1
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Arndt T, Keresztes M, Olivier B, Boone L, Chanut F, Ennulat D, Evans E, Freyberger A, Johannes S, Kuper CF, Maliver P, O'Brien P, Ramaiah L, Roman I, Strauss V, Vinken P, Walker D, Winter M, Pohlmeyer-Esch G, Tomlinson L. Considerations for the Identification and Conveyance of Clinical Pathology Findings in Preclinical Toxicity Studies: Results From the 9th ESTP International Expert Workshop. Toxicol Pathol 2024:1926233241245108. [PMID: 38661116 DOI: 10.1177/01926233241245108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The European Society of Toxicologic Pathology (ESTP) organized a panel of 24 international experts from many fields of toxicologic clinical pathology (e.g., industry, academia, and regulatory) that came together in 2021 to align the use of terminology to convey the importance of clinical pathology findings in preclinical toxicity studies. An additional goal consisted of how to identify important findings in standard and nonstandard clinical pathology associated endpoints. This manuscript summarizes the information and opinions discussed and shared at the ninth ESTP International Expert Workshop, April 5 to 6, 2022. In addition to terminology usage, the workshop considered topics related to the identification and conveyance of the importance of test item-related findings. These topics included sources of variability, comparators, statistics, reporting, correlations to other study data, nonstandard biomarkers, indirect/secondary findings, and an overall weight-of-evidence approach.
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Affiliation(s)
- Tara Arndt
- Altasciences Preclinical, Laval, Quebec, Canada
- Altasciences Preclinical, Seattle, Washington, USA
| | | | | | - L Boone
- Labcorp, Madison, Wisconsin, USA
| | | | - D Ennulat
- GlaxoSmithKline (Retired), King of Prussia, Pennsylvania, USA
| | - Ellen Evans
- Pfizer (Retired), Waterford, Connecticut, USA
| | | | | | | | - Pierre Maliver
- Roche Pharma Research and Early Development, Basel, Switzerland
| | | | - Lila Ramaiah
- Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Ian Roman
- GlaxoSmithKline, Ware, United Kingdom
| | | | | | - Dana Walker
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Michael Winter
- Roche Pharma Research and Early Development, Basel, Switzerland
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2
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Leach MW, Rana P, Hu W, Mittapalli RK, Pinkstaff J, Potter D, Qiu XM, Ramaiah L, Rohde C, Xia F, Khan KN. Translation of nonclinical to clinical safety findings for 27 biotherapeutics. Toxicol Appl Pharmacol 2024; 484:116854. [PMID: 38346540 DOI: 10.1016/j.taap.2024.116854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Abstract
Human adverse drug reactions (ADRs), and in vivo nonclinical adverse and nonadverse findings, were identified in 27 biotherapeutic programs and placed into organ categories to determine translation. The sensitivity of detecting human ADRs was 30.8% with a positive predictive value (PPV) of 53.3% for nonclinical adverse findings; sensitivity increased to 67.3% and PPV fell to 35.0% when including nonadverse findings. Nonclinical findings were associated with a greater likelihood of a human ADR in that organ category, especially for adverse findings [positive likelihood ratio (LR+) >10 (lower 95% confidence interval [CI] of >5)]. The specificity and negative predictive value (NPV) were very high (>85%). A lack of nonclinical findings in an organ category was associated with a lower likelihood of a human ADR in that organ category. About 40-50% of human ADRs and nonclinical adverse findings, and about 30% of nonclinical nonadverse findings, were attributed to pharmacology. Slightly more than half of the human ADRs with a translating nonclinical finding had findings in animals that could be considered very similar. Overall, 38% of nonclinical findings translated to a human ADR at the organ category level. When nonclinical findings did not translate to humans, the cause was usually higher exposures or longer dosing in animals. All programs with human ADRs attributed to immunogenicity also had nonclinical adverse or nonadverse findings related to immunogenicity. Overall, nonclinical adverse and nonadverse findings were useful in predicting human ADRs, especially at an organ category level, and the majority of human ADRs were predicted by nonclinical toxicity studies.
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Affiliation(s)
| | - Payal Rana
- Pfizer Inc., 445 Eastern Point Road, Groton, CT 06340, USA.
| | - Wenyue Hu
- Pfizer Inc., 10777 Science Center Dr, San Diego, CA 92121, USA
| | | | - Jason Pinkstaff
- Pfizer Inc., 10777 Science Center Dr, San Diego, CA 92121, USA
| | - David Potter
- Pfizer Inc., 1 Portland St, Cambridge, MA 02139, USA
| | - Xing Min Qiu
- Pfizer Inc., Lane 60 Naxian Road, Shanghai 201203, China
| | - Lila Ramaiah
- Pfizer Inc., 401 N Middletown Road, Pearl River, NY 10965, USA
| | - Cynthia Rohde
- Pfizer Inc., 401 N Middletown Road, Pearl River, NY 10965, USA
| | - Feng Xia
- Pfizer Inc., 66 Hudson Boulevard, New York, NY 10001, USA
| | - K Nasir Khan
- Pfizer Inc., 445 Eastern Point Road, Groton, CT 06340, USA
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3
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Barakat A, Jasuja R, Tomlinson L, Wenzel Z, Ramaiah L, Petterson BA, Kapinos B, Sawant A, Pagan V, Lintner N, Field D, Ahn Y, Knee KM. Effects of 2,3-DPG knockout on SCD phenotype in Townes SCD model mice. Am J Hematol 2023; 98:1838-1846. [PMID: 37688507 DOI: 10.1002/ajh.27082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/14/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023]
Abstract
Sickle cell disease (SCD) is a severe, multisystemic hematological disorder that impacts nearly every major organ in adults. The current approved treatments for SCD directly target mutant hemoglobin or address downstream disease pathology. Several compounds targeting reduction of 2,3-DPG by activation of Pyruvate Kinase-R are currently being evaluated in SCD patients. In this study, we genetically engineered a mouse lacking 2,3-DPG on the Townes SCD mouse model background and evaluated the effects of 2,3-DPG loss on disease pathology. Animals lacking 2,3-DPG showed improvements in hematological markers and reductions in RBC sickling relative to native Townes mice, however, minimal difference in organ damage was observed in 2,3-DPG deficient mice compared to native Townes animals. When animals lacking 2,3-DPG were dosed with a compound designed to increase hemoglobin oxygen affinity, oxygen delivery related toxicity was observed.
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Affiliation(s)
- Amey Barakat
- Rare Disease Research Unit, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Reema Jasuja
- Rare Disease Research Unit, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Lindsay Tomlinson
- Drug Safety Research and Development, Worldwide Research, Development, and Medical, Pfizer Inc, Groton, Connecticut, USA
| | - Zane Wenzel
- Discovery Sciences, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Lila Ramaiah
- Drug Safety Research and Development, Worldwide Research, Development, and Medical, Pfizer Inc, Groton, Connecticut, USA
| | - Betty A Petterson
- Drug Safety Research and Development, Worldwide Research, Development, and Medical, Pfizer Inc, Groton, Connecticut, USA
| | - Brendon Kapinos
- Discovery Sciences, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Anagha Sawant
- Rare Disease Research Unit, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Vicente Pagan
- Rare Disease Research Unit, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Nathanael Lintner
- Biomedicine Design, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Denise Field
- Medicine Design, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Youngwook Ahn
- Target Sciences, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
| | - Kelly M Knee
- Rare Disease Research Unit, Worldwide Research, Development, and Medical, Pfizer Inc, Cambridge, Massachusetts, USA
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4
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Rohde CM, Lindemann C, Giovanelli M, Sellers RS, Diekmann J, Choudhary S, Ramaiah L, Vogel AB, Chervona Y, Muik A, Sahin U. Toxicological Assessments of a Pandemic COVID-19 Vaccine-Demonstrating the Suitability of a Platform Approach for mRNA Vaccines. Vaccines (Basel) 2023; 11:vaccines11020417. [PMID: 36851293 PMCID: PMC9965811 DOI: 10.3390/vaccines11020417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
The emergence of SARS-CoV-2 at the end of 2019 required the swift development of a vaccine to address the pandemic. Nonclinical GLP-compliant studies in Wistar Han rats were initiated to assess the local tolerance, systemic toxicity, and immune response to four mRNA vaccine candidates encoding immunogens derived from the spike (S) glycoprotein of SARS-CoV-2, encapsulated in lipid nanoparticles (LNPs). Vaccine candidates were administered intramuscularly once weekly for three doses at 30 and/or 100 µg followed by a 3-week recovery period. Clinical pathology findings included higher white blood cell counts and acute phase reactant concentrations, lower platelet and reticulocyte counts, and lower RBC parameters. Microscopically, there was increased cellularity (lymphocytes) in the lymph nodes and spleen, increased hematopoiesis in the bone marrow and spleen, acute inflammation and edema at the injection site, and minimal hepatocellular vacuolation. These findings were generally attributed to the anticipated immune and inflammatory responses to the vaccines, except for hepatocyte vacuolation, which was interpreted to reflect hepatocyte LNP lipid uptake, was similar between candidates and resolved or partially recovered at the end of the recovery phase. These studies demonstrated safety and tolerability in rats, supporting SARS-CoV-2 mRNA-LNP vaccine clinical development.
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Affiliation(s)
- Cynthia M. Rohde
- Drug Safety Research and Development, Pfizer Worldwide Research, Development & Medical, Pfizer, Inc., Pearl River, NY 10965, USA
- Correspondence:
| | | | - Michael Giovanelli
- Drug Safety Research and Development, Pfizer Worldwide Research, Development & Medical, Pfizer, Inc., Groton, CT 06340, USA
| | - Rani S. Sellers
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | | | - Shambhunath Choudhary
- Drug Safety Research and Development, Pfizer Worldwide Research, Development & Medical, Pfizer, Inc., Pearl River, NY 10965, USA
| | - Lila Ramaiah
- Drug Safety Research and Development, Pfizer Worldwide Research, Development & Medical, Pfizer, Inc., Pearl River, NY 10965, USA
| | | | - Yana Chervona
- Drug Safety Research and Development, Pfizer Worldwide Research, Development & Medical, Pfizer, Inc., Pearl River, NY 10965, USA
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5
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Schultze AE, Ramaiah L. Overview of Session 3 Mechanisms of Decreased Erythropoiesis and Erythroid Cell Injury. Toxicol Pathol 2022; 50:881-882. [PMID: 36062427 DOI: 10.1177/01926233221120550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This session, held during the 41st Annual STP Symposium, focused on mechanisms of decreased erythropoiesis and erythroid cell injury. The speakers provided comprehensive overviews of physiologic and pathologic erythropoiesis, reviewed various mechanisms of erythroid cell injury, and shared innovative investigative research with the audience.
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Affiliation(s)
| | - Lila Ramaiah
- Drug Safety R&D, Pfizer, Inc., Pearl River, New York, USA
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6
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Zabka TS, Burkhardt J, Reagan WJ, Gautier JC, Glaab WE, Guffroy M, Harding J, Brees D, McDuffie E, Ramaiah L, Schultze AE, Smith JD, Wolfreys A, Dalmas DA. The use of emerging safety biomarkers in nonclinical and clinical safety assessment - The current and future state: An IQ DruSafe industry survey. Regul Toxicol Pharmacol 2020; 120:104857. [PMID: 33387566 DOI: 10.1016/j.yrtph.2020.104857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 12/17/2020] [Accepted: 12/24/2020] [Indexed: 11/17/2022]
Abstract
Pharmaceutical and biotechnology companies rarely disclose their use of translational emerging safety biomarkers (ESBs) during drug development, and the impact of ESB use on the speed of drug development remains unclear. A cross-industry survey of 20 companies of varying size was conducted to understand current trends in ESB use and future use prospects. The objectives were to: (1) determine current ESB use in nonclinical and clinical drug development and impact on asset advancement; (2) identify opportunities, gaps, and challenges to greater ESB implementation; and (3) benchmark perspectives on regulatory acceptance. Although ESBs were employed in only 5-50% of studies/programs, most companies used ESBs to some extent, with larger companies demonstrating greater nonclinical use. Inclusion of ESBs in investigational new drug applications (INDs) was similar across all companies; however, differences in clinical trial usage could vary among the prevailing health authority (HA). Broader implementation of ESBs requires resource support, cross-industry partnerships, and collaboration with HAs. This includes generating sufficient foundational data, demonstrating nonclinical to clinical translatability and practical utility, and clearly written criteria by HAs to enable qualification. If achieved, ESBs will play a critical role in the development of next-generation, translationally-tailored standard laboratory tests for drug development.
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Affiliation(s)
- Tanja S Zabka
- Genentech Inc, 1 DNA Way, South San Francisco, CA, USA.
| | | | | | | | | | | | - Joanna Harding
- AstraZeneca, Da Vinci Building, Melbourn Science Park, Cambridge Road, Melbourn, Royston, Hertfordshire, UK.
| | | | | | - Lila Ramaiah
- Pfizer, 401 North Middletown Road, Pearl River, NY, USA.
| | - A Eric Schultze
- Lilly Research Laboratories, 893 S Delaware St, Indianapolis, IN, USA.
| | - James D Smith
- Boehringer Ingelheim, 900 Ridgebury Rd, Ridgefield, CT, USA.
| | | | - Deidre A Dalmas
- GlaxoSmithKline, 1250 S. Collegeville Rd, Collegeville, PA, USA.
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7
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Wang B, Wang L, Batog A, Brodie T, Ramaiah L, Chadwick KD, Su T, Mangipudy R, Pilutla RC, Ji QC. Investigation on the Effect of Capillary Microsampling on Hematologic and Toxicokinetic Evaluation in Regulatory Safety Studies in Mice. AAPS J 2020; 22:55. [PMID: 32152888 DOI: 10.1208/s12248-020-00438-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/11/2020] [Indexed: 11/30/2022]
Abstract
Microsampling techniques enable the minimization of blood collection volume from animals and subsequent handling of the blood samples or their derived plasma or serum samples. This offers advantages over conventional large-volume sampling, such as eliminating the need for satellite animals and improving animal welfare aspects, and providing the opportunity for additional assessments in small animals where blood volume constraints limit endpoints. This study evaluated the feasibility of implementation of capillary microsampling (CMS) in a single-dose study in mice with the ultimate goal of enabling its use in toxicology studies. The focus was on the impact of microsampling on toxicokinetic assessment and on the subsequent hematology assessment in the same animal. A seventy (70)-μL blood collection via CMS from the tail vein had a minimal effect on the hematology parameters of mice (strain C57BL/6) in samples taken within 24 h of blood collection. TK parameters were similar in plasma samples collected via CMS and cardiac puncture sampling. A bioanalytical assay was developed which enabled the quantification of concentration of both the parent drug and a metabolite using only 5-μL plasma sample per analysis. Incurred sample reanalysis (ISR), unexpected event investigation, and re-assay were successfully performed on the limited samples (≤ 20 μL) collected from CMS. The results of this study confirmed the feasibility of implementing CMS in regulated mouse toxicity studies and demonstrated that it is possible to eliminate or reduce satellite animals.
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Affiliation(s)
- Bonnie Wang
- Drug Safety Evaluation, Bristol-Myers Squibb, New Brunswick, New Jersey, 08903, USA
| | - Linna Wang
- Bioanalytical Science, Bristol-Myers Squibb, Princeton, New Jersey, 08543, USA
| | - Alicja Batog
- Drug Safety Evaluation, Bristol-Myers Squibb, New Brunswick, New Jersey, 08903, USA
| | - Thomas Brodie
- Drug Safety Evaluation, Bristol-Myers Squibb, New Brunswick, New Jersey, 08903, USA
| | - Lila Ramaiah
- Drug Safety Evaluation, Bristol-Myers Squibb, New Brunswick, New Jersey, 08903, USA.,Drug Safety Research and Development, Pfizer, Pearl River, New York, 10965, USA
| | - Kristina D Chadwick
- Drug Safety Evaluation, Bristol-Myers Squibb, New Brunswick, New Jersey, 08903, USA
| | - Ting Su
- Drug Safety Evaluation, Bristol-Myers Squibb, New Brunswick, New Jersey, 08903, USA
| | - Raja Mangipudy
- Drug Safety Evaluation, Bristol-Myers Squibb, New Brunswick, New Jersey, 08903, USA
| | - Renuka C Pilutla
- Bioanalytical Science, Bristol-Myers Squibb, Princeton, New Jersey, 08543, USA
| | - Qin C Ji
- Bioanalytical Science, Bristol-Myers Squibb, Princeton, New Jersey, 08543, USA.
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8
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Roth SE, Avigan MI, Bourdet D, Brott D, Church R, Dash A, Keller D, Sherratt P, Watkins PB, Westcott‐Baker L, Lentini S, Merz M, Ramaiah L, Ramaiah SK, Stanley AM, Marcinak J. Next-Generation DILI Biomarkers: Prioritization of Biomarkers for Qualification and Best Practices for Biospecimen Collection in Drug Development. Clin Pharmacol Ther 2020; 107:333-346. [PMID: 31314926 PMCID: PMC7006882 DOI: 10.1002/cpt.1571] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/12/2019] [Indexed: 12/14/2022]
Abstract
The diagnosis and management of drug-induced liver injury (DILI) remains a challenge in clinical trials in drug development. The qualification of emerging biomarkers capable of predicting DILI soon after the initiation of treatment, differentiating DILI from underlying liver disease, identifying the causal entity, and assigning appropriate treatment options after DILI is diagnosed are needed. Qualification efforts have been hindered by lack of properly stored and consented biospecimens that are linked to clinical data relevant to a specific context of use. Recommendations are made for biospecimen collection procedures, with the focus on clinical trials, and for specific emerging biomarkers to focus qualification efforts.
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Affiliation(s)
| | | | - David Bourdet
- Theravance BiopharmaSouth San FranciscoCaliforniaUSA
| | | | - Rachel Church
- Department of Pharmacotherapy and Experimental TherapeuticsEshelman School of PharmacyUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Ajit Dash
- GenentechSouth San FranciscoCaliforniaUSA
| | | | | | - Paul B. Watkins
- Department of Pharmacotherapy and Experimental TherapeuticsEshelman School of PharmacyUniversity of North CarolinaChapel HillNorth CarolinaUSA
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9
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Aulbach A, Vitsky A, Arndt T, Ramaiah L, Logan M, Siska W, Cregar L, Tripathi N, Adedeji A, Provencher A, Gupta A, Jordan H, Bounous D, Boone L. Overview and considerations for the reporting of clinical pathology interpretations in nonclinical toxicology studies. Vet Clin Pathol 2019; 48:389-399. [DOI: 10.1111/vcp.12772] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | | | - Tara Arndt
- Covance Laboratories Inc. Madison WI USA
| | | | | | | | | | | | | | | | - Ara Gupta
- Boehringer Ingelheim Animal Health USA Inc. Duluth GA USA
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10
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Aulbach A, Vitsky A, Arndt T, Ramaiah L, Logan M, Siska W, Cregar L, Tripathi N, Adedeji A, Provencher A, Gupta A, Jordan H, Bounous D, Boone L. Interpretative considerations for clinical pathology findings in nonclinical toxicology studies. Vet Clin Pathol 2019; 48:383-388. [PMID: 31549731 DOI: 10.1111/vcp.12773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The interpretation of clinical pathology results from nonclinical safety studies is a fundamental component in hazard identification of new drug candidates. The ever-increasing complexity of nonclinical safety studies and sophistication of modern analytical methods have made the interpretation of clinical pathology information by a highly trained subject matter expert imperative. Certain interpretive techniques are particularly effective in the identification and characterization of clinical pathology effects. The purpose of this manuscript is to provide an overview of contemporary interpretive practices for clinical pathology results and to provide nonbinding recommendations aimed at improving consistency, quality, and overall value of clinical pathology interpretations generated in support of nonclinical toxicology studies.
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Affiliation(s)
| | | | - Tara Arndt
- Covance Laboratories Inc., Madison, WI, USA
| | | | | | | | | | | | | | | | - Ara Gupta
- Boehringer Ingelheim Animal Health USA Inc., Duluth, GA, USA
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11
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Carreira V, Palanisamy G, Quist E, Nelson K, Fossey S, Zimmerman B, Ramaiah L, Schafer KA. Practical Strategies for Navigating Toxicologic Pathology in One's Early Career…and Beyond! Toxicol Pathol 2018; 46:1037-1048. [PMID: 30352538 DOI: 10.1177/0192623318805716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The toxicologic pathologist plays a vital role in the scientific community, using their unique blend of diagnostic and investigative skills to advance biomedical research, public health, drug discovery, or regulatory practices. But what exactly do toxicologic pathologists contribute? Where do these specialized professionals work? How can toxicologic pathologists maximize their efficiency and potential? To enlighten students and trainees, as well as early- or mid-career toxicologic pathologists, or even those approaching retirement, the Career Development and Outreach Committee of the Society of Toxicologic Pathology (STP) sponsored a career development workshop entitled "Practical Strategies for Navigating Toxicologic Pathology in One's Early Career…and Beyond!" in conjunction with the STP 37th annual symposium. The workshop featured toxicologic pathologists from contract research organizations and the pharmaceutical industry, who provided their perspectives on career preparation, evolving veterinary pathologist roles within various sectors of toxicologic pathology, the fundamentals of safety assessment, logistics of projects involving good laboratory practices, tools for effective interpretation and communication of anatomic and clinical pathology results, and a recap of scientific resources available to support the toxicologic pathologist in his or her journey. This article provides brief summaries of the talks presented during this career development workshop.
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Affiliation(s)
| | | | - Erin Quist
- 3 Experimental Pathology Laboratories, Inc., Durham, North Carolina, USA
| | - Keith Nelson
- 4 MPI Research (A Charles River Laboratories Company), Mattawan, Michigan, USA
| | | | | | - Lila Ramaiah
- 7 Bristol-Myers Squibb, New Brunswick, New Jersey, USA
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12
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Price KD, Simutis F, Fletcher A, Ramaiah L, Srour R, Kozlosky J, Sathish J, Engelhardt J, Capozzi A, Crona J, Newsome C, Wheeler J, Szatkowski D, Thekkumthala A, Wang B, Freebern W, Haggerty H, Bunch T, Graziano M. Abstract LB-B33: Nonclinical safety evaluation of two distinct second generation variants of anti-CTLA4 monoclonal antibody, ipilimumab, in monkeys. Toxicology 2018. [DOI: 10.1158/1535-7163.targ-17-lb-b33] [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: 11/16/2022]
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13
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Ramaiah L, Tomlinson L, Tripathi NK, Cregar LC, Vitsky A, Beust BV, Barlow VG, Reagan WJ, Ennulat D. Principles for Assessing Adversity in Toxicologic Clinical Pathology. Toxicol Pathol 2017; 45:260-266. [DOI: 10.1177/0192623316681646] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is limited direction in the literature or regulatory guidance on determination of adversity for clinical pathology (CP) biomarkers in preclinical safety studies. Toxicologic clinical pathologists representing the American Society for Veterinary Clinical Pathology—Regulatory Affairs Committee and Society of Toxicologic Pathology—Clinical Pathology Interest Group identified principles, overall approach, and unique considerations for assessing adversity in CP data interpretation to provide a consensus opinion. Emphasized is the need for pathophysiologic context and a weight-of-evidence approach. Most CP biomarkers do not have the potential to be adverse in isolation, regardless of magnitude of change. Rather, they quantify or describe the impact of effects, provide adjunct or supportive information regarding a process or pathogenesis, and provide translational biomarkers of effect. Most often, CP changes are part of a constellation of findings that collectively are adverse. Thus, most CP changes must be interpreted in conjunction with other study findings and require contextual and integrative interpretation. Exceptions include critical CP changes without correlates that indicate a health risk in the tested species. Overall, CP changes should not be interpreted in isolation and their adversity is best addressed with an integrated approach.
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Affiliation(s)
- Lila Ramaiah
- Bristol-Myers Squibb, New Brunswick, New Jersey, USA
| | - Lindsay Tomlinson
- Pfizer Worldwide Research and Development, Andover, Massachusetts, USA
| | | | | | - Allison Vitsky
- Pfizer Worldwide Research and Development, San Diego, California, USA
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14
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Poitout-Belissent F, Aulbach A, Tripathi N, Ramaiah L. Reducing blood volume requirements for clinical pathology testing in toxicologic studies-points to consider. Vet Clin Pathol 2016; 45:534-551. [DOI: 10.1111/vcp.12429] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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15
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Abstract
The continuing education course on integrating clinical and anatomical pathology data was designed to communicate the importance of using a weight of evidence approach to interpret safety findings in toxicology studies. This approach is necessary, as neither clinical nor anatomic pathology data can be relied upon in isolation to fully understand the relationship between study findings and the test article. Basic principles for correlating anatomic pathology and clinical pathology findings and for integrating these with other study end points were reviewed. To highlight these relationships, a series of case examples, presented jointly by a clinical pathologist and an anatomic pathologist, were used to illustrate the collaborative effort required between clinical and anatomical pathologists. In addition, the diagnostic utility of traditional liver biomarkers was discussed using results from a meta-analysis of rat hepatobiliary marker and histopathology data. This discussion also included examples of traditional and novel liver and renal biomarker data implementation in nonclinical toxicology studies to illustrate the relationship between discrete changes in biochemistry and tissue morphology.
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Affiliation(s)
- Lila Ramaiah
- Envigo, East Millstone, New Jersey, USA
- Bristol-Myers Squibb, New Brunswick, New Jersey, USA
| | | | - Elizabeth V. Skuba
- Novartis Institutes for BioMedical Research, East Hanover, New Jersey, USA
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16
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Tomlinson L, Ramaiah L, Tripathi NK, Barlow VG, Vitsky A, Poitout-Belissent FM, Bounous DI, Ennulat D. STP Best Practices for Evaluating Clinical Pathology in Pharmaceutical Recovery Studies. Toxicol Pathol 2016; 44:163-72. [DOI: 10.1177/0192623315624165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Society of Toxicologic Pathology formed a working group in collaboration with the American Society for Veterinary Clinical Pathology to provide recommendations for the appropriate inclusion of clinical pathology evaluation in recovery arms of nonclinical toxicity studies but not on when to perform recovery studies. Evaluation of the recovery of clinical pathology findings is not required routinely but provides useful information on risk assessment in nonclinical toxicity studies and is recommended when the ability of the organ to recover is uncertain. The study design generally requires inclusion of concurrent controls to separate procedure-related changes from test article–related changes, but return of clinical pathology values toward baseline may be sufficient in some cases. Evaluation of either a select or full panel of standard hematology, coagulation, and serum and urine chemistry biomarkers can be scientifically justified. It is also acceptable to redesignate dosing phase animals to the recovery phase or vice versa to optimize data interpretation. Assessment of delayed toxicity during the recovery phase is not required but may be appropriate in development programs with unique concerns. Evaluation of the recovery of clinical pathology data for vaccine development is required and, for efficacy markers, is recommended if it furthers pharmacologic understanding.
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Affiliation(s)
| | - Lila Ramaiah
- Envigo (formerly Huntingdon Life Sciences), East Millstone, New Jersey, USA
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17
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Tomlinson L, Boone LI, Ramaiah L, Penraat KA, von Beust BR, Ameri M, Poitout-Belissent FM, Weingand K, Workman HC, Aulbach AD, Meyer DJ, Brown DE, MacNeill AL, Bolliger AP, Bounous DI. Best practices for veterinary toxicologic clinical pathology, with emphasis on the pharmaceutical and biotechnology industries. Vet Clin Pathol 2013; 42:252-69. [PMID: 23889060 DOI: 10.1111/vcp.12059] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this paper by the Regulatory Affairs Committee (RAC) of the American Society for Veterinary Clinical Pathology (ASVCP) is to review the current regulatory guidances (eg, guidelines) and published recommendations for best practices in veterinary toxicologic clinical pathology, particularly in the pharmaceutical and biotechnology industries, and to utilize the combined experience of ASVCP RAC to provide updated recommendations. Discussion points include (1) instrumentation, validation, and sample collection, (2) routine laboratory variables, (3) cytologic laboratory variables, (4) data interpretation and reporting (including peer review, reference intervals and statistics), and (5) roles and responsibilities of clinical pathologists and laboratory personnel. Revision and improvement of current practices should be in alignment with evolving regulatory guidance documents, new technology, and expanding understanding and utility of clinical pathology. These recommendations provide a contemporary guide for the refinement of veterinary toxicologic clinical pathology best practices.
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Affiliation(s)
- Lindsay Tomlinson
- Drug Safety and Research Development, Pfizer, Inc., Cambridge, MA, USA
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18
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Fabre KM, Ramaiah L, Dregalla RC, Desaintes C, Weil MM, Bailey SM, Ullrich RL. Murine Prkdc polymorphisms impact DNA-PKcs function. Radiat Res 2011; 175:493-500. [PMID: 21265624 DOI: 10.1667/rr2431.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Polymorphic variants of DNA repair genes can increase the carcinogenic potential of exposure to ionizing radiation. Two single nucleotide polymorphisms (SNPs) in Prkdc, the gene encoding the DNA-dependent protein kinase catalytic subunit (DNA-PKcs), have been identified in BALB/c mice and linked to reduced DNA-PKcs activity and mammary cancer susceptibility. We examined three additional mouse strains to better define the roles of the BALB/c Prkdc SNPs (R2140C and M3844V). One is a congenic strain (C.B6) that has the C57BL/6 Prkdc allele on a BALB/c background, and the other is a congenic strain (B6.C) that has the BALB/c variant Prkdc allele on a C57BL/6 background. We also examined the LEWES mouse strain, which possesses only one of the BALB/c Prkdc SNPs (M3844V). Our results demonstrate that both Prkdc SNPs are responsible for deficient DNA-PKcs protein expression, DNA repair and telomere function, while the LEWES SNP affects only DNA-PKcs expression and repair capacity. These studies provide insight into the separation of function between the two BALB/c SNPs as well as direct evidence that SNPs positioned within Prkdc can significantly influence DNA-PKcs function involving DNA repair capacity, telomere end-capping, and potentially cancer susceptibility.
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Affiliation(s)
- Kristin M Fabre
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado 80523, USA
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19
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Strausfeld NJ, Kong A, Milde JJ, Gilbert C, Ramaiah L. Oculomotor control in calliphorid flies: GABAergic organization in heterolateral inhibitory pathways. J Comp Neurol 1995; 361:298-320. [PMID: 8543664 DOI: 10.1002/cne.903610208] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In calliphorid Diptera, motor neurons mediating visually evoked head movements can be excited or inhibited by visual stimuli, depending on the directionality of the stimulus and whether it is in the ipsi- or contralateral visual field. The level at which inhibition occurs is of special interest because binocular activation of homolateral tangential neurons in the lobula plate demonstrates that excitatory interaction must occur between the left and right optic lobes. Recordings and dye fillings demonstrate a variety of motion-sensitive heterolateral pathways between the lobula plates, or between them and contralateral deutocerebral neuropil, which provides descending pathways to neck motor centers. The profiles of heterolateral tangential cells correspond to neurons stained by an antibody against gamma-aminobutyric acid (GABA). Other GABA-immunoreactive interneurons linking each side of the brain correspond to uniquely identified motion-sensitive neurons linking the deutocerebral. Additional inhibitory pathways include heterolateral GABAergic descending and ascending neurons, as well as heterolateral GABAergic neurons in the thoracic ganglia. The functional significance of heterolateral GABAergic pathways was tested surgically by making selective microlesions and monitoring the oculomotor output. The results demonstrate an important new attribute of the insect visual system. Although lesions can initially abolish an excitatory or inhibitory response, this response is reestablished through alternative pathways that provide inhibitory and excitatory information to the same motor neurons.
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Affiliation(s)
- N J Strausfeld
- Arizona Research Laboratories Division of Neurobiology, University of Arizona, Tucson 85721, USA
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