US Food and Drug Administration approval of generic versions of complex biologics: implications for the practicing physician using low molecular weight heparins

Low-molecular-weight heparins (LMWHs) have shown equivalent or superior efficacy and safety to unfractionated heparin as antithrombotic therapy for patients with acute coronary syndromes. Each approved LMWH is a pleotropic biological agent with a unique chemical, biochemical, biophysical and biological profile and displays different pharmacodynamic and pharmacokinetic profiles. As a result, LMWHs are neither equipotent in preclinical assays nor equivalent in terms of their clinical efficacy and safety. Previously, the US Food and Drug Administration (FDA) cautioned against using various LMWHs interchangeably, however recently, the FDA approved generic versions of LMWH that have not been tested in large clinical trials. This paper highlights the bio-chemical and pharmacological differences between the LMWH preparations that may result in different clinical outcomes, and also reviews the implications and challenges physicians face when generic versions of the original/innovator agents are approved for clinical use.

TLR2- and 4-independent immunomodulatory effect of high molecular weight components from Ascaris suum

Components of high molecular-weight (PI) obtained from Ascaris suum extract down-regulate the Th1/Th2-related immune responses induced by ovalbumin (OVA)-immunization in mice. Furthermore, the PI down-modulates the ability of dendritic cells (DCs) to activate T lymphocytes by an IL-10-mediated mechanism. Here, we evaluated the role of toll like receptors 2 and 4 (TLR2 and 4) in the modulatory effect of PI on OVA-specific immune response and the PI interference on DC full activation. An inhibition of OVA-specific cellular and humoral responses were observed in wild type (WT) or in deficient in TLR2 (TLR2(-/-)) or 4 (TLR4(-/-)) mice immunized with OVA plus PI when compared with OVA-immunized mice. Low expression of class II MHC, CD40, CD80 and CD86 molecules was observed in lymph node (LN) cells from WT, TLR2(-/-) or TLR4(-/-) mice immunized with OVA plus PI compared with OVA-primed cells. We also verified that PI was able to modulate the activation of DCs derived from bone marrow of WT, TLR2(-/-) or TLR4(-/-) mice induced in vitro by agonists of TLRs, as observed by a decreased expression of class II MHC and costimulatory molecules and by low secretion of pro-inflammatory cytokines. Its effect was accompanied by IL-10 synthesis. In this sense, the modulatory effect of PI on specific-immune response and DC activation is independent of TLR2 or TLR4.

Length scales of dynamic heterogeneities of low and high molecular weight glass formers from multidimensional NMR

Das Ziel der vorliegenden Arbeit ist die Untersuchung der räumlichen und zeitlichen Aspekte der heterogenen Dynamik in Modellglasbildnern. Dabei wird vor allem die langsame alpha-Relaxationsdynamik oberhalb des Glasüberganges Tg untersucht. Die nukleare Magnetresonanz zeigt ihre einmalige Vielseitigkeit bei der Untersuchung molekularer Dynamik, wenn die angewandten Techniken und Experimente durch Simulationen unterstützt werden. Die räumliche Aspekt dynamischer Heterogenitäten wird untersucht durch ein reduziertes vierdimensionales Spindiffusionsexperiment (4D3CP), ein Experiment, das Reorientierungsraten örtlich korreliert. Eine Simulation dieses Experimentes an einem System harter Kugeln liefert wertvolle Informationen über die Auswertemethode des 4D3CP Experiments. Glycerol und o-terphenyl werden durch das 4D3CP Experiment untersucht. Die erhaltenen Resultate werden mit bereits publizierten Daten des polymeren Glasbildners PVAc verglichen. Während PVAc und o-terphenyl eine Längenskale von 3.7 nm bzw. 2.9 nm aufweisen, ist die Längenskale von Glycerol signifikant kleiner bei 1.1 nm. Ein neues Experiment, welches sensitiv auf Translationsbewegung reagiert, wird vorgestellt. Durch Verwendung eines pi-Impulszuges kann eine separate Evolution unter dem Hamiltonian der dipolaren Kopplung und der chemischen Verschiebungsanisotropie erreicht werden.

Tailoring molecular weight of the conjugated model polymer MEH-PPV and its structure-property relations

In der vorliegenden Arbeit wurden Struktur-Eigenschaftsbeziehungen des konjugierten Modell-Polymers MEH-PPV untersucht. Dazu wurde Fällungs-fraktionierung eingesetzt, um MEH-PPV mit unterschiedlichem Molekulargewicht (Mw) zu erhalten, insbesondere MEH-PPV mit niedrigem Mw, da dieses für optische Wellenleiterbauelemente optimal geeignet ist Wir konnten feststellen, dass die Präparation einer ausreichenden Menge von MEH-PPV mit niedrigem Mw und geringer Mw-Verteilung wesentlich von der geeigneten Wahl des Lösungsmittels und der Temperatur während der Zugabe des Fällungsmittels abhängt. Alternativ dazu wurden UV-induzierte Kettenspaltungseffekte untersucht. Wir folgern aus dem Vergleich beider Vorgehensweisen, dass die Fällungsfraktionierung verglichen mit der UV-Behandlung besser geeignet ist zur Herstellung von MEH-PPV mit spezifischem Mw, da das UV-Licht Kettendefekte längs des Polymerrückgrats erzeugt. 1H NMR and FTIR Spektroskopie wurden zur Untersuchung dieser Kettendefekte herangezogen. Wir konnten außerdem beobachten, dass die Wellenlängen der Absorptionsmaxima der MEH-PPV Fraktionen mit der Kettenlänge zunehmen bis die Zahl der Wiederholeinheiten n  110 erreicht ist. Dieser Wert ist signifikant größer als früher berichtet. rnOptische Eigenschaften von MEH-PPV Wellenleitern wurden untersucht und es konnte gezeigt werden, dass sich die optischen Konstanten ausgezeichnet reproduzieren lassen. Wir haben die Einflüsse der Lösungsmittel und Temperatur beim Spincoaten auf Schichtdicke, Oberflächenrauigkeit, Brechungsindex, Doppelbrechung und Wellenleiter-Dämpfungsverlust untersucht. Wir fanden, dass mit der Erhöhung der Siedetemperatur der Lösungsmittel die Schichtdicke und die Rauigkeit kleiner werden, während Brechungsindex, Doppelbrechung sowie Wellenleiter-Dämpfungsverluste zunahmen. Wir schließen daraus, dass hohe Siedetemperaturen der Lösungsmittel niedrige Verdampfungsraten erzeugen, was die Aggregatbildung während des Spincoatings begünstigt. Hingegen bewirkt eine erhöhte Temperatur während der Schichtpräparation eine Erhöhung von Schichtdicke und Rauhigkeit. Jedoch nehmen Brechungsindex und der Doppelbrechung dabei ab.rn Für die Schichtpräparation auf Glassubstraten und Quarzglas-Fasern kam das Dip-Coating Verfahren zum Einsatz. Die Schichtdicke der Filme hängt ab von Konzentration der Lösung, Transfergeschwindigkeit und Immersionszeit. Mit Tauchbeschichtung haben wir Schichten von MEH-PPV auf Flaschen-Mikroresonatoren aufgebracht zur Untersuchung von rein-optischen Schaltprozessen. Dieses Verfahren erweist sich insbesondere für MEH-PPV mit niedrigem Mw als vielversprechend für die rein-optische Signalverarbeitung mit großer Bandbreite.rn Zusätzlich wurde auch die Morphologie dünner Schichten aus anderen PPV-Derivaten mit Hilfe von FTIR Spektroskopie untersucht. Wir konnten herausfinden, dass der Alkyl-Substitutionsgrad einen starken Einfluss auf die mittlere Orientierung der Polymerrückgrate in dünnen Filmen hat.rn

Inhibition of direct and indirect TLR-mediated activation of human NK cells by low molecular weight dextran sulfate

NK cells express toll-like receptors (TLR) that recognize conserved pathogen or damage associated molecular patterns and play a fundamental role in innate immunity. Low molecular weight dextran sulfate (DXS), known to inhibit the complement system, has recently been reported by us to inhibit TLR4-induced maturation of human monocyte-derived dendritic cells (MoDC). In this study, we investigated the capability of DXS to interfere with human NK cell activation triggered directly by TLR2 agonists or indirectly by supernatants of TLR4-activated MoDC. Both TLR2 agonists and supernatants of TLR4-activated MoDC activated NK cells phenotypically, as demonstrated by the analysis of NK cell activation markers (CD56, CD25, CD69, NKp30, NKp44, NKp46, DNAM-1 and NKG2D), and functionally as shown by increased NK cell degranulation (CD107a surface expression) and IFN-gamma secretion. DXS prevented the up-regulation of NK cell activation markers triggered by TLR2 ligands or supernatants of TLR4-activated MoDC and dose-dependently abrogated NK cell degranulation and IFN-gamma secretion. In summary our results suggest that DXS may be a useful reagent to inhibit the direct and indirect TLR-mediated activation of NK cells.

High molecular weight kininogen regulates platelet-leukocyte interactions by bridging Mac-1 and glycoprotein Ib

Leukocyte-platelet interaction is important in mediating leukocyte adhesion to a thrombus and leukocyte recruitment to a site of vascular injury. This interaction is mediated at least in part by the beta2-integrin Mac-1 (CD11b/CD18) and its counter-receptor on platelets, glycoprotein Ibalpha (GPIbalpha). High molecular weight kininogen (HK) was previously shown to interact with both GPIbalpha and Mac-1 through its domains 3 and 5, respectively. In this study we investigated the ability of HK to interfere with the leukocyte-platelet interaction. In a purified system, HK binding to GPIbalpha was inhibited by HK domain 3 and the monoclonal antibody (mAb) SZ2, directed against the epitope 269-282 of GPIbalpha, whereas mAb AP1, directed to the region 201-268 of GPIbalpha had no effect. In contrast, mAb AP1 inhibited the Mac-1-GPIbalpha interaction. Binding of GPIbalpha to Mac-1 was enhanced 2-fold by HK. This effect of HK was abrogated in the presence of HK domains 3 or 5 or peptides from the 475-497 region of the carboxyl terminus of domain 5 as well as in the presence of mAb SZ2 but not mAb AP1. Whereas no difference in the affinity of the Mac-1-GPIbalpha interaction was observed in the absence or presence of HK, maximal binding of GPIbalpha to Mac-1 doubled in the presence of HK. Moreover, HK/HKa increased the Mac-1-dependent adhesion of myelomonocytic U937 cells and K562 cells transfected with Mac-1 to immobilized GPIbalpha or to GPIbalpha-transfected Chinese hamster ovary cells. Finally, Mac-1-dependent adhesion of neutrophils to surface-adherent platelets was enhanced by HK. Thus, HK can bridge leukocytes with platelets by interacting via its domain 3 with GPIbalpha and via its domain 5 with Mac-1 thereby augmenting the Mac-1-GPIbalpha interaction. These distinct molecular interactions of HK with leukocytes and platelets contribute to the regulation of the adhesive behavior of vascular cells and provide novel molecular targets for reducing atherothrombotic pathologies.

[Bleeding complication due to accumulation of low-molecular-weight heparin in a patient with renal insufficiency]

We report of a 71-year-old woman with a history of chronic analgesic nephropathy, who underwent coronary angiography. Because of anterior ventricular aneurysm, anticoagulation with nadroparine was installed. Continued ACE-inhibitor and ASA with additional intravenous contrast substance lead to acute tubular necrosis with rapid decline of the renal function. Due to accumulation of the low molecular weight heparin, the patient developed an extensive retroperitoneal haematoma with circulatory shock and temporary anuric kidney failure. Low molecular weight heparins are commonly used during percutaneous coronary interventions. They are as safe and efficient compared to unfractioned heparin. But due to their renal elimination, they have to be monitored by measuring anti-factor Xa-activity if creatinine-clearance is <30 ml/min.

The complement inhibitor low molecular weight dextran sulfate prevents TLR4-induced phenotypic and functional maturation of human dendritic cells

Low molecular weight dextran sulfate (DXS) has been reported to inhibit the classical, alternative pathway as well as the mannan-binding lectin pathway of the complement system. Furthermore, it acts as an endothelial cell protectant inhibiting complement-mediated endothelial cell damage. Endothelial cells are covered with a layer of heparan sulfate (HS), which is rapidly released under conditions of inflammation and tissue injury. Soluble HS induces maturation of dendritic cells (DC) via TLR4. In this study, we show the inhibitory effect of DXS on human DC maturation. DXS significantly prevents phenotypic maturation of monocyte-derived DC and peripheral myeloid DC by inhibiting the up-regulation of CD40, CD80, CD83, CD86, ICAM-1, and HLA-DR and down-regulates DC-SIGN in response to HS or exogenous TLR ligands. DXS also inhibits the functional maturation of DC as demonstrated by reduced T cell proliferation, and strongly impairs secretion of the proinflammatory mediators IL-1beta, IL-6, IL-12p70, and TNF-alpha. Exposure to DXS leads to a reduced production of the complement component C1q and a decreased phagocytic activity, whereas C3 secretion is increased. Moreover, DXS was found to inhibit phosphorylation of IkappaB-alpha and activation of NF-kappaB. These findings suggest that DXS prevents TLR-induced maturation of human DC and may therefore be a useful reagent to impede the link between innate and adaptive immunity.

Low molecular weight dextran sulfate as complement inhibitor and cytoprotectant in solid organ and islet transplantation

Complement is an essential part of the innate immune system and plays a crucial role in organ and islet transplantation. Its activation, triggered for example by ischemia/reperfusion (I/R), significantly influences graft survival, and blocking of complement by inhibitors has been shown to attenuate I/R injury. Another player of innate immunity are the dendritic cells (DC), which form an important link between innate and adaptive immunity. DC are relevant in the induction of an immune response as well as in the maintenance of tolerance. Modulation or inhibition of both components, complement and DC, may be crucial to improve the clinical outcome of solid organ as well as islet transplantation. Low molecular weight dextran sulfate (DXS), a well-known complement inhibitor, has been shown to prevent complement-mediated damage of the donor graft endothelium and is thus acting as an endothelial protectant. In this review we will discuss the evidence for this cytoprotective effect of DXS and also highlight recent data which show that DXS inhibits the maturation of human DC. Taken together the available data suggest that DXS may be a useful reagent to prevent the activation of innate immunity, both in solid organ and islet transplantation.

Search for Low-Molecular-Weight Biomarkers in Plant Tissues and Seeds Using Metabolomics: Tools, Strategies, and Applications

This chapter summarises the metabolomic strategies currently in force used in plant science and describes the methods used. The metabolite profiling and fingerprinting of plant tissues through MS- and/or NMR-based approaches and the subsequent identification of biomarkers is detailed. Strategies for the microisolation and de novo identification of unknown biomarkers are also discussed. The various approaches are illustrated by a metabolomic study of the maize response to herbivory. A review of recent metabolomic studies performed on seed and crop plant tissues involving various analytical strategies is provided.

Seasonal variation of high-molecular-weight compounds in the water-soluble fraction of organic urban aerosols

Aerosol samples were collected in Zurich, Switzerland, at an urban background site and were analyzed with size exclusion chromatography (SEC) and laser/desorption ionization mass spectrometry (LDI-MS) for water-soluble organic compounds with high molecular weight. Daily samples were collected during two campaigns in winter and summer, for 1 month each. The concentration of high-molecular-weight compounds (humic-like substances (HULIS)) was between 0.4 and 4 μg/m3 in winter and summer. The most intense signals in the LDI-MS mass spectra were measured between m/z150 and 500, comparing well with the mode of the two main high mass peaks determined with SEC corresponding to masses between 200 and 600 Da. For the maximum molecular weight, however, different results were obtained by the two techniques: whereas a maximum molecular weight between 1300 and 3300 Da was found with SEC, hardly any peaks above m/z700 were measured with LDI-MS. During summer the maximum molecular weight of HULIS (determined with SEC) correlates positively with several parameters such as ozone and increased temperature indicative of enhanced atmospheric photo-oxidation. The HULIS concentration also correlates positively with the oxalic acid concentration in the particles. This suggests that HULIS are generated by secondary processes in summer. The lack of such correlations during winter suggests that other sources and processes might be important during colder seasons.