Search bioRxiv⌕ Search

SEARCH · Search bioRxiv

Results for “clinical trials”

Search indexed bioRxiv preprints in genomics, neuroscience, cell biology and bioinformatics. Read source abstracts and check manuscript versions; preprints are not peer reviewed.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources

Predicting clinically promising therapeutic hypotheses using tensor factorization

Determining which target to pursue is a challenging and error-prone first step in developing a therapeutic treatment for a disease, where missteps are potentially very costly given the long-time frames and high expenses of drug development. We identified examples of successes and failures of target-indication pairs in clinical trials across 875 targets and 574 disease indications to build a gold-standard data set of 6,140 known clinical outcomes. We used information from Open Targets and others databases that covered 17 different sources of evidence for target-indication association and represented the data as a matrix of 21,437x2,211x17 with over two million non-null values. We designed and executed three benchmarking strategies to examine the performance of multiple machine learning models: Logistic Regression, Elasticnet, Random Forest, Tensor Factorization and Gradient Boosting Machine. With ten-fold cross validation, tensor factorization achieved AUROC=0.82{+/-}0.02 and AUPRC=0.71{+/-}0.03. Across multiple validation schemes, this was comparable or better than other methods. Tensor factorization is a general form of matrix factorization that has been successfully exploited in recommendation systems that suggest items to users based on their existing preference on a small number of items. Our application, using Bayesian probabilistic modelling, extends the capacity of matrix factorization to model multiple relationships between and among targets and indications. We use the model to show that our predicted probabilities of success correlate with clinical phases, and within clinical phase we can predict which trials are most likely to succeed.

bioinformatics↗

CancerVar: a web server for improved evidence-based clinical interpretation of cancer somatic mutations and copy number abnormalities

Several knowledgebases, such as CIViC and OncoKB, have been manually curated to support clinical interpretations of a limited number of "hotspot" somatic mutations in cancer, yet discrepancies or even conflicting interpretations have been observed among these knowledgebases. Additionally, while these knowledgebases have been extremely useful, they typically cannot interpret novel mutations, which may also have functional and clinical impacts in cancer. To address these challenges, we developed an automated interpretation tool called CancerVar (Cancer Variants interpretation) to score more than 12.9 million somatic mutations and classify them into four tiers: strong clinical significance, potential clinical significance, uncertain clinical significance, and benign/likely benign, based on the AMP/ASCO/CAP 2017 guideline. Considering that the AMP/ASCO/CAP rule-based scoring system may have inherent limitations, such as lack of a clear guidance on weighing different pieces of functional evidence or unclear definition for certain clinical evidence, it may cause misinterpretation for certain variants that have functional impacts but no proven clinical significance. To address this issue, we further introduced a deep learning-based scoring system to predict oncogenicity of mutations by semi-supervised generative adversarial network (SGAN) method using both functional and clinical evidence. We trained and validated the SGAN model on 5,234 somatic mutations from an in-house database of clinical reports on cancer patients, and achieved a good performance when testing on 6,226 variants that were curated by us through literature search. We also compared the prediction with several independent datasets and showed great utility in classifying variants with previously unknown interpretations. CancerVar is also incorporated into a web server that can generate automated texts with summarized descriptive interpretations, such as diagnostic, prognostic, targeted drug responses and clinical trial information for many hotspot mutations. In summary, CancerVar can facilitate clinical interpretation and hypothesis generation for somatic mutations, and greatly reduce manual workload for retrieving relevant evidence and implementing existing guidelines.

cancer biology↗

Evaluation of the Efficacy and Safety of a Clinical Grade Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Patch: A Pre-Clinical Study

AimsCardiomyocyte-derived induced pluripotent stem cells (iPSCs) may represent a promising therapeutic strategy for severely damaged myocardium. This study aimed to assess the efficacy and safety of clinical grade human iPSC-derived cardiomyocyte (hiPSC-CM) patches and conduct a pre-clinical proof-of-concept analysis. Methods and resultsA clinical grade hiPSC line was established from peripheral blood mononuclear cells collected from a healthy volunteer homozygous for human leukocyte antigens and differentiated into cardiomyocytes using cytokines and chemical compounds. hiPSC-CMs were cultured on temperature-responsive culture dishes to fabricate the hiPSC-CM patch. The hiPSC-CMs expressed cardiomyocyte-specific genes and proteins while electrophysiological analyses revealed that hiPSC-CMs were similar to the human myocardium. In vitro safety studies using cell growth, soft agar colony formation, and undifferentiated cell assays indicated that tumourigenic cells were not present. Moreover, no genomic mutations were discovered using whole genome and exome sequencing analysis. Tumour formation was not detected in an in vivo tumourigenicity assay using NOG mice. General toxicity tests also showed no adverse events due to hiPSC-CM patch transplantation. An efficacy study using a porcine model of myocardial infarction demonstrated significantly improved cardiac function with angiogenesis and a reduction in interstitial fibrosis, which was enhanced by cytokine secretion from hiPSC-CM patches after transplantation. No lethal arrhythmias were observed. ConclusionhiPSC-CM patches show promise for future translational research and clinical trials for ischaemic heart failure. One-sentence summaryThis pre-clinical study provides a proof-of-concept of the safety and efficacy of hiPSC-CM patches for the treatment of heart failure. Translational PerspectiveRegenerative therapy using cells and tissues is attractive as a novel approach for treating severe heart failure. We focused on human iPS cell-derived cardiomyocytes (hiPSC-CMs) as a cell source. Using basic research, the characteristics of hiPSC, hiPSC-CMs, and hiPSC-CM patches were determined in vitro and in vivo. We also conducted a pre-clinical study using a porcine model of myocardial infarction that confirmed the safety and efficacy of the hiPSC-CM patch, highlighting its potential for clinical application.

cell biology↗

Mechanism of treatment-free remission in patients with chronic myeloid leukemia revealed by a computational model of CML evolution

In the past few years, international treatment guidelines for chronic myeloid leukemia (CML) have incorporated recommendations for attempting discontinuation of treatment with tyrosine kinase inhibitors (TKIs) outside of the setting of a clinical trial with the aim of treatment-free remission (TFR). Multiple clinical studies have shown consistent results that 40%-50% patients can achieve long-term TFR after TKI discontinuation, and most relapse patients undergo molecular recurrence within 6 months after TKI discontinuation, however the underling mechanisms remain unclear. To understand the mechanism of TFR in patients with CML, we consider the competition between leukemia stem cell and bone marrow microenvironment, and develop a mathematical model to investigate the CML progression dynamics. Model simulations are consistent with clinical observation of CML progression, and reveal a mechanism of dimorphic response after TKI discontinuation. Our model predicts that neoplasitic microenvironment is significant for CML occurrence and progression. We furthermore discuss the prediction of TFR based on the change rates of microenvironment index and leukemia stem cells ratio prior TKI discontinuation.

cancer biology↗

Acute stress impairs target enhancement but not disrtractor suppression in attention selection: Evidence from the N2pc and Pd

BackgroundStudies have shown that acute stress significantly impacts the selection of emotional stimuli. However, the extent to which acute stress affects the cognitive mechanisms underlying target enhancement and distractor suppression when selecting emotionally neutral stimuli remains unclear. MethodsWe explored this issue using the Maastricht Acute Stress Test (MAST), a visual search task, and event-related potential recordings. Eighty healthy adults participanted in the experiment, which required them to search for a specific target while ignoring a color singleton distractor. ResultsThe MAST successfully induced a stress response in the stress group, as indicated by the higher levels of salivary cortisol, state anxiety, negative emotion, as well as lower levels of positive emotion. Importantly, the stress group showed a significantly smaller N2pc in the lateral target with middle distractor displays than the control group. However, no significant differences in PD were observed in the middle target with lateral distractor displays. ConclusionsThese results suggest that acute stress impairs target enhancement rather than distractor suppression during the selection of attention. This impairment may be due to impaired prefrontal cortex function under acute stress. The present research provides new insight into how acute stress affects attention selection. Trial registrationThis study has been submitted for registration with the Chinese Clinical Trial Registry (ChiCTR) and is currently under review (PID: 274121). The status will be updated as soon as the review process is completed.

neuroscience↗

Leptospermum extract (QV0) suppresses pleural mesothelioma tumour growth in vitro and in vivo by mitochondrial dysfunction associated apoptosis

Pleural mesothelioma (PM) is a highly aggressive, fast-growing asbestos-induced cancer with limited effective treatments. There has been an interest in using naturally occurring anticancer agents derived from plant materials for the treatment of PM. However, it is unclear if aqueous extract from the Leptospermum polygalifolium (QV0) has activity against PM. Here we investigated the anti-cancer property of QV0 in vitro and in vivo. Animals treated with Defender(R) (QV0 dietary supply) exhibited a reduced tumour size over 30 days, which was associated with an average extended of seven days mouse life. There was no liver toxicity, nor increased blood glucose post-treatment in animals treated with Defender(R). Moreover, QV0 suppressed the growth of 13 cancer cell lines in a dose-dependent manner, effective at concentrations as low as 0.02% w/v. This response was found to be associated with inhibited cell migration, proliferation, and colony formation, but without evident cell cycle alteration. We observed mitochondrial dysfunction post QV0 treatment, as evidenced by significantly decreased basal and maximal oxygen consumption rates. Significantly enhanced tumour apoptosis was observed in the Defender(R)-treated animals, correlating with mitochondrial dysfunction. To the best of our knowledge, this study constitutes the first demonstration of an improved host survival (without adverse effects) response in a QV0-treated PM mouse model, associated with an evident inhibition of PM cell growth and mitochondrial dysfunction-related enhancement of tumour apoptosis. ImportanceA major problem with cancer chemotherapy or immunotherapy is the severe adverse effects associated with normal tissue damage. PM is known to be treatment resistant and has poor a prognosis, therefore new therapeutic treatment options are urgently needed. In the present study, we explored the potential utility of a Leptospermum extract (QV0) as a treatment option for mesothelioma. We demonstrated for the first time that QV0 exhibits an anti-tumour response in mesothelioma, without any associated adverse effects observed in the PM mouse model. These findings provide a rationale for early-stage clinical trials. We anticipate that prospective translational research will lead to the clinical implementation of a novel QV0-based treatment strategy that will ultimately benefit PM patients.

cancer biology↗

In vivo imaging of T-cell coregulator B7-H4 reveals protumor macrophage status in prostate cancer

BackgroundB7-H4 is a cell surface ligand overexpressed by tumors to inhibit T cell functions and evade the immune system. B7-H4 is minimally expressed in normal tissues but is highly expressed by various cancer cells and tumor-associated macrophages (TAM). Despite its importance as an immune checkpoint inhibitor, no imaging techniques specifically targeting B7-H4 have been established. To close this gap, we sought to assess the ability of a monoclonal antibody (mAb) based immunoPET radiotracer to visualize B7-H4 in human and murine prostate cancer models. MethodsAnti-B7-H4 mAb clone 2H9 was functionally characterized for binding to the human and mouse B7-H4 protein. The antibody was conjugated with chelator p-SCN-Bn-Deferoxamine (DFO) and labeled with radioisotope Zirconium-89 (89Zr) to obtain immunoPET tracer 89Zr-2H9-mAb. The biolayer interferometry method was used to test the binding kinetics of DFO-2H9-mAb compared to that of parental 2H9 mAb. A group of six athymic nude mice with human DU145 prostate tumor xenograft underwent MicroPET imaging after tail vein injection of [~]150{micro}Ci 89Zr-2H9-mAb or non-binding 89Zr-Isotype-mAb. Next, immunocompetent C57BL/6J mice with TRAMP-C2 tumors each were injected with either PBS (n=8), cold 2H9 mAb (10mg/kg) to block B7-H4 (n=6), or chlodronate liposome (15mg/kg) to cause total macrophage depletion (n=6), followed by 89Zr-2H9-mAb MicroPET imaging. An ex vivo biodistribution assay was performed after 144 hr post radiotracer injection. Tumor radiotracer binding, quantified as a percentage injected dose per gram (%ID/g), was compared between different experimental groups using two-way ANOVA with Bonferroni or Tukey corrections. ResultsImmunoconjugation yielded a 2.59 {+/-} 0.08 chelator-to-antibody ratio, and the binding of DFO conjugated 2H9-mAb was similar to that of parental 2H9 mAb, with unaffected affinity in targeting B7-H4 protein moiety. The radiochemical purity of 89Zr-2H9-mAb tracer was yielded >95% with an average specific activity of 5{micro}Ci/{micro}g antibody. DU145 tumor xenografts demonstrated significantly stronger radiotracer binding at 24, 48, 72, 96, and 120 hr than the non-binding isotype control group. In TRAMP-C2 tumor xenografts, the radiotracer binding in B7-H4 blocked tumors was significantly lower than in the non-blocked PBS-injected group. Macrophage depletion resulted in a significant decrease in tumor binding compared to the control group. 89Zr-2H9-mAb could efficiently distinguish tumors with high sensitivity, showing a high correlation between PET imaging and bio-distribution. More importantly, the immunohistochemistry of the harvested tumor revealed no significant difference between the three groups, as discernible through in vivo PET imaging. ConclusionThis study highlights the potential of B7-H4 immunoPET imaging for monitoring immunotherapy response. With the emerging potential of B7-H4 blocking as an immunotherapeutic, immunoPET imaging could be readily expanded to patient stratification and therapy monitoring. B7-H4 imaging could augment our understanding of B7-H4 dynamics in response to various therapeutic interventions in clinical trials. The new B7-H4 immunoPET probe is, in principle, clinically translatable.

immunology↗

The Androgen Receptor and MYC synergise to modulate the synthesis of Siglec-7 ligands in prostate cancer

Glyco-immune checkpoints have recently been shown to be critical mediators of immunotherapy resistance across multiple cancer types. In clinical trials, immunotherapeutic treatments for prostate cancer have failed to elicit durable clinical responses. PCa progression is driven by transcriptional networks regulated by key transcription factors including the androgen receptor (AR) and the oncogene MYC. How this crossover between hormone and oncogene-driven signalling pathways regulates tumour glyco-immune checkpoints remains unclear. Here, we show that O-glycans are the major substrates for sialylation in prostate cancer and that sialyltransferases that have preferences for O-glycans are differentially regulated by androgens. We show that supraphysiological levels of androgens produce distinct glycopeptide profiles in prostate cancer cells compared with cells exposed to physiological androgens. Additionally, we identify a direct and coordinated role for AR and MYC in regulating ST3Gal1 and the synthesis of Siglec-7 ligands in prostate cancer. Both transcription factors converge to repress ST3GAL1, thereby limiting the generation of Siglec-7 ligands. These findings highlight a context-dependent, cooperative relationship between the AR and MYC in shaping the tumour sialome, linking hormonal signalling and oncogenic transcription to Siglec biology. Our study highlights how cell-type specific differences in transcriptional networks has important downstream effects for immune modulating glycans and has tumour specific clinical implications.

cancer biology↗

Bayesian semi-nonnegative matrix tri-factorization to identify pathways associated with cancer phenotypes

Accurate identification of pathways associated with cancer phenotypes (e.g., cancer sub-types and treatment outcome) could lead to discovering reliable prognostic and/or predictive biomarkers for better patients stratification and treatment guidance. In our previous work, we have shown that non-negative matrix tri-factorization (NMTF) can be successfully applied to identify pathways associated with specific cancer types or disease classes as a prognostic and predictive biomarker. However, one key limitation of non-negative factorization methods, including various non-negative bi-factorization methods, is their lack of ability to handle non-negative input data. For example, many molecular data that consist of real-values containing both positive and negative values (e.g., normalized/log transformed gene expression data where negative value represents down-regulated expression of genes) are not suitable input for these algorithms. In addition, most previous methods provide just a single point estimate and hence cannot deal with uncertainty effectively.\n\nTo address these limitations, we propose a Bayesian semi-nonnegative matrix trifactorization method to identify pathways associated with cancer phenotypes from a realvalued input matrix, e.g., gene expression values. Motivated by semi-nonnegative factorization, we allow one of the factor matrices, the centroid matrix, to be real-valued so that each centroid can express either the up- or down-regulation of the member genes in a pathway. In addition, we place structured spike-and-slab priors (which are encoded with the pathways and a gene-gene interaction (GGI) network) on the centroid matrix so that even a set of genes that is not initially contained in the pathways (due to the incompleteness of the current pathway database) can be involved in the factorization in a stochastic way specifically, if those genes are connected to the member genes of the pathways on the GGI network. We also present update rules for the posterior distributions in the framework of variational inference. As a full Bayesian method, our proposed method has several advantages over the current NMTF methods which are demonstrated using synthetic datasets in experiments. Using the The Cancer Genome Atlas (TCGA) gastric cancer and metastatic gastric cancer immunotherapy clinical-trial datasets, we show that our method could identify biologically and clinically relevant pathways associated with the molecular sub-types and immunotherapy response, respectively. Finally, we show that those pathways identified by the proposed method could be used as prognostic biomarkers to stratify patients with distinct survival outcome in two independent validation datasets. Additional information and codes can be found at https://github.com/parks-cs-ccf/BayesianSNMTF.

bioinformatics↗

Targeted DUX4 base editing improves muscle function in an iPSC-derived model of childhood-onset FSHD

Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common dominant muscular dystrophies and remains without an approved disease modifying therapy. Caused by the aberrant expression of the cytotoxic gene DUX4, FSHD is typically diagnosed in adulthood, however clinical onset in children (<18 years of age) is often associated with a more severe and rapid disease. While clinical trials are underway, a lack of human-specific pre-clinical models limit effective testing of potential therapies, particularly in children. To fill this gap, we describe here the development of induced pluripotent stem cell-derived 2-and 3-dimensional skeletal muscle models of children with clinically defined mild, moderate, and severe FSHD. These iPSC-derived muscle models replicate key features of FSHD, including aberrant DUX4 mRNA expression, muscle atrophy, and weakness, which correlate with the individuals specific disease severity. Next, we assessed the efficacy of adenine base editing (ABE) as a potential gene therapy approach to treat FSHD. DUX4-targeted ABE reduced DUX4 mRNA expression, improved muscle area and force generation in the most severe individual. Together this work supports the use of iPSC-derived skeletal muscle models as a less invasive method to study childhood-onset FSHD and establishes targeted DUX4 gene editing therapies as a potential treatment approach.

cell biology↗

Computational Modeling of Effects of PKP2 Gene Therapy on Ventricular Conduction Properties in Arrhythmogenic Cardiomyopathy

BackgroundPatients with arrhythmogenic cardiomyopathy (ACM) due to pathogenic variants in PKP2, the gene for the desmosomal protein plakophilin-2, are being enrolled in gene therapy trials designed to replace the defective allele via adeno-associated viral (AAV) transduction of cardiac myocytes. Evidence from experimental systems and patients indicates that ventricular myocytes in PKP2 ACM have greatly reduced electrical coupling at gap junctions and reduced Na+ current density. In previous AAV gene therapy trials, <50% of ventricular myocytes have generally been transduced. MethodsWe used established computational models of ventricular cell electrophysiology to define the effects of varying levels of successful gene therapy on conduction in patients with PKP2 ACM. Conduction velocity and development of conduction block were analyzed in tissue constructs composed of cells with levels of electrical coupling and Na+ current density observed in experimental studies. ResultsWe observed a non-linear relationship between conduction velocity and the proportion of transduced cells. Conduction velocity increased only modestly when up to 40% of myocytes were transduced. Conduction block did not occur in tissue constructs with moderate levels of uncoupling (0.10 or 0.15 of normal) as this degree of coupling was sufficient to allow electrotonic current to pass through diseased cells. Thus, low levels of transduction, likely to occur in phase 1 clinical trials, do not appear to pose a major safety concern. However, our models did not incorporate potential effects of fibrosis and immune signaling, both of which will presumably be present in PKP2 ACM patients undergoing gene therapy. ConclusionsThe extent of successful ventricular myocyte transduction anticipated to be achieved in PKP2 AAV gene therapy trials will likely not restore conduction velocity to levels sufficient to decrease risk of reentrant arrhythmias. What is Known- Patients with arrhythmogenic cardiomyopathy due to pathogenic variants in PKP2 (the gene for the desmosomal protein plakophilin-2) are now being enrolled in gene therapy trials. - Experimental and clinical observations indicate that patients with arrhythmogenic cardiomyopathy have slow ventricular conduction with a propensity to conduction block due to source-sink mismatch. - <50% of ventricular myocytes are usually transduced after adeno-associated viral gene therapy. What the Study Adds- At anticipated levels of successful transduction of ventricular myocytes, little change in conduction velocity will be achieved in patients with arrhythmogenic cardiomyopathy due to variants in PKP2. - Higher levels of transduction could produce conditions that increase risk of conduction block, especially in the presence of areas of non-conducting fibrofatty scar tissue.

physiology↗

Repurposing the antidepressant sertraline as SHMT inhibitor to suppress serine/glycine synthesis addicted breast tumor growth.

Metabolic rewiring is a hallmark of cancer that supports tumor growth, survival and chemotherapy resistance. While normal cells often rely on extracellular serine and glycine supply, a significant subset of cancers becomes addicted to intracellular serine/glycine synthesis, offering an attractive drug target. Previously developed inhibitors of serine/glycine synthesis enzymes did not reach clinical trials due to unfavorable pharmacokinetic profiles, implying that further efforts to identify clinically applicable drugs targeting this pathway are required. In this study, we aimed to develop therapies that can rapidly enter the clinical practice by focusing on drug repurposing, as their safety and cost-effectiveness have been optimized before. Using a yeast model system, we repurposed two compounds, sertraline and thimerosal, for their selective toxicity against serine/glycine synthesis addicted breast cancer and T-cell acute lymphoblastic leukemia cell lines. Isotope tracer metabolomics, computational docking studies and an enzymatic activity assay revealed that sertraline and thimerosal inhibit serine/glycine synthesis enzymes serine hydroxymethyltransferase and phosphoglycerate dehydrogenase, respectively. In addition, we demonstrated that sertralines anti-proliferative activity was further aggravated by mitochondrial inhibitors, such as the antimalarial artemether, by causing G1-S cell cycle arrest. Most notably, this combination also resulted in serine-selective antitumor activity in breast cancer mouse xenografts. Collectively, this study provides molecular insights into the repurposed mode-of-action of the antidepressant sertraline and allows to delineate a hitherto unidentified group of cancers being particularly sensitive to treatment with sertraline. Furthermore, we highlight the simultaneous inhibition of serine/glycine synthesis and mitochondrial metabolism as a novel treatment strategy for serine/glycine synthesis addicted cancers.

cancer biology↗

Resolution of fibrosis in mdx dystrophic mouse after oral consumption of N-163 strain of Aureobasidium pullulans produced biological response modifier β-glucan (BRMG)`

Recent advances in the management of Duchenne Muscular Dystrophy (DMD), such as exon skipping therapy, have reached a clinical stage, and although gene therapy is in clinical trials, the outcome at its best is still considered suboptimal to yield clinically discernible progress. In this study, we evaluated a novel N-163 strain of Aureobasidium pullulans produced biological response modifier {beta}-glucan (BRMG) for its potential as an adjuvant to slow down the progression of the disease by anti-inflammatory and anti-fibrotic effects. This N-163 {beta}-glucan is a safe and orally consumable food supplement with similar effects that have been previously proven in pre-clinical studies of organ fibrosis, and their beneficial effects have been proven in DMD clinical studies through blood parameters as well. In this study, 45 mice in the three groups, 15 each in a group; Gr. 1 normal mice, Gr.2 mdx mice as vehicle, and Gr.3 mdx mice administered the N-163 strain produced {beta}-glucan for 45 days. Blood biochemical parameters, body weight, muscle weight, inflammation score, and fibrosis score were evaluated using H&E and Massons trichrome staining. The N-163 {beta}-glucan group showed a significant decrease in the plasma ALT, AST, and LDH levels (126 {+/-} 69, 634 {+/-} 371, 3335 {+/-} 1258 U/l) compared with the vehicle group (177 {+/-} 27 U/l, 912 {+/-} 126 U/l, 4186 {+/-} 398 U/l). Plasma TGF-{beta} levels increased, and plasma IL-13 levels decreased in the N-163 group. The inflammation score of HE-stained muscle sections in the N-163 group (1.5 {+/-} 0.8) was lower than that in the vehicle group (2.0 {+/-} 0.8). The percentage of centrally nucleated fibres (CNF) evaluated by Massons trichrome staining was 0 in the normal group, while it increased to 80% in the vehicle group and 76.8% in the N-163 group. The N-163 {beta}-glucan group (24.22 {+/-} 4.80) showed a significant decrease in the fibrosis area (Massons trichrome-positive area). The N-163 {beta}-glucan thus, demonstrated its anti-fibrotic effect in this study. Considering their safety and easy oral consumption, this BRMG could be worth large multicentre clinical studies as adjuvant in slowing down the progress of DMD.

genetics↗

Evaluating the Radiation Sensitivity Index and 12-chemokine gene expression signature for clinical use in a CLIA laboratory

BackgroundThe radiation sensitivity index (RSI) and 12-chemokine gene expression signature (12CK GES) are two gene expression signatures (GES) that were previously developed to predict tumor radiation sensitivity or identify the presence of tertiary lymphoid structures in tumors, respectively. To advance the use of these GES into clinical trial evaluation, their assays must be assessed within the context of the Clinical Laboratory Improvement Amendments (CLIA) process. MethodsUsing HG-U133Plus 2.0 arrays, we first established CLIA laboratory proficiency. Then the accuracy (limit of detection and macrodissection impact), precision (variability by time and operator), sample type (surgery vs. biopsy), and concordance with reference laboratory were evaluated. ResultsRSI and 12CK GES were reproducible (RSI: 0.01 mean difference, 12CK GES 0.17 mean difference) and precise with respect to time and operator. Taken together, the reproducibility analysis of the scores indicated a median RSI difference of 0.06 (6.47% of range) across samples and a median 12CK GES difference of 0.92 (12.29% of range). Experiments indicated that the lower limit of input RNA is 5 ng. Reproducibility with a second CLIA laboratory demonstrated reliability with the median RSI score difference of 0.065 (6% of full range) and 12CK GES difference of 0.93 (12 % of observed range). ConclusionsOverall, under CLIA, RSI and 12CK GES were demonstrated by the Moffitt Cancer Center Advanced Diagnostic Laboratory to be reproducible GES for clinical usage.

genomics↗

Lymphoid-tissue-on-chip recapitulates human antibody responses in vitro

In the past decades, vaccine development has made great strides. Nevertheless, more often than not, vaccine candidates fail in advanced stages of development and clinical trials. A key reason is the poor predictive value of non-clinical in vivo and in vitro models, due to either species-specific differences in the immune response or insufficient reflection of physiological vaccine mechanisms. Reliable modeling of human adaptive immune responses is a prerequisite to understand processes leading to vaccine-induced protective immunization and to drive informed decisions in vaccine development pipelines. Here, we present a centrifugal microfluidics based organ-on-chip approach to generate an organotypic high density lymphoid tissue on-chip. The model enables long-term culture of lymphoid tissue and raised antigen-specific antibody responses against influenza vaccines even after four weeks on-chip. Antibody response of different magnitude and quality could be induced both by direct antigen exposure as well as by recruitment of antigen-presenting cells from the periphery. The model represents an attractive approach to evaluate the impact of the mode of antigen delivery on adaptive immune responses. Beyond applications in vaccine development, the lymphoid-tissue-on-chip provides a platform to study cellular interactions during homeostasis, immune responses and long-term impact of immunomodulators over several weeks.

bioengineering↗

Arimoclomol as a potential therapy for neuronopathic Gaucher Disease

Gaucher Disease (GD) is caused by mutations of the GBA gene which encodes the lysosomal enzyme acid beta-glucosidase (GCase). GBA mutations commonly affect GCase function by perturbing its protein homeostasis rather than its catalytic activity. Heat shock proteins (HSPs) are well known cytoprotective molecules with numerous functions in protein homeostasis and lysosomal function and their manipulation has been suggested as a potential therapeutic strategy for GD. The investigational drug arimoclomol, which is currently in phase II/III clinical trials, is a well-characterized HSP amplifier and has been extensively clinically tested. Importantly, arimoclomol efficiently crosses the blood-brain-barrier hereby presenting an opportunity to target the neurological manifestations of GD, which remains without a disease modifying therapy.\n\nIn the present study, we found that arimoclomol induced relevant HSPs such as ER-resident HSP70 (BiP) and enhanced the folding, maturation, activity and correct cellular localization of mutated GCase across a number of genotypes including the common L444P and N370S mutations in primary cells from GD patients. These effects where recapitulated in a human neuronal model of GD obtained by differentiation of multipotent adult stem cells. Taken together, these data demonstrate the potential of HSP-targeting therapies in GCase-deficiencies and strongly support the clinical development of arimoclomol as a potential first therapeutic option for the neuronopathic forms of GD.\n\nSummaryThese studies provide proof-of-concept for the development of the Heat shock protein amplifier, arimoclomol, as a potential therapy for neuronopathic Gaucher disease as arimoclomol enhances folding, maturation, activity and correct localization of GCase in neuronopathic and non-neuronopathic Gaucher disease models.

neuroscience↗

A standardised framework to identify optimal animal models for efficacy assessment in drug development

IntroductionPoor translation of efficacy data derived from animal models is a potential contributor to costly and unnecessary attrition in clinical trials.\n\nObjectivesTo develop a tool to assess, validate and compare the clinical translatability of animal models used for the preliminary assessment of efficacy.\n\nDesign and ResultsWe conducted an exploratory literature search to identify the key aspects to validate animal models. Eight aspects (Epidemiology, Pathophysiology, Genetic, Biochemistry, Aetiology, Histology, Pharmacology and Endpoints) were identified for which questions were drafted to evaluate the different faces of the human disease simulation. Features of the framework include standardised instructions, a weighting and scoring system to compare models as well as contextualising factors regarding model similarity and evidence uncertainty. We included a quality assessment of the internal validity of drug intervention studies included in the Pharmacological validation section for both effective and ineffective drugs in humans. A web-based survey was conducted with experts from different stakeholders to gather input on the framework. Finally, we present a case study of a preliminary validation and comparison of two animal models for Duchenne Muscular Dystrophy (mdx mouse and GRMD dog) and Diabetes Type 2 (ZDF rat and db/db mouse). We show that there are significant differences between the mdx mouse and the GRMD dog, the latter mimicking the human condition to a greater extent than the mouse despite the considerable lack of published data. In DT2, both the ZDF rat and the db/db mouse are comparable with minor differences in pathophysiology.\n\nConclusionsFIMD facilitates drug development by serving as the basis to select the most relevant model that can provide meaningful and translatable results to progress drug candidates to the clinic.

pharmacology and toxicology↗

Advantage of the F(ab)'2 fragment over IgG for RIT and PRIT

Radioimmunotherapy (RIT) has proved clinically effective in the treatment of relapsed or consolidating NHL after chemotherapy. However, it is still at the clinical trial stage for the treatment of solid tumors. The efficacy of the treatment on this type of tumor is limited by hematological toxicity, which restricts the activities injected. Pre-targeted radioimmunotherapy (PRIT) enables radiolabeling to be carried out in vivo at a time when the quantities of antigen-targeted vector reach a maximum level in the tumor, but have largely decayed in the bloodstream, thus limiting hematological toxicity. This therapeutic approach would make it possible to use higher radiopharmaceutical activities than those used in RIT, thereby increasing the doses deposited in the tumor and the therapeutic response. Despite encouraging preclinical trials, this approach has failed to live up to expectations in terms of clinical applications. In the context of PRIT using the Inverse Electron Demand Diels Alder (IEDDA) reaction as a method for radiolabeling tumor-targeted vectors, a major research effort has been made to improve the quality of in vivo radiolabeling using tetrazine (Tz) and transcycloctene (TCO) variants whose stability and reactivity have been optimized. Most trials in this field have been carried out using antibodies which, thanks to their long biological half-life, enable prolonged irradiation of tumors. Low-molecular-weight vectors such as affinity proteins or antigen-specific antibody fragments (VHH,scFv, F(ab)) have the advantage of being rapidly eliminated from circulation by renal filtration, but on the other hand, the quantities and residence times of these vectors in the tumor are reduced compared with IgG. F(ab)2 antibody fragments have properties intermediate between those of IgG and low-molecular-weight vectors that could be suitable for PRIT approaches, but they have not yet been evaluated in PRIT using IEDDA. In preparation for a preclinical trial of radioimmunotherapy of triple-negative breast cancer in spontaneously affected dogs, we compared the biodistribution of IgG and its F(ab)2 fragment targeting canine CD138 in a xenogeneic model of canine breast cancer and in a mouse model of colon cancer expressing human ACE antigen. This analysis shows that the use of F(ab)2 fragments improves the therapeutic index compared with IgG. F(ab)2 fragments seem particularly well suited to tumor targeting in PRIT using short-lived isotopes such as 211At.

cancer biology↗