Predicting Anatomic Therapeutic Chemical Classification Codes Using Tiered Learning Thomas Olson1† and Rahul Singh1,2*†

Predicting Anatomic Therapeutic Chemical Classification Codes Using Tiered Learning Thomas Olson1† and Rahul Singh1,2*†

The Author(s) BMC Bioinformatics 2017, 18(Suppl 8):266 DOI 10.1186/s12859-017-1660-6 RESEARCH Open Access Predicting anatomic therapeutic chemical classification codes using tiered learning Thomas Olson1† and Rahul Singh1,2*† From Fifth IEEE International Conference on Computational Advances in Bio and Medical Sciences (ICCABS 2015) Miami, FL, USA. 15-17 October 2015 Abstract Background: The low success rate and high cost of drug discovery requires the development of new paradigms to identify molecules of therapeutic value. The Anatomical Therapeutic Chemical (ATC) Code System is a World Health Organization (WHO) proposed classification that assigns multi-level codes to compounds based on their therapeutic, pharmacological and chemical characteristics as well as the in-vivo sites(s) of activity. The ability to predict ATC codes of compounds can assist in creation of high-quality chemical libraries for drug screening and in applications such as drug repositioning. We propose a machine learning architecture called tiered learning for prediction of ATC codes that relies on the prediction results of the higher levels of the ATC code to simplify the predictions of the lower levels. Results: The proposed approach was validated using a number of compounds in both cross-validation and test setting. The validation experiments compared chemical descriptors, initialization methods and classification algorithms. The prediction accuracy obtained with tiered learning was found to be either comparable or better than that of established methods. Additionally, the experiments demonstrated the generalizability of the tiered learning architecture, in that its use was found to improve prediction rates for a majority of machine learning algorithms when compared to their stand-alone application. Conclusion: The basis of our approach lies in the observation that anatomical-therapeutic biological activity of certain types typically precludes activities of many other types. Thus, there exists a characteristic distribution of the ATC codes, which can be leveraged to limit the search-space of possible codes that can be ascribed at a particular level once the codes at the preceding levels are known. Tiered learning utilizes this observation to constrain the learning space for ATC codes at a particular level based on the ATC code at higher levels. This simplifies the prediction and allows for improved accuracy. Background the need to capture chemical diversity, and also because Discovery of efficacious drugs against diseases is one of the small structural variations can cardinally influence binding key challenges of modern science. Drug discovery efforts against a target. However, outside general principles such as typically start by screening a large number of compounds to the Lipinski rules [1], few rigorous criteria exist to guide identify “leads” which subsequently undergo optimization selection of the initial set of molecules for primary screen- and in vivo test of efficacy and pharmacokinetics to identify ing. Finally, repositioning an existing drug to a novel path- candidates for clinical trials. The selection of a large number ology is an alluring, though limited, alternative to de novo of compounds for primary screening is often driven both by drug design [2]. In both the above problems formulations, the ability to identify compounds that are therapeutically of * Correspondence: [email protected] † interest vis-à-vis a particular pathology is critical. Equal contributors Automatically determining the ATC code of a com- 1Department of Computer Science, San Francisco State University, San Francisco, CA, USA pound constitutes an attractive approach to both these 2Center for Discovery and Innovation in Parasitic Diseases, University of problems. Towards this goal, we present a learning California, San Diego, CA, USA © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The Author(s) BMC Bioinformatics 2017, 18(Suppl 8):266 Page 20 of 49 architecture called tiered learning that can be utilized by prediction, the learning space not only becomes smaller any prediction method (classifier) to obtain highly accur- but also more specific, reducing thereby the informa- ate ATC predictions. The proposed architecture is based tional heterogeneity and simplifying the learning task. In on the premise that while chemical compounds may parallel, the biochemical data used to train the predic- exhibit polypharmacology, that is, compounds may tion methods also becomes more specific in terms of its modulate multiple targets, this phenomenon has limits therapeutic/pharmacological content. and anatomical-therapeutic biological activity of certain types must preclude activities of many other types. In Anatomical Therapeutic Chemical codes other words, ATC classes must have characteristic distri- Created by the World Health Organization (WHO) to aid butions, which become increasingly specific as one in accurately performing drug consumptions studies, the traverses the ATC classification levels. ATCsystemassignsacodetodrugsbasedontheirthera- To motivate this premise, in Fig. 1, we plot the distri- peutic and pharmacological properties. The ATC system bution of ATC classes for the data used by us at the first has a tree-based hierarchy with five levels, each describing and second code levels. As can be seen from this figure, a new level of detail of a drug’s therapeutic profile as de- for each ATC class at the first level, the distribution of scribed in the following: first level: One letter signifying second level is highly specific. Figure 1 thus underlines which of the 14 anatomical groups the drug acts on. Second the existence of characteristic distribution for ATC level: two digits that represent the therapeutic group of the codes–an observation that can be employed to constrain drug. Third and Fourth levels: one letter each specifying the search-space of possible codes once preceding levels therapeutic and pharmacological subgroups. Fifth level:two are known. Based on this premise, in tiered learning, digits that are used to identify the drug within its group. prediction of the ATC code at a certain level is Consider, for example, the drug Aspirin, or acetylsalicylic constrained by the ATC code at the higher levels. An ad- acid, which is known to have fever and pain relieving prop- vantage of such an approach is that with each successive erties. Table 1 lists the ATC Codes for Aspirin. As can be Fig. 1 The empirical distribution of ATC codes at the top level (Pie chart) and at the second level for each of the fourteen anatomical groups in a dataset of 2232 compounds from the ChEMBL used in this study. The pie chart presents the distribution of ATC codes at the anatomical group-level. The bar charts present the distribution of compounds within each of the anatomical groups. It is apparent that each anatomical group has a characteristic distribution, which becomes increasingly specific as one traverses the ATC hierarchy The Author(s) BMC Bioinformatics 2017, 18(Suppl 8):266 Page 21 of 49 Table 1 ATC Codes (in bold) of aspirin ATC Level ATC Codes of Aspirin Antiplatelet effects Anti-fever/pain reliever 1: Anatomical main group B : Blood and Blood forming agents N : Nervous System 2: Threaputic main group B01 : Antithrombotic Agents N02: Analgesic 3: Therapeutic/pharmacological subgroup B01A : Antithrombotic Agents N02B: Other analgesics and Antipyretics (fever reducers) 4: Chemical/therapeutic/pharmacological B01AC : Platelet aggregation inhibitors excl. heparin N02BA: Salicylic acid and derivatives subgroup 5: Chemical substance identifiers B01AC06 : Acetylsalicylic acid N02BA01: Acetylsalicylic acid seen, the ATC codes represent each therapeutic effect of rule [10]. Next, the fragments were used to create a the drug and the information becomes increasingly specific matrix of size n × m, which contained the Tanimoto as we go down the code hierarchy. similarity of all fragment-pairs. The similarity scores of n the Cm fragment combinations were next obtained from Prior work this matrix and used for determining the most similar The problem of ATC code prediction has received sig- fragment correspondences. Finally, 3D similarity was de- nificant recent attention. In [3], a two-step approach was termined by structural superimposition computed over used to predict the ATC code of a compound. In the 100 low-energy conformers of each compound. The pre- first step, chemical-chemical interaction data from the diction accuracy of SuperPred was reported to be 75.3% STITCH database [4] were used based on the hypothesis at the fifth ATC code level. When the method was used that drugs that have a high STITCH interaction confi- to predict the top level ATC code only, an accuracy of dence score would share the first letter of their ATC 80.3% was achieved. It should be noted that the code. For compounds which lack a STITCH interaction SuperPred data sets consisted of compounds that were confidence score, the second step of the method was

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