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Jones BE, Brown-Augsburger PL, Corbett KS, Westendorf K, Davies J, Cujec TP, Wiethoff CM, Blackbourne JL, Heinz BA, Foster D, Higgs RE, Balasubramaniam D, Wang L, Zhang Y, Yang ES, Bidshahri R, Kraft L, Hwang Y, Žentelis S, Jepson KR, Goya R, Smith MA, Collins DW, Hinshaw SJ, Tycho SA, Pellacani D, Xiang P, Muthuraman K, Sobhanifar S, Piper MH, Triana FJ, Hendle J, Pustilnik A, Adams AC, Berens SJ, Baric RS, Martinez DR, Cross RW, Geisbert TW, Borisevich V, Abiona O, Belli HM, de Vries M, Mohamed A, Dittmann M, Samanovic MI, Mulligan MJ, Goldsmith JA, Hsieh CL, Johnson NV, Wrapp D, McLellan JS, Barnhart BC, Graham BS, Mascola JR, Hansen CL, Falconer E. The neutralizing antibody, LY-CoV555, protects against SARS-CoV-2 infection in nonhuman primates. Sci Transl Med 2021; 13:eabf1906. [PMID: 33820835 PMCID: PMC8284311 DOI: 10.1126/scitranslmed.abf1906] [Citation(s) in RCA: 287] [Impact Index Per Article: 95.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/19/2021] [Accepted: 03/31/2021] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a public health threat for which preventive and therapeutic agents are urgently needed. Neutralizing antibodies are a key class of therapeutics that may bridge widespread vaccination campaigns and offer a treatment solution in populations less responsive to vaccination. Here, we report that high-throughput microfluidic screening of antigen-specific B cells led to the identification of LY-CoV555 (also known as bamlanivimab), a potent anti-spike neutralizing antibody from a hospitalized, convalescent patient with coronavirus disease 2019 (COVID-19). Biochemical, structural, and functional characterization of LY-CoV555 revealed high-affinity binding to the receptor-binding domain, angiotensin-converting enzyme 2 binding inhibition, and potent neutralizing activity. A pharmacokinetic study of LY-CoV555 conducted in cynomolgus monkeys demonstrated a mean half-life of 13 days and a clearance of 0.22 ml hour-1 kg-1, consistent with a typical human therapeutic antibody. In a rhesus macaque challenge model, prophylactic doses as low as 2.5 mg/kg reduced viral replication in the upper and lower respiratory tract in samples collected through study day 6 after viral inoculation. This antibody has entered clinical testing and is being evaluated across a spectrum of COVID-19 indications, including prevention and treatment.
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Affiliation(s)
- Bryan E Jones
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA.
| | | | - Kizzmekia S Corbett
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Julian Davies
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA
| | - Thomas P Cujec
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA
| | | | | | | | - Denisa Foster
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA
| | | | | | - Lingshu Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yi Zhang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Eun Sung Yang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Lucas Kraft
- AbCellera Biologics Inc., Vancouver, BC V5Y0A1, Canada
| | - Yuri Hwang
- AbCellera Biologics Inc., Vancouver, BC V5Y0A1, Canada
| | | | | | - Rodrigo Goya
- AbCellera Biologics Inc., Vancouver, BC V5Y0A1, Canada
| | - Maia A Smith
- AbCellera Biologics Inc., Vancouver, BC V5Y0A1, Canada
| | | | | | - Sean A Tycho
- AbCellera Biologics Inc., Vancouver, BC V5Y0A1, Canada
| | | | - Ping Xiang
- AbCellera Biologics Inc., Vancouver, BC V5Y0A1, Canada
| | | | | | - Marissa H Piper
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA
| | - Franz J Triana
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA
| | - Jorg Hendle
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA
| | - Anna Pustilnik
- Lilly Biotechnology Center, Eli Lilly and Company, San Diego, CA 92121, USA
| | | | | | - Ralph S Baric
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - David R Martinez
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Robert W Cross
- Galveston National Laboratory and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Thomas W Geisbert
- Galveston National Laboratory and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Viktoriya Borisevich
- Galveston National Laboratory and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Olubukola Abiona
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Hayley M Belli
- Department of Population Health, Division of Biostatistics, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Maren de Vries
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Adil Mohamed
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Meike Dittmann
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Marie I Samanovic
- NYU Langone Vaccine Center, Department of Medicine, Division of Infectious Diseases and Immunology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Mark J Mulligan
- NYU Langone Vaccine Center, Department of Medicine, Division of Infectious Diseases and Immunology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Jory A Goldsmith
- Department of Molecular Biosciences, University of Texas at Austin, Austin, TX 78712, USA
| | - Ching-Lin Hsieh
- Department of Molecular Biosciences, University of Texas at Austin, Austin, TX 78712, USA
| | - Nicole V Johnson
- Department of Molecular Biosciences, University of Texas at Austin, Austin, TX 78712, USA
| | - Daniel Wrapp
- Department of Molecular Biosciences, University of Texas at Austin, Austin, TX 78712, USA
| | - Jason S McLellan
- Department of Molecular Biosciences, University of Texas at Austin, Austin, TX 78712, USA
| | | | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - John R Mascola
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Carl L Hansen
- AbCellera Biologics Inc., Vancouver, BC V5Y0A1, Canada
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Jones BE, Brown-Augsburger PL, Corbett KS, Westendorf K, Davies J, Cujec TP, Wiethoff CM, Blackbourne JL, Heinz BA, Foster D, Higgs RE, Balasubramaniam D, Wang L, Bidshahri R, Kraft L, Hwang Y, Žentelis S, Jepson KR, Goya R, Smith MA, Collins DW, Hinshaw SJ, Tycho SA, Pellacani D, Xiang P, Muthuraman K, Sobhanifar S, Piper MH, Triana FJ, Hendle J, Pustilnik A, Adams AC, Berens SJ, Baric RS, Martinez DR, Cross RW, Geisbert TW, Borisevich V, Abiona O, Belli HM, de Vries M, Mohamed A, Dittmann M, Samanovic M, Mulligan MJ, Goldsmith JA, Hsieh CL, Johnson NV, Wrapp D, McLellan JS, Barnhart BC, Graham BS, Mascola JR, Hansen CL, Falconer E. LY-CoV555, a rapidly isolated potent neutralizing antibody, provides protection in a non-human primate model of SARS-CoV-2 infection. bioRxiv 2020. [PMID: 33024963 DOI: 10.1101/2020.09.30.318972] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
SARS-CoV-2 poses a public health threat for which therapeutic agents are urgently needed. Herein, we report that high-throughput microfluidic screening of antigen-specific B-cells led to the identification of LY-CoV555, a potent anti-spike neutralizing antibody from a convalescent COVID-19 patient. Biochemical, structural, and functional characterization revealed high-affinity binding to the receptor-binding domain, ACE2 binding inhibition, and potent neutralizing activity. In a rhesus macaque challenge model, prophylaxis doses as low as 2.5 mg/kg reduced viral replication in the upper and lower respiratory tract. These data demonstrate that high-throughput screening can lead to the identification of a potent antiviral antibody that protects against SARS-CoV-2 infection. One Sentence Summary LY-CoV555, an anti-spike antibody derived from a convalescent COVID-19 patient, potently neutralizes SARS-CoV-2 and protects the upper and lower airways of non-human primates against SARS-CoV-2 infection.
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Byrd RA, Owens RA, Blackbourne JL, Coutant DE, Farmen MW, Michael MD, Moyers JS, Schultze AE, Sievert MK, Tripathi NK, Vahle JL. Nonclinical pharmacology and toxicology of the first biosimilar insulin glargine drug product (BASAGLAR ® /ABASAGLAR ® ) approved in the European Union. Regul Toxicol Pharmacol 2017; 88:56-65. [DOI: 10.1016/j.yrtph.2017.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
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Byrd RA, Blackbourne JL, Knadler MP, Schultze AE, Vahle JL. Chronic Toxicology Studies of Basal Insulin Peglispro in Rats and Dogs: A Novel, PEGylated Insulin Lispro Analog with a Prolonged Duration of Action. Toxicol Pathol 2017; 45:402-415. [DOI: 10.1177/0192623317696283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Basal insulin peglispro (BIL) consists of insulin lispro with a 20-kDa polyethylene glycol (PEG) moiety covalently attached to lysine B28. Because chronic parenteral administration of PEGylated proteins to animals has sometimes resulted in PEG vacuolation of tissue macrophages, renal tubular cells, and choroid plexus ependymal cells, we investigated whether chronic subcutaneous (sc) injection of BIL in rats (52 weeks) and dogs (39 weeks) was associated with systemic toxicities or other changes, including vacuolation of tissue macrophages, renal tubular cells, and ependymal cells. Rats and dogs received daily sc injections of BIL (rats: 0.17, 0.45, or 1.15 mg/kg/d and dogs: 0.025, 0.10, or 0.20 mg/kg/d) and the reference compound, HUMULIN N® (neutral protamine Hagedorn [NPH] human insulin; rats: 0.15 mg/kg/d and dogs: 0.02–0.03 mg/kg/d). Animals were evaluated for standard end points including mortality, clinical signs, body weights, toxicokinetics, glucodynamics, clinical pathology, and morphological pathology. Nonadverse injection site lipohypertrophy occurred for all BIL and NPH doses but more frequently with BIL. No BIL-related hyperplasia or neoplasia was observed. There was no vacuolation of tissue macrophages, renal tubular cells, or ependymal cells attributable to PEG. These studies demonstrate BIL is not associated with tissue vacuolation attributable to PEG at 4- to 6-fold multiple of the median clinical exposure in patients with diabetes.
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Affiliation(s)
- Richard A. Byrd
- Non-Clinical Safety Assessment, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Jamie L. Blackbourne
- Non-Clinical Safety Assessment, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Mary Pat Knadler
- Drug Disposition, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Albert E. Schultze
- Department of Pathology, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - John L. Vahle
- Department of Pathology, Eli Lilly and Company, Indianapolis, Indiana, USA
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Usborne A, Byrd RA, Meehan J, Blackbourne JL, Sullivan J, Poitout-Belissent F, Prefontaine A, Martin JA, Vahle JL. An Investigative Study of Pancreatic Exocrine Biomarkers, Histology, and Histomorphometry in Male Zucker Diabetic Fatty (ZDF) Rats Given Dulaglutide by Subcutaneous Injection Twice Weekly for 13 Weeks. Toxicol Pathol 2015; 43:1093-102. [PMID: 26269615 DOI: 10.1177/0192623315596857] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonist therapy has been implicated as a possible risk factor for acute pancreatitis in patients with type 2 diabetes. Dulaglutide is a long-acting GLP-1 receptor agonist in development for treatment of type 2 diabetes. The effects of dulaglutide were evaluated in male Zucker diabetic fatty (ZDF) rats to examine whether dulaglutide may induce or modulate pancreatitis. Rats were randomized to dose groups receiving twice-weekly subcutaneously administered dulaglutide 0.5, 1.5, and 5.0 mg/kg/dose (corresponding human plasma exposures following twice-weekly dosing are 3-, 8-, and 30-fold, respectively) for 13 weeks or to vehicle control. Following termination, serially trimmed sections of pancreases were stained with hematoxylin and eosin or co-stained with an epithelial marker and a marker of either proliferation or apoptosis. Efficacious reductions in glucose and hemoglobin A1c occurred at all dulaglutide doses. Lipase activity was unaffected, and there were modest increases in total and pancreatic amylase activities at all doses without individual microscopic inflammatory correlates. Microscopic dulaglutide-related pancreatic changes included increased interlobular ductal epithelium without ductal cell proliferation (≥0.5 mg/kg), increased acinar atrophy with/without inflammation (≥1.5 mg/kg), and increased incidence/severity of neutrophilic acinar pancreatic inflammation (5.0 mg/kg). In summary, dulaglutide treatment was associated with mild alterations in ductal epithelium and modest exacerbation of spontaneous lesions of the exocrine pancreas typically found in the ZDF rat model.
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Affiliation(s)
- Amy Usborne
- Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, Indiana, USA
| | - Richard A Byrd
- Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, Indiana, USA
| | - James Meehan
- Charles River Laboratories, Preclinical Services Montreal, Senneville, Quebec, Canada
| | - Jamie L Blackbourne
- Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, Indiana, USA
| | - John Sullivan
- Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, Indiana, USA
| | | | - Annick Prefontaine
- Charles River Laboratories, Preclinical Services Montreal, Senneville, Quebec, Canada
| | - Jennifer A Martin
- Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, Indiana, USA
| | - John L Vahle
- Eli Lilly and Company, Lilly Research Laboratories, Indianapolis, Indiana, USA
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Vahle JL, Byrd RA, Blackbourne JL, Martin JA, Sorden SD, Ryan T, Pienkowski T, Wijsman JA, Smith HW, Rosol TJ. Effects of Dulaglutide on Thyroid C Cells and Serum Calcitonin in Male Monkeys. Endocrinology 2015; 156:2409-16. [PMID: 25860028 DOI: 10.1210/en.2014-1717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonists, used for the treatment of type 2 diabetes, have caused hyperplasia/neoplasia of thyroid C cells in rodent carcinogenicity studies. Studies in monkeys have not identified an effect of GLP-1 receptor agonists on thyroid C cells; however, group sizes were small. Dulaglutide is a once-weekly, long-acting human GLP-1 receptor agonist recently approved in the United States and the European Union. The objective of this study was to determine whether dulaglutide altered C-cell mass in monkeys. Male cynomolgus monkeys (20 per group) were sc injected with dulaglutide 8.15 mg/kg (∼500-fold maximum human plasma exposure) or a vehicle control twice weekly for 52 weeks. Basal and calcium gluconate-stimulated serum calcitonin concentrations were obtained at 3, 6, 9, and 12 months. Thyroid glands were weighed, fixed, and sectioned at 500-μm intervals. C-cell volumes were measured using an automated image analysis. C-cell proliferation was estimated using Ki67/calcitonin colabeling and cell counting. Administration of dulaglutide 8.15 mg/kg twice weekly for 52 weeks did not increase serum calcitonin in monkeys or affect thyroid weight, histology, C-cell proliferation, or absolute/relative C-cell volume. This study represents a comprehensive evaluation of the monkey thyroid C cells after dosing with a GLP-1 receptor agonist, with a large group size, and measurement of multiple relevant parameters. The lack of effect of dulaglutide on C cells is consistent with other studies in monkeys using GLP-1 receptor agonists and suggests that nonhuman primates are less sensitive than rodents to the induction of proliferative changes in thyroid C cells by GLP-1 receptor agonists.
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Affiliation(s)
- John L Vahle
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Richard A Byrd
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Jamie L Blackbourne
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Jennifer A Martin
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Steven D Sorden
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Thomas Ryan
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Thomas Pienkowski
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - John A Wijsman
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Holly W Smith
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
| | - Thomas J Rosol
- Department of Toxicology, Pathology, and Drug Disposition (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Eli Lilly and Company (J.L.V., R.A.B., J.L.B., J.A.M., J.A.W., H.W.S.), Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P.), Covance Laboratories, Madison, Wisconsin 53704; and Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210
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Byrd RA, Sorden SD, Ryan T, Pienkowski T, LaRock R, Quander R, Wijsman JA, Smith HW, Blackbourne JL, Rosol TJ, Long GG, Martin JA, Vahle JL. Chronic Toxicity and Carcinogenicity Studies of the Long-Acting GLP-1 Receptor Agonist Dulaglutide in Rodents. Endocrinology 2015; 156:2417-28. [PMID: 25860029 DOI: 10.1210/en.2014-1722] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The tumorigenic potential of dulaglutide was evaluated in rats and transgenic mice. Rats were injected sc twice weekly for 93 weeks with dulaglutide 0, 0.05, 0.5, 1.5, or 5 mg/kg corresponding to 0, 0.5, 7, 20, and 58 times, respectively, the maximum recommended human dose based on plasma area under the curve. Transgenic mice were dosed sc twice weekly with dulaglutide 0, 0.3, 1, or 3 mg/kg for 26 weeks. Dulaglutide effects were limited to the thyroid C-cells. In rats, diffuse C-cell hyperplasia and adenomas were statistically increased at 0.5 mg/kg or greater (P ≤ .01 at 5 mg/kg), and C-cell carcinomas were numerically increased at 5 mg/kg. Focal C-cell hyperplasia was higher compared with controls in females given 0.5, 1.5, and 5 mg/kg. In transgenic mice, no dulaglutide-related C-cell hyperplasia or neoplasia was observed at any dose; however, minimal cytoplasmic hypertrophy of C cells was observed in all dulaglutide groups. Systemic exposures decreased over time in mice, possibly due to an antidrug antibody response. In a 52-week study designed to quantitate C-cell mass and plasma calcitonin responses, rats received twice-weekly sc injections of dulaglutide 0 or 5 mg/kg. Dulaglutide increased focal C-cell hyperplasia; however, quantitative increases in C-cell mass did not occur. Consistent with the lack of morphometric changes in C-cell mass, dulaglutide did not affect the incidence of diffuse C-cell hyperplasia or basal or calcium-stimulated plasma calcitonin, suggesting that diffuse increases in C-cell mass did not occur during the initial 52 weeks of the rat carcinogenicity study.
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Affiliation(s)
- Richard A Byrd
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Steven D Sorden
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Thomas Ryan
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Thomas Pienkowski
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Richard LaRock
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Ricardo Quander
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - John A Wijsman
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Holly W Smith
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Jamie L Blackbourne
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Thomas J Rosol
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Gerald G Long
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - Jennifer A Martin
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
| | - John L Vahle
- Department of Toxicology, Pathology, and Drug Disposition (R.A.B., J.A.W., H.W.S., J.L.B., J.A.M., J.L.V.), Eli Lilly and Company, Indianapolis, Indiana 46285; Early Development (S.D.S., T.R., T.P., R.L., R.Q.), Covance Laboratories, Madison, Wisconsin 53704; Department of Veterinary Biosciences (T.J.R.), The Ohio State University, Columbus, Ohio 43210; and Experimental Pathology Laboratories, Inc (G.G.L.), Sterling, Virginia 20166
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8
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Vahle JL, Byrd RA, Blackbourne JL, Martin JA, Sorden SD, Ryan T, Pienkowski T, Rosol TJ, Snyder PW, Klöppel G. Effects of the GLP-1 Receptor Agonist Dulaglutide on the Structure of the Exocrine Pancreas of Cynomolgus Monkeys. Toxicol Pathol 2015; 43:1004-14. [PMID: 26059826 DOI: 10.1177/0192623315588999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/25/2022]
Abstract
Clinical and nonclinical studies have implicated glucagon-like peptide-1 (GLP-1) receptor agonist therapy as a risk factor for acute pancreatitis in patients with type 2 diabetes. Therefore, it is critical to understand the effect that dulaglutide, an approved GLP-1 receptor agonist, has on the exocrine pancreas. Dulaglutide 8.15 mg/kg (approximately 500 times the maximum recommended human dose based on plasma exposure) was administered twice weekly for 12 months to cynomolgus monkeys. Serum amylase and lipase activities were measured and 6 sections of each pancreas were examined microscopically. Ductal epithelial cell proliferation was estimated using Ki67 labeling. Dulaglutide administration did not alter serum amylase or lipase activities measured at the end of treatment compared to control values. An extensive histologic evaluation of the pancreas revealed no changes in the acinar or endocrine portions and no evidence of pancreatitis, necrosis, or pancreatic intraepithelial neoplasia. An increase in goblet cells noted in 4 of the 19 treated monkeys was considered an effect of dulaglutide but was not associated with dilation, blockage, or accumulation of mucin in the pancreatic duct. There was no difference in cell proliferation in ductal epithelium between control and dulaglutide-treated monkeys. These data reveal that chronic dosing of nondiabetic primates with dulaglutide does not induce inflammatory or preneoplastic changes in exocrine pancreas.
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Affiliation(s)
- John L Vahle
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | | | | | | | - Thomas Ryan
- Covance Laboratories, Madison, Wisconsin, USA
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9
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Komocsar WJ, Blackbourne JL, Halstead CA, Winstead CJ, Wierda D. Fully human anti-BAFF inhibitory monoclonal antibody tabalumab does not adversely affect T-dependent antibody responses in cynomolgus monkey (Macaca fasicularis): A summary of three pre-clinical immunotoxicology evaluations. J Immunotoxicol 2015; 13:7-19. [PMID: 25585959 DOI: 10.3109/1547691x.2014.994793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The potential immunotoxicity of tabalumab was assessed as a component of standard pre-clinical toxicology studies in cynomolgus monkeys. To evaluate potential tabalumab-associated immunosuppression after antigen challenge, cynomolgus monkeys were administered placebo control or tabalumab in three immunotoxicological safety studies. Study 1, a 4-week pilot study, evaluated biweekly intravenous (IV) control, and 0.3, 1.0, 5.0, and 15.0 mg/kg tabalumab doses. Study 2 evaluated IV control, and 0.1, 1.0, and 30.0 mg/kg tabalumab doses biweekly for 6 weeks. Study 3 evaluated IV control and 0.1, 1.0, 30.0 mg/kg, and subcutaneous (SC) 30.0 mg/kg tabalumab biweekly for 6 months, with recovery (16 weeks) to monitor standard immunotoxicity endpoints. T-cell dependent primary and secondary antibody responses to tetanus toxoid antigen challenge (4-week and 6-week studies) or keyhole limpet hemocyanin (KLH; 6-week and 6-month studies) were evaluated as a measure of immunocompetence, together with quantitation of T- and B-cell subsets. In addition, anti-tabalumab antibody formation (6-week and 6-month studies) was assessed. The results indicated that, despite expected decreases in circulating B-cell populations, no changes in follicle histopathology or organ weights, except decreases in spleen weight (after 6-months of 30 mg/kg IV/SC treatment only), were attributed to tabalumab. Non-adverse microscopic decreases in size or number of germinal centers in spleen, mesenteric, and mandibular lymph nodes occurred, but without an effect on antibody responses to KLH or tetanus. At 16-weeks recovery, microscopic compound-related changes observed after 6 months of treatment were completely reversed (0.1 mg/kg group) and partially reversed (1.0 and 30.0 mg/kg groups), while peripheral blood B cells remained 66-72% reduced from baseline. Despite reduced germinal centres in lymphoid organs, and reductions in circulating B cells, T-cell-dependent humoral immunity was maintained following tabalumab administration in three safety studies in cynomolgus monkeys.
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Affiliation(s)
| | | | | | | | - Daniel Wierda
- c Wierda Toxicology Consulting, Inc. , New Palestine , IN , USA
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