Department of Development and Clinical Research and Medical Affairs, Cerus Corp., Concord, California, USA.
Transfusion. 2011 Oct;51(10):2208-18. doi: 10.1111/j.1537-2995.2011.03132.x. Epub 2011 Apr 19.
A system has been developed to inactivate a wide spectrum of blood-borne pathogens in red blood cells (RBCs) before transfusion. The system utilizes S-303 to target nucleic acids of pathogens and white blood cells. The safety of pathogen inactivated RBC was assessed using S-303-treated RBCs (S-303 RBCs) and S-300, the primary degradation product of S-303.
As part of a preclinical safety evaluation program, intravenous toxicity, safety pharmacology, toxicokinetic, and pharmacokinetic studies were conducted in rats and dogs with S-303 RBCs and S-300.
Single and repeated transfusions of S-303 RBCs were well tolerated in rats and dogs at S-303 concentrations up to five times higher than that used to prepare RBCs for clinical use. For S-300, the doses ranged from the lowest level representative of a clinical exposure from transfusion of 1 unit (0.052 mg/kg/day) to up to the amount of S-300 that would result from exposure to more than 1900 units of RBCs (100 mg/kg/day). There were no related effects of S-303 RBCs or S-300 on mortality, clinical status, body weight, or clinical laboratory assessments and no evidence of organ toxicity. S-300 did not accumulate in the plasma of rats and dogs after repeated transfusions. For all the studies, plasma S-303 was consistently below the limit of quantitation.
The level of residual S-303 and S-300 in the treated blood component is well below that at which no adverse effects were observed. These results support further clinical development of S-303 RBCs for prevention of transfusion-transmitted infections.
已开发出一种系统,用于在输血前使红细胞(RBC)中的广泛范围的血源性病原体失活。该系统利用 S-303 靶向病原体和白细胞的核酸。使用 S-303 处理的 RBC(S-303 RBC)和 S-303 的主要降解产物 S-300 评估了病原体失活 RBC 的安全性。
作为临床前安全性评估计划的一部分,在大鼠和狗中进行了 S-303 RBC 和 S-300 的静脉内毒性,安全性药理学,毒代动力学和药代动力学研究。
在 S-303 浓度高达比用于制备临床使用的 RBC 高五倍的情况下,S-303 RBC 的单次和重复输血在大鼠和狗中均耐受良好。对于 S-300,剂量范围从输血 1 单位(0.052 mg / kg /天)引起的临床暴露的最低水平到暴露于超过 1900 个 RBC(100 mg / kg /天)的 S-300 的量。S-303 RBC 或 S-300 对死亡率,临床状况,体重或临床实验室评估均无相关影响,也没有器官毒性的证据。重复输血后,S-300 不会在大鼠和狗的血浆中积聚。对于所有研究,血浆中的 S-303 始终低于定量下限。
处理后的血液成分中残留的 S-303 和 S-300 的水平远低于未观察到不良反应的水平。这些结果支持进一步开发 S-303 RBC 用于预防输血传播感染。