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Macdonald T, Dinnes J, Maniatopoulos G, Taylor-Phillips S, Shinkins B, Hogg J, Dunbar JK, Solebo AL, Sutton H, Attwood J, Pogose M, Given-Wilson R, Greaves F, Macrae C, Pearson R, Bamford D, Tufail A, Liu X, Denniston AK. Target Product Profile for a Machine Learning-Automated Retinal Imaging Analysis Software for Use in English Diabetic Eye Screening: Protocol for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e50568. [PMID: 38536234 PMCID: PMC11007610 DOI: 10.2196/50568] [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] [Received: 09/14/2023] [Revised: 02/02/2024] [Accepted: 02/13/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Diabetic eye screening (DES) represents a significant opportunity for the application of machine learning (ML) technologies, which may improve clinical and service outcomes. However, successful integration of ML into DES requires careful product development, evaluation, and implementation. Target product profiles (TPPs) summarize the requirements necessary for successful implementation so these can guide product development and evaluation. OBJECTIVE This study aims to produce a TPP for an ML-automated retinal imaging analysis software (ML-ARIAS) system for use in DES in England. METHODS This work will consist of 3 phases. Phase 1 will establish the characteristics to be addressed in the TPP. A list of candidate characteristics will be generated from the following sources: an overview of systematic reviews of diagnostic test TPPs; a systematic review of digital health TPPs; and the National Institute for Health and Care Excellence's Evidence Standards Framework for Digital Health Technologies. The list of characteristics will be refined and validated by a study advisory group (SAG) made up of representatives from key stakeholders in DES. This includes people with diabetes; health care professionals; health care managers and leaders; and regulators and policy makers. In phase 2, specifications for these characteristics will be drafted following a series of semistructured interviews with participants from these stakeholder groups. Data collected from these interviews will be analyzed using the shortlist of characteristics as a framework, after which specifications will be drafted to create a draft TPP. Following approval by the SAG, in phase 3, the draft will enter an internet-based Delphi consensus study with participants sought from the groups previously identified, as well as ML-ARIAS developers, to ensure feasibility. Participants will be invited to score characteristic and specification pairs on a scale from "definitely exclude" to "definitely include," and suggest edits. The document will be iterated between rounds based on participants' feedback. Feedback on the draft document will be sought from a group of ML-ARIAS developers before its final contents are agreed upon in an in-person consensus meeting. At this meeting, representatives from the stakeholder groups previously identified (minus ML-ARIAS developers, to avoid bias) will be presented with the Delphi results and feedback of the user group and asked to agree on the final contents by vote. RESULTS Phase 1 was completed in November 2023. Phase 2 is underway and expected to finish in March 2024. Phase 3 is expected to be complete in July 2024. CONCLUSIONS The multistakeholder development of a TPP for an ML-ARIAS for use in DES in England will help developers produce tools that serve the needs of patients, health care providers, and their staff. The TPP development process will also provide methods and a template to produce similar documents in other disease areas. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50568.
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Affiliation(s)
- Trystan Macdonald
- Ophthalmology Department, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom
- Academic Unit of Ophthalmology, Institute of Inflammation and Aging, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, Birmingham, United Kingdom
| | - Jacqueline Dinnes
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, Birmingham, United Kingdom
| | | | | | - Bethany Shinkins
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Jeffry Hogg
- Population Health Sciences Institute, Faculty of Medical Sciences, The University of Newcastle upon Tyne, Newcastle, United Kingdom
| | | | - Ameenat Lola Solebo
- Population Policy and Practice, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | | | - John Attwood
- Alder Hey Children's Hospital, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom
| | | | - Rosalind Given-Wilson
- St. George's University Hospitals National Health Service Foundation Trust, London, United Kingdom
| | - Felix Greaves
- National Institute for Health and Care Excellence, London, United Kingdom
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Carl Macrae
- Nottingham University Business School, University of Nottingham, Nottingham, United Kingdom
| | - Russell Pearson
- Medicines and Healthcare Products Regulatory Agency, London, United Kingdom
| | | | - Adnan Tufail
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Xiaoxuan Liu
- Ophthalmology Department, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom
- Academic Unit of Ophthalmology, Institute of Inflammation and Aging, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, Birmingham, United Kingdom
| | - Alastair K Denniston
- Ophthalmology Department, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom
- Academic Unit of Ophthalmology, Institute of Inflammation and Aging, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, Birmingham, United Kingdom
- Centre for Regulatory Science and Innovation, Birmingham Health Partners, Birmingham, United Kingdom
- National Institute for Health and Care Research Biomedical Research Centre at Moorfields and University College London Institute of Ophthalmology, London, United Kingdom
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2
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Lu K, Brauns T, Sluder AE, Poznansky MC, Dogan F. Combinatorial islet protective therapeutic approaches in β-cell transplantation: Rationally designed solutions using a target product profile. FASEB Bioadv 2023; 5:287-304. [PMID: 37415930 PMCID: PMC10320848 DOI: 10.1096/fba.2023-00029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/03/2023] [Accepted: 05/17/2023] [Indexed: 07/08/2023] Open
Abstract
While progress has been made in the development of islet cell transplantation (ICT) as a viable alternative to the use of exogenous insulin therapy in the treatment of type 1 diabetes, it has not yet achieved its full potential in clinical studies. Ideally, ICT would enable lifelong maintenance of euglycemia without the need for exogenous insulin, blood glucose monitoring or systemic immune suppression. To achieve such an optimal result, therapeutic approaches should simultaneously promote long-term islet viability, functionality, and localized immune protection. In practice, however, these factors are typically tackled individually. Furthermore, while the requirements of optimal ICT are implicitly acknowledged across numerous publications, the literature contains few comprehensive articulations of the target product profile (TPP) for an optimal ICT product, including key characteristics of safety and efficacy. This review aims to provide a novel TPP for ICT and presents promising tried and untried combinatorial approaches that could be used to achieve the target product profile. We also highlight regulatory barriers to the development and adoption of ICT, particularly in the United States, where ICT is only approved for use in academic clinical trials and is not reimbursed by insurance carriers. Overall, this review argues that the clear definition of a TPP in addition to the use of combinatorial approaches could help to overcome the clinical barriers to the widespread adoption of ICT for the treatment of type 1 diabetes.
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Affiliation(s)
- Katie Lu
- Vaccine and Immunotherapy CenterMassachusetts General HospitalBostonMassachusettsUSA
- Department of BiologyStanford UniversityStanfordCaliforniaUSA
| | - Timothy Brauns
- Vaccine and Immunotherapy CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Ann E. Sluder
- Vaccine and Immunotherapy CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Mark C. Poznansky
- Vaccine and Immunotherapy CenterMassachusetts General HospitalBostonMassachusettsUSA
| | - Fatma Dogan
- Vaccine and Immunotherapy CenterMassachusetts General HospitalBostonMassachusettsUSA
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3
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Caldwell N, Afshar R, Baragaña B, Bustinduy AL, Caffrey CR, Collins JJ, Fusco D, Garba A, Gardner M, Gomes M, Hoffmann KF, Hsieh M, Lo NC, McNamara CW, Nono JK, Padalino G, Read KD, Roestenberg M, Spangenberg T, Specht S, Gilbert IH. Perspective on Schistosomiasis Drug Discovery: Highlights from a Schistosomiasis Drug Discovery Workshop at Wellcome Collection, London, September 2022. ACS Infect Dis 2023; 9:1046-1055. [PMID: 37083395 PMCID: PMC10186373 DOI: 10.1021/acsinfecdis.3c00081] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Indexed: 04/22/2023]
Abstract
In September 2022, the Drug Discovery Unit at the University of Dundee, UK, organised an international meeting at the Wellcome Collection in London to explore the current clinical situation and challenges associated with treating schistosomiasis. The aim of this meeting was to discuss the need for new treatments in view of the clinical situation and to ascertain what the key requirements would be for any potential new anti-schistosomals. This information will be essential to inform ongoing drug discovery efforts for schistosomiasis. We also discussed the potential drug discovery pathway and associated criteria for progressing compounds to the clinic. To date, praziquantel (PZQ) is the only drug available to treat all species causing schistosomiasis, but it is often unable to completely clear parasites from an infected patient, partially due to its inactivity against juvenile worms. PZQ-mediated mass drug administration campaigns conducted in endemic areas (e.g., sub-Saharan Africa, where schistosomiasis is primarily prevalent) have contributed to reducing the burden of disease but will not eliminate the disease as a public health problem. The potential for Schistosoma to develop resistance towards PZQ, as the sole treatment available, could become a concern. Consequently, new anthelmintic medications are urgently needed, and this Perspective aims to capture some of the learnings from our discussions on the key criteria for new treatments.
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Affiliation(s)
- Nicola Caldwell
- Wellcome
Centre for Anti-Infectives Research, Drug Discovery Unit, Division
of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Rana Afshar
- Global
Health Institute of Merck, a subsidiary of Merck KGaA, Darmstadt,
Germany, Ares Trading
S.A., Route de Crassier 1, 1262 Eysins, Switzerland
| | - Beatriz Baragaña
- Wellcome
Centre for Anti-Infectives Research, Drug Discovery Unit, Division
of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Amaya L. Bustinduy
- Department
of Clinical Research, London School of Hygiene
& Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Conor R. Caffrey
- Center
for Discovery and Innovation in Parasitic Diseases, Skaggs School
of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, MC0657, La Jolla, California 92093, United States
| | - James J. Collins
- Department
of Pharmacology, UT Southwestern Medical
Center, Forest Park Road, Dallas, Texas 75235, United States
| | - Daniela Fusco
- Department
of Infectious Disease Epidemiology, Bernhard
Nocht Institute of Tropical Medicine, 20359 Hamburg, Germany
- German
Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, 38124 Brunswick, Germany
| | - Amadou Garba
- Department
of Control of Neglected Tropical Diseases, World Health Organization, 1202 Geneva, Switzerland
| | - Mark Gardner
- Salvensis
Ltd., 27 New Dover Rd., Canterbury, Kent CT1 3DN, United Kingdom
| | - Mireille Gomes
- Global
Health Institute of Merck, a subsidiary of Merck KGaA, Darmstadt,
Germany, Ares Trading
S.A., Route de Crassier 1, 1262 Eysins, Switzerland
| | - Karl F. Hoffmann
- Department
of Life Sciences (DLS), Aberystwyth University, Edward Llwyd Building, Aberystwyth SY23 3DA, United Kingdom
| | - Michael Hsieh
- Division
of Urology, Children’s National Hospital, and Department of
Urology, George Washington University, Washington, D.C. 20010, United States
| | - Nathan C. Lo
- Division
of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, California 94110, United States
| | - Case W. McNamara
- Calibr,
a division of Scripps Research, North Torrey Pines Road, La Jolla, California 92037, United States
| | - Justin Komguep Nono
- Unit
of Immunobiology and Helminth Infections, Institute of Medical Research
and Medicinal Plant Studies (IMPM), Ministry
of Scientific Research and Innovation, Yaoundé 13033, Cameroon
| | - Gilda Padalino
- School
of Pharmacy and Pharmaceutical Sciences, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff CF10 3NB, United
Kingdom
| | - Kevin D. Read
- Wellcome
Centre for Anti-Infectives Research, Drug Discovery Unit, Division
of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Meta Roestenberg
- Department
of Parasitology and Department of Infectious Diseases, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
| | - Thomas Spangenberg
- Global
Health Institute of Merck, a subsidiary of Merck KGaA, Darmstadt,
Germany, Ares Trading
S.A., Route de Crassier 1, 1262 Eysins, Switzerland
| | - Sabine Specht
- Drugs for Neglected Diseases Initiative, 1202 Geneva, Switzerland
| | - Ian H. Gilbert
- Wellcome
Centre for Anti-Infectives Research, Drug Discovery Unit, Division
of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
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Hagembe J, Baumann A, Haffar A, Pierce GF, Toulon P. Development of a target product profile (TTP) for haemophilia point-of-care (POC) diagnostic devices for low-resource countries and remote settings. Haemophilia 2023; 29:671-673. [PMID: 36640299 DOI: 10.1111/hae.14739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 01/15/2023]
Affiliation(s)
| | - Alain Baumann
- World Federation of Hemophilia, Montreal, Quebec, Canada
| | - Assad Haffar
- World Federation of Hemophilia, Montreal, Quebec, Canada
| | - Glenn F Pierce
- World Federation of Hemophilia, Montreal, Quebec, Canada
| | - Pierre Toulon
- Service d'hématologie biologique, Hôpital Pasteur, Hôpital Pasteur, Nice, France
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5
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Fongwen N, Asiedu KB, Bakhiet S, Bonifaz A, Cruz I, Argaw D, Estrada-Chavez G, Fahal AH, Litvintseva A, Marks M, Salinas-Carmona MC, Sow D, van de Sande WWJ. Diagnostics to support mycetoma management-Development of two target product profiles. Trop Med Int Health 2022; 27:1059-1064. [PMID: 36329624 PMCID: PMC10099886 DOI: 10.1111/tmi.13828] [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: 11/06/2022]
Abstract
OBJECTIVE Mycetoma is a neglected tropical disease caused by more than 70 different microorganisms and identified by the WHO as one of the high-priority diseases for developing diagnostic tests. To ensure the production of diagnostic assays for use by clinical staff in endemic regions, target product profiles (TPPs) were designed. METHODS We describe the development of two TPPs: one for a diagnostic test able to identify the causative agent of mycetoma and another that would determine when treatment could be stopped. The TPPs were developed by considering product use, design, performance, product configuration and costs. RESULTS Version 1.0 TPPs for two uses were posted by WHO for a 1-month online public consultation on 25 October 2021, and the final TPP was posted online on 5 May 2022. CONCLUSION A major difficulty encountered in developing both TPPs was the large number of agents able to cause mycetoma and the lack of specific biomarkers for most of them.
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Affiliation(s)
- Noah Fongwen
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Kingsley B Asiedu
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Sahar Bakhiet
- Mycetoma Research Center, Soba University Hospital, Khartoum, Sudan.,Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Alexandro Bonifaz
- Dermatology Service & Mycology Department, Hospital General de México, Cuauhtémoc, Mexico
| | - Israel Cruz
- National School of Public Health, CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Argaw
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Guadalupe Estrada-Chavez
- Community Dermatology Mexico C.A./Faculty of Medicine, Universidad Autonoma de Guerrero, Acapulco, Mexico
| | - Ahmed H Fahal
- Mycetoma Research Center, Soba University Hospital, Khartoum, Sudan
| | - Ana Litvintseva
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Michael Marks
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Infectious Diseases and General Medicine, Hospital for Tropical Diseases, London, UK.,Division of Infection and Immunity, University College London, London, UK
| | - Mario C Salinas-Carmona
- Departamento de Inmunología, Universidad Autónoma de Nuevo León, Facultad de Medicina, Nuevo León, Mexico
| | - Doudou Sow
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, Saint-Louis, Senegal
| | - Wendy W J van de Sande
- Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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6
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Martín-Escolano J, Marín C, Rosales MJ, Tsaousis AD, Medina-Carmona E, Martín-Escolano R. An Updated View of the Trypanosoma cruzi Life Cycle: Intervention Points for an Effective Treatment. ACS Infect Dis 2022; 8:1107-1115. [PMID: 35652513 PMCID: PMC9194904 DOI: 10.1021/acsinfecdis.2c00123] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
![]()
Chagas disease (CD)
is a parasitic, systemic, chronic, and often
fatal illness caused by infection with the protozoan Trypanosoma
cruzi. The World Health Organization classifies CD as the
most prevalent of poverty-promoting neglected tropical diseases, the
most important parasitic one, and the third most infectious disease
in Latin America. Currently, CD is a global public health issue that
affects 6–8 million people. However, the current approved treatments
are limited to two nitroheterocyclic drugs developed more than 50
years ago. Many efforts have been made in recent decades to find new
therapies, but our limited understanding of the infection process,
pathology development, and long-term nature of this disease has made
it impossible to develop new drugs, effective treatment, or vaccines.
This Review aims to provide a comprehensive update on our understanding
of the current life cycle, new morphological forms, and genetic diversity
of T. cruzi, as well as identify intervention points
in the life cycle where new drugs and treatments could achieve a parasitic
cure.
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Affiliation(s)
- Javier Martín-Escolano
- Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, E41013 Seville, Spain
| | - Clotilde Marín
- Department of Parasitology, University of Granada, Severo Ochoa s/n, 18071 Granada, Spain
| | - María J. Rosales
- Department of Parasitology, University of Granada, Severo Ochoa s/n, 18071 Granada, Spain
| | - Anastasios D. Tsaousis
- Laboratory of Molecular & Evolutionary Parasitology, RAPID group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, U.K
| | - Encarnación Medina-Carmona
- Department of Physical Chemistry, University of Granada, 18071 Granada, Spain
- School of Biosciences, University of Kent, Canterbury CT2 7NJ, U.K
| | - Rubén Martín-Escolano
- Laboratory of Molecular & Evolutionary Parasitology, RAPID group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, U.K
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Callahan RL, Mehta NJ, Nanda K, Kopf GS. The new contraceptive revolution: developing innovative products outside of industry†,‡. Biol Reprod 2021; 103:157-166. [PMID: 32529250 PMCID: PMC7401029 DOI: 10.1093/biolre/ioaa067] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Indexed: 12/02/2022] Open
Abstract
A significant global unmet need for new contraceptive options for both women and men remains due to side effect profiles, medical concerns, and inconvenience of many currently available products. The pharmaceutical industry has largely abandoned early research and development for contraception and will not likely engage to bring new products to the market unless they have been significantly de-risked by showing promise in early phase clinical trials. This lack of interest by big pharma comes at a time when scientific and technological advances in biology and medicine are creating more opportunities than ever for the development of new and innovative drug products. Novel partnerships between the academic sector, small biotechnology companies, foundations, non-government organizations (NGOs), and the federal government could accelerate the development of new contraceptive products. We discuss the challenges and opportunities that we have encountered as an NGO with a mission to develop novel contraceptive products for low- and middle-income countries and how it differs from developing products for higher-income markets. We hope that our experiences and “lessons learned” will be of value to others as they proceed down the product development path, be it for female or male or for hormonal or nonhormonal contraceptives.
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Affiliation(s)
- Rebecca L Callahan
- Reproductive Health Product Innovation & Introduction, Global Health Population & Nutrition, FHI 360, Durham, NC, USA
| | - Neha J Mehta
- Reproductive Health Product Innovation & Introduction, Global Health Population & Nutrition, FHI 360, Durham, NC, USA
| | - Kavita Nanda
- Reproductive Health Product Innovation & Introduction, Global Health Population & Nutrition, FHI 360, Durham, NC, USA
| | - Gregory S Kopf
- Reproductive Health Product Innovation & Introduction, Global Health Population & Nutrition, FHI 360, Durham, NC, USA
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Martín-Escolano R, Molina-Carreño D, Plano D, Espuelas S, Rosales MJ, Moreno E, Aydillo C, Sanmartín C, Sánchez-Moreno M, Marín C. Library of Selenocyanate and Diselenide Derivatives as In Vivo Antichagasic Compounds Targeting Trypanosoma cruzi Mitochondrion. Pharmaceuticals (Basel) 2021; 14:ph14050419. [PMID: 34062791 PMCID: PMC8147293 DOI: 10.3390/ph14050419] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 03/24/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022] Open
Abstract
Chagas disease is usually caused by tropical infection with the insect-transmitted protozoan Trypanosoma cruzi. Currently, Chagas disease is a major public health concern worldwide due to globalization, and there are no treatments neither vaccines because of the long-term nature of the disease and its complex pathology. Current treatments are limited to two obsolete drugs, benznidazole and nifurtimox, which lead to serious drawbacks. Taking into account the urgent need for strict research efforts to find new therapies, here, we describe the in vitro and in vivo trypanocidal activity of a library of selected forty-eight selenocyanate and diselenide derivatives that exhibited leishmanicidal properties. The inclusion of selenium, an essential trace element, was due to the well-known extensive pharmacological activities for selenium compounds including parasitic diseases as T. cruzi. Here we present compound 8 as a potential compound that exhibits a better profile than benznidazole both in vitro and in vivo. It shows a fast-acting behaviour that could be attributed to its mode of action: it acts in a mitochondrion-dependent manner, causing cell death by bioenergetic collapse. This finding provides a step forward for the development of a new antichagasic agent.
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Affiliation(s)
- Rubén Martín-Escolano
- Laboratory of Molecular & Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK
- Correspondence: (R.M.-E.); (C.M.)
| | - Daniel Molina-Carreño
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs.Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071 Granada, Spain; (D.M.-C.); (M.J.R.); (M.S.-M.)
| | - Daniel Plano
- Facultad de Farmacia y Nutrición, Departamento de Tecnología y Química Farmacéuticas, Universidad de Navarra, Irunlarrea, E-31008 Pamplona, Spain; (D.P.); (S.E.); (E.M.); (C.A.); (C.S.)
- Instituto de Salud Tropical, Universidad de Navarra, ISTUN, Irunlarrea, E-31008 Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA) Irunlarrea, E-31008 Pamplona, Spain
| | - Socorro Espuelas
- Facultad de Farmacia y Nutrición, Departamento de Tecnología y Química Farmacéuticas, Universidad de Navarra, Irunlarrea, E-31008 Pamplona, Spain; (D.P.); (S.E.); (E.M.); (C.A.); (C.S.)
- Instituto de Salud Tropical, Universidad de Navarra, ISTUN, Irunlarrea, E-31008 Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA) Irunlarrea, E-31008 Pamplona, Spain
| | - María J. Rosales
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs.Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071 Granada, Spain; (D.M.-C.); (M.J.R.); (M.S.-M.)
| | - Esther Moreno
- Facultad de Farmacia y Nutrición, Departamento de Tecnología y Química Farmacéuticas, Universidad de Navarra, Irunlarrea, E-31008 Pamplona, Spain; (D.P.); (S.E.); (E.M.); (C.A.); (C.S.)
- Instituto de Salud Tropical, Universidad de Navarra, ISTUN, Irunlarrea, E-31008 Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA) Irunlarrea, E-31008 Pamplona, Spain
| | - Carlos Aydillo
- Facultad de Farmacia y Nutrición, Departamento de Tecnología y Química Farmacéuticas, Universidad de Navarra, Irunlarrea, E-31008 Pamplona, Spain; (D.P.); (S.E.); (E.M.); (C.A.); (C.S.)
- Instituto de Salud Tropical, Universidad de Navarra, ISTUN, Irunlarrea, E-31008 Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA) Irunlarrea, E-31008 Pamplona, Spain
| | - Carmen Sanmartín
- Facultad de Farmacia y Nutrición, Departamento de Tecnología y Química Farmacéuticas, Universidad de Navarra, Irunlarrea, E-31008 Pamplona, Spain; (D.P.); (S.E.); (E.M.); (C.A.); (C.S.)
- Instituto de Salud Tropical, Universidad de Navarra, ISTUN, Irunlarrea, E-31008 Pamplona, Spain
- Instituto de Investigaciones Sanitarias de Navarra (IdiSNA) Irunlarrea, E-31008 Pamplona, Spain
| | - Manuel Sánchez-Moreno
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs.Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071 Granada, Spain; (D.M.-C.); (M.J.R.); (M.S.-M.)
| | - Clotilde Marín
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs.Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071 Granada, Spain; (D.M.-C.); (M.J.R.); (M.S.-M.)
- Correspondence: (R.M.-E.); (C.M.)
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9
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Funk CD, Laferrière C, Ardakani A. Target Product Profile Analysis of COVID-19 Vaccines in Phase III Clinical Trials and Beyond: An Early 2021 Perspective. Viruses 2021; 13:418. [PMID: 33807839 PMCID: PMC7998902 DOI: 10.3390/v13030418] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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] [Received: 02/11/2021] [Revised: 02/27/2021] [Accepted: 03/03/2021] [Indexed: 02/07/2023] Open
Abstract
The coronavirus SARS-CoV-2, which causes Coronavirus disease 2019 (COVID-19), has infected more than 100 million people globally and caused over 2.5 million deaths in just over one year since its discovery in Wuhan, China in December 2019. The pandemic has evoked widespread collateral damage to societies and economies, and has destabilized mental health and well-being. Early in 2020, unprecedented efforts went into the development of vaccines that generate effective antibodies to the SARS-CoV-2 virus. Teams developing twelve candidate vaccines, based on four platforms (messenger RNA, non-replicating viral vector, protein/virus-like particle, and inactivated virus) had initiated or announced the Phase III clinical trial stage by early November 2020, with several having received emergency use authorization in less than a year. Vaccine rollout has proceeded around the globe. Previously, we and others had proposed a target product profile (TPP) for ideal/optimal and acceptable/minimal COVID-19 vaccines. How well do these candidate vaccines stack up to a harmonized TPP? Here, we perform a comparative analysis in several categories of these candidate vaccines based on the latest available trial data and highlight the early successes as well as the hurdles and barriers yet to be overcome for ending the global COVID-19 pandemic.
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Affiliation(s)
- Colin D. Funk
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
- Scientific Research Division, Novateur Ventures Inc., Vancouver, BC V6E 3P3, Canada; (C.L.); (A.A.)
| | - Craig Laferrière
- Scientific Research Division, Novateur Ventures Inc., Vancouver, BC V6E 3P3, Canada; (C.L.); (A.A.)
| | - Ali Ardakani
- Scientific Research Division, Novateur Ventures Inc., Vancouver, BC V6E 3P3, Canada; (C.L.); (A.A.)
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10
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Ghaffari A, Meurant R, Ardakani A. COVID-19 Point-of-Care Diagnostics That Satisfy Global Target Product Profiles. Diagnostics (Basel) 2021; 11:115. [PMID: 33445727 PMCID: PMC7828180 DOI: 10.3390/diagnostics11010115] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 pandemic will continue to pose a major public health threat until vaccination-mediated herd immunity is achieved. Most projections predict vaccines will reach a large subset of the population late in 2021 or early 2022. In the meantime, countries are exploring options to remove strict lockdown measures and allow society and the economy to return to normal function. One possibility is to expand on existing COVID-19 testing strategies by including large-scale rapid point-of-care diagnostic tests (POCTs). Currently, there is significant variability in performance and features of available POCTs, making selection and procurement of an appropriate test for specific use case difficult. In this review, we have used the World Health Organization's (WHO) recently published target product profiles (TPPs) for specific use cases of COVID-19 diagnostic tests to screen for top-performing POCTs on the market. Several POCTs, based on clinical sensitivity/specificity, the limit of detection, and time to results, which meet WHO TPP criteria for direct detection of SARS-CoV-2 (acute infection) or indirect diagnosis of past infection (host antibodies), are highlighted here.
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Affiliation(s)
- Abdi Ghaffari
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada
- Novateur Ventures Inc., Vancouver, BC V6E 3P3, Canada
| | - Robyn Meurant
- NSF Health Sciences, Kirkbymoorside, York YO62 6AF, UK;
| | - Ali Ardakani
- Novateur Ventures Inc., Vancouver, BC V6E 3P3, Canada
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11
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Villamagna AH, Gore SJ, Lewis JS, Doggett JS. The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective. Front Med (Lausanne) 2020; 7:596587. [PMID: 33415116 PMCID: PMC7783399 DOI: 10.3389/fmed.2020.596587] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022] Open
Abstract
Respiratory failure due to SARS-CoV-2 has caused widespread mortality, creating an urgent need for effective treatments and a long-term need for antivirals for future emergent coronaviruses. Pharmacotherapy for respiratory viruses has largely been unsuccessful with the exception of early treatment of influenza viruses, which shortens symptom duration and prevents infection in close contacts. Under the rapidly evolving circumstances of the COVID-19 pandemic, most clinical trials of experimental treatments in the United States have focused on later stages of the disease process. Worldwide, the clinical studies of the most impactful drugs, remdesivir and dexamethasone in ACTT-1, RECOVERY, and Solidarity, have studied hospitalized patients. Less than half of clinical trials in the U.S. have investigated oral agents, and the majority have taken place in hospitals at a disease stage where the viral load is already decreasing. The limited success of treatments for respiratory viruses and the viral dynamics of COVID-19 suggest that an antiviral therapy with the greatest impact against pandemic coronaviruses would be orally administered, well-tolerated, target a highly conserved viral protein or host-coronavirus interaction and could be used effectively throughout the world, including resource-poor settings. We examine the treatment of respiratory viral infections and current clinical trials for COVID-19 to provide a framework for effective antiviral therapy and prevention of future emergent coronaviruses and call attention to the need for continued preclinical drug discovery.
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Affiliation(s)
- Angela Holly Villamagna
- Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland, OR, United States
| | - Sara J. Gore
- Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland, OR, United States
| | - James S. Lewis
- Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland, OR, United States
| | - J. Stone Doggett
- Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland, OR, United States
- Department of Hospital and Specialty Medicine, VA Portland Healthcare System, Portland, OR, United States
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12
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Abstract
Chagas disease is a neglected tropical disease and a global public health issue. In terms of treatment, no progress has been made since the 1960s, when benznidazole and nifurtimox, two obsolete drugs still prescribed, were used to treat this disease. Hence, currently, there are no effective treatments available to tackle Chagas disease. Over the past 20 years, there has been an increasing interest in the disease. However, parasite genetic diversity, drug resistance, tropism, and complex life cycle, along with the limited understanding of the disease and inadequate methodologies and strategies, have resulted in the absence of new insights in drugs development and disappointing outcomes in clinical trials so far. In summary, new drugs are urgently needed. This Review considers the relevant aspects related to the lack of drugs for Chagas disease, resumes the advances in tools for drug discovery, and discusses the main features to be taken into account to develop new effective drugs.
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Affiliation(s)
- Javier Martín-Escolano
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs.Granada), Hospitales Universitarios De Granada/University of Granada, Severo Ochoa s/n, 18071 Granada, Spain
| | | | - Rubén Martín-Escolano
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs.Granada), Hospitales Universitarios De Granada/University of Granada, Severo Ochoa s/n, 18071 Granada, Spain
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13
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Craciunas L, Pickering O, Chu J, Žurauskienė J, Coomarasamy A. Target Product Profile for an endometrial receptivity test: women's perspective. Eur J Obstet Gynecol Reprod Biol 2020; 253:42-7. [PMID: 32771887 DOI: 10.1016/j.ejogrb.2020.07.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the women's views in relation to the characteristics of an endometrial receptivity test in the context of recurrent miscarriage with an overarching aim to guide the development of a Target Product Profile (TPP) based on minimum acceptable ("worst-case") and ideal ("best-case") features. STUDY DESIGN This was a descriptive cross-sectional study involving a total of 131 women who answered questions related to the development of an endometrial receptivity test between December 2017 and May 2018. Women attending the recurrent miscarriage clinic at the Tommy's National Centre for Miscarriage Research in Birmingham, United Kingdom, were invited to participate. Referral criteria included two or more miscarriages irrespective of the timing in relation to successful pregnancies. The 'best-case' (ideal) and 'worst-case' (minimum acceptable) thresholds were arbitrary set to satisfy at least 80% and 40% of responders, respectively. RESULTS The ideal endometrial receptivity test should be indicated after two miscarriages to comply with the wish of 80.9% (106 women) of responders. It should be performed in a window of three to four days within the menstrual cycle (93.2%; 122 women) and results should be available within one to two days (87.7%; 115 women). Invasiveness of testing should not extend beyond a vaginal examination (85.4%; 112 women). Repeating the test should not be required more than twice (96.1%; 125 women) and the results should remain useful for at least six menstrual cycles (89.3%; 117 women). The importance score given for the endometrium was weakly associated with the willingness to pay for testing; however, there was no evidence to suggest this correlation was different from 0 (Kendall's tau = 0.1101765, z = 1.4327, p-value = 0.1519; Spearman's rho = 0.1268444, S = 327136, p-value = 0.1488). CONCLUSIONS Women understand the important role the endometrium plays for a successful pregnancy and they have specific views in relation to the indication, timing and invasiveness of testing, need for test repetition, validity of results and costs of testing.
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14
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Timpe C, Stegemann S, Barrett A, Mujumdar S. Challenges and opportunities to include patient-centric product design in industrial medicines development to improve therapeutic goals. Br J Clin Pharmacol 2020; 86:2020-2027. [PMID: 32441052 DOI: 10.1111/bcp.14388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/14/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/09/2023] Open
Abstract
In the past, drug developers in industry chose approaches mainly focusing on the drug product's efficacy, safety and quality according to the level required by regulatory expectations stipulated in guidelines, pharmacopoeia and other regulatory provisions. By putting more focus on the patient perspective, regulatory authorities are currently raising their requirements regarding successful product submissions. The increasing involvement of patients in the product development process (e.g. conduction of human factor use tests, integration of feedback from patient and patient advisory groups into clinical programmes) requires adaptations to the existing and established industrial drug development processes without compromising fast patient access to innovative therapies. This review provides an expert opinion on the emerging challenges and opportunities to implement a patient-centric approach into new drug development programmes. The aim is to better understand the challenge of finding the right balance between bringing innovative drugs fast to the patients and to develop these in parallel in a patient-centric product form as well as why this is an opportunity and how stakeholder parties (e.g. patients, clinicians, pharmacists, caregivers, regulators) can provide support to achieve desired outcomes.
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Affiliation(s)
| | - Sven Stegemann
- TU Graz, Institute for Process and Particle Engineering, Graz, Austria
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15
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Georghiou SB, Schumacher SG, Rodwell TC, Colman RE, Miotto P, Gilpin C, Ismail N, Rodrigues C, Warren R, Weyer K, Zignol M, Arafah S, Cirillo DM, Denkinger CM. Guidance for Studies Evaluating the Accuracy of Rapid Tuberculosis Drug-Susceptibility Tests. J Infect Dis 2020; 220:S126-S135. [PMID: 31593599 DOI: 10.1093/infdis/jiz106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/23/2022] Open
Abstract
The development and implementation of rapid molecular diagnostics for tuberculosis (TB) drug-susceptibility testing is critical to inform treatment of patients and to prevent the emergence and spread of resistance. Optimal trial planning for existing tests and those in development will be critical to rapidly gather the evidence necessary to inform World Health Organization review and to support potential policy recommendations. The evidence necessary includes an assessment of the performance for TB and resistance detection as well as an assessment of the operational characteristics of these platforms. The performance assessment should include analytical studies to confirm the limit of detection and assay ability to detect mutations conferring resistance across globally representative strains. The analytical evaluation is typically followed by multisite clinical evaluation studies to confirm diagnostic performance in sites and populations of intended use. This paper summarizes the considerations for the design of these analytical and clinical studies.
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Affiliation(s)
| | | | | | | | - Paolo Miotto
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Nazir Ismail
- University of Pretoria, South Africa.,National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.,University Hospital Heidelberg, Division of Tropical Medicine, Centre of Infectious Diseases, Germany
| | | | - Rob Warren
- SAMRC Centre for Tuberculosis Research, Stellenbosch University, Tygerberg, South Africa
| | - Karin Weyer
- World Health Organization, Geneva, Switzerland
| | | | | | | | - Claudia M Denkinger
- FIND, Geneva, Switzerland.,University of Heidelberg, Centre of Infectious Diseases, Germany
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16
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Dailey PJ, Osborn J, Ashley EA, Baron EJ, Dance DAB, Fusco D, Fanello C, Manabe YC, Mokomane M, Newton PN, Tessema B, Isaacs C, Dittrich S. Defining System Requirements for Simplified Blood Culture to Enable Widespread Use in Resource-Limited Settings. Diagnostics (Basel) 2019; 9:E10. [PMID: 30641976 DOI: 10.3390/diagnostics9010010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/20/2018] [Accepted: 12/26/2018] [Indexed: 01/30/2023] Open
Abstract
Bacterial blood stream infections (BSI) are a common cause of mortality and morbidity globally. As the causative agents and the resulting treatment decisions vary, near-patient testing and surveillance tools are necessary to monitor bacterial causes and resistance to antimicrobial agents. The gold standard to identify BSIs is blood culture (BC), a methodology not widely available in resource-limited settings. The aim of the study was to map out a target product profile of a simplified BC system (SBCS) to inform product development efforts. To identify the desired characteristics of a SBCS, we enlisted a small group of specialists working in Africa and Asia. Questions were used to understand challenges and how these constraints inform system requirements. The specialists were infectious disease physicians, public health/clinical microbiologists, clinical researchers, and technology experts with different geographical backgrounds. All suggested that BC should ideally be available at the district hospital level. Many of the same operational challenges, such as limited availability of culture bottles, electricity and internet connectivity, profuse dust, the lack of ambient temperature control, and human capacity constraints were identified across the different regions. BCs, although the accepted gold standard for diagnosis of BSIs, are not widely available outside of reference/research centers in Africa and Asia. To extend the reach of this important tool, it is crucial to engage product developers and academic research partners to develop accessible alternatives.
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17
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Biter AB, Weltje S, Hudspeth EM, Seid CA, McAtee CP, Chen WH, Pollet JB, Strych U, Hotez PJ, Bottazzi ME. Characterization and Stability of Trypanosoma cruzi 24-C4 (Tc24-C4), a Candidate Antigen for a Therapeutic Vaccine Against Chagas Disease. J Pharm Sci 2017; 107:1468-1473. [PMID: 29274820 DOI: 10.1016/j.xphs.2017.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 11/20/2017] [Accepted: 12/12/2017] [Indexed: 12/19/2022]
Abstract
Chagas disease due to chronic infection with Trypanosoma cruzi is a neglected cause of heart disease, affecting approximately 6-10 million individuals in Latin America and elsewhere. T. cruzi Tc24, a calcium-binding protein in the flagellar pocket of the parasite, is a candidate antigen for an injectable therapeutic vaccine as an alternative or a complement to chemotherapy. Previously, we reported that a genetically engineered construct from which all cysteine residues had been eliminated (Tc24-C4) yields a recombinant protein with reduced aggregation and improved analytical purity in comparison to the wild-type form, without compromising antigenicity and immunogenicity. We now report that the established process for producing Escherichia coli-expressed Tc24-C4 protein is robust and reproducibly yields protein lots with consistent analytical characteristics, freeze-thaw, accelerated, and long-term stability profiles. The data indicate that, like most proteins, Tc24-C4 should be stable at -80°C, but also at 4°C and room temperature for at least 30 days, and up to 7-15 days at 37°C. Thus, the production process for recombinant Tc24-C4 is suitable for Current Good Manufacturing Practice production and clinical testing, based on process robustness, analytical characteristics, and stability profile.
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Affiliation(s)
- Amadeo B Biter
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - Sarah Weltje
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - Elissa M Hudspeth
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - Christopher A Seid
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - C Patrick McAtee
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - Wen-Hsiang Chen
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - Jeroen B Pollet
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - Ulrich Strych
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030
| | - Peter J Hotez
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030; Department of Biology, Baylor University, Waco, Texas 76706
| | - Maria Elena Bottazzi
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030; Texas Children's Hospital Center for Vaccine Development, Houston, Texas 77030; Department of Biology, Baylor University, Waco, Texas 76706.
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18
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Abstract
The apicomplexan parasite Cryptosporidium is the second most important diarrheal pathogen causing life-threatening diarrhea in children, which is also associated with long-term growth faltering and cognitive deficiency. Cryptosporidiosis is a parasitic disease of public health concern caused by Cryptosporidium parvum and Cryptosporidium hominis. Currently, nitazoxanide is the only approved treatment for cryptosporidium infections. Unfortunately, it has limited efficacy in the most vulnerable patients, thus there is an urgent need for a safe and efficacious cryptosporidiosis drug. In this work, we present our current perspectives on the target product profile for novel cryptosporidiosis therapies and the perceived challenges and possible mitigation plans at different stages in the cryptosporidiosis drug discovery process.
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Affiliation(s)
- Ujjini H. Manjunatha
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01, Singapore 138670
| | - Alexander T. Chao
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01, Singapore 138670
| | - F. Joel Leong
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01, Singapore 138670
| | - Thierry T. Diagana
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01, Singapore 138670
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19
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Brooks A, Nunes JK, Garnett A, Biellik R, Leboulleux D, Birkett AJ, Loucq C. Aligning new interventions with developing country health systems: target product profiles, presentation, and clinical trial design. Glob Public Health 2012; 7:931-45. [PMID: 22783872 PMCID: PMC3479626 DOI: 10.1080/17441692.2012.699088] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 08/31/2011] [Revised: 04/20/2012] [Indexed: 11/22/2022]
Abstract
Many new interventions are being created to address health problems of the developing world. However, many developing countries have fragile health systems and find it difficult to accommodate change. Consequently, it is essential that new interventions are well aligned with health systems and their users. Establishing target product profiles (TPPs) is a critical, early step towards tailoring interventions to suit both of these constituencies. Specific analyses can help identify and establish relevant TPP criteria such as optimal formulation, presentation and packaging. Clinical trials for a new intervention should be designed to address both TPP-specific questions and anticipated use of the intervention in target countries. Examples are provided from research on malaria vaccines that are also applicable to other new public health interventions.
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Affiliation(s)
- Alan Brooks
- PATH Malaria Vaccine Initiative, Ferney- Voltaire, France
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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