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Innovative approaches to cardiovascular safety pharmacology assessment 心血管安全药理学评估的创新方法。
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107533
Michael K. Pugsley , Brett R. Winters , Yevgeniya E. Koshman , Simon Authier , C. Michael Foley , Eric S. Hayes , Michael J. Curtis

This editorial prefaces the annual themed issue on safety pharmacology (SP) methods which has been published since 2004 in the Journal of Pharmacological and Toxicological Methods (JPTM). Here we highlight content derived from the 2023 Safety Pharmacology Society (SPS) meeting held in Brussels, Belgium. The meeting generated 138 abstracts, reproduced in the current volume of JPTM. As in prior years, the manuscripts reflect various areas of innovation in SP including in silico modeling of stroke volume, cardiac output and systemic vascular resistance, computational approaches that compare drug-induced proarrhythmic sensitivity of human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), an evaluation of the utility of the corrected J-Tpeak and Tpeak-to-Tend parameters from the ECG as potential proarrhythmia biomarkers, and the applicability of nonclinical concentration-QTc (C-QTc) modeling of data derived from the conduct of the in vivo QTc study as a component of the core battery of safety pharmacology studies.

自 2004 年以来,《药理学和毒理学方法杂志》(JPTM)每年都会出版一期关于安全药理学(SP)方法的主题刊物,本期社论是该刊物的序言。在此,我们重点介绍在比利时布鲁塞尔举行的 2023 年安全药理学会(SPS)会议的内容。本次会议共收到 138 篇摘要,现刊于 JPTM 本卷。与往年一样,这些手稿反映了SPS的各个创新领域,包括搏出量、心输出量和全身血管阻力的硅学建模,比较药物诱导的人诱导多能干细胞衍生心肌细胞(hiPSC-CMs)促心律失常敏感性的计算方法、评估心电图中校正后的 J 峰值和 T 峰值-峰值参数作为潜在的促心律失常生物标志物的实用性,以及非临床浓度-QTc(C-QTc)建模的适用性,该建模是进行体内 QTc 研究得出的数据,是安全性药理学研究核心电池的组成部分。
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引用次数: 0
Contractility assessment using aligned human iPSC-derived cardiomyocytes 使用对齐的人类 iPSC 衍生心肌细胞进行收缩力评估。
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107530
Ayano Satsuka , Alexandre J.S. Ribeiro , Hiroyuki Kawagishi , Shota Yanagida , Naoya Hirata , Takashi Yoshinaga , Junko Kurokawa , Atsushi Sugiyama , David G. Strauss , Yasunari Kanda

Introduction

Cardiac safety assessment, such as lethal arrhythmias and contractility dysfunction, is critical during drug development. Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) have been shown to be useful in predicting drug-induced proarrhythmic risk through international validation studies. Although cardiac contractility is another key function, fit-for-purpose hiPSC-CMs in evaluating drug-induced contractile dysfunction remain poorly understood. In this study, we investigated whether alignment of hiPSC-CMs on nanopatterned culture plates can assess drug-induced contractile changes more efficiently than non-aligned monolayer culture.

Methods

Aligned hiPSC-CMs were obtained by culturing on 96-well culture plates with a ridge-groove-ridge nanopattern on the bottom surface, while non-aligned hiPSC-CMs were cultured on regular 96-well plates. Next-generation sequencing and qPCR experiments were performed for gene expression analysis. Contractility of the hiPSC-CMs was assessed using an imaging-based motion analysis system.

Results

When cultured on nanopatterned plates, hiPSC-CMs exhibited an aligned morphology and enhanced expression of genes encoding proteins that regulate contractility, including myosin heavy chain, calcium channel, and ryanodine receptor. Compared to cultures on regular plates, the aligned hiPSC-CMs also showed both enhanced contraction and relaxation velocity. In addition, the aligned hiPSC-CMs showed a more physiological response to positive and negative inotropic agents, such as isoproterenol and verapamil.

Discussion

Taken together, the aligned hiPSC-CMs exhibited enhanced structural and functional properties, leading to an improved capacity for contractility assessment compared to the non-aligned cells. These findings suggest that the aligned hiPSC-CMs can be used to evaluate drug-induced cardiac contractile changes.

简介:心脏安全性评估,如致命性心律失常和收缩功能障碍,在药物开发过程中至关重要。国际验证研究表明,人类诱导多能干细胞衍生的心肌细胞(hiPSC-CMs)可用于预测药物诱发致心律失常的风险。虽然心脏收缩力是另一项关键功能,但人们对用于评估药物诱导的收缩功能障碍的合适的hiPSC-CMs仍知之甚少。在这项研究中,我们探讨了在纳米图案培养板上对齐 hiPSC-CMs 是否能比非对齐单层培养更有效地评估药物诱导的收缩变化:对齐的hiPSC-CMs是通过在底面带有脊-槽-脊纳米图案的96孔培养板上培养获得的,而未对齐的hiPSC-CMs是在普通的96孔培养板上培养的。对基因表达进行了新一代测序和 qPCR 实验分析。使用基于成像的运动分析系统评估了 hiPSC-CMs 的收缩能力:结果:在纳米花纹板上培养时,hiPSC-CMs表现出排列整齐的形态,并增强了编码调控收缩力的蛋白的基因的表达,包括肌球蛋白重链、钙通道和雷诺丁受体。与普通平板上的培养物相比,排列整齐的 hiPSC-CMs 还显示出更强的收缩和松弛速度。此外,排列整齐的 hiPSC-CMs 对异丙肾上腺素和维拉帕米等正性和负性肌力药物表现出更多的生理反应:总之,与未配对的细胞相比,配对的 hiPSC-CMs 表现出更强的结构和功能特性,从而提高了收缩能力评估的能力。这些发现表明,配准的 hiPSC-CMs 可用于评估药物诱导的心脏收缩力变化。
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引用次数: 0
Preclinical mitigation of 5-HT2B agonism-related cardiac valvulopathy revisited 再论 5-HT2B 激动剂相关心脏瓣膜病的临床前缓解措施
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107542

Cardiac valvulopathy (Cardiac Valve Disease; CVD) associated with off-target activation of the 5-hydroxytryptamine (5-HT) 2B receptor has been well recognized, but is still poorly predicted during drug development. The regulatory guidance proposes the use of 5-HT2B binding data (i.e., Ki values) and free maximum therapeutic exposure (Cmax) to calculate safety margins as a threshold of detection (>10) for eliminating the risk of drug-induced cardiac valvulopathy. In this paper, we provide additional recommendations for preclinical prediction of CVD risk based on clinical pharmacodynamic and pharmacokinetic data obtained from drugs with or without 5-HT2B receptor activation. Our investigations showed that 5-HT2B agonist affinity of molecules tested in an in vitro 5-HT2B cell-based functional assay, placed in perspective to their sustained plasma exposure (AUCs) and not to their peak plasma exposure, Cmax (i.e., maximum therapeutic exposure) provide a solid basis for interpreting 5-HT2B data, for calculating safety margins and then, accurately differentiate drugs associated with a clinical risk of CVD from those which are not (despite having some agonist 5-HT2B activity). In addition, we discuss the risk of multi-organ fibrosis linked to 5-HT2B receptor activation, often underestimated, however well reported in FAERS for 5-HT2B agonists. We believe that our recommendations have the potential to mitigate the risk for the clinical development of CVD and fibrosis.

与 5- 羟色胺 (5-HT) 2B 受体的脱靶激活有关的心脏瓣膜病(CVD)已得到广泛认可,但在药物开发过程中对其预测仍然不足。监管指南建议使用 5-HT2B 结合数据(即 Ki 值)和自由最大治疗暴露量(Cmax)来计算安全系数,作为消除药物诱发心脏瓣膜病风险的检测阈值 (>10)。在本文中,我们根据从有或没有 5-HT2B 受体激活的药物中获得的临床药效学和药代动力学数据,为临床前预测心血管疾病风险提供了更多建议。我们的研究表明,在体外 5-HT2B 细胞功能检测中测试的分子的 5-HT2B 激动剂亲和力,与其持续血浆暴露量(AUCs)而非其峰值血浆暴露量、Cmax(即最大治疗暴露量)有关,为解释 5-HT2B 数据、计算安全系数以及准确区分与心血管疾病临床风险有关的药物和与心血管疾病临床风险无关的药物(尽管具有一定的 5-HT2B 激动剂活性)提供了坚实的基础。此外,我们还讨论了与 5-HT2B 受体激活相关的多器官纤维化风险,这种风险往往被低估,但在 FAERS 中却有关于 5-HT2B 激动剂的详细报告。我们相信,我们的建议有可能降低心血管疾病和纤维化的临床发展风险。
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引用次数: 0
Determination of unbound platinum concentrations in human plasma using ultrafiltration and precipitation methods 利用超滤和沉淀方法测定人体血浆中的非结合铂浓度。
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107535
Xia Wen , Cathleen Doherty , Lauren E. Thompson , Christine Kim , Brian S. Buckley , Edgar A. Jaimes , Melanie S. Joy , Lauren M. Aleksunes

Quantification of the unbound portion of platinum (Pt) in human plasma is important for assessing the pharmacokinetics of the chemotherapeutic drug cisplatin. In this study, we sought to compare the recovery of unbound Pt using Nanosep® filters to 1) traditional filters (Centrifree®, Centrisart®, Amicon®) or trichloroacetic acid (TCA) protein precipitation, and 2) unbound, bound, and total Pt concentrations in clinical specimens. For the tested filters, the impact of 1) molecular weight cut-offs, 2) centrifugation force, and 3) total Pt concentration on Pt binding in human plasma was evaluated. Pt was quantified using inductively coupled-plasma mass spectrometry. In human plasma spiked with 0.9 μg/mL Pt, the percent of unbound Pt increased at higher centrifugation speeds. By comparison, the percent of unbound Pt was highest (42.1%) following TCA protein precipitation. When total Pt was ≤0.9 μg/mL, unbound Pt (∼20–30%) was consistent across filters. Conversely, when plasma was spiked with Pt exceeding 0.9 μg/mL, the percent of unbound Pt increased from 36.5 to 48% using ultrafiltration, compared to 63.4% to 79% with TCA precipitation. In patients receiving cisplatin-containing chemotherapy, the fraction of unbound Pt at concentrations exceeding 0.9 μg/mL ranged between 35 and 90%. Moreover, the unbound fraction of Pt in plasma correlated with the concentration of unbound (R2 = 0.738) and total Pt (R2 = 0.335). In summary, this study demonstrates that 1) the percent of unbound Pt is influenced by total and unbound Pt levels in vitro and in clinical specimens, and 2) ultrafiltration with Nanosep® filters is a feasible method for quantifying unbound Pt concentrations in human plasma.

人体血浆中铂金(Pt)未结合部分的定量对于评估化疗药物顺铂的药代动力学非常重要。在这项研究中,我们试图比较使用 Nanosep® 过滤器和 1)传统过滤器(Centrifree®, Centrisart®, Amicon®)或三氯乙酸(TCA)蛋白沉淀法回收未结合铂的情况,以及 2)临床样本中未结合、结合和总铂浓度。对于测试的过滤器,评估了 1)分子量截止值、2)离心力和 3)总铂浓度对人体血浆中铂结合的影响。铂采用电感耦合等离子体质谱法进行定量。在添加了 0.9 μg/mL Pt 的人体血浆中,离心速度越快,未结合铂的百分比越高。相比之下,TCA 蛋白沉淀后未结合铂的百分比最高(42.1%)。当总铂量≤0.9 μg/mL时,各过滤器的未结合铂量(约20-30%)是一致的。相反,当血浆中的铂含量超过 0.9 μg/mL 时,使用超滤时,未结合铂的百分比从 36.5% 增加到 48%,而使用 TCA 沉淀时,未结合铂的百分比则从 63.4% 增加到 79%。在接受含顺铂化疗的患者中,浓度超过 0.9 μg/mL 的未结合铂的比例在 35% 到 90% 之间。此外,血浆中铂的非结合部分与非结合铂浓度(R2 = 0.738)和总铂浓度(R2 = 0.335)相关。总之,本研究证明:1)未结合铂的百分比受体外和临床样本中总铂和未结合铂水平的影响;2)使用 Nanosep® 过滤器进行超滤是量化人体血浆中未结合铂浓度的可行方法。
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引用次数: 0
Nonclinical pharmacokinetics of E3112, a recombinant human hepatocyte growth factor, in rats and monkeys by a simple ELISA kit assay 通过简单的酶联免疫吸附试剂盒测定重组人肝细胞生长因子 E3112 在大鼠和猴子体内的非临床药代动力学
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107541
Muneo Aoyama , Yuji Mano

E3112 is a recombinant human hepatocyte growth factor which is under development for the treatment of acute liver failure. Pharmacokinetics (PK) evaluation in experimental animals is important and thus a simple assay for the determination of E3112 in rat and monkey serum has been validated using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. E3112 in rat and monkey serum was quantifiable from 0.313 ng/mL to 15.0 ng/mL without prozone effects. Dilution integrity enabled accurate assay up to 500,000-fold dilution. Accuracy and precision were within the acceptance criteria. PK of E3112 was investigated after intravenous administration to rats and monkeys. PK of E3112 was similar between male and female animals in both species. Nonlinear PK of E3112 was observed in rats after intravenous bolus dose at 1–100 mg/kg while nonlinear PK was not significant in monkeys after intravenous infusion at 0.5–25 mg/kg. These findings suggest that the assay of E3112 in serum using a commercially available ELISA kit was validated and successfully applied to PK studies in rats and monkeys.

E3112 是一种重组人肝细胞生长因子,目前正在开发用于治疗急性肝功能衰竭。在实验动物中进行药代动力学(PK)评估非常重要,因此使用市售的酶联免疫吸附测定(ELISA)试剂盒验证了测定大鼠和猴子血清中 E3112 的简单测定方法。大鼠和猴子血清中 E3112 的定量范围为 0.313 纳克/毫升至 15.0 纳克/毫升,不会产生原区效应。稀释倍数高达 500,000 倍,稀释的完整性保证了检测的准确性。准确度和精密度均符合接受标准。对大鼠和猴子静脉注射 E3112 后的 PK 进行了研究。雌雄动物对E3112的PK值相似。大鼠静脉注射1-100 mg/kg剂量的E3112后出现了非线性PK,而猴子静脉注射0.5-25 mg/kg剂量的E3112后出现的非线性PK不明显。这些发现表明,使用市售的酶联免疫吸附试剂盒检测血清中的E3112是有效的,并成功地应用于大鼠和猴子的PK研究。
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引用次数: 0
Bayesian approach enabled objective comparison of multiple human iPSC-derived Cardiomyocytes' Proarrhythmia sensitivities. 贝叶斯方法能够客观地比较多种源于人类 iPSC 的心肌细胞对原心律失常的敏感性。
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107531
Tetsuro Wakatsuki , Neil Daily , Sunao Hisada , Kazuto Nunomura , Bangzhong Lin , Ko Zushida , Yayoi Honda , Mahoko Asyama , Kiyoshi Takasuna

The one-size-fits-all approach has been the mainstream in medicine, and the well-defined standards support the development of safe and effective therapies for many years. Advancing technologies, however, enabled precision medicine to treat a targeted patient population (e.g., HER2+ cancer). In safety pharmacology, computational population modeling has been successfully applied in virtual clinical trials to predict drug-induced proarrhythmia risks against a wide range of pseudo cohorts. In the meantime, population modeling in safety pharmacology experiments has been challenging. Here, we used five commercially available human iPSC-derived cardiomyocytes growing in 384-well plates and analyzed the effects of ten potential proarrhythmic compounds with four concentrations on their calcium transients (CaTs). All the cell lines exhibited an expected elongation or shortening of calcium transient duration with various degrees. Depending on compounds inhibiting several ion channels, such as hERG, peak and late sodium and L-type calcium or IKs channels, some of the cell lines exhibited irregular, discontinuous beating that was not predicted by computational simulations. To analyze the shapes of CaTs and irregularities of beat patterns comprehensively, we defined six parameters to characterize compound-induced CaT waveform changes, successfully visualizing the similarities and differences in compound-induced proarrhythmic sensitivities of different cell lines. We applied Bayesian statistics to predict sample populations based on experimental data to overcome the limited number of experimental replicates in high-throughput assays. This process facilitated the principal component analysis to classify compound-induced sensitivities of cell lines objectively. Finally, the association of sensitivities in compound-induced changes between phenotypic parameters and ion channel inhibitions measured using patch clamp recording was analyzed. Successful ranking of compound-induced sensitivity of cell lines was in lined with visual inspection of raw data.

"一刀切 "的方法一直是医学界的主流,多年来,定义明确的标准为开发安全有效的疗法提供了支持。然而,不断进步的技术使精准医学得以治疗目标患者群体(如 HER2+ 癌症)。在安全药理学方面,计算群体建模已成功应用于虚拟临床试验,针对各种假队列预测药物诱发原发性心律失常的风险。与此同时,安全药理学实验中的群体建模也面临挑战。在这里,我们使用了五种在 384 孔板中生长的市售人类 iPSC 衍生心肌细胞,分析了十种潜在的促心律失常化合物的四种浓度对其钙离子瞬态(CaTs)的影响。所有细胞系都表现出不同程度的钙离子瞬时持续时间延长或缩短。根据抑制多种离子通道(如 hERG、峰值和晚期钠和 L 型钙通道或 IKs 通道)的化合物,一些细胞系表现出不规则、不连续的跳动,这是计算模拟无法预测的。为了全面分析CaT的形状和不规则的跳动模式,我们定义了六个参数来表征化合物诱导的CaT波形变化,成功地将不同细胞系对化合物诱导促心律失常敏感性的异同形象化。我们应用贝叶斯统计法根据实验数据预测样本群,以克服高通量测定中实验重复次数有限的问题。这一过程有助于通过主成分分析客观地对化合物诱导的细胞系敏感性进行分类。最后,分析了表型参数与膜片钳记录测量的离子通道抑制之间化合物诱导的敏感性变化的关联。通过对原始数据的目测,成功地对细胞系的化合物诱导敏感性进行了排序。
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引用次数: 0
Effects of species of origin and mode of induction of microsomes on carbamazepine-induced cell toxicity 微粒体的来源种类和诱导方式对卡马西平诱导的细胞毒性的影响
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107536
Abdelbaset A. Elzagallaai , Awatif M. Abuzgaia , Michael J. Rieder

Standardization and validation of in vitro drug metabolism is essential for pre-clinical drug development as well as for in vitro toxicity assays including the lymphocyte toxicity assay (LTA) and the in vitro platelet toxicity assay (iPTA). Use of isolated liver microsomes (MIC) in in vitro testing has been utilized for a long time; however, the effect of species of origin and induction agents on the metabolic capacities of MIC is not adequately evaluated. In this study we investigated the impact of species of origin and induction agent on the capacity of MICs to bioactivate carbamazepine (CBZ) using cytotoxicity as a gross endpoint to measure the levels of cytotoxic metabolites generated by each type of MICs. Jurkat E6.1 cell line was used and MICs from human, rat, mouse, minipig and rabbit origin as well as rat MICs that is either non-induced or induced by phenobarbitone (PHB), dexamethasone (DEXA), 3-methylcholanthrene (3MC), clofibrate (CLOF) and isoniazid (INH) were investigated. MICs from minipig and rat MICs induced with 3MC exhibited the highest capacity to produce cytotoxic metabolites of CBZ. These findings will help optimize and standardize in vitro toxicity assays and provide guidance to pre-clinical investigation of drugs.

体外药物代谢的标准化和验证对于临床前药物开发以及体外毒性检测(包括淋巴细胞毒性检测(LTA)和体外血小板毒性检测(iPTA))至关重要。在体外测试中使用分离的肝脏微粒体(MIC)由来已久,但尚未充分评估来源物种和诱导剂对 MIC 代谢能力的影响。在本研究中,我们以细胞毒性为总终点,测量了各类 MIC 产生的细胞毒性代谢物的水平,从而研究了来源种类和诱导剂对 MIC 生物活化卡马西平(CBZ)能力的影响。我们使用了 Jurkat E6.1 细胞系,并研究了来自人、大鼠、小鼠、迷你猪和兔子的 MICs,以及未被苯巴比妥(PHB)、地塞米松(DEXA)、3-甲基胆蒽(3MC)、氯贝特(CLOF)和异烟肼(INH)诱导或诱导的大鼠 MICs。用 3MC 诱导的小鼠和大鼠 MICs 产生 CBZ 细胞毒性代谢物的能力最强。这些发现将有助于优化和规范体外毒性试验,并为药物的临床前研究提供指导。
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引用次数: 0
Maximizing insights from nonclinical safety studies in the context of rising costs and changing regulations 在成本上升和法规不断变化的背景下,最大限度地从非临床安全性研究中获得洞察力。
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107538
Donald Hodges , Michael Stonerook , Dany Salvail , Sandrine Lemouton

The traditional paradigm of non-rodent safety assessment studies, primarily reliant on non-human primates (NHPs) and dogs, is undergoing a transformation. During the 2023 Safety Pharmacology Society Annual Meeting, scientists from leading nonclinical contract organizations discussed how traditional IND-enabling studies can benefit from employing underutilized alternative non-rodent models, such as the swine. Swine offer a cost-effective approach to drug development and share many anatomical and physiological similarities with humans. The inclusion of non-traditional species in safety assessments, coupled with advanced measurement techniques, aids in de-risking compounds early on and adapting projects to the evolving cost landscape.

主要依赖非人灵长类动物 (NHP) 和狗进行非啮齿动物安全性评估研究的传统模式正在发生转变。在 2023 年安全药理学协会年会期间,来自领先的非临床合同组织的科学家们讨论了传统的 IND 使能研究如何从采用未充分利用的替代性非啮齿动物模型(如猪)中获益。猪为药物开发提供了一种具有成本效益的方法,并且在解剖学和生理学方面与人类有许多相似之处。将非传统物种纳入安全性评估,再加上先进的测量技术,有助于尽早降低化合物的风险,并使项目适应不断变化的成本状况。
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引用次数: 0
Comparison of electrocardiogram and blood pressure recording methods in non-rodent toxicology studies: A retrospective analysis 非啮齿动物毒理学研究中心电图和血压记录方法的比较:回顾性分析。
IF 1.3 4区 医学 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-01 DOI: 10.1016/j.vascn.2024.107537
Emma Pawluk, Annie Delaunois, Bastien Gamboa, Jean-Pierre Valentin

Our study retrospectively examines 51 non-rodent general toxicology studies conducted over the past 8 years to ascertain the influence of recording methodologies on baseline cardiovascular (CV) parameters and statistical sensitivity. Specifically, our work aims to evaluate the frequency of cardiovascular parameter recording categorized by therapeutic modality and study type, to assess the variability in these parameters based on measurement techniques, and to determine the sample sizes needed for detecting relevant changes in heart rate (HR), blood pressure (BP), and QTc interval in non-human primate (NHP) studies.

Results indicate that electrocardiogram (ECG) measurements in dogs and NHP were recorded in 63% of studies, combined with BP recording in 18% of studies, while BP was never recorded alone. Trend analysis reveals a decline in the utilisation of restraint-based methods for ECG measurements post-2017, to the benefit of telemetry-based recordings, particularly Jacketed External Telemetry (JET). There was a marked difference in baseline values, with restraint-based methods showing significantly higher HR and QTc values compared to JET, likely linked to animal stress.

Further analysis suggests an unrealistic and unethical sample size requirement in NHP studies for detecting biologically meaningful CV parameter changes using restraint-based methods, while JET methods necessitate significantly smaller sample sizes.

This retrospective study indicates a notable shift from snapshots short-duration, restraint-based methods towards telemetry approaches over the recent years, especially with an increased usage of implanted telemetry. The transition contributes to potential consensus within industry or regulatory frameworks for optimal practices in assessing ECG, HR, and BP in general toxicology studies.

我们的研究回顾性地检查了过去 8 年中进行的 51 项非啮齿类动物普通毒理学研究,以确定记录方法对基线心血管 (CV) 参数和统计敏感性的影响。具体来说,我们的工作旨在评估按治疗方式和研究类型分类的心血管参数记录频率,根据测量技术评估这些参数的可变性,并确定在非人灵长类动物 (NHP) 研究中检测心率 (HR)、血压 (BP) 和 QTc 间期的相关变化所需的样本量。结果表明,在 63% 的研究中记录了狗和 NHP 的心电图 (ECG),在 18% 的研究中结合了血压记录,而从未单独记录过血压。趋势分析表明,2017 年后,基于束缚的心电图测量方法的使用率有所下降,而基于遥测的记录方法,尤其是夹套式体外遥测技术 (JET) 则更受青睐。基线值存在明显差异,与 JET 相比,基于束缚的方法显示的心率和 QTc 值明显更高,这可能与动物应激有关。进一步分析表明,在使用基于束缚的方法检测具有生物学意义的 CV 参数变化时,对 NHP 研究样本量的要求既不现实也不道德,而 JET 方法所需的样本量要小得多。这项回顾性研究表明,近年来,特别是随着植入式遥测技术使用的增加,基于束缚的短时快照方法已明显转向遥测方法。这一转变有助于在行业或监管框架内就评估一般毒理学研究中心电图、心率和血压的最佳方法达成共识。
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引用次数: 0
Optimized J to T peak and T peak to T end measurements in nonclinical species administered moxifloxacin and amiodarone 对服用莫西沙星和胺碘酮的非临床物种进行优化的 J 峰至 T 峰和 T 峰至 T 端测量。
IF 1.9 4区 医学 Q3 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-06-08 DOI: 10.1016/j.vascn.2024.107527
Theresa M. Bartko , Stephen M. Lutgen , Rebecca A. Ross , Jacqueline A. Walisser , Eric P. Garske , Kerry R. Kopelke , Kelly Ashcroft-Hawley , Hai-Ming Tang , John J. Kremer , Gregory S. Friedrichs , Jill V. Nichols

Introduction

Cardiovascular safety and the risk of developing the potentially fatal ventricular tachyarrhythmia, Torsades de Pointes (TdP), have long been major concerns of drug development. TdP is associated with a delayed ventricular repolarization represented by QT interval prolongation in the electrocardiogram (ECG), typically due to block of the potassium channel encoded by the human ether-a-go-go related gene (hERG). Importantly however, not all drugs that prolong the QT interval are torsadagenic and not all hERG blockers prolong the QT interval. Recent clinical reports suggest that partitioning the QT interval into early (J to T peak; JTp) and late repolarization (T peak to T end; TpTe) components may be valuable for distinguishing low-risk mixed ion channel blockers (hERG plus calcium and/or late sodium currents) from high-risk pure hERG channel blockers. This strategy, if true for nonclinical animal models, could be used to de-risk QT prolonging compounds earlier in the drug development process.

Methods

To explore this, we investigated JTp and TpTe in ECG data collected from telemetered dogs and/or monkeys administered moxifloxacin or amiodarone at doses targeting relevant clinical exposures. An optimized placement of the Tpeak fiducial mark was utilized, and all intervals were corrected for heart rate (QTc, JTpc, TpTec).

Results

Increases in QTc and JTpc intervals with administration of the pure hERG blocker moxifloxacin and an initial QTc and JTpc shortening followed by prolongation with the mixed ion channel blocker amiodarone were detected as expected, aligning with clinical data. However, anticipated increases in TpTec by both standard agents were not detected.

Discussion

The inability to detect changes in TpTec reduces the utility of these subintervals for prediction of arrhythmias using continuous single‑lead ECGs collected from freely moving dogs and monkeys.

简介:长期以来,心血管安全性和可能致命的室性快速心律失常--Torsades de Pointes(TdP)--的发病风险一直是药物研发的主要关注点。TdP 与心电图(ECG)中以 QT 间期延长为代表的心室复极化延迟有关,通常是由于人类醚-a-go-go 相关基因(hERG)编码的钾通道受阻所致。但重要的是,并不是所有能延长 QT 间期的药物都有致扭转作用,也不是所有 hERG 阻滞剂都能延长 QT 间期。最近的临床报告表明,将 QT 间期分为早期(J 到 T 峰;JTp)和晚期复极化(T 峰到 T 端;TpTe)两部分可能对区分低风险混合离子通道阻滞剂(hERG 加钙和/或晚期钠离子电流)和高风险纯 hERG 通道阻滞剂很有价值。如果这一策略适用于非临床动物模型,则可用于在药物开发过程的早期阶段降低 QT 延长化合物的风险:为了探讨这一问题,我们研究了从遥测犬和/或猴身上收集的心电图数据中的 JTp 和 TpTe,这些数据是以相关临床暴露剂量为目标给药莫西沙星或胺碘酮的。对 Tpeak 标志的位置进行了优化,并对所有时间间隔进行了心率校正(QTc、JTpc、TpTec):结果:正如预期的那样,在使用纯 hERG 阻滞剂莫西沙星时检测到 QTc 和 JTpc 间期延长,而在使用混合离子通道阻滞剂胺碘酮时检测到 QTc 和 JTpc 间期先缩短后延长,这与临床数据一致。然而,两种标准药物均未检测到预期的 TpTec 增加:讨论:由于无法检测到 TpTec 的变化,因此利用从自由活动的狗和猴子身上采集的连续单导联心电图预测心律失常时,这些子区间的实用性降低了。
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Journal of pharmacological and toxicological methods
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