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Martchenko Shilman M, Bartolo G, Alameh S, Peterson JW, Lawrence WS, Peel JE, Sivasubramani SK, Beasley DWC, Cote CK, Demons ST, Halasahoris SA, Miller LL, Klimko CP, Shoe JL, Fetterer DP, McComb R, Ho CLC, Bradley KA, Hartmann S, Cheng LW, Chugunova M, Kao CY, Tran JK, Derbedrossian A, Zilbermintz L, Amali-Adekwu E, Levitin A, West J. In Vivo Activity of Repurposed Amodiaquine as a Host-Targeting Therapy for the Treatment of Anthrax. ACS Infect Dis 2021; 7:2176-2191. [PMID: 34218660 PMCID: PMC8369491 DOI: 10.1021/acsinfecdis.1c00190] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Anthrax is caused by Bacillus anthracis and can result in nearly 100% mortality due in part to anthrax toxin. Antimalarial amodiaquine (AQ) acts as a host-oriented inhibitor of anthrax toxin endocytosis. Here, we determined the pharmacokinetics and safety of AQ in mice, rabbits, and humans as well as the efficacy in the fly, mouse, and rabbit models of anthrax infection. In the therapeutic-intervention studies, AQ nearly doubled the survival of mice infected subcutaneously with a B. anthracis dose lethal to 60% of the animals (LD60). In rabbits challenged with 200 LD50 of aerosolized B. anthracis, AQ as a monotherapy delayed death, doubled the survival rate of infected animals that received a suboptimal amount of antibacterial levofloxacin, and reduced bacteremia and toxemia in tissues. Surprisingly, the anthrax efficacy of AQ relies on an additional host macrophage-directed antibacterial mechanism, which was validated in the toxin-independent Drosophila model of Bacillus infection. Lastly, a systematic literature review of the safety and pharmacokinetics of AQ in humans from over 2 000 published articles revealed that AQ is likely safe when taken as prescribed, and its pharmacokinetics predicts anthrax efficacy in humans. Our results support the future examination of AQ as adjunctive therapy for the prophylactic anthrax treatment.
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Affiliation(s)
- Mikhail Martchenko Shilman
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
- Shield Pharma LLC, 1420 North Claremont Boulevard, Suite 102A, Claremont, California 91711, United States
| | - Gloria Bartolo
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Saleem Alameh
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Johnny W. Peterson
- Department of Microbiology and Immunology, University of Texas Medical Branch (UTMB), 301 University Boulevard, Galveston, Texas 77555, United States
| | - William S. Lawrence
- Department of Microbiology and Immunology, University of Texas Medical Branch (UTMB), 301 University Boulevard, Galveston, Texas 77555, United States
| | - Jennifer E. Peel
- Department of Microbiology and Immunology, University of Texas Medical Branch (UTMB), 301 University Boulevard, Galveston, Texas 77555, United States
| | - Satheesh K. Sivasubramani
- Directorate of Environmental Health Effects Laboratory, Naval Medical Research Unit, Wright-Patterson Air Force Base, 2728 Q Street, Building 837, Wright-Patterson AFB, Ohio 45433, United States
| | - David W. C. Beasley
- Department of Microbiology and Immunology, University of Texas Medical Branch (UTMB), 301 University Boulevard, Galveston, Texas 77555, United States
| | - Christopher K. Cote
- Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, Maryland 21702, United States
| | - Samandra T. Demons
- Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, Maryland 21702, United States
| | - Stephanie A. Halasahoris
- Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, Maryland 21702, United States
| | - Lynda L. Miller
- Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, Maryland 21702, United States
| | - Christopher P. Klimko
- Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, Maryland 21702, United States
| | - Jennifer L. Shoe
- Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, Maryland 21702, United States
| | - David P. Fetterer
- Biostatistics Division, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, Maryland 21702, United States
| | - Ryan McComb
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Chi-Lee C. Ho
- Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles (UCLA), 609 Charles E. Young Drive East, Los Angeles, California 90095, United States
| | - Kenneth A. Bradley
- Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles (UCLA), 609 Charles E. Young Drive East, Los Angeles, California 90095, United States
| | - Stella Hartmann
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Luisa W. Cheng
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, United States Department of Agriculture (USDA), 800 Buchanan Street, Albany, California 94710, United States
| | - Marina Chugunova
- Institute of Mathematical Sciences, Claremont Graduate University (CGU), 150 East 10th Street, Claremont, California 91711, United States
| | - Chiu-Yen Kao
- Department of Mathematical Sciences, Claremont McKenna College (CMC), 888 North Columbia Avenue, Claremont, California 91711, United States
| | - Jennifer K. Tran
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Aram Derbedrossian
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Leeor Zilbermintz
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Emiene Amali-Adekwu
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Anastasia Levitin
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
| | - Joel West
- Henry E. Riggs School of Applied Life Sciences, Keck Graduate Institute (KGI), 535 Watson Drive, Claremont, California 91711, United States
- Shield Pharma LLC, 1420 North Claremont Boulevard, Suite 102A, Claremont, California 91711, United States
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Prokop JW, Hartog NL, Chesla D, Faber W, Love CP, Karam R, Abualkheir N, Feldmann B, Teng L, McBride T, Leimanis ML, English BK, Holsworth A, Frisch A, Bauss J, Kalpage N, Derbedrossian A, Pinti RM, Hale N, Mills J, Eby A, VanSickle EA, Pageau SC, Shankar R, Chen B, Carcillo JA, Sanfilippo D, Olivero R, Bupp CP, Rajasekaran S. High-Density Blood Transcriptomics Reveals Precision Immune Signatures of SARS-CoV-2 Infection in Hospitalized Individuals. Front Immunol 2021; 12:694243. [PMID: 34335605 PMCID: PMC8322982 DOI: 10.3389/fimmu.2021.694243] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 04/12/2021] [Accepted: 06/30/2021] [Indexed: 12/27/2022] Open
Abstract
The immune response to COVID-19 infection is variable. How COVID-19 influences clinical outcomes in hospitalized patients needs to be understood through readily obtainable biological materials, such as blood. We hypothesized that a high-density analysis of host (and pathogen) blood RNA in hospitalized patients with SARS-CoV-2 would provide mechanistic insights into the heterogeneity of response amongst COVID-19 patients when combined with advanced multidimensional bioinformatics for RNA. We enrolled 36 hospitalized COVID-19 patients (11 died) and 15 controls, collecting 74 blood PAXgene RNA tubes at multiple timepoints, one early and in 23 patients after treatment with various therapies. Total RNAseq was performed at high-density, with >160 million paired-end, 150 base pair reads per sample, representing the most sequenced bases per sample for any publicly deposited blood PAXgene tube study. There are 770 genes significantly altered in the blood of COVID-19 patients associated with antiviral defense, mitotic cell cycle, type I interferon signaling, and severe viral infections. Immune genes activated include those associated with neutrophil mechanisms, secretory granules, and neutrophil extracellular traps (NETs), along with decreased gene expression in lymphocytes and clonal expansion of the acquired immune response. Therapies such as convalescent serum and dexamethasone reduced many of the blood expression signatures of COVID-19. Severely ill or deceased patients are marked by various secondary infections, unique gene patterns, dysregulated innate response, and peripheral organ damage not otherwise found in the cohort. High-density transcriptomic data offers shared gene expression signatures, providing unique insights into the immune system and individualized signatures of patients that could be used to understand the patient’s clinical condition. Whole blood transcriptomics provides patient-level insights for immune activation, immune repertoire, and secondary infections that can further guide precision treatment.
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Affiliation(s)
- Jeremy W Prokop
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States
| | - Nicholas L Hartog
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Allergy & Immunology, Spectrum Health, Grand Rapids, MI, United States
| | - Dave Chesla
- Office of Research, Spectrum Health, Grand Rapids, MI, United States.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - William Faber
- Physical Sciences, Grand Rapids Community College, Grand Rapids, MI, United States
| | - Chanise P Love
- Office of Research, Spectrum Health, Grand Rapids, MI, United States
| | | | | | | | - Li Teng
- Ambry Genetics, Aliso Viejo, CA, United States
| | | | - Mara L Leimanis
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
| | - B Keith English
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Amanda Holsworth
- Allergy & Immunology, Spectrum Health, Grand Rapids, MI, United States
| | - Austin Frisch
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Jacob Bauss
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Nathisha Kalpage
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Aram Derbedrossian
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Ryan M Pinti
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Nicole Hale
- The Department of Chemistry and Biochemistry, Calvin University, Grand Rapids, MI, United States
| | - Joshua Mills
- Department of Biology, Grand Valley State University, Allendale, MI, United States
| | - Alexandra Eby
- Department of Science, Davenport University, Grand Rapids, MI, United States
| | | | - Spencer C Pageau
- Office of Research, Spectrum Health, Grand Rapids, MI, United States
| | - Rama Shankar
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States
| | - Bin Chen
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States
| | - Joseph A Carcillo
- Department of Critical Care Medicine and Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Dominic Sanfilippo
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
| | - Rosemary Olivero
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Infectious Disease, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
| | - Caleb P Bupp
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Medical Genetics, Spectrum Health Medical Genetics, Grand Rapids, MI, United States
| | - Surender Rajasekaran
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Office of Research, Spectrum Health, Grand Rapids, MI, United States.,Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
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Chang R, Knox J, Chang J, Derbedrossian A, Vasilevko V, Cribbs D, Boado RJ, Pardridge WM, Sumbria RK. Blood-Brain Barrier Penetrating Biologic TNF-α Inhibitor for Alzheimer's Disease. Mol Pharm 2017; 14:2340-2349. [PMID: 28514851 DOI: 10.1021/acs.molpharmaceut.7b00200] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [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: 01/30/2023]
Abstract
Tumor necrosis factor alpha (TNF-α) driven processes are involved at multiple stages of Alzheimer's disease (AD) pathophysiology and disease progression. Biologic TNF-α inhibitors (TNFIs) are the most potent class of TNFIs but cannot be developed for AD since these macromolecules do not cross the blood-brain barrier (BBB). A BBB-penetrating TNFI was engineered by the fusion of the extracellular domain of the type II human TNF receptor (TNFR) to a chimeric monoclonal antibody (mAb) against the mouse transferrin receptor (TfR), designated as the cTfRMAb-TNFR fusion protein. The cTfRMAb domain functions as a molecular Trojan horse, binding to the mouse TfR and ferrying the biologic TNFI across the BBB via receptor-mediated transcytosis. The aim of the study was to examine the effect of this BBB-penetrating biologic TNFI in a mouse model of AD. Six-month-old APPswe, PSEN 1dE9 (APP/PS1) transgenic mice were treated with saline (n = 13), the cTfRMAb-TNFR fusion protein (n = 12), or etanercept (non-BBB-penetrating biologic TNFI; n = 11) 3 days per week intraperitoneally. After 12 weeks of treatment, recognition memory was assessed using the novel object recognition task, mice were sacrificed, and brains were assessed for amyloid beta (Aβ) load, neuroinflammation, BBB damage, and cerebral microhemorrhages. The cTfRMAb-TNFR fusion protein caused a significant reduction in brain Aβ burden (both Aβ peptide and plaque), neuroinflammatory marker ICAM-1, and a BBB disruption marker, parenchymal IgG, and improved recognition memory in the APP/PS1 mice. Fusion protein treatment resulted in low antidrug-antibody formation with no signs of either immune reaction or cerebral microhemorrhage development with chronic 12-week treatment. Chronic treatment with the cTfRMAb-TNFR fusion protein, a BBB-penetrating biologic TNFI, offers therapeutic benefits by targeting Aβ pathology, neuroinflammation, and BBB-disruption, overall improving recognition memory in a transgenic mouse model of AD.
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Affiliation(s)
- Rudy Chang
- Department of Biopharmaceutical Sciences, School of Pharmacy, Keck Graduate Institute , Claremont, California 91711, United States
| | - Jillian Knox
- Department of Neuroscience, Claremont McKenna College , Claremont, California 91711, United States
| | - Jae Chang
- Department of Biopharmaceutical Sciences, School of Pharmacy, Keck Graduate Institute , Claremont, California 91711, United States
| | - Aram Derbedrossian
- Department of Biopharmaceutical Sciences, School of Pharmacy, Keck Graduate Institute , Claremont, California 91711, United States
| | - Vitaly Vasilevko
- Institute for Memory Impairments and Neurological Disorders, University of California , Irvine, California 92697, United States
| | - David Cribbs
- Institute for Memory Impairments and Neurological Disorders, University of California , Irvine, California 92697, United States
| | - Ruben J Boado
- ArmaGen, Inc. , Calabasas, California 91302, United States
| | | | - Rachita K Sumbria
- Department of Biopharmaceutical Sciences, School of Pharmacy, Keck Graduate Institute , Claremont, California 91711, United States.,Department of Neurology, University of California , Irvine, California 92697, United States
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