West Nile Virus Seroprevalence in a Selected Donkey Population of Namibia.

West Nile Virus (WNV) is a mosquito-borne virus enzootically maintained in birds. However, it can incidentally infect other species, leading to sometimes severe clinical consequences like in horses and especially human beings. Despite the topic relevance, the presence and distribution of WNV are currently unknown in Namibia. Several countries implement surveillance systems based on virus detection in birds, mosquitoes, and vertebrate species including horses. The present study aimed to fill this knowledge gap by serologically evaluating WNV exposure in Namibian donkeys, whose population is remarkably bigger than the horse one. Forty-seven out of 260 sampled animals showed neutralizing antibodies against WNV (18.07% [95% CI = 13.59-23.30%]), demonstrating its circulation in all country territory, although, with apparent regional differences. On the contrary, no association with animal age or sex could be identified. The present study demonstrates the widespread presence of WNV in Namibia as well as the practical utility and effectiveness of donkeys as sentinels for infection surveillance. Due to clinical relevance, vaccination campaigns should be considered for horses of high economic or genetic value. Additionally, the burden of WNV infection on human health should be carefully evaluated.

Seroprevalence of African horse sickness in selected donkey populations in Namibia.

BACKGROUND AND AIM: African horse sickness (AHS) is a non-contagious viral disease of horses and other equids caused by an arbovirus belonging to the Reoviridae family and genus Orbivirus. AHS is an endemic disease that is responsible for the death of a high number of horses every year in Namibia. At present, there is no information on the prevalence and distribution of AHS virus (AHSV) serotypes in the different regions of Namibia. Therefore, this survey aimed to fill this knowledge gap by investigating the AHSV seroprevalence in Namibian donkeys. MATERIALS AND METHODS: A total of 260 blood samples (20 samples for each region) were randomly collected from donkeys aged between 3 and 5 years. Sera were screened for AHSV-specific immunoglobulin G antibodies using acommercial competitive enzyme-linked immunosorbent assay kit and samples positive to AHSV antibodies were further tested by serum neutralization (SN) assay to evaluate the AHSV serotype-specific immune response. RESULTS: Seroprevalence of antibodies against AHSV in Namibian donkeys was 63.5%. The AHSV prevalence was significantly higher in the northern region (64%) than in the southern region (36%). A significantly (p<0.05) higher number of donkeys had antibodies against AHSV-6 (37.8%) and AHSV-9 (37.8%). The AHSV-2, AHSV-6, and AHSV-9 prevalence were higher (p<0.05) in the northern regions compared to the southern regions. None of the donkeys in this study, however, tested positive for AHSV-8. CONCLUSION: Results of the current study indicate that all AHSV serotypes have either circulated previously or are circulating in Namibia except for AHSV-8. In particular, AHSV-1, -2, -3, -4, -5, -6, and -9 serotypes have circulated or are circulating in the northern region of Namibia, while AHSV-1, -4, -5, -6, -7, and -9 have infected donkeys in the south. AHSV-9 and AHSV-6 were the most prevalent serotypes detected in donkeys in this study. SN results showed that several donkeys from Kavango East, Kavango West, and Ohangwena regions had been exposed to multiple serotypes, indicating the possibility of cocirculation of several strains in Namibia.

Demographics, distribution, ownership and naming patterns of pets presented to a mobile clinic for sterilisation in Namibia.

This study analysed the demographics, spatial distribution, ownership and naming patterns of dogs and cats presented to the University of Namibia's veterinary mobile clinic for sterilisation from small underserved towns around Namibia. The proportional distribution of pets was determined based on species, sex, age, owner gender, town of origin and naming categories. Overall, 84.4% (n = 2909) of the animals presented for sterilisation were dogs and the remainder were cats (15.6%, n = 539). Of the dogs presented for sterilisation, 51.9% (n = 1509) were male and 48.1% (n = 1400) were female. In cats, 51.4% (n = 277) were male, whilst 48.6% (n = 262) were female. Overall, the majority of pets (68.2%) were presented for sterilisation from urban areas than rural areas (31.8%). About 49.8% of men and 24.2% of women that presented pets for sterilisation came from urban areas, whilst 20.1% of the women and 11.7% of the men that presented pets for sterilisation were from rural areas. Of all the pets presented for sterilisation, the majority were male-owned (64%, n = 2206). Pets were mainly presented for sterilisation at 2 years (41.1%), 2 to 4 years (32.4%) and 4 to 6 years (15.4%). The naming of pets was mainly after people (42.4%), circumstances (20.6%) and appearance (15.5%). This community engagement exercise yielded valuable demographic data indicating that pet origin, sex and species and owner gender were important factors in determining the voluntary presentation of pets for sterilisation in the study area.

Randomized phase I trial HIV-CORE 003: Depletion of serum amyloid P component and immunogenicity of DNA vaccination against HIV-1.

BACKGROUND: The failure of DNA vaccination in humans, in contrast to its efficacy in some species, is unexplained. Observational and interventional experimental evidence suggests that DNA immunogenicity may be prevented by binding of human serum amyloid P component (SAP). SAP is the single normal DNA binding protein in human plasma. The drug (R)-1-[6-[(R)-2-carboxypyrrolidin-1-yl]-6-oxo-hexanoyl]pyrrolidine-2-carboxylic acid (CPHPC, miridesap), developed for treatment of systemic amyloidosis and Alzheimer's disease, depletes circulating SAP by 95-99%. The proof-of-concept HIV-CORE 003 clinical trial tested whether SAP depletion by CPHPC would enhance the immune response in human volunteers to DNA vaccination delivering the HIVconsv immunogen derived from conserved sub-protein regions of HIV-1. METHODS: Human volunteers received 3 intramuscular immunizations with an experimental DNA vaccine (DDD) expressing HIV-1-derived immunogen HIVconsv, with or without prior depletion of SAP by CPHPC. All subjects were subsequently boosted by simian (chimpanzee) adenovirus (C)- and poxvirus MVA (M)-vectored vaccines delivering the same immunogen. After administration of each vaccine modality, the peak total magnitudes, kinetics, functionality and memory subsets of the T-cell responses to HIVconsv were thoroughly characterized. RESULTS: No differences were observed between the CPHPC treated and control groups in any of the multiple quantitative and qualitative parameters of the T-cell responses to HIVconsv, except that after SAP depletion, there was a statistically significantly greater breadth of T-cell specificities, that is the number of recognized epitopes, following the DDDC vaccination. CONCLUSIONS: The protocol used here for SAP depletion by CPHPC prior to DNA vaccination produced only a very modest suggestion of enhanced immunogenicity. Further studies will be required to determine whether SAP depletion might have a practical value in DNA vaccination for other plasmid backbones and/or immunogens. TRIAL REGISTRATION: Clinicaltrials.gov NCT02425241.

Preclinical strategy to reduce clinical hepatotoxicity using in vitro bioactivation data for >200 compounds.

Drug-induced liver injury is the most common cause of market withdrawal of pharmaceuticals, and thus, there is considerable need for better prediction models for DILI early in drug discovery. We present a study involving 223 marketed drugs (51% associated with clinical hepatotoxicity; 49% non-hepatotoxic) to assess the concordance of in vitro bioactivation data with clinical hepatotoxicity and have used these data to develop a decision tree to help reduce late-stage candidate attrition. Data to assess P450 metabolism-dependent inhibition (MDI) for all common drug-metabolizing P450 enzymes were generated for 179 of these compounds, GSH adduct data generated for 190 compounds, covalent binding data obtained for 53 compounds, and clinical dose data obtained for all compounds. Individual data for all 223 compounds are presented here and interrogated to determine what level of an alert to consider termination of a compound. The analysis showed that 76% of drugs with a daily dose of <100 mg were non-hepatotoxic (p < 0.0001). Drugs with a daily dose of ≥100 mg or with GSH adduct formation, marked P450 MDI, or covalent binding ≥200 pmol eq/mg protein tended to be hepatotoxic (∼ 65% in each case). Combining dose with each bioactivation assay increased this association significantly (80-100%, p < 0.0001). These analyses were then used to develop the decision tree and the tree tested using 196 of the compounds with sufficient data (49% hepatotoxic; 51% non-hepatotoxic). The results of these outcome analyses demonstrated the utility of the tree in selectively terminating hepatotoxic compounds early; 45% of the hepatotoxic compounds evaluated using the tree were recommended for termination before candidate selection, whereas only 10% of the non-hepatotoxic compounds were recommended for termination. An independent set of 10 GSK compounds with known clinical hepatotoxicity status were also assessed using the tree, with similar results.

An integrated reactive metabolite evaluation approach to assess and reduce safety risk during drug discovery and development.

Metabolic bioactivation is widely considered an undesirable event and a likely prerequisite step in the expression of drug-induced hepatotoxicity and hypersensitivity. Reducing bioactivation risk early in drug discovery, therefore, may help reduce compound attrition and provide safer drug therapies. In vitro bioactivation data and clinical dose for a large set of marketed drugs were analysed for their concordance with clinical hepatotoxicity and the data used to develop an early reactive metabolite strategy. A contingency table analysis of cytochrome P450 metabolism-dependent inhibition (CYP MDI), glutathione trapping data, and dose for >200 marketed drugs with or without a clinical hepatotoxic signal; and microsomal covalent binding data and dose for ∼60 marketed compounds obtained from literature publications was performed to assess concordance with hepatotoxicity. Clinical daily dose ≥100mg or glutathione adduct formation was strongly associated with hepatotoxicity (p<0.0001, p=0.003, respectively). A trend towards clinical hepatotoxicity was observed with marked CYP MDI or metabolism-dependent covalent binding ≥200pmol/mg. The percentage of hepatotoxic drugs identified by high dose (67%) increased significantly when bioactivation data were combined with dose (80-100%). As CYP MDI and glutathione adduct assays do not require the synthesis of radiolabelled compound and are relatively easy to conduct, they may be of particular value for early assessment in programs with lower risk tolerance. Such information together with an overall understanding of the metabolic properties of the compound and risk/benefit considerations may trigger further assessment. Additionally hepatic transcriptomic data (e.g., Nrf2-activated gene expression) from rat toxicity studies can provide evidence of in vivo consequences of bioactivation. As attenuation of a metabolic bioactivation risk early in drug discovery could reduce compound attrition and provide safer drug therapies, we have developed a decision-based early reactive metabolite strategy that can be tailored to the needs of individual programs.

Use of human tissue in ADME and safety profiling of development candidates.

The clinical success of a compound is often curtailed because of inadequate safety, pharmacokinetics or efficacy. Human tissue can be used to identify the potential shortcomings of new drugs before they undergo testing in man. This review highlights the consent and ethical approval required for the use of human tissues and discusses their use for predicting human ADME and safety profiles of drugs in preclinical development. The ability to retrieve a wide range of viable tissues from human donors provides the opportunity to test drugs for many potential use-limiting side-effects.