Preclinical testing of new drugs for tuberculosis: current challenges

The continuing global epidemic of tuberculosis, the increasing rate of multidrug resistant (MDR) tuberculosis and the more recent emergence of extensively drug resistant (XDR) tuberculosis are great causes for concern. A major international effort is currently underway to optimize current drug therapies and to discover new drugs that are active against these organisms. This effort has created a pipeline of new candidate drugs at various stages of preclinical and early clinical evaluations. Major challenges still exist, however, varying from the standardization and application of current animal models and their application to drug discovery and characterization to the fact that our knowledge about the basic biology of the MDR and XDR strains of Mycobacterium tuberculosis is minimal at best.     

Dose-response and thresholds in mutagenicity studies: a statistical testing approach

The analysis of dose-response relationships is an important objective in toxicology, and one in which both modelling and testing approaches are used. One particular question is whether a threshold exists at low doses. The concept of a pragmatic threshold is used, i.e. low doses with biologically unimportant effects are assumed to be threshold doses. "Biologically unimportant" means, in statistical terms, a lower effect than the effect of the negative control, or at least a just-tolerable margin delta higher than the effect of the negative control. Therefore, threshold doses can be tested in terms of a one-sided hypothesis of equivalence. A new approach is proposed, assuming, at the least, that the low dose is a threshold dose, and the highest dose is superior to the negative control. By analogy to the k-fold rule commonly used in mutagenicity studies, tests on ratio-to-control are used. The a priori definition of the threshold margin is inherently needed. A further approach proposes the analysis of dose-response relationships by means of order-restricted inference (the so-called trend test). A modification of a multiple-contrast test is used, in which only those contrasts are included that are sensitive for no effects at low doses. A further modification treats the complicated, but real, problem of simultaneous existence of a threshold, a monotonic increase, and a downturn effect at high dose(s). A parametric procedure is considered, together with an extension for proportions. The important problem of a priori sample size definition is discussed. The approaches are demonstrated by means of examples based on real data.     

Proceedings: More about intrasanguineous mutagenicity testing.

Induction of mutations by X-rays in Schizosaccharomyces pombe cells in which sister-strand recombination appears to be excluded is offered as evidence against a requirement for recombination radiation-induced mutagenesis.     

Control of the mutagenicity of a new immunomodulator

New immunostimulator STP, peptide isolated from the cultivation medium of Streptococcus species producer strain TOM-1606 by chromatographic purification, was controlled for mutagenicity. The preparation, introduced into mice in doses of 6.7 X 10(2) - 6.7 X 10(4) micrograms/kg, i.e. exceeding the stimulating dose 1000-fold, did not induce the appearance of micronuclei in polychromatophilic erythrocytes of the marrow, the fixation of the material being made 24, 48 and 72 hours after the injection. In Ames' test on Salmonella typhimurium strains TA 98 and TA 100 neither native STP, nor STP activated with the microsomal fraction of rat liver enzymes did not increase the frequency of reversions to histidine independence. The absence of mutagenic properties in STP was demonstrated by the parallel pronounced genotoxic action of a number of known mutagens used as positive controls.     

Practical aspects of mutagenicity testing strategy: an industrial perspective

Genetic toxicology studies play a central role in the development and marketing of new chemicals for pharmaceutical, agricultural, industrial, and consumer use. During the discovery phase of product development, rapid screening tests that require minimal amounts of test materials are used to assist in the design and prioritization of new molecules. At this stage, a modified Salmonella reverse mutation assay and an in vitro micronucleus test with mammalian cell culture are frequently used for screening. Regulatory genetic toxicology studies are conducted with a short list of compounds using protocols that conform to various international guidelines. A set of four assays usually constitutes the minimum test battery that satisfies global requirements. This set includes a bacterial reverse mutation assay, an in vitro cytogenetic test with mammalian cell culture, an in vitro gene mutation assay in mammalian cell cultures, and an in vivo rodent bone marrow micronucleus test. Supplementary studies are conducted in certain instances either as a follow-up to the findings from this initial testing battery and/or to satisfy a regulatory requirement. Currently available genetic toxicology assays have helped the scientific and industrial community over the past several decades in evaluating the mutagenic potential of chemical agents. The emerging field of toxicogenomics has the potential to redefine our ability to study the response of cells to genetic damage and hence our ability to study threshold phenomenon.     

Motor agency: a new and highly sensitive measure to reveal agency disturbances in early psychosis

Background

Early diagnosis of young adults at risk of schizophrenia is essential for preventive approaches of the illness. Nevertheless, classic screening instruments are difficult to use because of the non-specific nature of the signs at this pre-onset phase of illness. The objective of the present contribution was to propose an innovating test that can probe the more specific symptom of psychosis, i.e., the sense of agency, which is defined as being the immediate experience of oneself as the cause of an action. More specifically, we tested whether motor agency is abnormal in early psychosis.

Methods

Thirty-two young symptomatic patients and their age-matched controls participated in the study. 15 of these patients were at ultra high-risk for developing psychosis (UHR), and 17 patients were suffering from first-episode psychosis (FEP). Patients'' neurocognitive capacities were assessed through the use of seven neuropsychological tests. A motor agency task was also introduced to obtain an objective indicator of the degree of sense of agency, by contrasting force levels applied during other and self-produced collisions between a hand-held objet and a pendulum.

Results

As reported in the literature for adult controls, healthy adolescents used more efficient force levels in self than in other-imposed collisions. For both UHR and FEP patients, abnormally high levels of grip force were used for self-produced collisions, leading to an absence of difference between self and other. The normalized results revealed that motor agency differentiated patients from controls with a higher level of sensitivity than the more classic neuropsychological test battery.

Conclusions

This study is in favour of the existence of an abnormal sense of agency early in the psychotic illness. Because it is quick and none verbal, motor agency may be a valuable tool to use in complement to classic interviews, especially when investigating complex ineffable experiences that are difficult to explicitly describe.     

Incorporation of mammalian metabolism into mutagenicity testing

In the 1950's and 1960's it became obvious that many chemicals in daily use were mutagenic or carcinogenic, but there seemed to be little relation between the two activities. As scientists were debating the cause of this discrepancy, it was hypothesized that mammalian metabolism could form highly reactive intermediates from rather innocuous chemicals and that these intermediates could react with DNA and were mutagenic. This commentary presents the historical development of metabolic activation in mutagenicity tests, beginning with Udenfriend's hydroxylation system, which mimics aspects of mammalian metabolism in a purely chemical mixture, and extending through procedures that moved closer and closer to incorporating actual mammalian metabolism into the test systems. The stages include microsomal activation systems, host-mediated assays, incorporation of human P450 genes into the target cells or organisms, and detecting mutations in single cells in vivo. A recent development in this progression is the insertion of recoverable vectors containing mutational targets into the mammalian genome. Since the target genes of transgenic assays are in the genome, they are not only exposed to active metabolites, but they also undergo the same repair processes as endogenous genes of the mammalian genome.     

Legislative and technical aspects of mutagenicity testing.

A brief account is given of the history of the legislative acts that give responsibility to the U.S. Food and Drug Administration (FDA) for ensuring the safety of foods, drugs, and cosmetics. Within the present legislative framework the FDA has the authority to impose regulations which are designed to ensure the safety of all foods, drugs, and cosmetics. The existing legislative authority is adequate for this purpose; however, the difficulty lies instead with technology and the inadequacy of scientific perspective in the emerging area of mutagenicity testing. Earlier efforts in development of mutagenicity screening systems culminated only a few years ago in the proposal to use the host-mediated assay, somatic cell cytogenetics, and dominant lethal tests collectively. Subsequent research efforts indicated that there were serious practical and scientific deficiencies in using this approach. More recently a new proposal, the tier system, has been suggested as an alternative measure. The proposed tier system at FDA consists of three testing levels of increasing complexity. The first tier is an initial screening effort using techniques having maximum sensitivity that are also useful for large-scale, rapid testing. The second tier is designed to identify and confirm that the presumptive mutagens detected in the first tier are truly mutagenic for higher organisms, most especially, for mammals. The third tier would be devoted to explicit genetic tests in mammals designed to ascertain the imposed risk to man by the introduction of a mutagen in our environment. The FDA is currently involved in a number of research activities in the area of mutagenicity safety screening which will explore the adequacies and possible deficiencies of the tier system approach. These efforts are described for our in-house activities, our contract activities, and our cooperative and collaborative activities with other government agencies and institutions.     

Plant tissue culture as a model system for mutagenicity testing of chemicals

Two karyotypically stabilized callus strains of Crepis capillaris (2n = 7 and 2n greater than or equal to 12, respectively) were employed to illustrate the utility of plant tissue culture method for screening and analysis of cytogenetic effects of chemicals following long-term treatment. The cytogenetic analysis of callus cells revealed significant differences in the toxic and mutagenic effects of chemicals under study (2,4-D, MH, NMU and kinetin). A certain dose-response relationship (though not necessarily linear) was observed. The maximum cytogenetic activity of chemicals was associated with certain intermediate concentrations (4.5 X 10(-5) M-9 X 10(-5) M), whereas a further increase in the dose either gave rise to the opposite effects (i.e. decrease in the ana- and telo-phase aberration rates and increase in the modal karyotype frequency) or the aberration rate remained unchanged.