FDA-approved drug screening in patient-derived organoids demonstrates potential of drug repurposing for rare cystic fibrosis genotypes.

BACKGROUND: Preclinical cell-based assays that recapitulate human disease play an important role in drug repurposing. We previously developed a functional forskolin induced swelling (FIS) assay using patient-derived intestinal organoids (PDIOs), allowing functional characterization of CFTR, the gene mutated in people with cystic fibrosis (pwCF). CFTR function-increasing pharmacotherapies have revolutionized treatment for approximately 85% of people with CF who carry the most prevalent F508del-CFTR mutation, but a large unmet need remains to identify new treatments for all pwCF. METHODS: We used 76 PDIOs not homozygous for F508del-CFTR to test the efficacy of 1400 FDA-approved drugs on improving CFTR function, as measured in FIS assays. The most promising hits were verified in a secondary FIS screen. Based on the results of this secondary screen, we further investigated CFTR elevating function of PDE4 inhibitors and currently existing CFTR modulators. RESULTS: In the primary screen, 30 hits were characterized that elevated CFTR function. In the secondary validation screen, 19 hits were confirmed and categorized in three main drug families: CFTR modulators, PDE4 inhibitors and tyrosine kinase inhibitors. We show that PDE4 inhibitors are potent CFTR function inducers in PDIOs where residual CFTR function is either present, or created by additional compound exposure. Additionally, upon CFTR modulator treatment we show rescue of CF genotypes that are currently not eligible for this therapy. CONCLUSION: This study exemplifies the feasibility of high-throughput compound screening using PDIOs. We show the potential of repurposing drugs for pwCF carrying non-F508del genotypes that are currently not eligible for therapies. ONE-SENTENCE SUMMARY: We screened 1400 FDA-approved drugs in CF patient-derived intestinal organoids using the previously established functional FIS assay, and show the potential of repurposing PDE4 inhibitors and CFTR modulators for rare CF genotypes.

[Therapy of vasculitides and vasculopathies]. / Therapie von Vaskulitiden und Vaskulopathien.

Treatment and course of leukocytoclastic immune-complex vasculitis (LcV) depend on absence or presence of IgA in immune complexes [Henoch-Schoenlein-Purpura (PSH)]. LcV due to IgG- or IgM-containing immune complexes has a better prognosis. If triggers cannot be detected or avoided, symptomatic treatments are usually sufficient due to a usually favourable course. When hemorrhagic blisters suggest incipient skin necrosis corticosteroids are indicated. For chronic or relapsing LcV we suggest colchicine or dapsone. In adults with PSH and severe glomerulonephritis there is insufficient evidence for the efficacy of glucocorticoids; but e.g. ACE inhibitors can be helpful depending on symptoms. In cryoglobulinemic vasculitis underlying diseases (often plasmocytoma or hepatitis C) should be treated, sometimes supplemented by plasmapheresis. Dapsone or colchicine are usually started for urticarial vasculitis. ANCA-associated systemic vasculitis requires rapid and aggressive induction therapy, usually with glucocorticoids and cyclophosphamide. In classic polyarteriitis nodosa glucocorticoids improve prognosis, in polyarteriitis nodosa cutanea colchicine or dapsone are more appropriate. Giant cell arteriitis requires rapid therapy with glucocorticoids. For livedo vasculopathy antithrombotic measures are required with low molecular heparin or antagonists to vitamin K, for maintenance dipyridamol und aspirin.

Use of an osteoinductive biomaterial as a bone morphogenetic protein carrier.

A porous calcium phosphate ceramic, which induced bone formation in soft tissues of dogs, was termed as osteoinductive biomaterial and studied as a carrier of bone morphogenetic protein (rhBMP-2). Cylinder implants (laser spot 4 x 5 mm) impregnated with 0, 1, 10 and 40 microg rhBMP-2 were implanted in dorsal muscles of rabbits for five weeks. Histological observation and histomorphometric analysis were performed on thin un-decalcified sections. No bone formation was detected in the implants without rhBMP-2, while mature lamellar bone was found inside the implants with 1 microg rhBMP-2, both on the outer surface and inside the implants with 10 microg and 40 microg rhBMP-2. Little difference in formed bone was found between 1 microg and 10 microg rhBMP-2, but no difference was found between 10 microg and 40 microg rhBMP-2. A significant difference in bone marrow formation was found among 1, 10 and 40 microg rhBMP-2. The more rhBMP-2, the more bone marrow formed. The present results indicate that osteoinductive biomaterial is a good carrier of BMP and high dose of BMP is not necessary for bone formation in clinic.

Preparation of bioactive Ti6Al4V surfaces by a simple method.

Boiling diluted alkali incubation was found to be an effective way to prepare bioactive Ti6Al4V surfaces, whether polished or not, as indicated in vitro after immersion in two different supersaturated calcification solutions (SCSs). The induction of calcium phosphate (Ca-P) precipitation from the SCSs is most probably made possible by the formation of a new TiO2 surface layer and a large number of submicron-scaled etched pits therein. The morphologies and composition of the Ca-P deposited from different SCSs are entirely different from each other. The processes on Ti6Al4V surfaces during treatment and immersion were investigated in detail by means of scanning electron microscopy combined with energy dispersive X-ray analysis, X-ray photoelectron spectroscopy and X-ray diffraction.

In vivo dissolution behavior of various RF magnetron sputtered Ca-P coatings.

Radiofrequency magnetron sputter deposition was used to deposit Ca-P sputter coatings on titanium discs, and these coatings were implanted subcutaneously into the backs of rabbits. Half of the as-sputtered coatings were subjected to additional heat treatment for 2 h at 500 degrees C. X-ray diffraction (XRD) demonstrated that annealing at 500 degrees C changed the amorphous sputtered coating into an amorphous-crystalline apatite structure. Scanning electron microscopic (SEM) examination of the sputtered coatings showed excellent coverage of the substrate surface. Annealing of the 4-microm-thick coatings resulted in the appearance of small cracks. SEM demonstrated that until 4 weeks of implantation, all heat-treated coatings were present and all amorphous coatings were completely or mostly dissolved. Fourier transform infrared spectroscopy showed the formation of carbonate apatite (CO3-AP) on these specimens. Furthermore, XRD analysis showed that these CO3-AP precipitated coatings disappeared after 8 weeks of implantation. On the other hand, SEM inspection of these specimens revealed that the 4-microm heat-treated coating was still partially maintained and that small Ca-P crystals were present on the titanium substrate. On the basis of these results, we conclude that apparently 0.1 microm heat-treated Ca-P sputter coating is of sufficient thicknesses to stimulate carbonate apatite deposition under in vivo conditions.

A gene encoding a protein elicitor of Phytophthora infestans is down-regulated during infection of potato.

Most species of the genus Phytophthora produce 10-kDa extracellular protein elicitors, collectively termed elicitins. Elicitins induce hypersensitive response in a restricted number of plants, particularly in the genus Nicotiana within the Solanaceae family. A cDNA encoding INF1, the major secreted elicitin of Phytophthora infestans, a pathogen of solanaceous plants, was isolated and characterized. The expression of the corresponding inf1 gene during the disease cycle of P. infestans was analyzed. inf1 was shown to be expressed in mycelium grown in various culture media, whereas it was not expressed in sporangiospores, zoospores, cysts, and germinating cysts. In planta, during infection of potato, particularly during the biotrophic stage, expression of inf1 was down-regulated compared to in vitro. The highest levels of expression of inf1 were observed in in vitro grown mycelium and in late stages of infection when profuse sporulation and leaf necrosis occur. The potential role of INF1 as an elicitor in interactions between P. infestans and Solanum species was investigated. Nineteen lines, representing nine solanaceous species with various levels of resistance to P. infestans, were tested for response to an Escherichia coli expressed INF1. Within the genus Solanum, resistance to P. infestans did not appear to be mediated by a defense response elicited by INF1. However, INF1 recognition could be a component of nonhost resistance of tobacco to P. infestans.

Chronic administration of a new potent agonist of growth hormone- releasing hormone induces compensatory linear growth in growth hormone-deficient rats: mechanism of action.

To assess the efficacy of a potent agonist analog of GH-releasing hormone (GH-RH), [Dat1,Gln8,Orn12,21,Abu15,Nle27,Asp28,A gm29]hGH-RH(1-29) (JI-38), we investigated the effects of its chronic administration on growth responses in monosodium glutamate (MSG)-lesioned and normal young rats. Body weight (BW), body length (BL), tibia length (TIL), and tail length (TAL) were monitored. Basal serum GH concentrations, GH responses to bolus injections of GH-RH, pituitary GH and serum IGF-I concentrations were measured by RIA. Pituitary GH-RH receptor concentration and binding affinity was also evaluated after the treatment. Neonatal treatment with MSG resulted, as expected, in blunted growth and a decrease in serum and pituitary GH concentration and serum IGF-I levels. A reduction in GH-RH receptor concentration, associated with increased binding affinity of the GH-RH receptor was also found. Chronic administration of GH-RH agonist JI-38 in doses of 2 micrograms at 12-hour intervals for 2 weeks markedly increased the GH responsiveness to GH-RH and stimulated growth, with MSG-treated animals achieving the growth rate of normal controls. Acceleration of growth was associated with stimulated GH synthesis and IGF-I secretion, although basal serum GH levels did not change. Pituitary GH-RH receptor concentration and binding affinity were not significantly modified by the treatment. Treatment of normal young growing rats with agonist JI-38 did not further increase the normal growth acceleration in these rats, but stimulated the GH synthesis and augmented the GH secretory responsiveness. The treatment of MSG-lesioned rats with GH-RH agonist was generally more effective in female than in male animals, and in some cases masked the sex differences in growth rate. Our findings provide the first evidence that the blunted growth rate of the MSG-lesioned rats is associated with a decreased pituitary GH-RH receptor concentration. Our work demonstrates that administration of GH-RH agonist JI-38 is able to restore the normal growth rate of the GH-deficient rats by stimulating GH synthesis and IGF-I secretion.

Gene pool similarities of potato cyst nematode populations assessed by AFLP analysis.

AFLP was used to characterize 24 potato cyst nematode populations. This novel DNA fingerprinting technique enabled the identification of 987 marker loci by screening only 12 primer combinations. Data on presence or absence polymorphisms and data on the intensities of corresponding DNA fragments were collected. Separate analysis of both data sets revealed similar dendrograms for the nine G. rostochiensis populations included in this study. Both dendrograms consisted of two groups containing three and five related populations, respectively. One population differed from either of these groups. Each group represented a different pathotype as defined by Kort et al. (J. Kort, H. Ross, H. J. Rumpenhorst, and A. R. Stone, Nematologica 23:333-339, 1977). Previously, a similar arrangement was found after analysis of the genetic variation using random amplified polymorphic DNA (RAPD) (R. T. Folkertsma, J. N. A. M. Rouppe van der Voort, M. P. E. van Gent-Pelzer, K. E. de Groot, W. J. van den Bos, A. Schots, J. Bakker, and F. J. Gommers, Phytopathology 84:807-811, 1994). For the 15 G. pallida populations analyzed, complex AFLP patterns were obtained and therefore only qualitative AFLP data were used. Incongruities were observed between clustering on the basis of AFLP data and classical pathotyping. This strongly confirms earlier findings obtained with RAPDs, because the AFLP markers used in this study outnumbered the population characteristics revealed by RAPDs by a factor of five. To arrive at a reliable pathotype designation of potato cyst nematode populations molecular data and virulence characteristics should be integrated. Possible causes for the difference in distribution of polymorphisms among g. rostochiensis and G. pallida populations are discussed.

A model for the evaluation of mandibular bone response to implant materials.

An in vivo animal (goat) mandibular bone model has been evaluated for the cortical and trabecular bone response to biomaterials with different elastic modulus and/or different surfaces. The effect of the elastic modulus on the bone formation was also studied. The difficulties encountered in orientation of the implants probably could have been surmounted if pre-operative radiographs had been available. It was also established that there is a large variance in the amount of trabecular and cortical bone in the mandible of the goat 'bone model'.

In vivo reactions of Ca,P particle containing surface reactive glasses.

Four Ca,P particle containing surface reactive glass composites and two glasses (in the SiO2-CaO-P2O5-Na2O-Al2O3-B2O3 system) were implanted in the diaphyseal area of goat femora up to 24 weeks. Scanning electron microscopic, energy dispersive x-ray, and histological analysis were performed to evaluate the material-tissue interactions. A new type of integration mechanism was observed. Instead of the bone growing to the material surface, a gel-like silica formation appeared between the cortex bone and the material surface. In time the gel-like formation was replaced by a Ca,P layer. The results provided indirect evidence that pure silica gel formed in the tissues could also achieve an apatite layer formation and bone bonding on its surface.

The role of hydrated silica, titania, and alumina in inducing apatite on implants.

Pure soluble silica prepared by a sol-gel method induced bone-like hydroxyapatite formation onto its surface when the silica was immersed in a simulated body fluid (SBF), whereas silica glass and quartz did not. This finding directly supports the hypothesis that hydrated silica plays an important role in biologically active hydroxyapatite formation on the surfaces of bioactive glasses and glass-ceramics, which leads to bone-bonding. Gel-derived titania is also a hydroxyapatite inducer because of its abundant TiOH groups. These results provide further insight into the unique osseointegration of titanium and its alloys. It is suspected that gel-derived titania develops an apatite layer by taking calcium and phosphate from the body fluid, thus producing bone-bonding. Although sufficient AlOH groups may remain in the alumina gel, they do not serve to initiate apatite generation when immersed in SBF. This phenomenon explains the fact that an intermediate fibrous tissue is usually found to separate the alumina implant from bone. One may infer that both abundant OH groups and negatively charged surfaces of gel-derived silica and titania are important for hydroxyapatite induction. material which possesses and/or develops both a negatively charged surface and abundant OH groups in a physiologically-related fluid is most likely to be an efficient apatite inducer. Such materials are suitable candidates to serve as bone-bonding biomaterials.

Induction and morphology of hydroxyapatite, precipitated from metastable simulated body fluids on sol-gel prepared silica.

Hydroxyapatite crystallization is induced at 37 degrees C by sol-gel prepared silica from metastable calcium phosphate solutions. The morphology of the apatite forming on the silica surface depends on the nature of the solutions. For example, apatite grew in a flake-like form at pH 7.4. The morphology changed to plate-like when the pH was adjusted to pH 7.2. At this lower pH, the apatite plate even exhibited a hexagonal feature, reflecting the unique hexagonal structure of hydroxyapatite. An increase in either Mg or P ion concentration of the fluid can cause apatite to grow in a rod-like shape while addition of F ions to the fluid leads to a perfect needle pattern. The flake geometry of apatite was not altered by increasing Ca concentration from 2.5 to 3.8 mM in the solution. From this we conclude that sol-gel prepared silica is an efficient apatite inducer and the morphology of the hydroxyapatite deposit is determined by factors of the fluid such as pH, Ca/P molar ratio, Mg and F concentrations.

Successful induction of allergic contact dermatitis to mercury and chromium in mice.

Availability of reproducible mouse models for allergic contact dermatitis (ACD) to the metal allergens nickel, mercury and chromium, would be of great value for pathogenetic and preventive studies. We explored epicutaneous sensitization to nickel, mercury and chromium in mice in which oral grooming of the sensitization site was prevented by a plaster cast around the abdomen and lower thorax. This procedure was based on earlier findings that oral ingestion of allergen could prevent contact sensitization. The present results show that BALB/c mice can be readily sensitized to mercury and chromium using this epicutaneous casting method, without the further use of adjuvants. With nickel, however, neither this method, nor conventional methods involving the use of Freund's complete adjuvant (FCA) were effective.

Oral induction of immunological tolerance to chromium in the guinea pig.

Metal alloys used in dentistry may elicit adverse side-effects. Contact allergic reactions to metals released from such alloys are among the most frequently encountered problems. In an earlier study, we observed that oral contacts with nickel or chromium salts did not sensitize, but rather decreased the risk of subsequent sensitization to these metals. In the present study, we focused on chromium allergy and extended our earlier observations by further dose-response studies. In addition, we compared different chromium valencies as to their potential oral tolerogenic effects. Development of immunological tolerance in chromium-fed guinea pigs was demonstrated by their inability to develop chromium hypersensitivity after a subsequent immunization attempt. For these studies, the techniques of immunization and skin testing were first improved. One feeding with a high dose of K2Cr2O7 (containing hexavalent chromium) was effective in full tolerance induction. In contrast, trivalent chromium (CrCl3) induced a distinctly lower degree of tolerance, whereas metallic chromium powder was not detectably tolerogenic after a limited number of feedings. Dose-frequency-response studies with K2Cr2O7 showed that full tolerance could also be induced by an increase in the number of feedings with sub-optimal tolerogenic doses. The present results therefore support our hypothesis that long-lasting oral contact with chromium-releasing metal alloys may ultimately result in strong immune tolerance to this metal in subjects without previous skin contact with it. This view is further supported by recent insights into the unique tolerogenicity of oral, as compared with gastro-intestinal, allergenic contacts.

The stimulation of somatostatin release by hpGRF44 from rat hypothalamic cells and fragments in vitro.

Growth hormone releasing factor (GHRF) was examined to determine whether it affects somatostatin (SRIF) release from cultured rat hypothalamic cells and fragments in vitro. The hypothalami of rat fetuses were collected on the 17th day of pregnancy under a dissection microscope. Thirty hypothalami were placed in phosphate buffered saline, and the cells were dispersed with 0.1% collagenase. The dispersed cells were cultured in Dulbecco's modified Eagle medium (DMEM) containing 10% horse serum and 2.5% fetal calf serum at 37 degrees C under 5% CO2 in air. On the 12th day of culture, the cells were washed with Krebs Ringer bicarbonate buffer containing glucose (KRBG), and then incubated with KRBG for 1 hour. The medium was replaced with KRBG alone (control) or KRBG containing test substances, and incubated for another hour. SRIF released into the medium was quantitated by RIA. The mean basal release of SRIF was 14.7 +/- 0.9 pg/dish/hour. One-tenth, 1, and 10nM hpGRF44 stimulated SRIF release by 1.4, 1.5, and 1.8 fold respectively in a dose-related manner. Ten nM ovine corticotropin releasing factor (o-CRF) also stimulated SRIF release by 2.3 fold. One, 10, and 100 nM hpGRF44, 10nM o-CRF, 10nM thyrotropin releasing hormone (TRH) and 60 mM K+ also stimulated SRIF release from rat hypothalamic fragments. Removal of Ca++ from the medium resulted in a decrease of basal release of SRIF. In Ca++ free medium, 10nM hpGRF44 failed to release SRIF. One-tenth nM hpGRF44, 10nM GnRH, and 10nM VIP have no effect on SRIF release statistically. The results of this study demonstrate that a high concentration of GHRF stimulates SRIF release from the hypothalamus in vitro, suggesting a possibility that GHRF may increase the release of SRIF from the median eminence and the hypothalamus in vivo under certain conditions.

Induction of immunological tolerance by oral administration of nickel and chromium.

Oral administration of nickel-chromium to guinea pigs by way of a fixed occlusal splint, or the incorporation of metallic powder or salts into the pelleted food, did not induce hypersensitivity to these metals. In addition, a subsequent attempt to immunize the pre-treated guinea pigs failed in most animals, whereas non-pre-treated guinea pigs became clearly hypersensitive. These results show that oral administration of nickel and chromium induced a state of (partial) tolerance to both metals.

Implant materials in dentistry.

A review is given of current dental implants, as divided in permucosal and nonpermucosal applications. Each has its own material requirements, and therefore the various biomaterials currently used are discussed separately. The conclusion is that bioactive ceramics made of calcium phosphate, and where necessary reinforced with metals, will be the material of choice for future dental implants.