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Sutherland JJ, Yonchev D, Fekete A, Urban L. A preclinical secondary pharmacology resource illuminates target-adverse drug reaction associations of marketed drugs. Nat Commun 2023; 14:4323. [PMID: 37468498 DOI: 10.1038/s41467-023-40064-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023] Open
Abstract
In vitro secondary pharmacology assays are an important tool for predicting clinical adverse drug reactions (ADRs) of investigational drugs. We created the Secondary Pharmacology Database (SPD) by testing 1958 drugs using 200 assays to validate target-ADR associations. Compared to public and subscription resources, 95% of all and 36% of active (AC50 < 1 µM) results are unique to SPD, with bias towards higher activity in public resources. Annotating drugs with free maximal plasma concentrations, we find 684 physiologically relevant unpublished off-target activities. Furthermore, 64% of putative ADRs linked to target activity in key literature reviews are not statistically significant in SPD. Systematic analysis of all target-ADR pairs identifies several putative associations supported by publications. Finally, candidate mechanisms for known ADRs are proposed based on SPD off-target activities. Here we present a freely-available resource for benchmarking ADR predictions, explaining phenotypic activity and investigating clinical properties of marketed drugs.
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Affiliation(s)
| | - Dimitar Yonchev
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | | | - Laszlo Urban
- Novartis Institutes for Biomedical Research, Cambridge, MA, USA.
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Brahmer JR, Lee JS, Ciuleanu TE, Bernabe Caro R, Nishio M, Urban L, Audigier-Valette C, Lupinacci L, Sangha R, Pluzanski A, Burgers J, Mahave M, Ahmed S, Schoenfeld AJ, Paz-Ares LG, Reck M, Borghaei H, O'Byrne KJ, Gupta RG, Bushong J, Li L, Blum SI, Eccles LJ, Ramalingam SS. Five-Year Survival Outcomes With Nivolumab Plus Ipilimumab Versus Chemotherapy as First-Line Treatment for Metastatic Non-Small-Cell Lung Cancer in CheckMate 227. J Clin Oncol 2023; 41:1200-1212. [PMID: 36223558 PMCID: PMC9937094 DOI: 10.1200/jco.22.01503] [Citation(s) in RCA: 72] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We present 5-year results from CheckMate 227 Part 1, in which nivolumab plus ipilimumab improved overall survival (OS) versus chemotherapy in patients with metastatic non-small-cell lung cancer, regardless of tumor programmed death ligand 1 (PD-L1) status. METHODS Adults with stage IV/recurrent non-small-cell lung cancer without EGFR mutations or ALK alterations and with tumor PD-L1 ≥ 1% or < 1% (n = 1739) were randomly assigned. Patients with tumor PD-L1 ≥ 1% were randomly assigned to first-line nivolumab plus ipilimumab, nivolumab alone, or chemotherapy. Patients with tumor PD-L1 < 1% were randomly assigned to nivolumab plus ipilimumab, nivolumab plus chemotherapy, or chemotherapy. End points included exploratory 5-year results for efficacy, safety, and quality of life. RESULTS At a minimum follow-up of 61.3 months, 5-year OS rates were 24% versus 14% for nivolumab plus ipilimumab versus chemotherapy (PD-L1 ≥ 1%) and 19% versus 7% (PD-L1 < 1%). The median duration of response was 24.5 versus 6.7 months (PD-L1 ≥ 1%) and 19.4 versus 4.8 months (PD-L1 < 1%). Among patients surviving 5 years, 66% (PD-L1 ≥ 1%) and 64% (PD-L1 < 1%) were off nivolumab plus ipilimumab without initiating subsequent systemic anticancer treatment by the 5-year time point. Survival benefit continued after nivolumab plus ipilimumab discontinuation because of treatment-related adverse events, with a 5-year OS rate of 39% (combined PD-L1 ≥ 1% and < 1% populations). Quality of life in 5-year survivors treated with nivolumab plus ipilimumab was similar to that in the general US population through the 5-year follow-up. No new safety signals were observed. CONCLUSION With all patients off immunotherapy treatment for ≥ 3 years, nivolumab plus ipilimumab increased 5-year survivorship versus chemotherapy, including long-term, durable clinical benefit regardless of tumor PD-L1 expression. These data support nivolumab plus ipilimumab as an effective first-line treatment for patients with metastatic non-small-cell lung cancer.
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Affiliation(s)
| | - Jong-Seok Lee
- National University Bundang Hospital, Seongnam, Republic of Korea
| | - Tudor-Eliade Ciuleanu
- Institutul Oncologic Prof Dr Ion Chiricuta and University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Reyes Bernabe Caro
- Hospital Universitario Virgen Del Rocio, Instituto de Biomedicina de Seville, Seville, Spain
| | - Makoto Nishio
- Department of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | | | | | - Adam Pluzanski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Mauricio Mahave
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | - Samreen Ahmed
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, United Kingdom
| | - Adam J Schoenfeld
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY
| | - Luis G Paz-Ares
- Hospital Universitario 12 de Octubre, H12O-CNIO Lung Cancer Clinical Research Unit, Universidad Complutense & CiberOnc, Madrid, Spain
| | - Martin Reck
- Airway Research Center North, German Center for Lung Research, Lung Clinic, Grosshansdorf, Germany
| | | | - Kenneth J O'Byrne
- Princess Alexandra Hospital, Translational Research Institute and Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Li Li
- Bristol Myers Squibb, Princeton, NJ
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Ready NE, Audigier-Valette C, Goldman JW, Felip E, Ciuleanu TE, Rosario García Campelo M, Jao K, Barlesi F, Bordenave S, Rijavec E, Urban L, Aucoin JS, Zannori C, Vermaelen K, Arén Frontera O, Curioni Fontecedro A, Sánchez-Gastaldo A, Juan-Vidal O, Linardou H, Poddubskaya E, Spigel DR, Ahmed S, Maio M, Li S, Chang H, Fiore J, Acevedo A, Paz-Ares L. First-line nivolumab plus ipilimumab for metastatic non-small cell lung cancer, including patients with ECOG performance status 2 and other special populations: CheckMate 817. J Immunother Cancer 2023; 11:jitc-2022-006127. [PMID: 36725084 PMCID: PMC9896179 DOI: 10.1136/jitc-2022-006127] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [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] [Accepted: 12/30/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND CheckMate 817, a phase 3B study, evaluated flat-dose nivolumab plus weight-based ipilimumab in patients with metastatic non-small cell lung cancer (NSCLC). Here, in this research, we report on first-line treatment in patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 (cohort A) and special populations (cohort A1: ECOG PS 2; or ECOG PS 0-1 with untreated brain metastases, renal impairment, hepatic impairment, or controlled HIV infection). METHODS Cohorts A and A1 received nivolumab 240 mg every 2 weeks plus ipilimumab 1 mg/kg every 6 weeks. The primary endpoint was the incidence of grade 3-4 and grade 5 immune-mediated adverse events (IMAEs; adverse events (AEs) deemed potentially immune-related, occurring <100 days of last dose, and treated with immune-modulating medication (except endocrine events)) and treatment-related select AEs (treatment-related AEs with potential immunological etiology requiring frequent monitoring/intervention, reported between first dose and 30 days after the last dose) in cohort A; efficacy endpoints were secondary/exploratory. In cohort A1, safety/efficacy assessment was exploratory. RESULTS The most common grade 3-4 IMAEs were pneumonitis (5.1%), diarrhea/colitis (4.9%), and hepatitis (4.6%) in cohort A (N=391) and diarrhea/colitis (3.5%), hepatitis (3.5%), and rash (3.0%) in cohort A1 (N=198). The most common grade 3-4 treatment-related select AEs were hepatic (5.9%), gastrointestinal (4.9%), and pulmonary (4.6%) events in cohort A and gastrointestinal (4.0%), skin (3.5%), and endocrine (3.0%) events in cohort A1. No grade 5 IMAEs or treatment-related select AEs occurred. Treatment-related deaths occurred in 4 (1.0%) and 3 (1.5%) patients in cohorts A and A1, respectively. Three-year overall survival (OS) rates were 33.7% and 20.5%, respectively. CONCLUSIONS Flat-dose nivolumab plus weight-based ipilimumab was associated with manageable safety and durable efficacy in cohort A, consistent with data from phase 3 metastatic NSCLC studies. Special populations of cohort A1 including patients with ECOG PS 2 or ECOG PS 0-1 with untreated brain metastases had manageable treatment-related toxicity and clinically meaningful 3-year OS rate. TRIAL REGISTRATION NUMBER NCT02869789.
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Affiliation(s)
- Neal E Ready
- Department of Medicine, Duke University, Durham, North Carolina, USA
| | | | - Jonathan W Goldman
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Enriqueta Felip
- Oncology Department, Vall d’Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Tudor-Eliade Ciuleanu
- Department of Oncology, Oncology Institute Prof Dr Ion Chiricuta, Cluj-Napoca, Romania,University of Medicine and Pharmacy Iuliu Hațieganu, Cluj-Napoca, Romania
| | | | - Kevin Jao
- Division of Medical Oncology and Hematology, Hôpital du Sacré‐Coeur de Montréal, Montréal, Quebec, Canada
| | - Fabrice Barlesi
- Department of Thoracic Oncology, Aix-Marseille Université, CNRS, INSERM, CRCM, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, Provence-Alpes-Côte d'Azur, France,Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphanie Bordenave
- Department of Thoracic and Digestive Medical Oncology, Centre Hospitalier Universitaire de Nantes, Nantes, Pays de la Loire, France
| | - Erika Rijavec
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Lombardia, Italy
| | - Laszlo Urban
- Onco-pulmonology Department, Matrahaza University and Teaching Hospital, Matrahaza, Heves, Hungary
| | - Jean-Sébastien Aucoin
- Division of Medical Oncology and Hematology, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec, Trois-Rivières, Quebec, Canada
| | - Cristina Zannori
- Department of Medical Oncology, Azienda Ospedaliera Santa Maria di Terni, Terni, Umbria, Italy
| | - Karim Vermaelen
- Department of Pulmonary Medicine, Ghent University Hospital, Ghent, Oost-Vlaanderen, Belgium
| | - Osvaldo Arén Frontera
- Department of Medical Oncology, Centro de Investigación Clínica Bradford Hill, Santiago, RM, Chile
| | - Alessandra Curioni Fontecedro
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland,Department of Oncology, University of Fribourg, Fribourg, Fribourg, Switzerland
| | | | - Oscar Juan-Vidal
- Department of Medical Oncology, Hospital Politécnico y Universitario La Fe, Valencia, Comunidad Valenciana, Spain
| | - Helena Linardou
- 4th Oncology Department and Comprehensive Clinical Trials Centre, Metropolitan Hospital Athens, Athens, Attike, Greece
| | | | - David R Spigel
- Department of Thoracic Medical Oncology, Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee, USA
| | - Samreen Ahmed
- Department of Medical Oncology, University Hospitals of Leicester NHS Trust, Leicester, Leicester, UK
| | - Michele Maio
- Department of Oncology, University of Siena and Center for Immuno-Oncology, University Hospital, Siena, Italy
| | - Sunney Li
- Global Biometrics and Data Sciences, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Han Chang
- Department of Translational Bioinformatics, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Joseph Fiore
- Oncology Clinical Development, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Angelic Acevedo
- Oncology Clinical Development, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Luis Paz-Ares
- Medical Oncology Department, Hospital Universitario 12 de Octubre, CNIO-H12o Lung Cancer Unit, Universidad Complutense and Ciberonc, Madrid, Comunidad de Madrid, Spain
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Herman R, Hlivak P, Bernat V, Svetlosak M, Demolder A, Palus T, Urban L, Hatala R. Predictors of long-term atrial fibrillation recurrence after catheter ablation: non-linear analytical approach for individualized prognostic stratification. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Recurrences are common in patients with atrial fibrillation (AF) during long-term follow-up after catheter ablation (CA) for pulmonary vein isolation (PVI). Recently, machine learning (ML) models identifying non-linear relationships among various patient parameters have been applied for prognostic stratification in different cardiac diseases.
Aim
This is a retrospective study aimed to determine whether ML-based models can identify non-linear relationships in individual clinical baseline characteristics and CT-quantified volumetric parameters of epicardial fat tissue (EFT) to aid in prognosing outcome of catheter ablation for PVI in patients with paroxysmal AF.
Methods
A cohort of 92 patients (median age 60.2 [51.9–64.0]; 74% male) with paroxysmal AF (a single persistent AF episode was accepted) undergoing catheter ablation targeting PVI was analysed. All patients underwent cardiac CT imaging and were fitted with implantable loop recorder (ILR) prior to CA. For PVI, radiofrequency CA with electro-anatomical mapping was used in 79 patients, cryoballoon ablation in 13 patients. AF recurrence, defined as AF burden >0.1% after the blanking period (90 days), was continuously assessed by ILR. Feature selection on 23 baseline parameters was performed using random forest models (XGBoostRegressor). Mean absolute Shapley values (|mSHAP| – Shapley Additive expLanations) were used to quantify the relative discriminative power of analysed parameters.
Results
During a follow-up of 3-years, AF recurrence was detected in 58 (63%) patients, 29 (50%) of them underwent a repeat ablation. Five most important predictors of AF recurrence during 3-year follow-up were upper epicardial fat volume, BMI, baseline AF burden, age and pericardial volume (lower segment) (Fig. 1). Upper EFT volume was twice as important for males than females (0.44 and 0.21 |mSHAP| respectively). For a patient with no AF recurrence, low age (41 years) and low upper EFT volume (13.2 ml) were the most important drivers predicting positive ablation outcome (Fig. 2A). In contrast, in a patient with AF recurrence post CA, an above-average EFT volume of 55.5 ml and a high BMI had the most significant net contribution for predicting his failed CA outcome (Fig. 2B).
Conclusion
Non-linear ML analysis applied to our limited cohort of patients with paroxysmal AF undergoing CA suggests: i) a significant association of high EFT volume with ILR determined AF recurrence during a 3-year follow-up; ii) potential role of such analyses for a more granular and highly individualized prediction of outcome of planned CA. However, these results need further testing, and validation in prospective trials.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Herman
- University of Naples Federico II , Naples , Italy
| | - P Hlivak
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - V Bernat
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - M Svetlosak
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - A Demolder
- Powerful Medical, AI Research , Bratislava , Slovakia
| | - T Palus
- Powerful Medical, AI Research , Bratislava , Slovakia
| | - L Urban
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - R Hatala
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
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Herman R, Hlivak P, Bernat V, Svetlosak M, Demolder A, Palus T, Urban L, Hatala R. High epicardial fat volume is associated with atrial fibrillation recurrences after catheter ablation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation therapy for atrial fibrillation (AF). However, even with important technological improvements, AF recurrences are common in long-term follow-up. Recently, epicardial fat tissue (EFT) has been proposed as a potential AF modulator promoting and sustaining atrial arrhythmogenic milieu.
Aim
In this retrospective single-centre study, we sought to evaluate the association between CT-quantified EFT volume and long-term primary PVI outcome assed by means of continuous ECG monitoring with implantable loop recorders (ILR) in paroxysmal AF patients.
Methods
A cohort of 92 patients (median age 60.2 [IQR 51.9–64.0]; 74% male) with paroxysmal AF (a single persistent AF episode was accepted) undergoing catheter ablation targeted at PVI was analysed. Prior to CA all patients underwent cardiac CT imaging with subsequent implantation of implantable loop recorder (ILR). Radiofrequency CA ablation with electro-anatomical mapping for PVI was used in 79 patients, balloon cryoablation was used in 13 patients. Verified complete PVI was defined as procedural endpoint. EFT volume was semi-automatically segmented and quantified on contrast enhanced CT studies. AF recurrence, defined as AF burden >0.1% after the blanking period (90 days), was continuously assessed by ILR. Kaplan-Meier analysis of AF recurrence-free survival at 1-year, 2-year and 3-year follow-up periods compared patients stratified into EFT volume tertiles.
Results
During a median follow-up of 52.6 months [IQR 43–64], AF recurrence was detected in 58 (63%) patients, 29 (50%) of them underwent a repeat ablation. Patients in high, mid, and low total EFT volume tertiles had a median time to late AF recurrence of 154, 373, and 284 days (Fig. 1A). At a 1-year follow-up, patients in the high EFT volume tertile had the worst AF ablation outcome (p=0.023). However, this difference gradually faded-out and became non-significant at 2 and 3 years. ROC analysis revealed an EFT of 95 ml as an optimal cut-off (p=0.002) for expected arrhythmia recurrence post acutely successful PVI (Fig. 1B).
Conclusion
EFT volume quantification in a relatively homogenous, continuously monitored cohort of patients undergoing catheter ablation for paroxysmal AF revealed a significant association between AF recurrence at 1 year post ablation and volume of epicardial fat. These results suggest a possible role of epicardial adipose tissue as an adverse pro-fibrillatory factor. Identified EFT volume cut-offs have to be validated prospectively on a larger and balanced patient population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Herman
- University of Naples Federico II , Naples , Italy
| | - P Hlivak
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - V Bernat
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - M Svetlosak
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - A Demolder
- Powerful Medical, AI Research , Bratislava , Slovakia
| | - T Palus
- Powerful Medical, AI Research , Bratislava , Slovakia
| | - L Urban
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
| | - R Hatala
- National Institute of Cardiovascular Diseases, Arrhythmia and Pacing , Bratislava , Slovakia
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Kaňuchová M, Urban L, Melegová N, Čoma M, Dvořánková B, Smetana K, Gál P. Genistein does not inhibit TGF-beta1-induced conversion of human dermal fibroblasts to myofibroblasts. Physiol Res 2021; 70:815-820. [PMID: 34505520 DOI: 10.33549/physiolres.934666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Transforming growth factor beta 1 (TGF-beta1) is a pro-fibrotic cytokine with a key role in wound repair and regeneration, including induction of fibroblast-to-myofibroblast transition. Genistein is a naturally occurring selective estrogen receptor modulator with promising anti-fibrotic properties. In the present study we aimed to investigate whether genistein modulates TGF-beta1 (canonical and non-canonical) signaling in normal dermal fibroblasts at the protein level (Western blot and immunofluorescence). We demonstrated that TGF-beta1 induces the myofibroblast-like phenotype in the studied fibroblast signaling via canonical (SMAD) and non-canonical (AKT, ERK1/2, ROCK) pathways. Genistein induced only ERK1/2 expression, whereas the combination of TGF-beta1 and genistein attenuated the ERK1/2 and ROCK signaling. Of note, the other studied pathways remained almost unaffected. From this point of view, genistein does not impair conversion of normal fibroblasts to myofibroblast-like cells.
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Affiliation(s)
- M Kaňuchová
- Department of Pharmacology, MediPark and East-Slovak Institute of Cardiovascular Diseases, Košice, Slovak Republic. or
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Paz-Ares LG, Ramalingam SS, Ciuleanu TE, Lee JS, Urban L, Caro RB, Park K, Sakai H, Ohe Y, Nishio M, Audigier-Valette C, Burgers JA, Pluzanski A, Sangha R, Gallardo C, Takeda M, Linardou H, Lupinacci L, Lee KH, Caserta C, Provencio M, Carcereny E, Otterson GA, Schenker M, Zurawski B, Alexandru A, Vergnenegre A, Raimbourg J, Feeney K, Kim SW, Borghaei H, O'Byrne KJ, Hellmann MD, Memaj A, Nathan FE, Bushong J, Tran P, Brahmer JR, Reck M. First-Line Nivolumab Plus Ipilimumab in Advanced NSCLC: 4-Year Outcomes From the Randomized, Open-Label, Phase 3 CheckMate 227 Part 1 Trial. J Thorac Oncol 2021; 17:289-308. [PMID: 34648948 DOI: 10.1016/j.jtho.2021.09.010] [Citation(s) in RCA: 143] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION In CheckMate 227, nivolumab plus ipilimumab prolonged overall survival (OS) versus chemotherapy in patients with tumor programmed death-ligand 1 (PD-L1) greater than or equal to 1% (primary end point) or less than 1% (prespecified descriptive analysis). We report results with minimum 4 years' follow-up. METHODS Adults with previously untreated stage IV or recurrent NSCLC were randomized (1:1:1) to nivolumab plus ipilimumab, nivolumab, or chemotherapy (PD-L1 ≥1%); or to nivolumab plus ipilimumab, nivolumab plus chemotherapy, or chemotherapy (PD-L1 <1%). Efficacy included OS and other measures. Safety included timing and management of immune-mediated adverse events (AEs). A post hoc analysis evaluated efficacy in patients who discontinued nivolumab plus ipilimumab due to treatment-related AEs (TRAEs). RESULTS After 54.8 months' median follow-up, OS remained longer with nivolumab plus ipilimumab versus chemotherapy in patients with PD-L1 greater than or equal to 1% (hazard ratio = 0.76; 95% confidence interval: 0.65-0.90) and PD-L1 less than 1% (0.64; 0.51-0.81); 4-year OS rate with nivolumab plus ipilimumab versus chemotherapy was 29% versus 18% (PD-L1 ≥1%); and 24% versus 10% (PD-L1 <1%). Benefits were observed in both squamous and nonsquamous histologies. In a descriptive analysis, efficacy was improved with nivolumab plus ipilimumab relative to nivolumab (PD-L1 ≥1%) and nivolumab plus chemotherapy (PD-L1 <1%). Safety was consistent with previous reports. The most common immune-mediated AE with nivolumab plus ipilimumab, nivolumab, and nivolumab plus chemotherapy was rash; most immune-mediated AEs (except endocrine events) occurred within 6 months from start of treatment and resolved within 3 months after, mainly with systemic corticosteroids. Patients who discontinued nivolumab plus ipilimumab due to TRAEs had long-term OS benefits, as seen in the all randomized population. CONCLUSIONS At more than 4 years' minimum follow-up, with all patients off immunotherapy treatment for at least 2 years, first-line nivolumab plus ipilimumab continued to demonstrate durable long-term efficacy in patients with advanced NSCLC. No new safety signals were identified. Immune-mediated AEs occurred early and resolved quickly with guideline-based management. Discontinuation of nivolumab plus ipilimumab due to TRAEs did not have a negative impact on the long-term benefits seen in all randomized patients.
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Affiliation(s)
- Luis G Paz-Ares
- Hospital Universitario 12 de Octubre, H12O-CNIO Lung Cancer Clinical Research Unit, Universidad Complutense & CiberOnc, Madrid, Spain.
| | | | - Tudor-Eliade Ciuleanu
- Institutul Oncologic Prof Dr Ion Chiricuta and UMF Iuliu Hatieganu, Cluj Napoca, România
| | - Jong-Seok Lee
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | | | - Reyes Bernabe Caro
- Hospital Universitario Virgen Del Rocio, Instituto de Biomedicina de Seville, Seville, Spain
| | - Keunchil Park
- Samsung Medical Center at Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | | | - Makoto Nishio
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | | | - Adam Pluzanski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | | | | | | | | | - Ki Hyeong Lee
- Chungbuk National University Hospital, Cheongju-si, Republic of Korea
| | | | - Mariano Provencio
- Hosp. Univ. Puerta De Hierro-IDIPHIM, Universidad Autónoma de Madrid, Madrid, Spain
| | - Enric Carcereny
- Catalan Institute of Oncology-Germans Trias i Pujol Hospital, B-ARGO group, Badalona, Spain
| | | | | | | | - Aurelia Alexandru
- Institute of Oncology "Prof. Dr. Alexandru Trestioreanu" Bucha, Bucharest, Romania
| | | | | | - Kynan Feeney
- St John of God Hospital Murdoch, Perth, Australia
| | - Sang-We Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Kenneth John O'Byrne
- Queensland University of Technology, Princess Alexandra Hospital, Brisbane, Australia
| | | | | | | | | | | | | | - Martin Reck
- Airway Research Center North, German Center for Lung Research, LungClinic, Grosshansdorf, Germany
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Tummino TA, Rezelj VV, Fischer B, Fischer A, O'Meara MJ, Monel B, Vallet T, White KM, Zhang Z, Alon A, Schadt H, O'Donnell HR, Lyu J, Rosales R, McGovern BL, Rathnasinghe R, Jangra S, Schotsaert M, Galarneau JR, Krogan NJ, Urban L, Shokat KM, Kruse AC, García-Sastre A, Schwartz O, Moretti F, Vignuzzi M, Pognan F, Shoichet BK. Drug-induced phospholipidosis confounds drug repurposing for SARS-CoV-2. Science 2021; 373:541-547. [PMID: 34326236 PMCID: PMC8501941 DOI: 10.1126/science.abi4708] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/15/2021] [Indexed: 01/16/2023]
Abstract
Repurposing drugs as treatments for COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has drawn much attention. Beginning with sigma receptor ligands and expanding to other drugs from screening in the field, we became concerned that phospholipidosis was a shared mechanism underlying the antiviral activity of many repurposed drugs. For all of the 23 cationic amphiphilic drugs we tested, including hydroxychloroquine, azithromycin, amiodarone, and four others already in clinical trials, phospholipidosis was monotonically correlated with antiviral efficacy. Conversely, drugs active against the same targets that did not induce phospholipidosis were not antiviral. Phospholipidosis depends on the physicochemical properties of drugs and does not reflect specific target-based activities-rather, it may be considered a toxic confound in early drug discovery. Early detection of phospholipidosis could eliminate these artifacts, enabling a focus on molecules with therapeutic potential.
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Affiliation(s)
- Tia A Tummino
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA
- Graduate Program in Pharmaceutical Sciences and Pharmacogenomics, UCSF, San Francisco, CA, USA
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
| | - Veronica V Rezelj
- Institut Pasteur, Viral Populations and Pathogenesis Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Benoit Fischer
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Audrey Fischer
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Matthew J O'Meara
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Blandine Monel
- Institut Pasteur, Virus and Immunity Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Thomas Vallet
- Institut Pasteur, Viral Populations and Pathogenesis Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Kris M White
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ziyang Zhang
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
- Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
- Howard Hughes Medical Institute, UCSF, San Francisco, CA, USA
| | - Assaf Alon
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Heiko Schadt
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Henry R O'Donnell
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Jiankun Lyu
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
| | - Romel Rosales
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Briana L McGovern
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raveen Rathnasinghe
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sonia Jangra
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Schotsaert
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean-René Galarneau
- Novartis Institutes for BioMedical Research, Preclinical Safety, Cambridge, MA, USA
| | - Nevan J Krogan
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
- Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
- Gladstone Institute of Data Science and Biotechnology, J. David Gladstone Institutes, San Francisco, CA, USA
| | - Laszlo Urban
- Novartis Institutes for BioMedical Research, Preclinical Safety, Cambridge, MA, USA
| | - Kevan M Shokat
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
- Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
- Howard Hughes Medical Institute, UCSF, San Francisco, CA, USA
| | - Andrew C Kruse
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Olivier Schwartz
- Institut Pasteur, Virus and Immunity Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Francesca Moretti
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland.
| | - Marco Vignuzzi
- Institut Pasteur, Viral Populations and Pathogenesis Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France.
| | - Francois Pognan
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland.
| | - Brian K Shoichet
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA.
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
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Bieberich AA, Rajwa B, Irvine A, Fatig RO, Fekete A, Jin H, Kutlina E, Urban L. TEMPORARY REMOVAL: Acute cell stress screen with supervised machine learning predicts cytotoxicity of excipients. J Pharmacol Toxicol Methods 2021; 111:107088. [PMID: 34144174 DOI: 10.1016/j.vascn.2021.107088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/17/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022]
Abstract
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Andrew A Bieberich
- AsedaSciences Inc., 1281 Win Hentschel Boulevard, West Lafayette, IN 47906, USA.
| | - Bartek Rajwa
- Bindley Bioscience Center, Purdue University, West Lafayette, IN 47906, USA.
| | - Allison Irvine
- AsedaSciences Inc., 1281 Win Hentschel Boulevard, West Lafayette, IN 47906, USA.
| | - Raymond O Fatig
- AsedaSciences Inc., 1281 Win Hentschel Boulevard, West Lafayette, IN 47906, USA.
| | - Alexander Fekete
- Preclinical Safety, Translational Medicine, Novartis Institutes of Biomedical Research, Cambridge, MA, 02139, USA.
| | - Hong Jin
- Preclinical Safety, Translational Medicine, Novartis Institutes of Biomedical Research, Cambridge, MA, 02139, USA.
| | - Elena Kutlina
- Preclinical Safety, Translational Medicine, Novartis Institutes of Biomedical Research, Cambridge, MA, 02139, USA.
| | - Laszlo Urban
- Preclinical Safety, Translational Medicine, Novartis Institutes of Biomedical Research, Cambridge, MA, 02139, USA.
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Paz-Ares LG, Ciuleanu TE, Lee JS, Urban L, Bernabe Caro R, Park K, Sakai H, Ohe Y, Nishio M, Pluzanski A, Ramalingam SS, Brahmer JR, Borghaei H, O'Byrne KJ, Hellmann MD, Memaj A, Bushong J, Tran P, Reck M. Nivolumab (NIVO) plus ipilimumab (IPI) versus chemotherapy (chemo) as first-line (1L) treatment for advanced non-small cell lung cancer (NSCLC): 4-year update from CheckMate 227. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9016] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9016 Background: 1L NIVO + IPI was shown to provide durable long-term overall survival (OS) benefit vs chemo regardless of tumor programmed death ligand 1 (PD-L1) expression in patients (pts) with advanced NSCLC in CheckMate 227 Part 1 (NCT02477826); 3-year OS rates were 33% vs 22% in pts with PD-L1 ≥ 1% (HR, 0.79 [95% CI, 0.67–0.93]) and 34% vs 15% in pts with PD-L1 < 1% (HR, 0.64 [95% CI, 0.51–0.81]). Here we report updated results from the study with 4 years’ minimum follow-up. Methods: Adults with previously untreated stage IV / recurrent NSCLC, no known EGFR/ ALK alterations , and ECOG performance status ≤ 1 were enrolled; pts were stratified by squamous (SQ) and non-squamous (NSQ) histology. Pts with PD-L1 ≥ 1% (n = 1189) were randomized 1:1:1 to receive NIVO (3 mg/kg Q2W) + IPI (1 mg/kg Q6W), NIVO alone (240 mg Q2W), or chemo. Pts with PD-L1 < 1% (n = 550) were randomized 1:1:1 to receive NIVO + IPI, NIVO (360 mg Q3W) + chemo, or chemo. OS with NIVO + IPI vs chemo in pts with PD-L1 ≥ 1% was the primary endpoint. Results: With minimum follow-up of 49.4 months (database lock, Feb 18, 2021), pts were at least 2 years beyond the protocol-specified end of immunotherapy treatment. Pts with PD-L1 ≥ 1% continued to show durable benefit with NIVO + IPI vs chemo (HR, 0.76 [95% CI, 0.65–0.90]); 4-year OS rates were 29% (NIVO + IPI), 21% (NIVO), and 18% (chemo). At 4 years, 14% (NIVO + IPI), 10% (NIVO), and 4% (chemo) remained progression free. Among responders, 34%, 30%, and 7% remained in response, respectively. In an exploratory analysis in pts with PD-L1 ≥ 50%, 4-year OS rates were 37% (NIVO + IPI), 26% (NIVO), and 20% (chemo). In pts with PD-L1 < 1%, OS HR for NIVO + IPI vs chemo was 0.64 (95% CI, 0.51–0.81); 4-year OS rates were 24% (NIVO + IPI), 13% (NIVO + chemo) and 10% (chemo). At 4 years, 12% (NIVO + IPI), 7% (NIVO + chemo), and 0% (chemo) remained progression free. Among responders, 31%, 13%, and 0% remained in response, respectively. Among pts who progressed on NIVO + IPI vs chemo, 7% vs 40% (PD-L1 ≥ 1%), and 9% vs 33% (PD-L1 < 1%), received subsequent immunotherapy. Benefit with NIVO + IPI vs chemo was observed for both SQ and NSQ histology (Table). With long-term follow-up, no new safety signals were identified. Conclusions: With 4 years’ minimum follow-up, 1L NIVO + IPI continued to provide durable, long-term OS benefit vs chemo in pts with advanced NSCLC regardless of PD-L1 expression or histology. Clinical trial information: NCT02477826. [Table: see text]
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Affiliation(s)
- Luis G. Paz-Ares
- Hospital Universitario 12 de Octubre, CNIO-H12o Lung Cancer Clinical Research Unit, Universidad Complutense & CiberOnc, Madrid, Spain
| | - Tudor-Eliade Ciuleanu
- Institutul oncologic Prof Dr Ion Chiricuta and UMF Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Jong-Seok Lee
- Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Reyes Bernabe Caro
- Hospital Universitario Virgen Del Rocio, Instituto de Biomedicina de Seville, Seville, Spain
| | - Keunchil Park
- Samsung Medical Center at Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Makoto Nishio
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Adam Pluzanski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | | | | | | | | | | | | | | | - Martin Reck
- Airway Research Center North, German Center for Lung Research, LungClinic, Grosshansdorf, Germany
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11
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Jordaan P, Dumotier B, Traebert M, Miller PE, Ghetti A, Urban L, Abi-Gerges N. Cardiotoxic Potential of Hydroxychloroquine, Chloroquine and Azithromycin in Adult Human Primary Cardiomyocytes. Toxicol Sci 2021; 180:356-368. [PMID: 33483756 PMCID: PMC7928616 DOI: 10.1093/toxsci/kfaa194] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Indexed: 12/17/2022] Open
Abstract
Substantial efforts have been recently committed to develop coronavirus disease-2019 (COVID-19) medications, and Hydroxychloroquine alone or in combination with Azithromycin has been promoted as a repurposed treatment. Although these drugs may increase cardiac toxicity risk, cardiomyocyte mechanisms underlying this risk remain poorly understood in humans. Therefore, we evaluated the proarrhythmia risk and inotropic effects of these drugs in the cardiomyocyte contractility-based model of the human heart. We found Hydroxychloroquine to have a low proarrhythmia risk, whereas Chloroquine and Azithromycin were associated with high risk. Hydroxychloroquine proarrhythmia risk changed to high with low level of K+, whereas high level of Mg2+ protected against proarrhythmic effect of high Hydroxychloroquine concentrations. Moreover, therapeutic concentration of Hydroxychloroquine caused no enhancement of elevated temperature-induced proarrhythmia. Polytherapy of Hydroxychloroquine plus Azithromycin and sequential application of these drugs were also found to influence proarrhythmia risk categorization. Hydroxychloroquine proarrhythmia risk changed to high when combined with Azithromycin at therapeutic concentration. However, Hydroxychloroquine at therapeutic concentration impacted the cardiac safety profile of Azithromycin and its proarrhythmia risk only at concentrations above therapeutic level. We also report that Hydroxychloroquine and Chloroquine, but not Azithromycin, decreased contractility while exhibiting multi-ion channel block features, and Hydroxychloroquine's contractility effect was abolished by Azithromycin. Thus, this study has the potential to inform clinical studies evaluating repurposed therapies, including those in the COVID-19 context. Additionally, it demonstrates the translational value of the human cardiomyocyte contractility-based model as a key early discovery path to inform decisions on novel therapies for COVID-19, malaria, and inflammatory diseases.
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Affiliation(s)
- Pierre Jordaan
- Chief Medical Officer and Patient Safety, Novartis AG, Basel, Switzerland
| | - Bérengère Dumotier
- Novartis Institutes for Biomedical Research, Preclinical Safety, Basel, Switzerland
| | - Martin Traebert
- Novartis Institutes for Biomedical Research, Preclinical Safety, Basel, Switzerland
| | - Paul E Miller
- AnaBios Corporation, San Diego, California 92109, USA
| | - Andre Ghetti
- AnaBios Corporation, San Diego, California 92109, USA
| | - Laszlo Urban
- Novartis Institutes for Biomedical Research, Preclinical Secondary Pharmacology, Cambridge, Massachusetts, USA
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12
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Tummino TA, Rezelj VV, Fischer B, Fischer A, O’Meara MJ, Monel B, Vallet T, Zhang Z, Alon A, O’Donnell HR, Lyu J, Schadt H, White KM, Krogan NJ, Urban L, Shokat KM, Kruse AC, García-Sastre A, Schwartz O, Moretti F, Vignuzzi M, Pognan F, Shoichet BK. Phospholipidosis is a shared mechanism underlying the in vitro antiviral activity of many repurposed drugs against SARS-CoV-2. bioRxiv 2021:2021.03.23.436648. [PMID: 33791693 PMCID: PMC8010720 DOI: 10.1101/2021.03.23.436648] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Repurposing drugs as treatments for COVID-19 has drawn much attention. A common strategy has been to screen for established drugs, typically developed for other indications, that are antiviral in cells or organisms. Intriguingly, most of the drugs that have emerged from these campaigns, though diverse in structure, share a common physical property: cationic amphiphilicity. Provoked by the similarity of these repurposed drugs to those inducing phospholipidosis, a well-known drug side effect, we investigated phospholipidosis as a mechanism for antiviral activity. We tested 23 cationic amphiphilic drugs-including those from phenotypic screens and others that we ourselves had found-for induction of phospholipidosis in cell culture. We found that most of the repurposed drugs, which included hydroxychloroquine, azithromycin, amiodarone, and four others that have already progressed to clinical trials, induced phospholipidosis in the same concentration range as their antiviral activity; indeed, there was a strong monotonic correlation between antiviral efficacy and the magnitude of the phospholipidosis. Conversely, drugs active against the same targets that did not induce phospholipidosis were not antiviral. Phospholipidosis depends on the gross physical properties of drugs, and does not reflect specific target-based activities, rather it may be considered a confound in early drug discovery. Understanding its role in infection, and detecting its effects rapidly, will allow the community to better distinguish between drugs and lead compounds that more directly impact COVID-19 from the large proportion of molecules that manifest this confounding effect, saving much time, effort and cost.
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Affiliation(s)
- Tia A. Tummino
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA
- Graduate Program in Pharmaceutical Sciences and Pharmacogenomics, UCSF, San Francisco, CA, USA
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
| | - Veronica V. Rezelj
- Institut Pasteur, Viral Populations and Pathogenesis Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Benoit Fischer
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Audrey Fischer
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Matthew J. O’Meara
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Blandine Monel
- Institut Pasteur, Virus and Immunity Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Thomas Vallet
- Institut Pasteur, Viral Populations and Pathogenesis Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Ziyang Zhang
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
- Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
- Howard Hughes Medical Institute, UCSF, San Francisco, CA, USA
| | - Assaf Alon
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Henry R. O’Donnell
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Jiankun Lyu
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
| | - Heiko Schadt
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Kris M White
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nevan J. Krogan
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
- Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Gladstone Institute of Data Science and Biotechnology, J. David Gladstone Institutes, San Francisco, CA, USA
| | - Laszlo Urban
- Novartis Institutes for BioMedical Research, Preclinical Safety, Cambridge, MA, USA
| | - Kevan M. Shokat
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
- Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
- Howard Hughes Medical Institute, UCSF, San Francisco, CA, USA
| | - Andrew C. Kruse
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Olivier Schwartz
- Institut Pasteur, Virus and Immunity Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Francesca Moretti
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Marco Vignuzzi
- Institut Pasteur, Viral Populations and Pathogenesis Unit, CNRS UMR 3569, 75724 Paris, Cedex 15, France
| | - Francois Pognan
- Novartis Institutes for BioMedical Research, Preclinical Safety, Basel, Switzerland
| | - Brian K. Shoichet
- Department of Pharmaceutical Chemistry, University of California San Francisco (UCSF), San Francisco, CA, USA
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA
- QBI COVID-19 Research Group (QCRG), San Francisco, CA, USA
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13
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Bohm A, Urban L, Tothova L, Bezak B, Uher T, Musil P, Kyselovic J, Lipton J, Olejnik P, Hatala R. Concentration of apelin inversely correlates with atrial fibrillation burden. ACTA ACUST UNITED AC 2021; 122:165-171. [PMID: 33618523 DOI: 10.4149/bll_2021_026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM Asymptomatic atrial fibrillation (AF) detection and pulmonary veins isolation (PVI) outcome prediction remain challenging. Our aim was to study the association between apelin and paroxysmal AF in patients undergoing radiofrequency catheter PVI. METHODS Sixty-three consecutive patients (55 ± 8years, 12 females) with paroxysmal AF without a structural heart disease and implanted ECG loop recorders undergoing PVI and healthy control group of 34 persons (41 ± 9.5years, 21 females) were included. Apelin plasmatic concentrations were measured before and three months after PVI. AF burden was continually assessed for three years. RESULTS Apelin was significantly decreased in AF patients compared to the healthy controls (0.79 ± 0.09 vs 0.98 ± 0.06 ng/ml; p < 0.00001). Apelin plasmatic concentration of 0.89 ng/ml had 94 % specificity and 89 % sensitivity for AF prediction with the area under the curve (AUC) of 0.96. After propensity matching to sex, age and comorbidities, apelin concentration was significantly lower in AF group (0.78 ± 0.1 vs 0.99 ±0.06 ng/ml; p < 0.0001; AUC: 0.97). There was a significant inverse correlation between apelin concentration and AF burden both before and after PVI (Rho = ‒0.22; p = 0.05) and (Rho = ‒0.51; p = 0.006), respectively. There was no significant association between pre-PVI apelin and PVI long-term outcome. CONCLUSION In patients without a structural heart disease apelin showed a significant specificity and sensitivity for AF prediction and inversely correlated with AF burden (Tab. 3, Fig. 3, Ref. 34).
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Urban L, Thompson TH, Ochsenfeld C. A scaled explicitly correlated F12 correction to second-order Møller-Plesset perturbation theory. J Chem Phys 2021; 154:044101. [PMID: 33514114 DOI: 10.1063/5.0033411] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
An empirically scaled version of the explicitly correlated F12 correction to second-order Møller-Plesset perturbation theory (MP2-F12) is introduced. The scaling eliminates the need for many of the most costly terms of the F12 correction while reproducing the unscaled explicitly correlated F12 interaction energy correction to a high degree of accuracy. The method requires a single, basis set dependent scaling factor that is determined by fitting to a set of test molecules. We present factors for the cc-pVXZ-F12 (X = D, T, Q) basis set family obtained by minimizing interaction energies of the S66 set of small- to medium-sized molecular complexes and show that our new method can be applied to accurately describe a wide range of systems. Remarkably good explicitly correlated corrections to the interaction energy are obtained for the S22 and L7 test sets, with mean percentage errors for the double-zeta basis of 0.60% for the F12 correction to the interaction energy, 0.05% for the total electron correlation interaction energy, and 0.03% for the total interaction energy, respectively. Additionally, mean interaction energy errors introduced by our new approach are below 0.01 kcal mol-1 for each test set and are thus negligible for second-order perturbation theory based methods. The efficiency of the new method compared to the unscaled F12 correction is shown for all considered systems, with distinct speedups for medium- to large-sized structures.
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Affiliation(s)
- L Urban
- Department of Chemistry, Ludwig-Maximilians-University Munich (LMU Munich), D-81377 Munich, Germany
| | - T H Thompson
- Department of Chemistry, Ludwig-Maximilians-University Munich (LMU Munich), D-81377 Munich, Germany
| | - C Ochsenfeld
- Department of Chemistry, Ludwig-Maximilians-University Munich (LMU Munich), D-81377 Munich, Germany
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15
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Forges M, Bardin M, Urban L, Aarrouf J, Charles F. Impact of UV-C Radiation Applied during Plant Growth on Pre- and Postharvest Disease Sensitivity and Fruit Quality of Strawberry. Plant Dis 2020; 104:3239-3247. [PMID: 33026955 DOI: 10.1094/pdis-02-20-0306-re] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Ultraviolet-C (UV-C) radiation is efficient in reducing the development of diseases in many species, including strawberry (Fragaria × ananassa). Several studies suggest that UV-C radiation is effective not only because of its disinfecting effect but also because it may stimulate plant defenses. In this study, the effect of preharvest UV-C radiation applied during strawberry cultivation on plant growth, fruit quality, and susceptibility to major fungal diseases such as gray mold, powdery mildew, and soft rot was evaluated. UV-C treatments had an impact on flowering initiation and fruit development. Flowering occurred earlier for UV-C-treated plants than for nontreated plants. At harvest, a larger amount of fruit was produced by treated plants despite their slight decrease in leaf area. UV-C treatment did not improve strawberry shelf life but did not alter the physical integrity of strawberry fruit. Natural infection of leaves to powdery mildew and of fruit to Rhizopus spp. strongly decreased in response to UV-C treatment.
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Affiliation(s)
- M Forges
- Unité Mixte de Recherche Qualisud, Laboratoire de Physiologie des fruits et Légumes, Université d'Avignon, 301 Rue Baruch de Spinoza, BP2139-84916, Avignon, France
| | - M Bardin
- INRAE, Pathologie Végétale, F-84140, Montfavet, France
| | - L Urban
- Unité Mixte de Recherche Qualisud, Laboratoire de Physiologie des fruits et Légumes, Université d'Avignon, 301 Rue Baruch de Spinoza, BP2139-84916, Avignon, France
| | - J Aarrouf
- Unité Mixte de Recherche Qualisud, Laboratoire de Physiologie des fruits et Légumes, Université d'Avignon, 301 Rue Baruch de Spinoza, BP2139-84916, Avignon, France
| | - F Charles
- Unité Mixte de Recherche Qualisud, Laboratoire de Physiologie des fruits et Légumes, Université d'Avignon, 301 Rue Baruch de Spinoza, BP2139-84916, Avignon, France
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16
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Ivanchenko V, Bagulya A, Bakr S, Bandieramonte M, Bernard D, Bordage MC, Burkhardt H, Dondero P, Grichine V, Guatelli S, Hřivnáčová I, Incerti S, Kadri O, Konstantinov D, Kyriakou I, Maire M, Mantero A, RamosMendez J, Novak M, Pandola L, Sakata D, Sawkey D, Semeniouk I, Shin WG, Tran NH, Urban L. Geant4 electromagnetic physics progress. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202024502009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The Geant4 electromagnetic (EM) physics sub-packages are a component of LHC experiment simulations. During long shutdown 2 for LHC, these packages are under intensive development and we report progress of EM physics in Geant4 versions 10.5 and 10.6, which includes faster computation, more accurate EM models, and extensions to the validation suite. New approaches are developed to simulate radiation damage for silicon vertex detectors and for configuration of multiple scattering per detector region. Improvements in user interfaces developed for low-energy and the Geant4-DNA project are used also for LHC simulation optimisation.
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17
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Zampieri M, Beltrami M, Fumagalli C, Dei L, Urban L, Emmi G, Marchi A, Carrassa G, Chiriatti C, Tomberli A, Baldini K, Olivotto I. Eosinophilic granulomatosis with polyangiitis, a new recurrent feature in an extremely rare disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Eosinophilic granulomatosis with polyangiitis (EGPA) is an extremely rare necrotizing vasculitis affecting small- and medium-sized vessels. EGPA may affect the heart leading to myocardial inflammation and necrosis. Although, only a few cardiological based studies have been conducted.
Purpose
This study aimed to investigate the prevalence and clinical impact of cardiac-specific involvement (CSI+) and to give an update on EGPA cardiological manifestations.
Methods
This is a single-centre study. Cardiological evaluation included ECG, blood test, echocardiography, global longitudinal strain (GLS), cardiac magnetic resonance (CMR).
Results
We prospectively enrolled 52 consecutive EGPA patients, between October 2018 and October 2019, mean age 59±3 years, 30 (57%) female. We identified 13 (25%) CSI+ patients: 6 myocarditis, 2 pericarditis, 1 coronaritis, 1 Prinzmetal angina, 2 LV apical thrombosis, 1 unexplained wall motions abnormalities (WMA) in the absence of coronary artery disease.
Twelve-leads ECG revealed abnormalities in 11 (85%) CSI+ vs 9 (23%) CSI−, p=0.0001; ECG abnormalities identified CSI+ with 85% sensitivity, 77% specificity, 94% negative predictive value.
Median troponin level in CSI+ 9 ng/L (IQR 6–11) vs CSI− 11 ng/L (IQR 6–25), p=0.2548; NT-pro-BNP value in CSI+ 210 pg/L (IQR 175–484) vs CSI− 159 ng/L (IQR 66–299), p=0.0576.
Echocardiographic left ventricular end diastolic volume in CSI+ 62±4 ml/m2 vs CSI− 52±1 ml/m2, p=0.0116; LV ejection fraction in CSI+ 57%±2 vs CSI− 66%±1, p=0.0002. In CSI+ patients GLS was −15±1 vs CSI− GLS −21±0.4, p<0.0001. Echocardiography identified WMA in 8 (61%) CSI+ vs 1 (3%) CSI−. In 7 (54%) CSI+ patients, apical segments showed WMA and among them 5 demonstrated the presence of apical aneurysm.
Twelve patients underwent CMR, it showed non ischaemic late gadolinium enhancement in 7 patients; in 5 patients we identified akinetic or dyskinetic segments without associated LGE. Two patients showed LV apical thrombus.
Conclusions
EGPA showed a high prevalence of CSI. We repeatedly found a tropism for apical involvement in WMA that often manifested themselves as apical aneurysm. These may be a new clinical feature, previously not described, in such a rare condition.
Cardiac involvement EGPA
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Zampieri
- Careggi University Hospital (AOUC), Florence, Italy
| | - M Beltrami
- Careggi University Hospital (AOUC), Florence, Italy
| | - C Fumagalli
- Careggi University Hospital (AOUC), Florence, Italy
| | - L Dei
- Careggi University Hospital (AOUC), Florence, Italy
| | - L Urban
- Careggi University Hospital (AOUC), Florence, Italy
| | - G Emmi
- Careggi University Hospital (AOUC), Florence, Italy
| | - A Marchi
- Careggi University Hospital (AOUC), Florence, Italy
| | - G Carrassa
- Careggi University Hospital (AOUC), Florence, Italy
| | - C Chiriatti
- Careggi University Hospital (AOUC), Florence, Italy
| | - A Tomberli
- Careggi University Hospital (AOUC), Florence, Italy
| | - K Baldini
- Careggi University Hospital (AOUC), Florence, Italy
| | - I Olivotto
- Careggi University Hospital (AOUC), Florence, Italy
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18
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Uher T, Bohm A, Urban L, Tothova L, Bacharova L, Musil P, Kyselovic J, Michalek P, Vachalcova M, Olejnik P, Hatala R. Association of apelin and AF in patients with implanted loop recorders undergoing catheter ablation. BRATISL MED J 2020; 121:484-487. [PMID: 32990001 DOI: 10.4149/bll_2020_079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous studies showed an association between apelin and atrial fibrillation (AF). The aim of this study was to analyse the effect of pulmonary vein isolation (PVI) in patients with paroxysmal AF on plasmatic apelin concentrations. METHODS Nine consecutive patients (aged from 43 to 69 years, 3 females and 6 males) with documented paroxysmal atrial fibrillation and implanted loop recorders (ILR) for continuous ECG monitoring were included in this study. All the patients underwent a radiofrequency catheter ablation with PVI. RESULTS The plasmatic concentration of apelin increased after PVI. The average plasmatic concentration of apelin before PVI was 0.299 ng/ml (±0.16), 3 months after PVI 0.462 ng/ml (±0.10) and 9 months after PVI 0.565 ng/ml (±0.146). There was an increase in the concentration of apelin 3 months and 9 months after the PVI by 0.163 ng/ml (p=0.07) and by 0.266 ng/ml (p=0.01), respectively. The concentration of apelin inversely correlated with the AF burden (r=-0.44, p=0.03). CONCLUSIONS Our study showed a significant increase in apelin levels after the reduction of AF burden via PVI and an inverse correlation with AF burden. Apelin might be a promising marker of AF (Tab. 2, Fig. 2, Ref. 28).
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Pottel J, Armstrong D, Zou L, Fekete A, Huang XP, Torosyan H, Bednarczyk D, Whitebread S, Bhhatarai B, Liang G, Jin H, Ghaemi SN, Slocum S, Lukacs KV, Irwin JJ, Berg EL, Giacomini KM, Roth BL, Shoichet BK, Urban L. The activities of drug inactive ingredients on biological targets. Science 2020; 369:403-413. [PMID: 32703874 DOI: 10.1126/science.aaz9906] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/18/2020] [Indexed: 12/22/2022]
Abstract
Excipients, considered "inactive ingredients," are a major component of formulated drugs and play key roles in their pharmacokinetics. Despite their pervasiveness, whether they are active on any targets has not been systematically explored. We computed the likelihood that approved excipients would bind to molecular targets. Testing in vitro revealed 25 excipient activities, ranging from low-nanomolar to high-micromolar concentration. Another 109 activities were identified by testing against clinical safety targets. In cellular models, five excipients had fingerprints predictive of system-level toxicity. Exposures of seven excipients were investigated, and in certain populations, two of these may reach levels of in vitro target potency, including brain and gut exposure of thimerosal and its major metabolite, which had dopamine D3 receptor dissociation constant K d values of 320 and 210 nM, respectively. Although most excipients deserve their status as inert, many approved excipients may directly modulate physiologically relevant targets.
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Affiliation(s)
- Joshua Pottel
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA 94158, USA
| | - Duncan Armstrong
- Preclinical Safety, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Ling Zou
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA
| | - Alexander Fekete
- Preclinical Safety, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Xi-Ping Huang
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC 27759, USA
| | - Hayarpi Torosyan
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA 94158, USA
| | - Dallas Bednarczyk
- PK Sciences, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Steven Whitebread
- Preclinical Safety, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Barun Bhhatarai
- PK Sciences, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Guiqing Liang
- PK Sciences, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Hong Jin
- Preclinical Safety, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - S Nassir Ghaemi
- Translational Medicine, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA.,Tufts University School of Medicine, Boston, MA 02111, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Samuel Slocum
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC 27759, USA
| | - Katalin V Lukacs
- National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
| | - John J Irwin
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA 94158, USA
| | - Ellen L Berg
- Eurofins, DiscoverX, South San Francisco, CA 94080, USA
| | - Kathleen M Giacomini
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA
| | - Bryan L Roth
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC 27759, USA
| | - Brian K Shoichet
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA 94158, USA.
| | - Laszlo Urban
- Preclinical Safety, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA.
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20
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Ietswaart R, Arat S, Chen AX, Farahmand S, Kim B, DuMouchel W, Armstrong D, Fekete A, Sutherland JJ, Urban L. Machine learning guided association of adverse drug reactions with in vitro target-based pharmacology. EBioMedicine 2020; 57:102837. [PMID: 32565027 PMCID: PMC7379147 DOI: 10.1016/j.ebiom.2020.102837] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/08/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adverse drug reactions (ADRs) are one of the leading causes of morbidity and mortality in health care. Understanding which drug targets are linked to ADRs can lead to the development of safer medicines. METHODS Here, we analyse in vitro secondary pharmacology of common (off) targets for 2134 marketed drugs. To associate these drugs with human ADRs, we utilized FDA Adverse Event Reports and developed random forest models that predict ADR occurrences from in vitro pharmacological profiles. FINDINGS By evaluating Gini importance scores of model features, we identify 221 target-ADR associations, which co-occur in PubMed abstracts to a greater extent than expected by chance. Amongst these are established relations, such as the association of in vitro hERG binding with cardiac arrhythmias, which further validate our machine learning approach. Evidence on bile acid metabolism supports our identification of associations between the Bile Salt Export Pump and renal, thyroid, lipid metabolism, respiratory tract and central nervous system disorders. Unexpectedly, our model suggests PDE3 is associated with 40 ADRs. INTERPRETATION These associations provide a comprehensive resource to support drug development and human biology studies. FUNDING This study was not supported by any formal funding bodies.
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Affiliation(s)
- Robert Ietswaart
- Department of Genetics, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, United States.
| | - Seda Arat
- The Jackson Laboratory, Farmington, CT 06032, United States.
| | - Amanda X Chen
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, United States; Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - Saman Farahmand
- Computational Sciences PhD program, University of Massachusetts Boston, Boston, MA 02125, United States
| | - Bumjun Kim
- Department of Chemical Engineering, Northeastern University, Boston, MA 02115, United States
| | | | - Duncan Armstrong
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, United States
| | - Alexander Fekete
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, United States
| | - Jeffrey J Sutherland
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, United States.
| | - Laszlo Urban
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, United States.
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21
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Feichtinger M, Urban L, Falch S, Nagai Y, Ulm PA, Hengstschläger M, Oberle A. Oxford Nanopore Sequenzierung zur Bestimmung des Endometrium-Mikrobioms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
| | - L Urban
- Wunschbaby Institut Feichtinger
| | - S Falch
- Wunschbaby Institut Feichtinger
| | - Y Nagai
- Wunschbaby Institut Feichtinger
| | - P A Ulm
- Wunschbaby Institut Feichtinger
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22
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Barlesi F, Audigier-Valette C, Felip E, Ciuleanu TE, Jao K, Rijavec E, Urban L, Aucoin JS, Zannori C, Vermaelen K, Frontera OA, Ready N, Curioni A, Linardou H, Poddubskaya E, Fischer J, Pillai R, Li S, Acevedo A, Paz-Ares L. Nivolumab Plus Low-Dose IPILIMUMAB as First-Line Treatment of Advanced NSCLC: Overall Survival Analysis of Checkmate 817. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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23
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Tihanyi D, Kispeter E, Vidermann M, Doczi R, Tihanyi D, Hegedus C, Filotas P, Urban L, Petak I. AI oncology algorithm-based prioritisation of EGFR inhibitors in case of rare EGFR mutations. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Ivanchenko V, Bagulya A, Bakr S, Bandieramonte M, Bernard D, Bordage MC, Brown J, Burkhardt H, Dondero P, Elles S, Grichine V, Guatelli S, Hariri F, Howard A, Incerti S, Yung Jun S, Kadri O, Kyriakou I, Maire M, Mantero A, Novak M, Sawkey D, Sawkey D, Semeniouk I, Sokolov A, Urban L. Progress of Geant4 electromagnetic physics developments and applications. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201921402046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We report on developments of the Geant4 electromagnetic physics sub-libraries of Geant4 release 10.4 and beyond. Modifications are introduced to the models of photoelectric effect, bremsstrahlung, gamma conversion, single and multiple scattering. The theory-based Goudsmit-Saunderson model of electron/positron multiple scattering has been recently reviewed and a new improved version, providing the most accurate results for scattering of electrons and positrons, was made available. The updated interfaces, models and configurations have already been integrated into LHC applications and may be useful for any type of simulations.
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25
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Böhm A, Tothova L, Urban L, Slezak P, Musil P, Gazova A, Kyselovic J, Hatala R. PO327 Advanced Glycation End-Products Paradox in Patients Undergoing Catheter Ablation of Atrial Fibrillation. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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26
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Paz-Ares L, Urban L, Audigier-Valette C, Grossi F, Jao K, Aucoin J, Linardou H, Vladimirovna Poddubskaya E, Fischer J, Curioni Fontecedro A, Groen H, Vermaelen K, Bourhaba M, Kowalski D, Pillai R, Spigel D, Ahmed S, Hu W, Vickery D, Fiore J, Ready N. P1.01-79 CheckMate 817: Safety of Flat-Dose Nivolumab Plus Weight-Based Ipilimumab for the First-line (1L) Treatment of Advanced NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Uteng M, Urban L, Brees D, Muller PY, Kullak-Ublick GA, Bouchard P, Tougas G, Chibout SD. Safety differentiation: emerging competitive edge in drug development. Drug Discov Today 2018; 24:285-292. [PMID: 30244081 DOI: 10.1016/j.drudis.2018.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/24/2018] [Accepted: 09/12/2018] [Indexed: 12/12/2022]
Abstract
With increasing expectations to provide evidence of drug efficacy, safety, and cost-effectiveness, best-in-class drugs are a major value driver for the pharmaceutical industry. Superior safety is a key differentiation criterion that could be achieved through better risk:benefit profiles, safety margins, fewer contraindications, and improved patient compliance. To accomplish this, comparative safety assessments using innovative and adaptive nonclinical and clinical outcome-based approaches should be undertaken, and continuous strategic adjustments must be made as the risk:benefit profiles evolve. Key success criteria include scientific expertise and integration between all disciplines during the full extent of the drug development process.
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Affiliation(s)
- Marianne Uteng
- Novartis Institutes for Biomedical Research, Translational Medicine, Pre-Clinical Safety, Basel, Switzerland.
| | - Laszlo Urban
- Novartis Institutes for Biomedical Research, Translational Medicine, Pre-Clinical Safety, Cambridge, MA, USA
| | - Dominique Brees
- Novartis Institutes for Biomedical Research, Translational Medicine, Pre-Clinical Safety, Basel, Switzerland
| | | | - Gerd A Kullak-Ublick
- Novartis Pharma AG, Global Drug Development, Chief Medical Office and Patient Safety, Basel, Switzerland; Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Page Bouchard
- Novartis Institutes for Biomedical Research, Translational Medicine, Pre-Clinical Safety, Cambridge, MA, USA
| | - Gervais Tougas
- Novartis Pharma AG, Global Drug Development, Chief Medical Office and Patient Safety, Basel, Switzerland
| | - Salah-Dine Chibout
- Novartis Institutes for Biomedical Research, Translational Medicine, Pre-Clinical Safety, Basel, Switzerland
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28
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Armstrong D, Dumotier B, Fekete A, Shankey V, Bieberich A, Fatig R, Pottel J, Shoichet B, Berg E, Urban L. Testing excipients for possible adverse reactions. J Pharmacol Toxicol Methods 2018. [DOI: 10.1016/j.vascn.2018.01.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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29
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Urban L, Slegrova Z, Chroust K, Kaliska G. P4810Do we follow evidence-based recommendations for NOACs dosing? Results from a nationwide cross-sectional registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Urban
- National Institute of Cardiovasc Diseases - NUSCH, Bratislava, Slovak Republic
| | | | | | - G Kaliska
- Central Slovakia Institute of Cardiovascular Diseases, Banska Bystrica, Slovak Republic
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30
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Urban L, Slegrova Z, Chroust K, Kaliska G. P1209Secondary stroke prevention in national observational cross-sectional registry of patients with non-valvular atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Urban
- National Institute of Cardiovasc Diseases - NUSCH, Bratislava, Slovak Republic
| | | | | | - G Kaliska
- Central Slovakia Institute of Cardiovascular Diseases, Banska Bystrica, Slovak Republic
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31
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Hecht V, Ferrante J, Atwater N, Werley K, McManus O, Urban L, Dempsey G. Characterization of hERG Channel Modulators in Optically Paced Human iPSC-Derived Cardiomyocytes Using Ultra-widefield Optopatch. J Pharmacol Toxicol Methods 2017. [DOI: 10.1016/j.vascn.2017.09.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Vicart A, Kinyamu-Akunda J, Whitebread S, Dumotier B, Urban L, Kluwe W, Moggs J, Pognan F, Chibout SD. Learning from approved kinase inhibitors to better inform on the safety risks of specific kinases. Toxicol Lett 2017. [DOI: 10.1016/j.toxlet.2017.07.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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33
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P M White J, Cibelli M, Urban L, Nilius B, McGeown G, Nagy I. REPLY TO THORNELOE ET AL. Physiol Rev 2017; 97:1233-1234. [PMID: 28794167 DOI: 10.1152/physrev.00020.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 05/19/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
- John P M White
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care Section, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Preclinical Compound Profiling, Secondary Pharmacology, Preclinical Safety, NIBR, Cambridge, Massachusetts; Department of Molecular Cell Biology, Campus Gasthuisberg, Leuven, Belgium; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Mario Cibelli
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care Section, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Preclinical Compound Profiling, Secondary Pharmacology, Preclinical Safety, NIBR, Cambridge, Massachusetts; Department of Molecular Cell Biology, Campus Gasthuisberg, Leuven, Belgium; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Laszlo Urban
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care Section, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Preclinical Compound Profiling, Secondary Pharmacology, Preclinical Safety, NIBR, Cambridge, Massachusetts; Department of Molecular Cell Biology, Campus Gasthuisberg, Leuven, Belgium; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Bernd Nilius
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care Section, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Preclinical Compound Profiling, Secondary Pharmacology, Preclinical Safety, NIBR, Cambridge, Massachusetts; Department of Molecular Cell Biology, Campus Gasthuisberg, Leuven, Belgium; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Graham McGeown
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care Section, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Preclinical Compound Profiling, Secondary Pharmacology, Preclinical Safety, NIBR, Cambridge, Massachusetts; Department of Molecular Cell Biology, Campus Gasthuisberg, Leuven, Belgium; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Istvan Nagy
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine and Intensive Care Section, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Preclinical Compound Profiling, Secondary Pharmacology, Preclinical Safety, NIBR, Cambridge, Massachusetts; Department of Molecular Cell Biology, Campus Gasthuisberg, Leuven, Belgium; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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Maciejewski M, Lounkine E, Whitebread S, Farmer P, DuMouchel W, Shoichet BK, Urban L. Reverse translation of adverse event reports paves the way for de-risking preclinical off-targets. eLife 2017; 6. [PMID: 28786378 PMCID: PMC5548487 DOI: 10.7554/elife.25818] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 02/10/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023] Open
Abstract
The Food and Drug Administration Adverse Event Reporting System (FAERS) remains the primary source for post-marketing pharmacovigilance. The system is largely un-curated, unstandardized, and lacks a method for linking drugs to the chemical structures of their active ingredients, increasing noise and artefactual trends. To address these problems, we mapped drugs to their ingredients and used natural language processing to classify and correlate drug events. Our analysis exposed key idiosyncrasies in FAERS, for example reports of thalidomide causing a deadly ADR when used against myeloma, a likely result of the disease itself; multiplications of the same report, unjustifiably increasing its importance; correlation of reported ADRs with public events, regulatory announcements, and with publications. Comparing the pharmacological, pharmacokinetic, and clinical ADR profiles of methylphenidate, aripiprazole, and risperidone, and of kinase drugs targeting the VEGF receptor, demonstrates how underlying molecular mechanisms can emerge from ADR co-analysis. The precautions and methods we describe may enable investigators to avoid confounding chemistry-based associations and reporting biases in FAERS, and illustrate how comparative analysis of ADRs can reveal underlying mechanisms. DOI:http://dx.doi.org/10.7554/eLife.25818.001 New treatments are tested in clinical trials before they are licensed for use in patients, but until the drugs are available for prescribing it’s not always possible to identify every side effect. When the drugs enter the clinic, they might be prescribed to patients with multiple medical conditions, or combined with other treatments. The drugs may also be taken for longer periods of time than tested in trials. It is therefore common for new adverse reactions to emerge after a drug is in widespread use. The FDA Adverse Event Reporting System (FAERS) is a surveillance system used in the United States for reporting drug side effects after new treatments have been licensed. Healthcare professionals and patients can submit reports to the database, logging the adverse drug reactions that they have experienced. FAERS currently contains over 8.5 million entries, and is growing all the time. However, Maciejewski et al. show that the database has several shortcomings that are reducing its usefulness. For instance, on average any given drug will have 16 different names in the system; this makes it challenging to group all of the reported side effects so that trends and patterns can be correctly seen. To address this first problem, Maciejewski et al. grouped together drugs according to their active ingredients, rather than their name. This made it much easier to account for subsequent, and more crucial conflating factors such as multiple reports for the same adverse event and patient, or cases where adverse reactions were confused with the diseases that the drugs are trying to treat. For example, diabetes was listed as a side effect for drugs used to treat diabetes. Building on this cleaned-up dataset, Maciejewski et al. monitored how adverse event signals evolve over time and uncovered biases that were hard to see otherwise. For example, side-effects were reported more often when drugs were in the news. More strikingly, this bias affected not only the drug in question, but also other drugs that acted in the same way or on the same molecular target. The computational method developed by Maciejewski et al. allows the data in FAERS to be combined and corrected, making easier to evaluate the safety of different medicines. The link between adverse side effects and the molecular targets of the drug, via the ingredient’s chemical structure, furthermore makes it possible to analyze such clinical data reliably by using chemical and genetic information. In the future, this method could also help to identify previously unknown side effects and the biological mechanisms behind them. This could help researchers to develop new drugs with improved side effect profiles. DOI:http://dx.doi.org/10.7554/eLife.25818.002
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Affiliation(s)
| | - Eugen Lounkine
- Novartis Institutes for Biomedical Research, Cambridge, United States
| | - Steven Whitebread
- Novartis Institutes for Biomedical Research, Cambridge, United States
| | - Pierre Farmer
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - William DuMouchel
- Oracle Health Sciences, Oracle Health Sciences, Burlington, United States
| | | | - Laszlo Urban
- Novartis Institutes for Biomedical Research, Cambridge, United States
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Bohm A, Tothova L, Urban L, Slezak P, Musil P, Hlivak P, Hatala R. P2666Advanced glycation end-products as a new predictor of long term outcome after catheter ablation of atrial fibrillation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Transient receptor potential vanilloid type 4 (TRPV4) is a calcium-permeable nonselective cation channel, originally described in 2000 by research teams led by Schultz (Nat Cell Biol 2: 695-702, 2000) and Liedtke (Cell 103: 525-535, 2000). TRPV4 is now recognized as being a polymodal ionotropic receptor that is activated by a disparate array of stimuli, ranging from hypotonicity to heat and acidic pH. Importantly, this ion channel is constitutively expressed and capable of spontaneous activity in the absence of agonist stimulation, which suggests that it serves important physiological functions, as does its widespread dissemination throughout the body and its capacity to interact with other proteins. Not surprisingly, therefore, it has emerged more recently that TRPV4 fulfills a great number of important physiological roles and that various disease states are attributable to the absence, or abnormal functioning, of this ion channel. Here, we review the known characteristics of this ion channel's structure, localization and function, including its activators, and examine its functional importance in health and disease.
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Affiliation(s)
- John P M White
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Academic Department of Anaesthesia and Intensive Care Medicine, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom; Preclinical Secondary Pharmacology, Preclinical Safety, Novartis Institute for Biomedical Research, Cambridge, Massachusetts; Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Campus Gasthuisberg, Leuven, Belgium; and School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
| | - Mario Cibelli
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Academic Department of Anaesthesia and Intensive Care Medicine, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom; Preclinical Secondary Pharmacology, Preclinical Safety, Novartis Institute for Biomedical Research, Cambridge, Massachusetts; Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Campus Gasthuisberg, Leuven, Belgium; and School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
| | - Laszlo Urban
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Academic Department of Anaesthesia and Intensive Care Medicine, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom; Preclinical Secondary Pharmacology, Preclinical Safety, Novartis Institute for Biomedical Research, Cambridge, Massachusetts; Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Campus Gasthuisberg, Leuven, Belgium; and School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
| | - Bernd Nilius
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Academic Department of Anaesthesia and Intensive Care Medicine, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom; Preclinical Secondary Pharmacology, Preclinical Safety, Novartis Institute for Biomedical Research, Cambridge, Massachusetts; Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Campus Gasthuisberg, Leuven, Belgium; and School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
| | - J Graham McGeown
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Academic Department of Anaesthesia and Intensive Care Medicine, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom; Preclinical Secondary Pharmacology, Preclinical Safety, Novartis Institute for Biomedical Research, Cambridge, Massachusetts; Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Campus Gasthuisberg, Leuven, Belgium; and School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
| | - Istvan Nagy
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Anaesthetics, The Queen Elizabeth Hospital, Birmingham, United Kingdom; Academic Department of Anaesthesia and Intensive Care Medicine, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom; Preclinical Secondary Pharmacology, Preclinical Safety, Novartis Institute for Biomedical Research, Cambridge, Massachusetts; Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Campus Gasthuisberg, Leuven, Belgium; and School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
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Pearlstein RA, MacCannell KA, Erdemli G, Yeola S, Helmlinger G, Hu QY, Farid R, Egan W, Whitebread S, Springer C, Beck J, Wang HR, Maciejewski M, Urban L, Duca JS. Implications of Dynamic Occupancy, Binding Kinetics, and Channel Gating Kinetics for hERG Blocker Safety Assessment and Mitigation. Curr Top Med Chem 2017; 16:1792-818. [PMID: 26975508 DOI: 10.2174/1568026616666160315142156] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/30/2015] [Accepted: 10/01/2015] [Indexed: 11/22/2022]
Abstract
Blockade of the hERG potassium channel prolongs the ventricular action potential (AP) and QT interval, and triggers early after depolarizations (EADs) and torsade de pointes (TdP) arrhythmia. Opinions differ as to the causal relationship between hERG blockade and TdP, the relative weighting of other contributing factors, definitive metrics of preclinical proarrhythmicity, and the true safety margin in humans. Here, we have used in silico techniques to characterize the effects of channel gating and binding kinetics on hERG occupancy, and of blockade on the human ventricular AP. Gating effects differ for compounds that are sterically compatible with closed channels (becoming trapped in deactivated channels) versus those that are incompatible with the closed/closing state, and expelled during deactivation. Occupancies of trappable blockers build to equilibrium levels, whereas those of non-trappable blockers build and decay during each AP cycle. Occupancies of ~83% (non-trappable) versus ~63% (trappable) of open/inactive channels caused EADs in our AP simulations. Overall, we conclude that hERG occupancy at therapeutic exposure levels may be tolerated for nontrappable, but not trappable blockers capable of building to the proarrhythmic occupancy level. Furthermore, the widely used Redfern safety index may be biased toward trappable blockers, overestimating the exposure-IC50 separation in nontrappable cases.
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Affiliation(s)
- Robert A Pearlstein
- Novartis Institutes for Bio- Medical Research, Inc., 100 Technology Square, Cambridge, MA 02139, USA.
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Ramalingam SS, Blais N, Mazieres J, Reck M, Jones CM, Juhasz E, Urban L, Orlov S, Barlesi F, Kio E, Keiholz U, Qin Q, Qian J, Nickner C, Dziubinski J, Xiong H, Ansell P, McKee M, Giranda V, Gorbunova V. Randomized, Placebo-Controlled, Phase II Study of Veliparib in Combination with Carboplatin and Paclitaxel for Advanced/Metastatic Non-Small Cell Lung Cancer. Clin Cancer Res 2016; 23:1937-1944. [PMID: 27803064 DOI: 10.1158/1078-0432.ccr-15-3069] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 08/17/2016] [Accepted: 09/08/2016] [Indexed: 11/16/2022]
Abstract
Purpose: PARP plays an important role in DNA repair. Veliparib, a PARP inhibitor, enhances the efficacy of platinum compounds and has been safely combined with carboplatin and paclitaxel. The primary endpoint of this phase II trial determined whether addition of veliparib to carboplatin and paclitaxel improved progression-free survival (PFS) in previously untreated patients with advanced/metastatic non-small cell lung cancer.Experimental Design: Patients were randomized 2:1 to carboplatin and paclitaxel with either veliparib or placebo. Veliparib (120 mg) or placebo was given on days 1 to 7 of each 3-week cycle, with carboplatin (AUC = 6 mg/mL/min) and paclitaxel (200 mg/m2) administered on day 3, for a maximum of 6 cycles.Results: Overall, 158 were included (median age, 63 years; male 68%, squamous histology 48%). Median PFS was 5.8 months in the veliparib group versus 4.2 months in the placebo group [HR, 0.72; 95% confidence interval (CI), 0.45-1.15; P = 0.17)]. Median overall survival (OS) was 11.7 and 9.1 months in the veliparib and placebo groups, respectively (HR, 0.80; 95% CI, 0.54-1.18; P = 0.27). In patients with squamous histology, median PFS (HR, 0.54; 95% CI, 0.26-1.12; P = 0.098) and OS (HR, 0.73; 95% CI, 0.43-1.24; P = 0.24) favored veliparib treatment. Objective response rate was similar between groups (veliparib: 32.4%; placebo: 32.1%), but duration of response favored veliparib treatment (HR, 0.47; 95% CI, 0.16-1.42; P = 0.18). Grade III/IV neutropenia, thrombocytopenia, and anemia were comparable between groups.Conclusions: Veliparib combination with carboplatin and paclitaxel was well-tolerated and demonstrated a favorable trend in PFS and OS versus chemotherapy alone. Patients with squamous histology had the best outcomes with veliparib combination. Clin Cancer Res; 23(8); 1937-44. ©2016 AACR.
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Affiliation(s)
| | | | | | - Martin Reck
- LungenClinic Grosshansdorf, Airway Research Center North (ARCN), member of the German center for lung research (DZL), Grosshansdorf, Germany
| | | | - Erzsebet Juhasz
- Országos Koranvi TBC és Pulmonologiai Intézet, Budapest, Hungary
| | | | - Sergey Orlov
- Pavlov Medical University, St Petersburg, Russia
| | - Fabrice Barlesi
- Aix Marseille University; Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Ebenezer Kio
- IU Health Goshen Center for Cancer Care, Goshen, Indiana
| | | | - Qin Qin
- AbbVie Inc., North Chicago, Illinois
| | | | | | | | - Hao Xiong
- AbbVie Inc., North Chicago, Illinois
| | | | | | | | - Vera Gorbunova
- Institution of Russian Academy of Medical Science, Russian Oncological Research Center, Moscow, Russia
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Petak I, Hegedus C, Binder Z, Peeters M, Rolfo C, Keri G, Schwab R, Urban L. Similarity-based automated evidence ranking for clinical interpretation of multigene diagnostic panels. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chen J, Varga A, Selvarajah S, Jenes A, Dienes B, Sousa-Valente J, Kulik A, Veress G, Brain SD, Baker D, Urban L, Mackie K, Nagy I. Spatial Distribution of the Cannabinoid Type 1 and Capsaicin Receptors May Contribute to the Complexity of Their Crosstalk. Sci Rep 2016; 6:33307. [PMID: 27653550 PMCID: PMC5032030 DOI: 10.1038/srep33307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 08/24/2016] [Indexed: 01/07/2023] Open
Abstract
The cannabinoid type 1 (CB1) receptor and the capsaicin receptor (TRPV1) exhibit co-expression and complex, but largely unknown, functional interactions in a sub-population of primary sensory neurons (PSN). We report that PSN co-expressing CB1 receptor and TRPV1 form two distinct sub-populations based on their pharmacological properties, which could be due to the distribution pattern of the two receptors. Pharmacologically, neurons respond either only to capsaicin (COR neurons) or to both capsaicin and the endogenous TRPV1 and CB1 receptor ligand anandamide (ACR neurons). Blocking or deleting the CB1 receptor only reduces both anandamide- and capsaicin-evoked responses in ACR neurons. Deleting the CB1 receptor also reduces the proportion of ACR neurons without any effect on the overall number of capsaicin-responding cells. Regarding the distribution pattern of the two receptors, neurons express CB1 and TRPV1 receptors either isolated in low densities or in close proximity with medium/high densities. We suggest that spatial distribution of the CB1 receptor and TRPV1 contributes to the complexity of their functional interaction.
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Affiliation(s)
- Jie Chen
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.,Department of Anaesthesiology, Southwest Hospital, Third Military Medical University, Gaotanyan 19 Street, Shapingba, Chongqing 400038, P. R. China
| | - Angelika Varga
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.,MTA-DE-NAP B-Pain Control Research GroupDepartment of Physiology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4012, Hungary
| | - Srikumaran Selvarajah
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK
| | - Agnes Jenes
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.,MTA-DE-NAP B-Pain Control Research GroupDepartment of Physiology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4012, Hungary
| | - Beatrix Dienes
- MTA-DE-NAP B-Pain Control Research GroupDepartment of Physiology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4012, Hungary
| | - Joao Sousa-Valente
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK
| | - Akos Kulik
- Institute of Physiology, University of Freiburg, Germany D-79104 Freiburg, Germany.,BIOSS Centre for Biological Signalling Studies, University of Freiburg, D-79104, Germany
| | - Gabor Veress
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Susan D Brain
- BHF Cardiovascular Centre of Excellence and Centre of Integrative Biomedicine, Cardiovascular Division, King's College London, London SE1 9NH, UK
| | - David Baker
- Centre for Neuroscience and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK
| | - Laszlo Urban
- Preclinical Secondary Pharmacology, Preclinical Safety, Novartis Institutes for Biommedical Research, Cambridge, MA 01932, USA
| | - Ken Mackie
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, The Gill Center, 702 N. Walnut Grove Avenue, Bloomington, IN 47405, USA
| | - Istvan Nagy
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK
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Abstract
BACKGROUND Telocytes represent a relatively newly discovered population of cells found within the various tissues and organs, including Fallopian tubes. It is presumed that telocytes could serve as a sensor of hormone levels or regulate activity of muscle peristaltic movement. METHODS Tissue sections from anatomically different parts of Fallopian tubes of 48 women (age 48.8±9.1) were stained for the expression of five different antigens: c-kit (CD117), CD34, vimentin, podoplanin (D2-40) and Dog-1. RESULTS Telocytes form a network associated with the smooth muscle cells. From the mentioned antibodies, only anti-c-kit (CD117) seems to be relatively selective specific to the telocytes, others react also with numerous other cells and tissue structures. Our results when using antibodies against podoplanin and Dog-1 are in dissonance with recent literature - with regards to our results, they are not suitable for detection of telocytes. CONCLUSION Methods of immunohistochemistry are suitable for identification of telocytes in Fallopian tubes. C-kit (CD117) antigens are useful for routine identification of telocytes in histological sections. This antigen can be combined with CD34 or vimentin in cases of double staining immunohistochemistry.
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Böhm A, Musil P, Urban L, Slezak P, Hatala R, Bacharova L, Cvicela M. PS188 Association of Apelin and Atrial Fibrillation in Patients Undergoing Catheter Ablation. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Böhm A, Tothova L, Urban L, Slezak P, Bacharova L, Musil P, Hatala R. The relation between oxidative stress biomarkers and atrial fibrillation after pulmonary veins isolation. J Electrocardiol 2016; 49:423-8. [PMID: 27034122 DOI: 10.1016/j.jelectrocard.2016.03.007] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The current paradigm claims a link between oxidative stress and atrial fibrillation. The aim of our research was to study a relation between the percentage of time spent in atrial fibrillation (AF burden) and concentrations of oxidative stress biomarkers, before and after pulmonary veins isolation (PVI). METHODOLOGY We included 19 patients (mean age 55±10years, 4 females and 15 males) with implanted loop recorders undergoing PVI. Plasmatic concentrations of advanced glycation end-products (AGEs), fructosamine, advanced oxidation protein products and thiobarbituric-acid reacting substances (TBARS) were measured and AF burden was recorded immediately before and 3months after the PVI. AF burden was also recorded 9months after the PVI. RESULTS Post procedural AGEs concentration significantly negatively correlated with AF burden after 3months (ρ=-0.63; p<0.01) and 9months (ρ=-0.5; p=0.04), respectively as well as TBARS concentration significantly negatively correlated with AF burden after 9months (ρ=-0.61; p=0.01). CONCLUSION Our study showed AGEs and TBARS to be potential predictors for AF burden after the PVI. We suppose that the more oxidative stress after the PVI is provoked, the more fibrotic tissue is produced. That means a better electrical isolation of pulmonary veins and consequently a lower AF burden.
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Affiliation(s)
- A Böhm
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia; Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia.
| | - L Tothova
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Center for Molecular Medicine, Slovak Academy of Sciences, Bratislava, Slovakia; Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - L Urban
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia
| | - P Slezak
- Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - L Bacharova
- Faculty of Medicine, Comenius University, Bratislava, Slovakia; International Laser Center, Comenius University, Bratislava, Slovakia
| | - P Musil
- Faculty of Pharmacy, Comenius University, Bratislava, Slovakia
| | - R Hatala
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia; Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia
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Božíková S, Urban L, Kajanová M, Béder I, Pohlodek K, Varga I. [Functional morphology of recently discovered telocytes inside the female reproductive system]. Ceska Gynekol 2016; 81:31-37. [PMID: 26982062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Discovery of telocytes has become an important and key challenge in past few years. These cells are interstitial cells extending very long cytoplasmic processes named telopodes, by which they create functional networks in the interstitium of different organs. Telocytes are considered to be connective tissue elements that create contacts among each other, but they also function as intercellular structures, functionally connected with cells of the immune system, neurons and smooth muscle cells. Telocytes can be found also in the different parts of female reproductive system with functions and purpose, which is summarized in our overview. Telocytes regulate for example peristaltic movements in fallopian tubes. The decrease of their number (due to inflammatory disease or endometriosis) causes impairment in transport through fallopian tubes which may result in sterility or tubal gravidity. In uterus they regulate contraction of myometrial smooth muscle (blood expulsion in menstrual phase, childbirth) as well as they contribute in immunological care during embryo implantation. Telocytes probably control also the involution of uterus after delivery. Their function in vagina has not been yet clearly defined; they probably take part in slow muscle contraction movement during sexual intercourse. In mammary glands some scientists suppose their function in control of cell proliferation and apoptosis, that is why, they may play a role in carcinogenesis. In placenta they probably monitor and regulate flow of blood in vessels of chorionic villi and they may be responsible also for etiopathogenesis of pre-eclampsy. All these mentioned functions of telocytes are only in the level of hypothesis and have been published recently. New research and studies will try to answer the questions whether telocytes play a key role in these processes. Our review we completed with some original microphotographs of telocytes in different organs of female reproductive system.
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45
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Apostolakis J, Asai M, Bagulya A, Brown JMC, Burkhardt H, Chikuma N, Cortes-Giraldo MA, Elles S, Grichine V, Guatelli S, Incerti S, Ivanchenko VN, Jacquemier J, Kadri O, Maire M, Pandola L, Sawkey D, Toshito T, Urban L, Yamashita T. Progress in Geant4 Electromagnetic Physics Modelling and Validation. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/1742-6596/664/7/072021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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46
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Albisu S, Rosada R, Jochen H, Higgie J, Urban L, Perna A. Thymectomy in patients with Non Thymomatous Myasthenia Gravis: a systematic review. What is the current evidence? J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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47
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Juhasz E, Ramalingam S, Blais N, Mazieres J, Reck M, Jones M, Urban L, Orlov S, Barlesi F, Kio E, Keilholz U, Qian J, Qin Q, Ansell P, Dziubinski J, Nickner C, McKee M, Giranda V, Gorbunova V. 3091 Characterization of advanced NSCLC patients with prolonged benefit after veliparib plus carboplatin/paclitaxel: Phase 2 results. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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48
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Reck M, Ramalingam S, Blais N, Mazieres J, Jones M, Juhasz E, Urban L, Orlov S, Barlesi F, Kio E, Keilholz U, Qian J, Qin Q, Dziubinski J, Nickner C, Ansell P, McKee M, Giranda V, Gorbunova V. 3093 Veliparib with carboplatin and paclitaxel: factors predictive of favorable outcomes in NSCLC. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31734-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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49
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Muller PY, Dambach D, Gemzik B, Hartmann A, Ratcliffe S, Trendelenburg C, Urban L. Integrated risk assessment of suicidal ideation and behavior in drug development. Drug Discov Today 2015; 20:1135-42. [DOI: 10.1016/j.drudis.2015.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 03/10/2015] [Accepted: 05/19/2015] [Indexed: 12/27/2022]
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50
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Rapoport BL, Chasen MR, Gridelli C, Urban L, Modiano MR, Schnadig ID, Poma A, Arora S, Kansra V, Schwartzberg LS, Navari RM. Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of cisplatin-based highly emetogenic chemotherapy in patients with cancer: two randomised, active-controlled, double-blind, phase 3 trials. Lancet Oncol 2015; 16:1079-1089. [DOI: 10.1016/s1470-2045(15)00035-2] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 11/27/2022]
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