Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
Innovation Pathways, Palo Alto, CA, USA.
Int J Radiat Biol. 2023;99(7):1119-1129. doi: 10.1080/09553002.2023.2173825. Epub 2023 Feb 15.
To test IPW-5371 for the mitigation of the delayed effects of acute radiation exposure (DEARE). Survivors of acute radiation exposure are at risk for developing delayed multi-organ toxicities; however, there are no FDA-approved medical countermeasures (MCM) to mitigate DEARE.
WAG/RijCmcr female rat model of partial-body irradiation (PBI), by shielding part of one hind leg, was used to test IPW-5371 (7 and 20 mg kgd) for mitigation of lung and kidney DEARE when started 15 d after PBI. Rats were fed known amounts of IPW-5371 using a syringe, instead of delivery by daily oral gavage, sparing exacerbation of esophageal injury by radiation. The primary endpoint, all-cause morbidity was assessed over 215 d. Secondary endpoints: body weight, breathing rate and blood urea nitrogen were also assessed.
IPW-5371 enhanced survival (primary endpoint) as well as attenuated secondary endpoints of lung and kidney injuries by radiation.
To provide a window for dosimetry and triage, as well as avoid oral delivery during the acute radiation syndrome (ARS), the drug regimen was started at 15 d after 13.5 Gy PBI. The experimental design to test mitigation of DEARE was customized for translation in humans, using an animal model of radiation that was designed to simulate a radiologic attack or accident. The results support advanced development of IPW-5371 to mitigate lethal lung and kidney injuries after irradiation of multiple organs.
测试 IPW-5371 减轻急性辐射暴露延迟效应(DEARE)的作用。急性辐射暴露的幸存者有发生延迟性多器官毒性的风险;然而,目前尚无 FDA 批准的医疗对策(MCM)来减轻 DEARE。
使用屏蔽一条后腿的部分身体照射(PBI)的 Wag/RijCmcr 雌性大鼠模型,测试 IPW-5371(7 和 20mg/kg/d)在 PBI 后 15 天开始时减轻肺和肾 DEARE 的作用。大鼠通过注射器摄入已知量的 IPW-5371,而不是每天口服灌胃,从而避免了辐射引起的食管损伤恶化。主要终点是全因发病率,评估期为 215 天。次要终点:体重、呼吸频率和血尿素氮也进行了评估。
IPW-5371 提高了生存率(主要终点),并减轻了肺和肾损伤的次要终点。
为了提供剂量测定和分类的窗口,以及避免在急性辐射综合征(ARS)期间进行口服给药,在接受 13.5Gy PBI 后 15 天开始药物治疗。测试 DEARE 缓解作用的实验设计是为在人类中进行转化而定制的,使用了一种旨在模拟放射性攻击或事故的辐射动物模型。结果支持 IPW-5371 的进一步开发,以减轻照射多个器官后的致命性肺和肾损伤。