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药物研发中的Trp53半合子小鼠:病理学家需考虑的要点

The Trp53 hemizygous mouse in pharmaceutical development: points to consider for pathologists.

作者信息

Floyd Eugenia, Mann Peter, Long Gerald, Ochoa Ricardo

机构信息

Pfizer Nagoya Laboratories, Taketoyo, Aichi, Japan.

出版信息

Toxicol Pathol. 2002 Jan-Feb;30(1):147-56. doi: 10.1080/01926230252824860.

DOI:10.1080/01926230252824860
PMID:11890468
Abstract

ILSI-HESI sponsored an international consortium for the evaluation of alternative models, including the TrpS3+/- mouse. for use in short-term carcinogenicity testing of pharmaceuticals. Products of the ILSI evaluation included guidance for protocol design and assay interpretation, spontaneous tumor incidences, diagnostic criteria for common proliferative lesions, and results of assays for pharmaceutical agents that are known human and/or rodent carcinogens and non-carcinogens. Based on the ILSI evaluation, recommended protocol elements for this model include: 26-week study duration, groups > or = 15/sex/dose, a positive control group (benzene or p-cresidine), a negative control group and 3 dose groups, the high dose set at MTD or MFD, routine in-life evaluations, and complete necropsies with microscopic evaluation of tissues. Favored statistical analyses are trend tests or pair-wise comparisons, with no adjustments for survival. For an assay to be valid, positive control groups must demonstrate an effect, and the MTD or MFD must be reached in both sexes. Criteria for a negative response include a valid assay, no statistical increase in common tumors, no biologically significant numerical increase in rare tumors, and no tumor incidence above that of historical controls. Positive responses can consist of statistically significant increases in the incidence of a common tumor or numerical increases in a rare tumor, which may not be statistically significant. In either case, the incidence should be clearly above historical control values. Evidence of a dose response or occurrence of hyperplasia in a tissue with a neoplastic response can support interpreting an assay as positive. The two most common spontaneous tumors (> 1 %) in Trp53+/- mice are malignant thymic lymphomas and subcutaneous sarcomas. Use of implanted electronic transponders can increase the incidence of sarcomas. Important rare spontaneous tumors (incidence < or = 1%) are osteosarcomas and pulmonary adenomas. Many other tumor types have been reported to occur sporadically in Trp53+/- mice. Diagnostic challenges for this model include differentiating lymphoma from atypical thymic hyperplasia and recognizing the variable histopathology of subcutaneous sarcomas. In reported bioassays, Trp53+/- mice responded positively to genotoxic carcinogens, negatively to non-genotoxic rodent carcinogens, and negatively to noncarcinogens, indicating that unlike the 2-year mouse assay, this short-term assay is not overly sensitive. Positive responses often elicited an increase in tumors that occur spontaneously. To successfully use this model, pathologists must understand the biology of the Trp53 tumor suppressor gene and the principles of protocol design and data interpretation for short-term bioassays. They must also know the historical response pattern of Trp53+/- mice to test agents and be able to accurately diagnose tumors in this model. Use of the Trp53+/- mouse presents the pharmaceutical industry with several challenges, one of which is managing the uncertainty created by a lack of precedents for regulatory decisions about some possible outcomes for short-term carcinogenicity assays.

摘要

国际生命科学研究所健康与环境科学研究所(ILSI-HESI)发起了一个国际联盟来评估替代模型,包括TrpS3+/-小鼠,用于药物的短期致癌性测试。ILSI评估的成果包括方案设计和检测结果解读指南、自发肿瘤发生率、常见增殖性病变的诊断标准,以及已知的人类和/或啮齿类致癌物及非致癌物的药物检测结果。基于ILSI的评估,该模型推荐的方案要素包括:26周的研究周期、每组≥15只/性别/剂量、一个阳性对照组(苯或对甲酚)、一个阴性对照组和3个剂量组,高剂量设定为最大耐受剂量(MTD)或最大耐受量(MFD)、常规的在体评估,以及完整的尸检并对组织进行显微镜评估。适宜的统计分析方法是趋势检验或两两比较,不对生存率进行校正。为使检测有效,阳性对照组必须显示出效应,且雌雄两性均须达到MTD或MFD。阴性反应的标准包括检测有效、常见肿瘤无统计学增加、罕见肿瘤无生物学意义的数值增加,以及肿瘤发生率不高于历史对照。阳性反应可能包括常见肿瘤发生率的统计学显著增加或罕见肿瘤的数值增加(可能无统计学显著性)。在任何一种情况下,发生率都应明显高于历史对照值。剂量反应的证据或在有肿瘤反应的组织中出现增生,可支持将检测结果解释为阳性。Trp53+/-小鼠中两种最常见的自发肿瘤(>1%)是恶性胸腺淋巴瘤和皮下肉瘤。植入电子应答器会增加肉瘤的发生率。重要的罕见自发肿瘤(发生率≤1%)是骨肉瘤和肺腺瘤。据报道,许多其他肿瘤类型也偶尔在Trp53+/-小鼠中出现。该模型的诊断挑战包括区分淋巴瘤与非典型胸腺增生,以及识别皮下肉瘤的可变组织病理学。在已报道的生物检测中,Trp53+/-小鼠对基因毒性致癌物呈阳性反应,对非基因毒性啮齿类致癌物呈阴性反应,对非致癌物呈阴性反应,这表明与两年期小鼠检测不同,这种短期检测并非过于敏感。阳性反应通常会引发自发出现的肿瘤增加。为成功使用该模型,病理学家必须了解Trp53肿瘤抑制基因的生物学特性以及短期生物检测的方案设计和数据解读原则。他们还必须了解Trp53+/-小鼠对受试药物的历史反应模式,并能够准确诊断该模型中的肿瘤。使用Trp53+/-小鼠给制药行业带来了几个挑战,其中之一是应对因缺乏关于短期致癌性检测某些可能结果的监管决策先例而产生的不确定性。

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