods A total of 202 patients from two clinical trials, SHPD002 and SHPD003, were included. Binary logistic regression analysis was used to assess the association between the PNI and pathological complete response (pCR). Univariate and multivariate survival analyses were performed to assess the prognostic factors used to predict disease-free survival (DFS). Results An excessively high PNI was more difficult to achieve pCR (OR =0.322; 95% CI, 0.132-0.788, P=0.013) and was associated with a worse DFS (log-rank P=0.013). The PNI was an independent prognostic factor for DFS in all patients (HR =3.027; 95% CI, 1.207-7.592, P=0.018), the premenopausal (HR =8.292; 95% CI, 1.670-41.17, P=0.010), clinical T3 and T4 (HR =3.405; 95% CI, 1.141-10.16, P=0.028), ER negative (HR =9.698; 95% CI, 1.205-78.07, P=0.033), HER2 negative (HR =3.765; 95% CI, 1.101-12.88, P=0.035) and pCR subgroups (HR =11.912; 95% CI, 1.326-107.0, P=0.027). Conclusions An excessively high PNI was a risk factor for sensitivity to neoadjuvant therapy and prognosis of patients with locally advanced breast cancer.
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Affiliation(s)
- Yaohui Wang
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Bayarmaa Battseren
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Wenjin Yin
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yanping Lin
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Liheng Zhou
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Fan Yang
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yan Wang
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Lu Sun
- Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Jinsong Lu
- Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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41
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Weydert Z, Lal-Nag M, Mathews-Greiner L, Thiel C, Cordes H, Küpfer L, Guye P, Kelm JM, Ferrer M. A 3D Heterotypic Multicellular Tumor Spheroid Assay Platform to Discriminate Drug Effects on Stroma versus Cancer Cells. SLAS Discov 2019; 25:265-276. [PMID: 31658853 DOI: 10.1177/2472555219880194] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Three-dimensional (3D) cell culture models are thought to mimic the physiological and pharmacological properties of tissues in vivo more accurately than two-dimensional cultures on plastic dishes. For the development of cancer therapies, 3D spheroid models are being created to reflect the complex histology and physiology of primary tumors with the hopes that drug responses will be more similar to and as predictive as those obtained in vivo. The effect of additional cell types in tumors, such as stromal cells, and the resulting heterotypic cell-cell crosstalk can be investigated in these heterotypic 3D cell cultures. Here, a high-throughput screening-compatible drug testing platform based on 3D multicellular spheroid models is described that enables the parallel assessment of toxicity on stromal cells and efficacy on cancer cells by drug candidates. These heterotypic microtissue tumor models incorporate NIH3T3 fibroblasts as stromal cells that are engineered with a reporter gene encoding secreted NanoLUC luciferase. By tracking the NanoLUC signal in the media over time, a time-related measurement of the cytotoxic effects of drugs on stromal cells over the cancer cells was possible, thus enabling the identification of a therapeutic window. An in vitro therapeutic index parameter is proposed to help distinguish and classify those compounds with broad cytotoxic effects versus those that are more selective at targeting cancer cells.
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Affiliation(s)
| | | | | | - Christoph Thiel
- Institute of Applied Microbiology (iAMB), Aachen Biology and Biotechnology (ABBt), RWTH Aachen University, Aachen, Germany
| | - Henrik Cordes
- Institute of Applied Microbiology (iAMB), Aachen Biology and Biotechnology (ABBt), RWTH Aachen University, Aachen, Germany
| | - Lars Küpfer
- Institute of Applied Microbiology (iAMB), Aachen Biology and Biotechnology (ABBt), RWTH Aachen University, Aachen, Germany
| | | | - Jens M Kelm
- InSphero AG, Schlieren, Switzerland.,PreComb Therapeutics AG, Wädenswil, Switzerland
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Chargari C, Deutsch E, Blanchard P, Gouy S, Martelli H, Guérin F, Dumas I, Bossi A, Morice P, Viswanathan AN, Haie-Meder C. Brachytherapy: An overview for clinicians. CA Cancer J Clin 2019; 69:386-401. [PMID: 31361333 DOI: 10.3322/caac.21578] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Brachytherapy is a specific form of radiotherapy consisting of the precise placement of radioactive sources directly into or next to the tumor. This technique is indicated for patients affected by various types of cancers. It is an optimal tool for delivering very high doses to the tumor focally while minimizing the probability of normal tissue complications. Physicians from a wide range of specialties may be involved in either the referral to or the placement of brachytherapy. Many patients require brachytherapy as either primary treatment or as part of their oncologic care. On the basis of high-level evidence from randomized controlled trials, brachytherapy is mainly indicated: 1) as standard in combination with chemoradiation in patients with locally advanced cervical cancer; 2) in surgically treated patients with uterine endometrial cancer for decreasing the risk of vaginal vault recurrence; 3) in patients with high-risk prostate cancer to perform dose escalation and improve progression-free survival; and 4) in patients with breast cancer as adjuvant, accelerated partial breast irradiation or to boost the tumor bed. In this review, the authors discuss the clinical relevance of brachytherapy with a focus on indications, levels of evidence, and results in the overall context of radiation use for patients with cancer.
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Affiliation(s)
- Cyrus Chargari
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
- French Military Health Academy, Paris, France
| | - Eric Deutsch
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
- Faculty of Medicine, Paris-South University/Paris Saclay, Paris, France
- Molecular Radiotherapy Unit 1030, National Institute of Health and Medical Research (INSERM), Paris, France
| | - Pierre Blanchard
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Sebastien Gouy
- Department of Surgery, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Hélène Martelli
- Department of Pediatric Surgery, Kremlin Bicetre University Hospital, Kremlin Bicetre, France
| | - Florent Guérin
- Department of Pediatric Surgery, Kremlin Bicetre University Hospital, Kremlin Bicetre, France
| | - Isabelle Dumas
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Alberto Bossi
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
| | - Philippe Morice
- Department of Surgery, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
- Paris-South University/Paris Saclay, Paris, France
| | - Akila N Viswanathan
- Department of Radiation Oncology, Johns Hopkins Medicine, Baltimore, Maryland
| | - Christine Haie-Meder
- Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
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Gomis-Pastor M, Roig Mingell E, Mirabet Perez S, Brossa Loidi V, Lopez Lopez L, Diaz Bassons A, Aretio Pousa A, Feliu Ribera A, Ferrero-Gregori A, Guirado Perich L, Mangues Bafalluy MA. Multimorbidity and medication complexity: New challenges in heart transplantation. Clin Transplant 2019; 33:e13682. [PMID: 31368585 DOI: 10.1111/ctr.13682] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/30/2019] [Accepted: 07/29/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Multimorbidity and therapeutic complexity are a recognized problem in the heart transplant (HTx) population. However, little is known about how best to quantify this complexity or the strategies that could reduce its burden. METHODS This single-center, observational study included adult heart transplant recipients (HTxR) >1.5 years from transplant. We assessed multimorbidity (>2 comorbidities) and the patient-level Medication Regimen Complexity Index Spanish version (pMRCI-S) score. We also analyzed the independent predictors of pMRCI-S and the impact of the index score on specific clinical variables. RESULTS We included 135 chronic-stage HTxR. Comorbidities significantly increased after HTx (6 ± 3 vs 2 ± 2, P-value < .001). Patients took 12 ± 3 chronic drugs/d, 58% of them to treat comorbidities. The mean total pMRCI-S score was 42 ± 11, higher than in several other chronic diseases. The medication category drugs to treat comorbidities predicted a higher total pMRCI-S score (OR = 3.12, 95% CI 2.8-3.43, P-value < .001). Therapeutic complexity after HTx had an impact on solid malignancies (OR = 1.1, 95% CI 1.02-1.18, P-value = .02) and renal function (OR=-0.81, 95% CI -1.21-(-0.42), P-value < .001). CONCLUSIONS The multimorbidity and pMRCI-S scores obtained in HTx population were worrisomely high. The pMRCI score is a sensitive method that allows identification of the factors determining therapeutic complexity after HTx and selection of strategies to reduce pMRCI-S values.
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Affiliation(s)
- Mar Gomis-Pastor
- Heart Transplant Unit and Pharmacy Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain.,UAB Medicine Department, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Eulalia Roig Mingell
- UAB Medicine Department, Autonomous University of Barcelona (UAB), Barcelona, Spain.,Heart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain
| | - Sonia Mirabet Perez
- Heart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain
| | - Vicente Brossa Loidi
- Heart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain
| | - Laura Lopez Lopez
- Heart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain
| | - Alba Diaz Bassons
- Pharmacy Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain
| | - Ana Aretio Pousa
- Pharmacy Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain
| | - Anna Feliu Ribera
- Pharmacy Department, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain
| | - Andreu Ferrero-Gregori
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Institute of Biomedical Research IIB Sant Pau, CIBERCV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lluís Guirado Perich
- UAB Medicine Department, Autonomous University of Barcelona (UAB), Barcelona, Spain.,Nephrology Department and Renal Transplant Unit, Nephrology Department, Fundació Puigvert, Barcelona, Spain
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Chow SC, Huang Z. Innovative Thinking on Endpoint Selection in Clinical Trials. J Biopharm Stat 2019; 29:941-951. [PMID: 31454270 DOI: 10.1080/10543406.2019.1657140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In clinical trials, selection of appropriate study endpoints is critical for an accurate and reliable evaluation of safety and effectiveness of a test treatment under investigation. In practice, however, there are usually multiple endpoints available for measurement of disease status and/or therapeutic effect of the test treatment under study. For example, in cancer clinical trials, overall survival, response rate, and/or time to disease progression are usually considered as primary clinical endpoints for evaluation of safety and effectiveness of the test treatment under investigation. Once the study endpoints have been selected, sample size required for achieving a desired power is then determined. It, however, should be noted that different study endpoints may result in different sample sizes. In practice, it is usually not clear which study endpoint can best inform the disease status and measure the treatment effect. Moreover, different study endpoints may not translate one another although they may be highly correlated one another. In this article, we intend to develop an innovative endpoint namely therapeutic index based on a utility function to combine and utilize information collected from all study endpoints. Statistical properties and performances of the proposed therapeutic index are evaluated theoretically. A numerical example concerning a cancer clinical trial is given to illustrate the use of the proposed therapeutic index.
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Affiliation(s)
- Shein-Chung Chow
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine , Durham , NC , USA
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Peng C, Yu M, Hsieh JT, Kapur P, Zheng J. Correlating Anticancer Drug Delivery Efficiency with Vascular Permeability of Renal Clearable Versus Non-renal Clearable Nanocarriers. Angew Chem Int Ed Engl 2019; 58:12076-12080. [PMID: 31278873 PMCID: PMC7416736 DOI: 10.1002/anie.201905738] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/03/2019] [Indexed: 11/07/2022]
Abstract
Enhancing tumor targeting of nanocarriers has been a major strategy for advancing clinical translation of cancer nanomedicines. Herein, we report a head-to-head comparison between 5 nm renal clearable and 30 nm non-renal clearable gold nanoparticle (AuNP)-based drug delivery systems (DDSs) in the delivery of doxorubicin (DOX). While the two DDSs themselves had comparable tumor targeting, we found their different vascular permeability played an even more important role than blood retention in the delivery and intratumoral transport of DOX, of which tumor accumulation, efficacy, and therapeutic index were enhanced 2, 7, and 10-fold, respectively, for the 5 nm DDS over 30 nm one. These findings indicate that ultrahigh vascular permeability of renal clearable nanocarriers can be utilized to further improve anticancer drug delivery without the need for prolonged blood retention.
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Affiliation(s)
- Chuanqi Peng
- Department of Chemistry and Biochemistry, The University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX, 75080, USA
| | - Mengxiao Yu
- Department of Chemistry and Biochemistry, The University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX, 75080, USA
| | - Jer-Tsong Hsieh
- Department of Urology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Payal Kapur
- Department of Urology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
- Department of Pathology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - Jie Zheng
- Department of Chemistry and Biochemistry, The University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX, 75080, USA
- Department of Urology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
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Younis MR, Wang C, An R, Wang S, Younis MA, Li ZQ, Wang Y, Ihsan A, Ye D, Xia XH. Low Power Single Laser Activated Synergistic Cancer Phototherapy Using Photosensitizer Functionalized Dual Plasmonic Photothermal Nanoagents. ACS Nano 2019; 13:2544-2557. [PMID: 30730695 DOI: 10.1021/acsnano.8b09552] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Combination therapy, especially photodynamic/photothermal therapy (PDT/PTT), has shown promising applications in cancer therapy. However, sequential irradiation by two different laser sources and even the utilization of single high-power laser to induce either combined PDT/PTT or individual PTT will be subjected to prolonged treatment time, complicated treatment process, and potential skin burns. Thus, low power single laser activatable combined PDT/PTT is still a formidable challenge. Herein, we propose an effective strategy to achieve synergistic cancer phototherapy under low power single laser irradiation for short duration. By taking advantage of dual plasmonic PTT nanoagents (AuNRs/MoS2), a significant increase in temperature up to 60 °C with an overall photothermal conversion efficiency (PCE) of 68.8% was achieved within 5 min under very low power (0.2 W/cm2) NIR laser irradiation. The enhanced PCE and PTT performance is attributed to the synergistic plasmonic PTT effect (PPTT) of dual plasmonic nanoagents, promoting simultaneous release (85%) of electrostatically bonded indocyanine green (ICG) to induce PDT effects, offering simultaneous PDT/synergistic PPTT. Both in vitro and in vivo investigations reveal complete cell/tumor eradication, implying that simultaneous PDT/synergistic PPTT effects induced by AuNRs/MoS2-ICG are much superior over individual PDT or synergistic PPTT. Notably, synergistic PPTT induced by dual plasmonic nanoagents also demonstrates higher in vivo antitumor efficacy than either individual PDT or PTT agents. Taken together, under single laser activation with low power density, the proposed strategy of simultaneous PDT/synergistic PPTT effectively reduces the treatment time, achieves high therapeutic index, and offers safe treatment option, which may serve as a platform to develop safer and clinically translatable approaches for accelerating cancer therapeutics.
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Affiliation(s)
- Muhammad Rizwan Younis
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering , Nanjing University , Nanjing 210023 , China
| | - Chen Wang
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering , Nanjing University , Nanjing 210023 , China
- Department of Physical Chemistry, School of Science , China Pharmaceutical University , Nanjing 210009 , China
| | - Ruibing An
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering , Nanjing University , Nanjing 210023 , China
| | - Shouju Wang
- Department of Radiology , The First Affiliated Hospital of Nanjing Medical University , Nanjing 210000 , China
| | - Muhammad Adnan Younis
- Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering , Zhejiang University , 38 Zheda Road , Hangzhou 310058 , China
| | - Zhong-Qiu Li
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering , Nanjing University , Nanjing 210023 , China
| | - Yang Wang
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering , Nanjing University , Nanjing 210023 , China
| | - Ayesha Ihsan
- National Institute for Biotechnology and Genetic Engineering (NIBGE) , P.O. Box No. 577, Jhang Road , Faisalabad 38000 , Pakistan
| | - Deju Ye
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering , Nanjing University , Nanjing 210023 , China
| | - Xing-Hua Xia
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering , Nanjing University , Nanjing 210023 , China
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Li XX, Yin J, Tang J, Li Y, Yang Q, Xiao Z, Zhang R, Wang Y, Hong J, Tao L, Xue W, Zhu F. Determining the Balance Between Drug Efficacy and Safety by the Network and Biological System Profile of Its Therapeutic Target. Front Pharmacol 2018; 9:1245. [PMID: 30429792 PMCID: PMC6220079 DOI: 10.3389/fphar.2018.01245] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 07/28/2018] [Accepted: 10/12/2018] [Indexed: 12/14/2022] Open
Abstract
One of the most challenging puzzles in drug discovery is the identification and characterization of candidate drug of well-balanced profile between efficacy and safety. So far, extensive efforts have been made to evaluate this balance by estimating the quantitative structure–therapeutic relationship and exploring target profile of adverse drug reaction. Particularly, the therapeutic index (TI) has emerged as a key indicator illustrating this delicate balance, and a clinically successful agent requires a sufficient TI suitable for it corresponding indication. However, the TI information are largely unknown for most drugs, and the mechanism underlying the drugs with narrow TI (NTI drugs) is still elusive. In this study, the collective effects of human protein–protein interaction (PPI) network and biological system profile on the drugs' efficacy–safety balance were systematically evaluated. First, a comprehensive literature review of the FDA approved drugs confirmed their NTI status. Second, a popular feature selection algorithm based on artificial intelligence (AI) was adopted to identify key factors differencing the target mechanism between NTI and non-NTI drugs. Finally, this work revealed that the targets of NTI drugs were highly centralized and connected in human PPI network, and the number of similarity proteins and affiliated signaling pathways of the corresponding targets was much higher than those of non-NTI drugs. These findings together with the newly discovered features or feature groups clarified the key factors indicating drug's narrow TI, and could thus provide a novel direction for determining the delicate drug efficacy-safety balance.
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Affiliation(s)
- Xiao Xu Li
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.,School of Pharmaceutical Sciences and Collaborative Innovation Center for Brain Science, Chongqing University, Chongqing, China
| | - Jiayi Yin
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Jing Tang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.,School of Pharmaceutical Sciences and Collaborative Innovation Center for Brain Science, Chongqing University, Chongqing, China
| | - Yinghong Li
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.,School of Pharmaceutical Sciences and Collaborative Innovation Center for Brain Science, Chongqing University, Chongqing, China
| | - Qingxia Yang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.,School of Pharmaceutical Sciences and Collaborative Innovation Center for Brain Science, Chongqing University, Chongqing, China
| | - Ziyu Xiao
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Runyuan Zhang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Yunxia Wang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Jiajun Hong
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Lin Tao
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province, School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Weiwei Xue
- School of Pharmaceutical Sciences and Collaborative Innovation Center for Brain Science, Chongqing University, Chongqing, China
| | - Feng Zhu
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.,School of Pharmaceutical Sciences and Collaborative Innovation Center for Brain Science, Chongqing University, Chongqing, China
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Abstract
Generic antiepileptic drugs (AED) are significantly cheaper than brand name drugs, and may reduce overall health care expenditures. Regulatory bodies in Europe and North America require bioequivalence between generic and innovator drugs with regard to area under the plasma concentration-time curve (AUC) and peak plasma concentration (Cmax ); strict cutoff values have been defined. The main issue is if bioequivalence ensures therapeutic equivalence. Are switches from brand to generic, or between generic AEDs entirely safe or potentially harmful in patients with epilepsy? We summarized and evaluated the available evidence from bioequivalence, health care utilization, and clinical studies on safety of generic AEDs. In most cases, variations in AUC and Cmax were negligible when comparing innovator and generic AEDs. Due to interindividual pharmacokinetic and pharmacodynamic variability, measured differences between innovator and generic drugs may be the same as differences between different lots of the same brand. Studies from several countries based on insurance data have reported an increase in health care usage after switch from brand to generic AEDs; switchback rates are significantly higher for AEDs compared to other compounds. Patients may be confused, and nonadherence may increase, when AEDs are switched between manufacturers, perhaps due to changes in medication shape and color. But clinical studies do not report changes in seizure frequency and tolerability attributable to generics. Sufficient evidence indicates that most generics are bioequivalent to innovator AEDs; they do not pose a relevant risk for patients with epilepsy. However, some patients are reluctant towards variations in color and shape of their AEDs which may result in nonadherence. We recommend administering generics when a new AED is initiated. Switches from brand to generic AEDs for cost reduction and between generics, which is rarely required, generally seem to be safe, but should be accompanied by thorough counseling of patients on low risks.
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Affiliation(s)
- Martin Holtkamp
- Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - William H Theodore
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
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49
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Verkade JMM, Wijdeven MA, Van Geel R, Janssen BMG, Van Berkel SS, Van Delft FL. A Polar Sulfamide Spacer Significantly Enhances the Manufacturability, Stability, and Therapeutic Index of Antibody-Drug Conjugates. Antibodies (Basel) 2018; 7:E12. [PMID: 31544864 DOI: 10.3390/antib7010012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/08/2018] [Accepted: 02/17/2018] [Indexed: 11/17/2022] Open
Abstract
Despite tremendous efforts in the field of targeted cancer therapy with antibody–drug conjugates (ADCs), attrition rates have been high. Historically, the priority in ADC development has been the selection of target, antibody, and toxin, with little focus on the nature of the linker. We show here that a short and polar sulfamide spacer (HydraSpace™, Oss, The Netherlands) positively impacts ADC properties in various ways: (a) efficiency of conjugation; (b) stability; and (c) therapeutic index. Different ADC formats are explored in terms of drug-to-antibody ratios (DAR2, DAR4) and we describe the generation of a DAR4 ADC by site-specific attachment of a bivalent linker–payload construct to a single conjugation site in the antibody. A head-to-head comparison of HydraSpace™-containing DAR4 ADCs to marketed drugs, derived from the same antibody and toxic payload components, indicated a significant improvement in both the efficacy and safety of several vivo models, corroborated by in-depth pharmacokinetic analysis. Taken together, HydraSpace™ technology based on a polar sulfamide spacer provides significant improvement in manufacturability, stability, and ADC design, and is a powerful platform to enable next-generation ADCs with enhanced therapeutic index.
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Song J, Ren W, Xu T, Zhang Y, Guo H, Zhu S, Yang L. Reversal of multidrug resistance in human lung cancer cells by delivery of 3-octadecylcarbamoylacrylic acid-cisplatin-based liposomes. Drug Des Devel Ther 2017; 11:441-449. [PMID: 28255230 PMCID: PMC5322835 DOI: 10.2147/dddt.s124912] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Liposome-based drug delivery system would be an innovative and promising candidate to circumvent multidrug resistance (MDR) of cisplatin (CDDP). However, the reversal efficacy of liposomal CDDP was severely impaired by weak cellular uptake and insufficient intracellular drug release. In this study, 3-octadecylcarbamoylacrylic acid–CDDP nanocomplex (OMI–CDDP–N)-based liposomes (OCP-L) with high cellular uptake and sufficient intracellular drug release were designed to circumvent MDR of lung cancer. OMI–CDDP–N was synthesized through a pH-sensitive monocarboxylato and an O→Pt coordinate bond, which is more efficient than CDDP. Also, OCP-L incorporated with OMI–CDDP–N could induce effective cellular uptake, enhanced nuclear distribution, and optimal cellular uptake kinetics. In particular, OCP-L presented superior effects on enhancing cell apoptosis and in vitro cytotoxicity in CDDP-resistant human lung cancer (A549/CDDP) cells. The mechanisms of MDR reversal in A549/CDDP cells by OCP-L could attribute to organic cation transporter 2 restoration, ATPase copper-transporting beta polypeptide suppression, hypoxia-inducible factor 1 α-subunit depletion, and phosphatidylinositol 3-kinase/Akt pathway inhibition. These results demonstrated that OCP-L may provide an effective delivery of CDDP to resistant cells to circumvent MDR and enhance the therapeutic index of the chemotherapy.
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Affiliation(s)
- Juan Song
- Department of Pharmaceutics, College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, People's Republic of China
| | - Weifang Ren
- Department of Pharmaceutics, College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, People's Republic of China
| | - Tingting Xu
- Department of Pharmaceutics, College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, People's Republic of China
| | - Yi Zhang
- Department of Pharmaceutics, College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, People's Republic of China
| | - Hongyu Guo
- Department of Pharmaceutics, College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, People's Republic of China
| | - Shanshan Zhu
- Department of Pharmaceutics, College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, People's Republic of China
| | - Li Yang
- Department of Pharmaceutics, College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, People's Republic of China
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