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1.
Expert meeting report : towards a joint European roadmap to address the unmet needs and priorities of paediatric asthma patients on biologic therapy
Kornel Golebski, Uroš Potočnik, 2021, pregledni znanstveni članek

Opis: Biologics use in severe paediatric asthma The global prevalence of severe asthma among adolescents ranges from 4% to 11%; and up to 7% of children with asthma display an uncontrolled and severe form that is often associated with a substantial burden on the quality of life of patients and their families, and increasing costs of healthcare [1, 2]. “Childhood asthma” is an umbrella term describing a heterogeneous disease comprising different phenotypes and a wide range of symptoms [3–5]. Despite decades of basic and clinical research, tailored strategies to modify the natural course of asthma, prevent severe exacerbations and inhibit lung function decline are still lacking. In addition, clinical phenotypes are only moderately reliable in the prediction of treatment responses and our current understanding of asthma endotypes is limited. Most asthma endotypes involve concomitant inflammatory pathways and distorted immune parameters. Advances in understanding severe paediatric asthma pathophysiological mechanisms and immunological pathways mediating the airway inflammation would allow better characterisation of these patients as well as optimised intervention, guided by treatable traits and biomarkers [6, 7]. Recent studies have demonstrated the effectiveness of monoclonal antibodies (mAbs), also known as biologics, targeting type 2 inflammation in controlling the symptoms of severe asthma. Currently, four human mAbs are approved for use in children: mAbs that target interleukin (IL)-5 or IL-5 receptor (R) (mepolizumab and benralizumab), mAbs that target IL-4R (dupilumab), and mAbs that target immunoglobulin E (omalizumab). Omalizumab was the first biologic approved to treat moderate-to-severe allergic asthma (≥6 years of age). Mepolizumab and dupilumab have been approved for severe eosinophilic asthma (≥6 and ≥12 years of age, respectively), while benralizumab has been approved in the USA to treat children (≥12 years of age) with severe eosinophilic asthma [8–13]. The introduction of mAb agents in asthma treatment is a milestone in the application of personalised medicine. However, comparative studies and standardised algorithms for the management of paediatric severe asthma to guide the best therapeutic option for paediatric patients with severe asthma are lacking [14]. More personalised medicine approaches may benefit the patient by better matching patients with the most appropriate therapy. Risk stratification, remote monitoring and the integration of multiple data sources could help tailor management for the individual child with severe asthma. A digital multidisciplinary European expert meeting took place on 9 July 2020. In this workshop, we brought together European respiratory/allergy paediatricians, immunologists, epidemiologists and basic scientists to identify the unmet needs of paediatric severe asthma patients, and set the priorities for clinical and research activities ahead. The participants discussed ongoing initiatives and knowledge gaps, and formulated proposals on how to address these challenges. In this report, we describe the main findings of this expert meeting.
Ključne besede: asthma, paediatric asthma, severe asthma, children, biologics, monoclonal antibodies, biologic therapy, therapy
Objavljeno v DKUM: 14.08.2024; Ogledov: 84; Prenosov: 4
.pdf Celotno besedilo (695,54 KB)
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2.
Optimization of cultivation conditions for mammalian cell lines producing complex biosimilars
Jure Strnad, 2011, doktorska disertacija

Opis: EXTENDED ABSTRACT The possibility to replace standard single use 250 mL shake flasks with single use 50 mL spin tubes was investigated using the design of experiments methodology. Experimental throughput could be tripled to a maximum of 120 spin tubes per shaker-incubator unit if similar process performance could be proven in shake flasks and spin tubes. A D-optimal response surface design was used to model titer values in a seven day batch process producing recombinant erythropoietin. Shaking rate and working volume in spin tubes were adjusted to simulate titers that are produced in shake flasks at the reference setting. Research results indicated that equivalent titers as in shake flasks at the reference setting can be produced in spin tubes; moreover, even higher titers are possible. The maximal titers in spin tubes reached values as observed in 6 L bioreactors. Furthermore, a comparison of process performance and product quality attributes between two spin tube settings, the reference shake flask setting, a standard bioreactor run and a bioreactor run without pH control was made. Process performance and product quality attributes in spin tubes at the equality setting (shaking rate of 180 rpm and 30 mL working volume) were comparable to the ones derived from the reference shake flask setting. Results derived for both bioreactor runs were not fully comparable to the spin tube and shake flask systems. The statistical model for calculating titers on day seven of a batch process in spin tubes was successfully validated and can be used for titer prediction in the proposed design space. The optimized spin tube settings were further used in a repetitive batch process where in the harvest phase of the process medium was daily exchanged to prevent component depletion or build-up of inhibitors. Spin tubes and shake flasks were used to simulate the industrial process of erythropoietin production. The effect of process mode change from seven-day batch to repetitive batch was investigated on process performance and product quality attributes, such as isoform distribution and glycan group distribution. Spin tube performance at the equality setting was comparable to the shake flask performance also in the repetitive batch process. Performance, especially titers at the maximal titer spin tube setting was, however, not fully comparable to the results obtained in previous optimization experiments. The spin tube equality setting was also used for cultivating two cell lines producing different monoclonal antibodies. The goal was to investigate how different cell lines influence process performance and product quality attributes, such as monoclonal antibody charge variant distribution and glycan group distribution. Both cell lines were derived from a Chinese hamster ovary parental cell line, therefore, it was proposed that maybe the optimal spin tube setting derived for the erythropoietin producing cell line, which was also derived from the Chinese hamster ovary parental cell line, could also be used for these subtypes. Cell growth of the monoclonal antibody producing cell lines was extensively better as observed for the erythropoietin producing cell line, which meant that culture demands were more pronounced, such as oxygen transfer or mass transfer. It was observed that the erythropoietin derived equality spin tube setting did not produce similar process responses as shake flask at the reference setting for both monoclonal antibodies. The foremost difference was that the metabolite lactate was being consumed in shake flasks after it reached a maximum value but was not consumed in spin tubes for both monoclonal antibody producing cell lines. In these experiments also amino acid time profiles during a seven day batch process were monitored and subsequently compared. It was seen that several amino acids seemed to be in excess as most of them were only half way consumed. Product quality attributes also differed between the spin tube and the shake flask setting. The conclusion of the experimental work was that some fine tuning of th
Ključne besede: design of experiments, spin tube, shake flask, optimization, erythropoietin, monoclonal antibodies
Objavljeno v DKUM: 22.12.2011; Ogledov: 3783; Prenosov: 203
.pdf Celotno besedilo (6,72 MB)

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