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Sela T, Mansø M, Siegel M, Marban-Doran C, Ducret A, Niewöhner J, Ravn J, Martin RE, Sommer A, Lohmann S, Krippendorff BF, Ladefoged M, Indlekofer A, Quaiser T, Bueddefeld F, Koller E, Mohamed MY, Oelschlaegel T, Gothelf KV, Hofer K, Schumacher FF. Diligent Design Enables Antibody-ASO Conjugates with Optimal Pharmacokinetic Properties. Bioconjug Chem 2023; 34:2096-2111. [PMID: 37916986 DOI: 10.1021/acs.bioconjchem.3c00393] [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] [Indexed: 11/03/2023]
Abstract
Antisense-oligonucleotides (ASOs) are a promising drug modality for the treatment of neurological disorders, but the currently established route of administration via intrathecal delivery is a major limitation to its broader clinical application. An attractive alternative is the conjugation of the ASO to an antibody that facilitates access to the central nervous system (CNS) after peripheral application and target engagement at the blood-brain barrier, followed by transcytosis. Here, we show that the diligent conjugate design of Brainshuttle-ASO conjugates is the key to generating promising delivery vehicles and thereby establishing design principles to create optimized molecules with drug-like properties. An innovative site-specific transglutaminase-based conjugation technology was chosen and optimized in a stepwise process to identify the best-suited conjugation site, tags, reaction conditions, and linker design. The overall conjugation performance was found to be specifically governed by the choice of buffer conditions and the structure of the linker. The combination of the peptide tags YRYRQ and RYESK was chosen, showing high conjugation fidelity. Elaborate conjugate analysis revealed that one leading differentiating factor was hydrophobicity. The increase of hydrophobicity by the ASO payload could be mitigated by the appropriate choice of conjugation site and the heavy chain position 297 proved to be the most optimal. Evaluating the properties of the linker suggested a short bicyclo[6.1.0]nonyne (BCN) unit as best suited with regards to conjugation performance and potency. Promising in vitro activity and in vivo pharmacokinetic behavior of optimized Brainshuttle-ASO conjugates, based on a microtubule-associated protein tau (MAPT) targeting oligonucleotide, suggest that such designs have the potential to serve as a blueprint for peripherally delivered ASO-based drugs for the CNS in the future.
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Affiliation(s)
- Tatjana Sela
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
- Department of Biochemistry, Ludwig-Maximilians-Universität, Munich 80539, Germany
| | - Mads Mansø
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Copenhagen, F. Hoffmann-La Roche Ltd., Fremtidsvej 3, Hørsholm 2970, Denmark
| | - Michel Siegel
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Basel 4070, Switzerland
| | - Céline Marban-Doran
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Basel 4070, Switzerland
| | - Axel Ducret
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Basel 4070, Switzerland
| | - Jens Niewöhner
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - Jacob Ravn
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Copenhagen, F. Hoffmann-La Roche Ltd., Fremtidsvej 3, Hørsholm 2970, Denmark
| | - Rainer E Martin
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Basel 4070, Switzerland
| | - Annika Sommer
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - Sabine Lohmann
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - Ben-Fillippo Krippendorff
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Basel 4070, Switzerland
| | - Mette Ladefoged
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Copenhagen, F. Hoffmann-La Roche Ltd., Fremtidsvej 3, Hørsholm 2970, Denmark
| | - Annette Indlekofer
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - Tom Quaiser
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - Florian Bueddefeld
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - Erich Koller
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Basel 4070, Switzerland
| | | | | | - Kurt V Gothelf
- Department of Chemistry and Interdisciplinary Nanoscience Centre (iNANO), Aarhus University, Aarhus 8000, Central Denmark Region, Denmark
| | - Kerstin Hofer
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - Felix F Schumacher
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, Basel 4070, Switzerland
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Zeidan NMS, Lateef HMAE, Selim DM, Razek SA, Abd-Elrehim GAB, Nashat M, ElGyar N, Waked NM, Soliman AA, Elhewala AA, Shehab MMM, Ibraheem AAA, Shehata H, Yousif YM, Akeel NE, Hashem MIA, Ahmed AA, Emam AA, Abdelmohsen MM, Ahmed MF, Saleh ASE, Eltrawy HH, Shahin GH, Nabil RM, Hosny TA, Abdelhamed MR, Afify MR, Alharbi MT, Nagshabandi MK, Tarabulsi MK, Osman SF, Abd-Elrazek ASM, Rashad MM, El-Gaaly SAA, Gad SAB, Mohamed MY, Abdelkhalek K, Yousef AA. Vitamin D deficiency and vitamin D receptor FokI polymorphism as risk factors for COVID-19. Pediatr Res 2022; 93:1383-1390. [PMID: 36085364 PMCID: PMC9461391 DOI: 10.1038/s41390-022-02275-6] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/22/2022] [Accepted: 08/05/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Given the sparse data on vitamin D status in pediatric COVID-19, we investigated whether vitamin D deficiency could be a risk factor for susceptibility to COVID-19 in Egyptian children and adolescents. We also investigated whether vitamin D receptor (VDR) FokI polymorphism could be a genetic marker for COVID-19 susceptibility. METHODS One hundred and eighty patients diagnosed to have COVID-19 and 200 matched control children and adolescents were recruited. Patients were laboratory confirmed as SARS-CoV-2 positive by real-time RT-PCR. All participants were genotyped for VDR Fok1 polymorphism by RT-PCR. Vitamin D status was defined as sufficient for serum 25(OH) D at least 30 ng/mL, insufficient at 21-29 ng/mL, deficient at <20 ng/mL. RESULTS Ninety-four patients (52%) had low vitamin D levels with 74 (41%) being deficient and 20 (11%) had vitamin D insufficiency. Vitamin D deficiency was associated with 2.6-fold increased risk for COVID-19 (OR = 2.6; [95% CI 1.96-4.9]; P = 0.002. The FokI FF genotype was significantly more represented in patients compared to control group (OR = 4.05; [95% CI: 1.95-8.55]; P < 0.001). CONCLUSIONS Vitamin D deficiency and VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. IMPACT Vitamin D deficiency could be a modifiable risk factor for COVID-19 in children and adolescents because of its immune-modulatory action. To our knowledge, ours is the first such study to investigate the VDR Fok I polymorphism in Caucasian children and adolescents with COVID-19. Vitamin D deficiency and the VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. Clinical trials should be urgently conducted to test for causality and to evaluate the efficacy of vitamin D supplementation for prophylaxis and treatment of COVID-19 taking into account the VDR polymorphisms.
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Affiliation(s)
- Nancy M. S. Zeidan
- grid.7776.10000 0004 0639 9286Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Hanan M. Abd El Lateef
- grid.7269.a0000 0004 0621 1570Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Dalia M. Selim
- grid.7269.a0000 0004 0621 1570Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Suzan A. Razek
- grid.7269.a0000 0004 0621 1570Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Ghada A. B. Abd-Elrehim
- grid.412659.d0000 0004 0621 726XDepartment of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Nashat
- grid.417764.70000 0004 4699 3028Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Noha ElGyar
- grid.252487.e0000 0000 8632 679XDepartment of Pediatrics, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Nevin M. Waked
- grid.412319.c0000 0004 1765 2101Department of Pediatrics, Faculty of Medicine, October 6 University, 6th of October City, Egypt
| | - Attia A. Soliman
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A. Elhewala
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed M. M. Shehab
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A. A. Ibraheem
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan Shehata
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yousif M. Yousif
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nagwa E. Akeel
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mustafa I. A. Hashem
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amani A. Ahmed
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A. Emam
- grid.31451.320000 0001 2158 2757Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed M. Abdelmohsen
- grid.411303.40000 0001 2155 6022Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Mohamed F. Ahmed
- grid.411303.40000 0001 2155 6022Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Ahmed S. E. Saleh
- grid.411660.40000 0004 0621 2741Department of Otorhinolaryngology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Heba H. Eltrawy
- grid.411303.40000 0001 2155 6022Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Gehan H. Shahin
- grid.7776.10000 0004 0639 9286Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rehab M. Nabil
- grid.31451.320000 0001 2158 2757Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Thoraya A. Hosny
- grid.31451.320000 0001 2158 2757Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Mona R. Afify
- grid.460099.2Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohanned T. Alharbi
- grid.460099.2Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohammed K. Nagshabandi
- grid.460099.2Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Muyassar K. Tarabulsi
- grid.460099.2Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Sherif F. Osman
- grid.416992.10000 0001 2179 3554Department of Radiology, Texas Tech University Health Sciences Center, El Paso, TX USA
| | - Amal S. M. Abd-Elrazek
- grid.411775.10000 0004 0621 4712Department of Radio-Diagnosis, Menoufia University, Shibin Al Kawm, Egypt
| | - Manal M. Rashad
- grid.31451.320000 0001 2158 2757Department of Anesthesia, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sonya A. A. El-Gaaly
- grid.7269.a0000 0004 0621 1570Department of Internal Medicine, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Said A. B. Gad
- grid.31451.320000 0001 2158 2757Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Y. Mohamed
- grid.7269.a0000 0004 0621 1570Department of Psychiatry, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Khalil Abdelkhalek
- grid.7776.10000 0004 0639 9286Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Aly A. Yousef
- grid.412093.d0000 0000 9853 2750Department of Pediatrics, Faculty of Medicine, Helwan University, Helwan, Egypt
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A. Ramy H, H. Elghonemy S, M. Mohsen N, M. Nagib S, Y. Mohamed M. Pathways to Psychiatry Care among Children with Mental Health Problems. International Journal of Mental Health Promotion 2022. [DOI: 10.32604/ijmhp.2022.020108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Shafiek HK, El Lateef HMA, Boraey NF, Nashat M, Abd-Elrehim GAB, Abouzeid H, Hafez SFM, Shehata H, Elhewala AA, Abdel-Aziz A, Zeidan NMS, Soliman MM, Sallam MM, Nawara AM, Elgohary EA, Badr AI, Selim DM, Razek SA, Abdel Raouf BM, Elmikaty HA, Ibrahim LM, Shahin GH, Nabil RM, Ibrahim MAM, Salem HF, Moustafa AAM, Elshehawy NA, Abdel-Aziz MM, Eltrawy HH, Osman SF, Fouad RA, Afify MR, Mohamed MY, Yousif YM, Yousef AA, Arafa MA. Cytokine profile in Egyptian children and adolescents with COVID-19 pneumonia: A multicenter study. Pediatr Pulmonol 2021; 56:3924-3933. [PMID: 34536070 PMCID: PMC8661994 DOI: 10.1002/ppul.25679] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/20/2021] [Accepted: 09/16/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND To date, the cytokine profile in children and adolescent with novel coronavirus disease 2019 (COVID-19) has not been reported. OBJECTIVES We investigated serum levels of a panel of key cytokines in children and adolescent with COVID-19 pneumonia with a primary focus on "cytokine storm" cytokines such as interleukin (IL)-1β, IL-6, IL-17, IL-2, IL-4, IL-10, interferon (IFN-γ), tumor necrosis factor (TNF)-α, and two chemokines interferon-inducible protein-10 (IP-10) and IL-8. We also studied whether these cytokines could be potential markers for illness severity in COVID-19 pneumonia. METHODS Ninety-two symptomatic patients aged less than 18 years with confirmed COVID-19 pneumonia and 100 well-matched healthy controls were included in this multi-center study. For all patients, the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory fluid specimens was detected by real-time reverse-transcriptase polymerase chain reaction. We measured serum concentrations of studied cytokines by using flow cytometry. RESULTS Patients with COVID-19 had significantly higher median IL-1β, IL-6, IL-8, IL-10, IL-17, TNF-α, and IP-10 serum levels than did control children (all p < 0.01). Patients with severe COVID-19 pneumonia had significantly higher median IL-1β, IL-6, and IP-10 serum levels as compared with those with moderate COVID-19 pneumonia; all p < 0.01. ROC analysis revealed that three of the studied markers (IL-6, IL-1β, and IP-10) could predict severe COVID-19 pneumonia cases with the largest AUC for IL-6 of 0.893 (95% confidence interval: 0.84-0.98; p < 0.01). CONCLUSION Our study shows that pediatric patients with COVID-19 pneumonia have markedly elevated serum IL-1β, IL-6, IL-8, IL-10, IL-17, TNF-α, and IP-10 levels at the initial phase of the illness indicating a cytokine storm following SARS-CoV-2 infection. Moreover, serum IL-6, IL-1β, and IP-10 concentrations were independent predictors for severe COVID-19 pneumonia.
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Affiliation(s)
- Hala K Shafiek
- Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Naglaa F Boraey
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Nashat
- Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
| | | | - Heba Abouzeid
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sahbaa F M Hafez
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan Shehata
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Elhewala
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Alsayed Abdel-Aziz
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nancy M S Zeidan
- Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | | | - Mohammad M Sallam
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Abdalla M Nawara
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Elsayed A Elgohary
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Abdallah I Badr
- Department of Cardiothoracic Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dalia M Selim
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Suzan A Razek
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Batoul M Abdel Raouf
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Hani A Elmikaty
- Department of Pediatrics, National Research Centre, Cairo, Egypt
| | - Lamya M Ibrahim
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Gehan H Shahin
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Egypt
| | - Rehab M Nabil
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed A M Ibrahim
- Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanan F Salem
- Department of Anesthesia, Faculty of Medicine, Benha University, Banha, Egypt
| | - Ahmed A M Moustafa
- Department of Anesthesia, Faculty of Medicine, Benha University, Banha, Egypt
| | - Naglaa A Elshehawy
- Department of Anathesia, Faculty of Medicine, Al Azhar University, Egypt
| | - Marwa M Abdel-Aziz
- Department of Anathesia, Faculty of Medicine, Al Azhar University, Egypt
| | - Heba H Eltrawy
- Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Egypt
| | - Sherif F Osman
- Department of Radiology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Rania A Fouad
- Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Department of Medical Biochemistry, College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
| | - Mona R Afify
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudia Arabia
| | - Mohamed Y Mohamed
- Department of Psychiatry, Faculty of Medicine, Ain-Shams University, Egypt
| | - Yousif M Yousif
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Aly A Yousef
- Department of Pediatrics, Faculty of Medicine, Helwan University, Egypt
| | - Mohamed A Arafa
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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