National Institute of Nutrition (ICMR), Hyderabad, India.
Indian J Med Res. 2013 Jun;137(6):1072-88.
BACKGROUND & OBJECTIVES: Pre-clinical toxicology evaluation of biotechnology products is a challenge to the toxicologist. The present investigation is an attempt to evaluate the safety profile of the first indigenously developed recombinant DNA anti-rabies vaccine [DRV (100 μg)] and combination rabies vaccine [CRV (100 μg DRV and 1.25 IU of cell culture-derived inactivated rabies virus vaccine)], which are intended for clinical use by intramuscular route in Rhesus monkeys.
As per the regulatory requirements, the study was designed for acute (single dose - 14 days), sub-chronic (repeat dose - 28 days) and chronic (intended clinical dose - 120 days) toxicity tests using three dose levels, viz. therapeutic, average (2x therapeutic dose) and highest dose (10 x therapeutic dose) exposure in monkeys. The selection of the model i.e. monkey was based on affinity and rapid higher antibody response during the efficacy studies. An attempt was made to evaluate all parameters which included physical, physiological, clinical, haematological and histopathological profiles of all target organs, as well as Tiers I, II, III immunotoxicity parameters.
In acute toxicity there was no mortality in spite of exposing the monkeys to 10XDRV. In sub chronic and chronic toxicity studies there were no abnormalities in physical, physiological, neurological, clinical parameters, after administration of test compound in intended and 10 times of clinical dosage schedule of DRV and CRV under the experimental conditions. Clinical chemistry, haematology, organ weights and histopathology studies were essentially unremarkable except the presence of residual DNA in femtogram level at site of injection in animal which received 10X DRV in chronic toxicity study. No Observational Adverse Effects Level (NOAEL) of DRV is 1000 ug/dose (10 times of therapeutic dose) if administered on 0, 4, 7, 14, 28 th day.
INTERPRETATION & CONCLUSIONS: The information generated by this study not only draws attention to the need for national and international regulatory agencies in formulating guidelines for pre-clinical safety evaluation of biotech products but also facilitates the development of biopharmaceuticals as safe potential therapeutic agents.
生物技术产品的临床前毒理学评价对毒理学家来说是一个挑战。本研究旨在评估我国自主研发的重组 DNA 抗狂犬病疫苗[DRV(100μg)]和狂犬病联合疫苗[CRV(100μgDRV 和 1.25IU 细胞培养来源的狂犬病病毒灭活疫苗)]的安全性概况,这两种疫苗拟通过肌肉途径用于恒河猴临床使用。
根据监管要求,该研究设计用于急性(单次剂量-14 天)、亚慢性(重复剂量-28 天)和慢性(预期临床剂量-120 天)毒性试验,使用三个剂量水平,即治疗、平均(2x 治疗剂量)和最高剂量(10x 治疗剂量)暴露于猴子。选择猴子作为模型是基于在功效研究中亲和力和快速产生更高抗体反应的原理。尝试评估所有参数,包括所有目标器官的身体、生理、临床、血液学和组织病理学特征,以及 I、II、III 级免疫毒性参数。
尽管将猴子暴露于 10XDRV 中,但在急性毒性试验中没有死亡。在亚慢性和慢性毒性研究中,在 DRV 和 CRV 的预期和 10 倍临床剂量方案下,在实验条件下,给予受试化合物后,猴子的身体、生理、神经、临床参数均无异常。临床化学、血液学、器官重量和组织病理学研究基本无异常,除了在慢性毒性研究中接受 10XDRV 的动物注射部位存在痕量水平的残留 DNA 外。如果在第 0、4、7、14、28 天给予 1000μg/剂量(10 倍治疗剂量),DRV 的无观察不良效应水平(NOAEL)为 1000μg/剂量。
本研究提供的信息不仅引起了各国和国际监管机构制定生物技术产品临床前安全性评价指南的注意,而且还促进了生物制药作为安全有效的治疗药物的开发。