The Effects of Flow on Therapeutic Protein Aggregation

Total Page:16

File Type:pdf, Size:1020Kb

The Effects of Flow on Therapeutic Protein Aggregation The Effects of Flow on Therapeutic Protein Aggregation Leon Fitzroy Willis Submitted in accordance with the requirements for the degree of Doctor of Philosophy The University of Leeds Astbury Centre for Structural Molecular Biology School of Molecular and Cellular Biology September 2018 This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement. © Leon Fitzroy Willis and the University of Leeds i Statement regarding inclusion of published work in this thesis The candidate confirms that the work submitted is his/her own, except where work which has formed part of jointly-authored publications has been included. The contribution of the candidate and the other authors to this work has been explicitly indicated below. The candidate confirms that appropriate credit has been given within the thesis where reference has been made to the work of others: Chapters 3 and 4 "Characterising protein aggregation induced by extensional flow" include work published in the following publication: Dobson, J., Kumar, A., Willis, L.F., Tuma, R., Higazi, D.R., Turner, R., Lowe, D.C., Ashcroft, A.E., Radford, S.E., Kapur, N. and Brockwell, D.J., 2017. Inducing protein aggregation by extensional flow. Proceedings of the National Academy of Sciences, 114 (18), 4673-4678. Chapter 4 "Mapping the aggregation landscapes of proteins under defined fluid fields" includes work from the following publication: Willis, L.F., Kumar, A., Dobson, J., Bond, N., Lowe, D., Turner, R., Radford, S.E., Kapur, N. and Brockwell, D.J., 2018. Using extensional flow to reveal diverse aggregation landscapes for three IgG1 molecules. Biotechnology and Bioengineering, 115, 1216–1225. In Dobson et al. 2017 Proc. Natl. Acad. Sci., The author contribution reads: “ J.D., A.K., L.F.W., A.E.A., S.E.R., N.K., and D.J.B. designed research; J.D., A.K., and L.F.W. performed research; R. Tuma, D.R.H., R. Turner, and D.C.L. contributed new reagents/analytic tools.; J.D., A.K., L.F.W., R. Tuma, D.R.H., R. Turner, D.C.L., A.E.A., S.E.R., N.K., and D.J.B. analyzed data; and J.D., A.K., L.F.W., A.E.A., S.E.R., N.K., and D.J.B. wrote the paper.” In Willis et al. 2018, Biotechnol. Bioeng. I prepared the vast majority of the protein samples ahead of stress in the flow device. I co-performed the vast majority of the flow stress experiments with A Kumar (joint-first author). I performed the vast majority of the pelleting assays, with A Kumar measuring the A280 of the vast majority of samples following overnight incubation. I performed the vast majority of the final analysis of the data, in addition to the writing of the manuscript (submitted as part of Year 3 Draft Paper and Thesis Plan in FBS). J Dobson helped conceive the study. All authors contributed to the writing of the final manuscript. ii Acknowledgements Firstly, I would like to thank my supervisory team, Dr David Brockwell, Prof Nikil Kapur and Prof Alison Ashcroft, for their guidance and encouragement of me over the past four years and hopefully, the years to come. I also wish to thank Professor Sheena Radford for her help and tutelage despite not formally being part of my supervisory team. Secondly, I wish to thank the EPSRC Centre for Doctoral Training in Emergent Macromolecular Therapies for funding my studentship. In particular, I wish to thank Professor Paul Dalby and the other academics in the Department of Biochemical Engineering at UCL, who have introduced me to a field I did not know existed before my PhD, of which I now feel proud to be part of. I wish to thank the friends I made during my training events for making this experience as enjoyable as possible. I also wish to thank MedImmune LLC and Adimab LLC for providing additional funding, materials and advice over the last four years. Without this, most of the work in this thesis would not exist. I particularly wish to thank Drs David Lowe, Richard Turner, Nick Bond and Paul Varley (MedImmune) and Drs Tushar Jain, Yingda Xu and Max Vasquez (Adimab). Thirdly, I wish to thank Drs John Dobson and Amit Kumar for their endless help, advice and friendship. As the original ‘squishing team,’ it’s been great to get this project off the ground with you. I wish to thank all members of the Radford and Brockwell groups, past and present, for not just being great colleagues, but also great friends. I must also thank the lab manager, Mr G Nasir Khan, who always makes time for you despite his busyness! I wish to thank Drs Nuria Benseny- Cases, Sophie Goodchild, Esther Martin, James Ault and Iain Manfield for offering their time and advice to teach me many practical techniques throughout my PhD. Finally, I wish to thank my past teachers who always encouraged me to aim higher. Thanks also to all my friends and family for their timeless support and encouragement- without you I would not have written this thesis! I particularly wish to thank my parents, Debbie and Fitzroy, their respective partners Chris and Tricia, and my grandparents Janet and Roy Wilson, as they have all made me the man I am today. I dedicate this thesis to my late grandparents, Iris and Fred Willis, who I hope would be proud. At this point people usually thank their other half… As my luck has not stretched that far, I think I will end the sentiment here and talk instead about science! iii Abstract To date, over 70 monoclonal antibody (mAb) biopharmaceuticals have been approved, allowing effective treatment of serious diseases such as cancer. In addition to improving human health, these powerful medicines are very valuable, generating billions of dollars in sales annually. Like all proteins, environmental changes can cause mAbs to unfold, misfold and aggregate. Aggregation can block the progress of mAbs to market, as aggregates have been linked to adverse effects in patients. The hydrodynamic forces mAbs encounter during their manufacturing process have long been thought to be one of the causes of aggregation. This link remains tenuous, however, partly due to a lack of knowledge surrounding how specific flow fields (e.g. shear and extensional flows) perturb protein structure. To assess the effects of flow on therapeutic protein aggregation, a recently developed, bespoke Extensional Flow Device (EFD) was characterised, which mimics the hydrodynamic forces mAbs encounter at manufacturing scale. In this thesis, the model proteins BSA and three mAbs (WFL, mAb1 and STT) were subjected to the defined fluid fields present in the EFD, with the resulting aggregates characterised using an array of biophysical techniques. The data show that protein aggregation can be induced by extensional flow. The extent of aggregation depends on a protein’s sequence and topology, in addition to the flow conditions and buffer composition. For example, the mAbs WFL and STT show disparate aggregation behaviour following hydrodynamic stress, despite having >99 % sequence identity, with the generic mAb1 somewhere in between the two. Reinforced by data from a screen of 33 clinically relevant mAbs, the data in this thesis support future use of the EFD to: explore flow-induced protein aggregation mechanisms; improve mAb bioprocessing and; screen mAb candidates to select sequences and/or formulations which are resistant to potentially deleterious hydrodynamic forces, facilitating the development of next-generation mAb therapeutics. iv Table of Contents Contents Statement regarding inclusion of published work in this thesis ..................................ii Acknowledgements .................................................................................................. iii Abstract ................................................................................................................... iv Table of Contents .................................................................................................... v List of Tables ........................................................................................................... x List of Figures .......................................................................................................... xi List of Abbreviations .............................................................................................. xvi 1. Introduction ....................................................................................................... 1 1.1 Protein folding, misfolding and aggregation ............................................... 1 1.2 Introduction to biopharmaceuticals ............................................................ 4 1.2.1 . Biological molecules as therapies: A revolution in modern medicine . 4 1.2.2 Monoclonal antibodies (mAbs): The dominant products in the biopharmaceutical arena................................................................................... 5 1.2.3 Biochemical engineering: Selection, expression, purification and formulation of therapeutic antibodies .............................................................. 12 1.2.4 ‘The aggregation problem’ in the biopharmaceutical industry............ 22 1.2. Techniques used to study biopharmaceutical aggregation ....................... 26 1.3.1 In silico predictors of aggregation-prone regions .................................... 26 1.3.2. Spectroscopic and spectrometric techniques to probe higher-order structure ......................................................................................................... 29 1.2.3. Separation-based methods to probe biopharmaceutical aggregation. 37 1.2.4. Light
Recommended publications
  • Print PDF Opens in a New Window
    CADTH ISSUES IN EMERGING HEALTH TECHNOLOGIES Informing Decisions About New Health Technologies Issue July 173 2018 Monoclonal Antibodies for Osteoarthritis of the Hip or Knee Image courtesy of iStock CADTH ISSUES IN EMERGING HEALTH TECHNOLOGIES 1 Authors: Sirjana Pant, Ke Xin Li, Melissa Severn Cite As: Monoclonal Antibodies for Osteoarthritis of the Hip or Knee. Ottawa: CADTH; 2018. (CADTH issues in emerging health technologies; issue 173). Acknowledgments: CADTH would like to acknowledge the contribution of Dr. Tom Appleton, MD, PhD, FRCPC, Assistant Professor, Rheumatologist; Department of Medicine, Department of Physiology and Pharmacology, The University of Western Ontario; Clinician Scientist, Lawson Health Research Institute; The Rheumatology Centre, St. Joseph’s Health Care London; for his review of the draft version of this bulletin. ISSN: 1488-6324 (online) Disclaimer: The information in this document is intended to help Canadian health care decision-makers, health care professionals, health systems leaders, and policy- makers make well-informed decisions and thereby improve the quality of health care services. While patients and others may access this document, the document is made available for informational purposes only and no representations or warranties are made with respect to its fitness for any particular purpose. The information in this document should not be used as a substitute for professional medical advice or as a substitute for the application of clinical judgment in respect of the care of a particular patient or other professional judgment in any decision-making process. The Canadian Agency for Drugs and Technologies in Health (CADTH) does not endorse any information, drugs, therapies, treatments, products, processes, or services.
    [Show full text]
  • MEDICAL Injectables & ONCOLOGY TREND REPORT™
    MEDICAL INJECTABLEs & ONCOLOGY TREND REPORT™ 2010 firsT edition ICORE HEALTHCARE www.ICOREHealthcare.com/Trends.AsPx letter to OuR readers 1 Injectable Drugs: Giving You the Data You Need It is my pleasure to present you with the 2010 ICORE For this first edition, we surveyed 60 medical, pharmacy, and Healthcare Medical Injectables & Oncology Trend clinical directors representing 146 million lives to get an understanding ReportTM. It is the first of what will be an annual of what payors are doing today and planning to do in the future to publication. The purpose of our investment in this manage the quality and cost of care for medical benefit injectables. report is straightforward: Back in 2003 when ICORE We then evaluated health plan medical benefit injectable claims such Healthcare first began assisting payors in managing that benchmarks and trends could be determined. medical injectables, no reference or benchmark data ICORE Healthcare’s mission has not changed in the past seven existed. Frankly, this has continued to be the case years: We serve as the center of medical injectable drug management. until the release of this report, since few, if any, benefit To this end, we believe this report is one additional resource to assist managers are able to review and assess medical benefit our customers, colleagues, and partners. injectable claims. I want to give special thanks to the Assessing medical injectable use, costs, and trends payors who served on our advisory is more critical now than ever, since five of the top board of this publication and 16 drugs in 2009 (based upon sales dollars) were who provided invaluable input specialty drugs, whereas it is expected that 11 drugs of into the report’s overall objective, the top 16 will be injectable or specialty products by content, and design.
    [Show full text]
  • Strategies to Enhance Monoclonal Antibody Uptake and Distribution in Solid Tumors
    Cancer Biol Med 2021. doi: 10.20892/j.issn.2095-3941.2020.0704 REVIEW Strategies to enhance monoclonal antibody uptake and distribution in solid tumors Brandon M. Bordeau, Joseph P. Balthasar Department of Pharmaceutical Science, University at Buffalo, Buffalo, NY 14214, USA ABSTRACT Despite the significant resources dedicated to the development of monoclonal antibody (mAb) therapies for solid tumors, the clinical success, thus far, has been modest. Limited efficacy of mAb in solid tumors likely relates to unique aspects of tumor physiology. Solid tumors have an aberrant vasculature and a dense extracellular matrix that slow both the convective and diffusive transport of mAbs into and within tumors. For mAbs that are directed against cellular antigens, high antigen expression and rapid antigen turnover can result in perivascular cells binding to and eliminating a significant amount of extravasated mAb, limiting mAb distribution to portions of the tumor that are distant from functional vessels. Many preclinical investigations have reported strategies to improve mAb uptake and distribution; however, to our knowledge, none have translated into the clinic. Here, we provide an overview of several barriers in solid tumors that limit mAb uptake and distribution and discuss approaches that have been utilized to overcome these barriers in preclinical studies. KEYWORDS Solid tumors; antibody uptake and distribution; monoclonal antibody; antibody–drug conjugate Introduction Currently, monoclonal antibodies (mAbs) are heralded as the “magic bullets” that Ehrlich envisioned, and in many cases, the In 1900, Paul Ehrlich developed the receptor theory, which moniker is well deserved. Antibodies can bind most substances was built on the foundational hypothesis that toxins, nutri- with high affinity and high selectivity and are used for the treat- ents, and drugs exert their observed effect through binding to ment of many diseases.
    [Show full text]
  • Predictive QSAR Tools to Aid in Early Process Development of Monoclonal Antibodies
    Predictive QSAR tools to aid in early process development of monoclonal antibodies John Micael Andreas Karlberg Published work submitted to Newcastle University for the degree of Doctor of Philosophy in the School of Engineering November 2019 Abstract Monoclonal antibodies (mAbs) have become one of the fastest growing markets for diagnostic and therapeutic treatments over the last 30 years with a global sales revenue around $89 billion reported in 2017. A popular framework widely used in pharmaceutical industries for designing manufacturing processes for mAbs is Quality by Design (QbD) due to providing a structured and systematic approach in investigation and screening process parameters that might influence the product quality. However, due to the large number of product quality attributes (CQAs) and process parameters that exist in an mAb process platform, extensive investigation is needed to characterise their impact on the product quality which makes the process development costly and time consuming. There is thus an urgent need for methods and tools that can be used for early risk-based selection of critical product properties and process factors to reduce the number of potential factors that have to be investigated, thereby aiding in speeding up the process development and reduce costs. In this study, a framework for predictive model development based on Quantitative Structure- Activity Relationship (QSAR) modelling was developed to link structural features and properties of mAbs to Hydrophobic Interaction Chromatography (HIC) retention times and expressed mAb yield from HEK cells. Model development was based on a structured approach for incremental model refinement and evaluation that aided in increasing model performance until becoming acceptable in accordance to the OECD guidelines for QSAR models.
    [Show full text]
  • Nimotuzumab, an Antitumor Antibody That Targets the Epidermal Growth Factor Receptor, Blocks Ligand Binding While Permitting the Active Receptor Conformation
    Published OnlineFirst July 7, 2009; DOI: 10.1158/0008-5472.CAN-08-4518 Experimental Therapeutics, Molecular Targets, and Chemical Biology Nimotuzumab, an Antitumor Antibody that Targets the Epidermal Growth Factor Receptor, Blocks Ligand Binding while Permitting the Active Receptor Conformation Ariel Talavera,1,2 Rosmarie Friemann,2,3 Silvia Go´mez-Puerta,1 Carlos Martinez-Fleites,4 Greta Garrido,1 Ailem Rabasa,1 Alejandro Lo´pez-Requena,1 Amaury Pupo,1 Rune F. Johansen,3 Oliberto Sa´nchez,5 Ute Krengel,2 and Ernesto Moreno1 1Center of Molecular Immunology, Havana, Cuba; 2Department of Chemistry, University of Oslo, Oslo, Norway; and 3Center for Molecular and Behavioral Neuroscience, Institute of Medical Microbiology, University of Oslo, Rikshospitalet HF, Oslo, Norway; 4Department of Chemistry, University of York, Heslington, York, United Kingdom; and 5Center for Genetic Engineering and Biotechnology, Havana, Cuba Abstract region of the EGFR (eEGFR), leaving the dimerization ‘‘arm’’ in Overexpression of the epidermal growth factor (EGF) receptor domain II ready for binding a second monomer (4, 5). It has been (EGFR) in cancer cells correlates with tumor malignancy and shown that the eEGFR adopts a ‘‘tethered’’ or inactive conformation poor prognosis for cancer patients. For this reason, the EGFR in the absence of EGF (6). In this characteristic conformation, has become one of the main targets of anticancer therapies. the dimerization arm is hidden by interactions with domain IV, Structural data obtained in the last few years have revealed whereas domains I and III remain separated. Thus, to adopt the the molecular mechanism for ligand-induced EGFR dimeriza- ‘‘extended’’ or active conformation observed in the crystal structure tion and subsequent signal transduction, and also how this of the complex with EGF (4), the receptor must undergo a major signal is blocked by either monoclonal antibodies or small conformational change that brings together domains I and III (6).
    [Show full text]
  • Deciphering Molecular Mechanisms and Prioritizing Therapeutic Targets in Cardio-Oncology
    Figure 1. This is a pilot view to explore the potential of EpiGraphDB to inform us about proteins that are linked to the pathophysiology of cancer and cardiovascular disease (CVD). For each cancer type (pink diamonds), we searched for cancer related proteins (light blue circles) that interact with other proteins identified as protein quantitative trait loci (pQTLs) for CVD (red diamonds for pathologies, orange triangles for risk factors). These pQTLs can be acting in cis (solid lines) or trans-acting (dotted lines). Proteins can interact either directly, a protein-protein interaction (dotted blue edges), or through the participation in the same pathway (red parallel lines). Shared pathways are represented with blue hexagons. We also queried which of these proteins are targeted by existing drugs. We found that the cancer drug cetuximab (yellow circle) inhibits EGFR. Other potential drugs are depicted in light brown hexagonal meta-nodes that are detailed below. Deciphering molecular mechanisms and prioritizing therapeutic targets in cardio-oncology Pau Erola1,2, Benjamin Elsworth1,2, Yi Liu2, Valeriia Haberland2 and Tom R Gaunt1,2,3 1 CRUK Integrative Cancer Epidemiology Programme; 2 MRC Integrative Epidemiology Unit, University of Bristol; 3 The Alan Turing Institute Cancer and cardiovascular disease (CVD) make by far the immense What is EpiGraphDB? contribution to the totality of human disease burden, and although mortality EpiGraphDB is an analytical platform and graph database that aims to is declining the number of those living with the disease shows little address the necessity of innovative and scalable approaches to harness evidence of change (Bhatnagar et al., Heart, 2016).
    [Show full text]
  • Targeted and Novel Therapy in Advanced Gastric Cancer Julie H
    Selim et al. Exp Hematol Oncol (2019) 8:25 https://doi.org/10.1186/s40164-019-0149-6 Experimental Hematology & Oncology REVIEW Open Access Targeted and novel therapy in advanced gastric cancer Julie H. Selim1 , Shagufta Shaheen2 , Wei‑Chun Sheu3 and Chung‑Tsen Hsueh4* Abstract The systemic treatment options for advanced gastric cancer (GC) have evolved rapidly in recent years. We have reviewed the recent data of clinical trial incorporating targeted agents, including inhibitors of angiogenesis, human epidermal growth factor receptor 2 (HER2), mesenchymal–epithelial transition, epidermal growth factor receptor, mammalian target of rapamycin, claudin‑18.2, programmed death‑1 and DNA. Addition of trastuzumab to platinum‑ based chemotherapy has become standard of care as front‑line therapy in advanced GC overexpressing HER2. In the second‑line setting, ramucirumab with paclitaxel signifcantly improves overall survival compared to paclitaxel alone. For patients with refractory disease, apatinib, nivolumab, ramucirumab and TAS‑102 have demonstrated single‑agent activity with improved overall survival compared to placebo alone. Pembrolizumab has demonstrated more than 50% response rate in microsatellite instability‑high tumors, 15% response rate in tumors expressing programmed death ligand 1, and non‑inferior outcome in frst‑line treatment compared to chemotherapy. This review summarizes the current state and progress of research on targeted therapy for advanced GC. Keywords: Gastric cancer, Targeted therapy, Human epidermal growth factor receptor 2, Programmed death‑1, Vascular endothelial growth factor receptor 2 Background GC mortality which is consistent with overall decrease in Gastric cancer (GC), including adenocarcinoma of the GC-related deaths [4]. gastroesophageal junction (GEJ) and stomach, is the ffth Tere have been several eforts to perform large-scale most common cancer and the third leading cause of can- molecular profling and classifcation of GC.
    [Show full text]
  • Classification Decisions Taken by the Harmonized System Committee from the 47Th to 60Th Sessions (2011
    CLASSIFICATION DECISIONS TAKEN BY THE HARMONIZED SYSTEM COMMITTEE FROM THE 47TH TO 60TH SESSIONS (2011 - 2018) WORLD CUSTOMS ORGANIZATION Rue du Marché 30 B-1210 Brussels Belgium November 2011 Copyright © 2011 World Customs Organization. All rights reserved. Requests and inquiries concerning translation, reproduction and adaptation rights should be addressed to [email protected]. D/2011/0448/25 The following list contains the classification decisions (other than those subject to a reservation) taken by the Harmonized System Committee ( 47th Session – March 2011) on specific products, together with their related Harmonized System code numbers and, in certain cases, the classification rationale. Advice Parties seeking to import or export merchandise covered by a decision are advised to verify the implementation of the decision by the importing or exporting country, as the case may be. HS codes Classification No Product description Classification considered rationale 1. Preparation, in the form of a powder, consisting of 92 % sugar, 6 % 2106.90 GRIs 1 and 6 black currant powder, anticaking agent, citric acid and black currant flavouring, put up for retail sale in 32-gram sachets, intended to be consumed as a beverage after mixing with hot water. 2. Vanutide cridificar (INN List 100). 3002.20 3. Certain INN products. Chapters 28, 29 (See “INN List 101” at the end of this publication.) and 30 4. Certain INN products. Chapters 13, 29 (See “INN List 102” at the end of this publication.) and 30 5. Certain INN products. Chapters 28, 29, (See “INN List 103” at the end of this publication.) 30, 35 and 39 6. Re-classification of INN products.
    [Show full text]
  • The Antibody Zalutumumab Inhibits Epidermal Growth Factor Receptor Signaling by Limiting Intra- and Intermolecular Flexibility
    The antibody zalutumumab inhibits epidermal growth factor receptor signaling by limiting intra- and intermolecular flexibility Jeroen J. Lammerts van Bueren*, Wim K. Bleeker*, Annika Bra¨ nnstro¨ m†, Anne von Euler†, Magnus Jansson†, Matthias Peipp‡, Tanja Schneider-Merck‡, Thomas Valerius‡, Jan G. J. van de Winkel*§, and Paul W. H. I. Parren*¶ *Genmab, 3508 AD, Utrecht, The Netherlands; †Sidec, SE-164 40 Kista, Sweden; ‡Division of Nephrology and Hypertension, Christian-Albrecht-University, 24105 Kiel, Germany; and §Immunotherapy Laboratory, Department of Immunology, University Medical Centre Utrecht, 3584 EA, Utrecht, The Netherlands Edited by Michael Sela, Weizmann Institute of Science, Rehovot, Israel, and approved February 7, 2008 (received for review October 8, 2007) The epidermal growth factor receptor (EGFR) activates cellular intervene in EGFR signaling, as reflected by two classes of pathways controlling cell proliferation, differentiation, migration, anti-EGFR drugs that are currently used clinically: tyrosine and survival. It thus represents a valid therapeutic target for kinase inhibitors (TKIs) and monoclonal antibodies (mAbs). treating solid cancers. Here, we used an electron microscopy-based TKIs represent small-molecule inhibitors that block EGFR- technique (Protein Tomography) to study the structural rearrange- kinase activity by binding to the ATP-binding pocket, thereby ment accompanying activation and inhibition of native, individual, abrogating downstream EGFR signaling. The effects of TKI EGFR molecules. Reconstructed tomograms (3D density maps) seem to be primarily related to enzyme inhibition. showed a level of detail that allowed individual domains to be For mAbs, the mechanisms of action are more diverse and discerned. Monomeric, resting EGFR ectodomains demonstrated their relative contribution to antitumor activity is still being large flexibility, and a number of distinct conformations were investigated.
    [Show full text]
  • Valstybinės Vaistų Kontrolės Tarnybos Prie Lietuvos Respublikos Sveikatos Apsaugos Ministerijos Viršininko Į S a K Y M a S
    VALSTYBINĖS VAISTŲ KONTROLĖS TARNYBOS PRIE LIETUVOS RESPUBLIKOS SVEIKATOS APSAUGOS MINISTERIJOS VIRŠININKO Į S A K Y M A S DĖL VALSTYBINĖS VAISTŲ KONTROLĖS TARNYBOS PRIE LIETUVOS RESPUBLIKOS SVEIKATOS APSAUGOS MINISTERIJOS VIRŠININKO 2006 M. LAPKRIČIO 2 D. ĮSAKYMO NR. 1A-658 „DĖL TARPTAUTINIŲ PREKĖS ŽENKLU NEREGISTRUOTŲ VAISTINIŲ MEDŽIAGŲ PAVADINIMŲ ATITIKMENŲ LIETUVIŲ KALBA SĄRAŠO PATVIRTINIMO“ PAKEITIMO 2013 m. gegužės 2 d. Nr. (1.4)1A-480 Vilnius Atsižvelgdamas į Pasaulio sveikatos organizacijos 2013 m. paskelbtą 69-ąjį Rekomenduojamų tarptautinių prekės ženklu neregistruotų vaistinių medžiagų pavadinimų (INN) sąrašą, p a k e i č i u Tarptautinių prekės ženklu neregistruotų vaistinių medžiagų pavadinimų atitikmenų lietuvių kalba sąrašą, patvirtintą Valstybinės vaistų kontrolės tarnybos prie Lietuvos Respublikos sveikatos apsaugos ministerijos viršininko 2006 m. lapkričio 2 d. įsakymu Nr. 1A-658 „Dėl Tarptautinių prekės ženklu neregistruotų vaistinių medžiagų pavadinimų atitikmenų lietuvių kalba sąrašo patvirtinimo“ (Žin., 2006, Nr. 119-4557; 2007, Nr. 13-519; 2008, Nr. 24-896; 2010, Nr. 152-7773; 2011, Nr. 56-2700, Nr. 159-7553; 2012, Nr. 53-2664, Nr. 113-5776): 1. Papildau nauja eilute, kurią po eilutės „Actodigin Aktodiginas Actodiginum“ išdėstau taip: „Actoxumab Aktoksumabas Actoxumabum“ 2. Papildau nauja eilute, kurią po eilutės „Alacizumab pegol Alacizumabas pegolas Alacizumabum pegolum“ išdėstau taip: „Aladorian Aladorianas Aladorianum“ 3. Papildau nauja eilute, kurią po eilutės „Alipogene tiparvovec Alipogenas tiparvovekas Alipogenum tiparvovecum“ išdėstau taip: „Alirocumab Alirokumabas Alirocumabum“ 4. Papildau nauja eilute, kurią po eilutės „Antithrombin alfa Antitrombinas alfa Antithrombinum alfa“ išdėstau taip: „Antithrombin gamma Antitrombinas gama Antithrombinum gamma“ 5. Papildau nauja eilute, kurią po eilutės „Astromicin Astromicinas Astromicinum“ išdėstau taip: „Asudemotide Asudemotidas Asudemotidum“ 6. Papildau nauja eilute, kurią po eilutės „Auranofin Auranofinas Auranofinum“ išdėstau taip: „Auriclosene Auriklozenas Auriclosenum“ 7.
    [Show full text]
  • The Two Tontti Tudiul Lui Hi Ha Unit
    THETWO TONTTI USTUDIUL 20170267753A1 LUI HI HA UNIT ( 19) United States (12 ) Patent Application Publication (10 ) Pub. No. : US 2017 /0267753 A1 Ehrenpreis (43 ) Pub . Date : Sep . 21 , 2017 ( 54 ) COMBINATION THERAPY FOR (52 ) U .S . CI. CO - ADMINISTRATION OF MONOCLONAL CPC .. .. CO7K 16 / 241 ( 2013 .01 ) ; A61K 39 / 3955 ANTIBODIES ( 2013 .01 ) ; A61K 31 /4706 ( 2013 .01 ) ; A61K 31 / 165 ( 2013 .01 ) ; CO7K 2317 /21 (2013 . 01 ) ; (71 ) Applicant: Eli D Ehrenpreis , Skokie , IL (US ) CO7K 2317/ 24 ( 2013. 01 ) ; A61K 2039/ 505 ( 2013 .01 ) (72 ) Inventor : Eli D Ehrenpreis, Skokie , IL (US ) (57 ) ABSTRACT Disclosed are methods for enhancing the efficacy of mono (21 ) Appl. No. : 15 /605 ,212 clonal antibody therapy , which entails co - administering a therapeutic monoclonal antibody , or a functional fragment (22 ) Filed : May 25 , 2017 thereof, and an effective amount of colchicine or hydroxy chloroquine , or a combination thereof, to a patient in need Related U . S . Application Data thereof . Also disclosed are methods of prolonging or increasing the time a monoclonal antibody remains in the (63 ) Continuation - in - part of application No . 14 / 947 , 193 , circulation of a patient, which entails co - administering a filed on Nov. 20 , 2015 . therapeutic monoclonal antibody , or a functional fragment ( 60 ) Provisional application No . 62/ 082, 682 , filed on Nov . of the monoclonal antibody , and an effective amount of 21 , 2014 . colchicine or hydroxychloroquine , or a combination thereof, to a patient in need thereof, wherein the time themonoclonal antibody remains in the circulation ( e . g . , blood serum ) of the Publication Classification patient is increased relative to the same regimen of admin (51 ) Int .
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2017/0172932 A1 Peyman (43) Pub
    US 20170172932A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2017/0172932 A1 Peyman (43) Pub. Date: Jun. 22, 2017 (54) EARLY CANCER DETECTION AND A 6LX 39/395 (2006.01) ENHANCED IMMUNOTHERAPY A61R 4I/00 (2006.01) (52) U.S. Cl. (71) Applicant: Gholam A. Peyman, Sun City, AZ CPC .......... A61K 9/50 (2013.01); A61K 39/39558 (US) (2013.01); A61K 4I/0052 (2013.01); A61 K 48/00 (2013.01); A61K 35/17 (2013.01); A61 K (72) Inventor: sham A. Peyman, Sun City, AZ 35/15 (2013.01); A61K 2035/124 (2013.01) (21) Appl. No.: 15/143,981 (57) ABSTRACT (22) Filed: May 2, 2016 A method of therapy for a tumor or other pathology by administering a combination of thermotherapy and immu Related U.S. Application Data notherapy optionally combined with gene delivery. The combination therapy beneficially treats the tumor and pre (63) Continuation-in-part of application No. 14/976,321, vents tumor recurrence, either locally or at a different site, by filed on Dec. 21, 2015. boosting the patient’s immune response both at the time or original therapy and/or for later therapy. With respect to Publication Classification gene delivery, the inventive method may be used in cancer (51) Int. Cl. therapy, but is not limited to such use; it will be appreciated A 6LX 9/50 (2006.01) that the inventive method may be used for gene delivery in A6 IK 35/5 (2006.01) general. The controlled and precise application of thermal A6 IK 4.8/00 (2006.01) energy enhances gene transfer to any cell, whether the cell A 6LX 35/7 (2006.01) is a neoplastic cell, a pre-neoplastic cell, or a normal cell.
    [Show full text]