Gauvreau Gail M, Boulet Louis Philippe, Cockcroft Donald W, Baatjes Adrian, Cote Johanne, Deschesnes Francine, Davis Beth, Strinich Tara, Howie Karen, Duong Mylinh, Watson Richard M, Renzi Paolo M, O'Byrne Paul M
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Am J Respir Crit Care Med. 2008 May 1;177(9):952-8. doi: 10.1164/rccm.200708-1251OC. Epub 2008 Jan 31.
The drug product TPI ASM8 contains two modified phosphorothioate antisense oligonucleotides designed to inhibit allergic inflammation by down-regulating human CCR3 and the common beta chain (beta(c)) of IL-3, IL-5, and granulocyte-macrophage colony-stimulating factor receptors.
This study examined the effects of inhaled TPI ASM8 on sputum cellular influx, CCR3 and beta(c) mRNA and protein levels, and the airway physiologic response after inhaled allergen.
Seventeen subjects with mild atopic asthma were randomized in a crossover study to inhale 1,500 microg TPI ASM8 or placebo by nebulizer, once daily for 4 days. On Day 3, subjects underwent allergen inhalation challenge. Sputum samples were collected before and after allergen. CCR3 and beta(c) protein levels were measured by flow cytometry, mRNA was measured using real-time quantitative polymerase chain reaction, and the FEV1 was measured over 7 hours after challenge.
Compared with placebo, TPI ASM8 inhibited sputum eosinophil influx by 46% (P = 0.02) and blunted the increase in total cells (63%) after allergen challenge. TPI ASM8 significantly reduced the early asthmatic response (P = 0.04) with a trend for the late asthmatic response (P = 0.08). The allergen-induced (Day 2 to Day 3) levels of beta(c) mRNA and CCR3 mRNA in sputum-derived cells were inhibited by TPI ASM8 (P = 0.039 and P = 0.054, respectively), with no significant effects on the cell surface protein expression of CCR3 and beta(c) (P > 0.05). No serious adverse events were reported.
TPI ASM8 attenuates the allergen-induced increase in target gene mRNA and airway responses in subjects with mild asthma. Clinical trial registered with www.clinicaltrials.gov (NCT 00264966).
药品TPI ASM8包含两种经过修饰的硫代磷酸酯反义寡核苷酸,旨在通过下调人CCR3以及白细胞介素-3、白细胞介素-5和粒细胞-巨噬细胞集落刺激因子受体的共同β链(β(c))来抑制过敏性炎症。
本研究考察了吸入TPI ASM8对痰液细胞流入、CCR3和β(c) mRNA及蛋白水平,以及吸入过敏原后气道生理反应的影响。
17名轻度特应性哮喘患者在一项交叉研究中被随机分组,通过雾化器每天吸入1500微克TPI ASM8或安慰剂,共4天。在第3天,受试者接受过敏原吸入激发试验。在过敏原激发前后收集痰液样本。通过流式细胞术测量CCR3和β(c)蛋白水平,使用实时定量聚合酶链反应测量mRNA,并在激发后7小时测量第一秒用力呼气容积(FEV1)。
与安慰剂相比,TPI ASM8使痰液嗜酸性粒细胞流入减少46%(P = 0.02),并减弱了过敏原激发后总细胞的增加(63%)。TPI ASM8显著降低了早期哮喘反应(P = 0.04),晚期哮喘反应有降低趋势(P = 0.08)。TPI ASM8抑制了痰液来源细胞中过敏原诱导的(第2天至第3天)β(c) mRNA和CCR3 mRNA水平(分别为P = 0.039和P = 0.054),对CCR3和β(c)的细胞表面蛋白表达无显著影响(P > 0.05)。未报告严重不良事件。
TPI ASM8可减轻轻度哮喘患者过敏原诱导的靶基因mRNA增加和气道反应。临床试验已在www.clinicaltrials.gov注册(NCT 00264966)。