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IPW-5371 减轻了骨髓保护后 15 天开始 PBI 的 WAG/RijCmcr 大鼠急性辐射暴露的延迟效应。

IPW-5371 mitigates the delayed effects of acute radiation exposure in WAG/RijCmcr rats when started 15 days after PBI with bone marrow sparing.

机构信息

Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.

Innovation Pathways, Palo Alto, CA, USA.

出版信息

Int J Radiat Biol. 2023;99(7):1119-1129. doi: 10.1080/09553002.2023.2173825. Epub 2023 Feb 15.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

IPW-5371 enhanced survival (primary endpoint) as well as attenuated secondary endpoints of lung and kidney injuries by radiation.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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