Document Detail


Toxicity, biological activity, and pharmacokinetics of TXU (anti-CD7)-pokeweed antiviral protein in chimpanzees and adult patients infected with human immunodeficiency virus.
MedLine Citation:
PMID:  10565855     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the present study was to evaluate the toxicity and pharmacokinetics of TXU (anti-CD7)-pokeweed antiviral protein (PAP) in human immunodeficiency virus (HIV)-infected chimpanzees and adult patients. At a total dose of 100 microg/kg, TXU-PAP did not cause severe (grade >/= 3) toxicity in any of the four HIV type 1 (HIV-1)-infected or two healthy chimpanzees. The only side effects were a transient elevation of the liver enzyme alanine aminotransferase between days 2 and 14 without a concomitant rise in total bilirubin levels and a decrease in the serum albumin levels between days 1 and 5 without any concomitant weight gain or peripheral edema. TXU-PAP showed favorable pharmacokinetics in chimpanzees with a plasma elimination half-life of 5.1 to 12.0 h and a systemic clearance of 5.8 to 15.1 ml/h/kg. At 2 months after initiation of the TXU-PAP infusions, the HIV-1 burden was reduced to below-detection levels in three of the four chimpanzees, and in the remaining chimpanzee, the HIV burden was <500 RNA copies/ml at 2 weeks but returned to the pretreatment levels by 2 months. TXU-PAP was well tolerated by HIV-1-infected adult patients who received a single 5 microg/kg i.v. infusion of TXU-PAP. TXU-PAP showed very favorable pharmacokinetics in these patients with a relatively long plasma elimination half-life of 12.4 +/- 1.4 h, a mean residence time of 17.9 +/- 2.0 h, and a slow systemic clearance of 2.7 +/- 0.7 ml/h/kg. Concentrations of TXU-PAP required for effective inhibition of HIV-1 replication in preclinical models were achieved in HIV-1-infected patients at the 5 microg/kg dose level without any adverse reactions, and the mean value for AUC was 3059 +/- 721 ng. h/ml. The 1-h postinfusion plasma samples from TXU-PAP-treated patients showed potent anti-HIV activity in vitro and inhibited the replication of HIV in normal peripheral blood mononuclear cells (PBMCs) even at a 1:100 dilution. Although treatment with TXU-PAP at the 5 microg/kg dose level does not provide sustained therapeutic levels, it was capable of reducing the viral burden in six of six patients evaluated. To our knowledge, this is the first report of a clinical pharmacokinetics study of a PAP immunoconjugate in HIV-infected patients. The favorable long plasma elimination half-life of TXU-PAP in combination with its low toxicity provides the basis for further investigation of TXU-PAP as a potential anti-HIV agent.
Authors:
F M Uckun; K Bellomy; K O'Neill; Y Messinger; T Johnson; C L Chen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pharmacology and experimental therapeutics     Volume:  291     ISSN:  0022-3565     ISO Abbreviation:  J. Pharmacol. Exp. Ther.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  1999-12-20     Completed Date:  1999-12-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376362     Medline TA:  J Pharmacol Exp Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1301-7     Citation Subset:  IM; X    
Affiliation:
Biotherapy Program, Hughes Institute, St. Paul, Minnesota 55113, USA. faith.uckun@ih.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Anti-HIV Agents / administration & dosage,  pharmacokinetics,  therapeutic use*
Antigens, CD56 / immunology
Area Under Curve
CD4-CD8 Ratio / drug effects
Female
Follow-Up Studies
HIV Infections / blood,  drug therapy*,  virology
HIV-1 / drug effects*
Half-Life
Humans
Immunoconjugates / administration & dosage,  pharmacokinetics,  therapeutic use*
Male
Middle Aged
Pan troglodytes
Plant Proteins / administration & dosage,  pharmacokinetics,  therapeutic use*
Ribosome Inactivating Proteins, Type 1
Viral Load
Virus Replication / drug effects
Grant Support
ID/Acronym/Agency:
R01-AI44671/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Antigens, CD56; 0/Immunoconjugates; 0/Plant Proteins; 0/Ribosome Inactivating Proteins, Type 1; 0/TXU-pokeweed antiviral protein, Phytolacca

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