Dr. Miller is a Board Certified Veterinary Ophthalmologist and a Clinical Professor at the School of Veterinary Medicine, University of Wisconsin-Madison. His research and clinical interests focus on glaucoma in animals and, recently, he has worked extensively with non-human primate models of glaucoma.
Generation of left ventricle-like cardiomyocytes with improved structural, functional, and metabolic maturity from human pluripotent stem cells
Cell Rep Methods. 2023 Apr 24;3(4):100456. doi: 10.1016/j.crmeth.2023.100456. eCollection 2023 Apr 24.
Decreased left ventricle (LV) function caused by genetic mutations or injury often leads to debilitating and fatal cardiovascular disease. LV cardiomyocytes are, therefore, a potentially valuable therapeutical target. Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) are neither homogeneous nor functionally mature, which reduces their utility. Here, we exploit cardiac development knowledge to instruct differentiation of hPSCs specifically toward LV cardiomyocytes. Correct mesoderm patterning and retinoic acid pathway blocking are essential to generate near-homogenous LV-specific hPSC-CMs (hPSC-LV-CMs). These cells transit via first heart field progenitors and display typical ventricular action potentials. Importantly, hPSC-LV-CMs exhibit increased metabolism, reduced proliferation, and improved cytoarchitecture and functional maturity compared with age-matched cardiomyocytes generated using the standard WNT-ON/WNT-OFF protocol. Similarly, engineered heart tissues made from hPSC-LV-CMs are better organized, produce higher force, and beat more slowly but can be paced to physiological levels. Together, we show that functionally matured hPSC-LV-CMs can be obtained rapidly without exposure to current maturation regimes.
PMID:37159667 | PMC:PMC10163040 | DOI:10.1016/j.crmeth.2023.100456
Characterization and Potential Mitigation of Corneal Effects in Nonclinical Toxicology Studies in Animals Administered Depatuxizumab Mafodotin
J Ocul Pharmacol Ther. 2022 Sep;38(7):471-480. doi: 10.1089/jop.2022.0006. Epub 2022 May 10.
Purpose: To characterize the ocular toxicity of an antibody-drug conjugate (ADC), depatuxizumab mafodotin (Depatux-m), in nonclinical species and to evaluate the effects of drug-antibody ratios (DARs), variations of the ADC construct, and potential methods for mitigation of the corneal toxicity. Depatux-m contains the potent cytotoxic agent monomethyl auristatin F as the ADC payload. Methods: Depatux-m was administered intravenously to cynomolgus monkeys at doses up to 30 mg/kg and to mice up to 100 mg/kg. Ocular toxicity was evaluated by clinical ophthalmic examinations and histopathology. Potential mitigation was tested through agents to block target engagement and multiple topical ophthalmic treatments (antioxidant, vasoconstrictor, tear stimulant). Results: Effects primarily involved corneal epithelium and were dose-dependent with respect to onset, severity, and time to reversal in both monkeys and mice. On slit lamp biomicroscopy, the initial effect in monkeys was superficial multifocal punctate opacities (granularity), which migrated axially and were followed by pigmentation and multifocal punctate fluorescein staining. Microscopically, findings were characterized by single-cell necrosis, pigmentation, disordered basilar layer, and thinning of the corneal epithelium. Increased toxicity was associated with a higher DAR or more stably attached linker. Treatment with agents to block target engagement did not affect toxicity, and none of the topical treatments was successful. Conclusions: The corneal findings observed were similar to the effects described in clinical trials with Depatux-m and other ADCs. Collectively, these studies and available literature support the hypothesis that ADC-mediated toxicity is driven primarily by mechanism of action of the payload.
PMID:35537481 | DOI:10.1089/jop.2022.0006
Mechanistic insights into the antipruritic effects of lebrikizumab, an anti-IL-13 mAb
J Allergy Clin Immunol. 2022 Sep;150(3):690-700. doi: 10.1016/j.jaci.2022.01.028. Epub 2022 Mar 1.
BACKGROUND: Atopic dermatitis is a chronic inflammatory skin disease with persistent and severe itch among its hallmark features. Significant increases in type 2 cytokines (ie, IL-4, IL-13, IL-31) have been documented in acute atopic dermatitis lesions and lead to multifaceted downstream effects, including inflammation, epidermal barrier dysfunction, and itch.
OBJECTIVE: The primary objective of preclinical studies reported here was to test direct effects of IL-13 and an anti-IL-13 mAb, lebrikizumab, in a human dorsal root ganglion model in itch amplification, neuronal excitability, and transcriptional downstream targets.
METHODS: Neuroactive effects were assessed via live cell calcium imaging, electric field stimulation, and RNA sequencing of human dorsal root ganglia stimulated with IL-13 alone or in combination with lebrikizumab.
RESULTS: These preclinical findings suggest that IL-13 plays a direct enhancer role in multiple itch and neuroactive pathways as well as transcriptional downstream effects, and provide key insights into the mechanistic basis for lebrikizumab's anti-itch effects.
CONCLUSION: IL-13 is a potent enhancer of neuronal responses to different itch stimuli, consistent with the neuroimmune axis contributing to chronic itch-associated inflammatory skin disease, and blockade of this cytokine pathway may provide a therapeutic approach.
PMID:35240144 | DOI:10.1016/j.jaci.2022.01.028
Characterization and Potential Mitigation of Corneal Effects in Nonclinical Toxicology Studies in Animals Administered Depatuxizumab Mafodotin
Journal of Ocular Pharmacology and Therapeutics. 2022 Sep 1;38(7):471-80
Comparison of intraocular pressures estimated by rebound and applanation tonometry in dogs with lens instability: 66 cases (2012-2018)
J Am Vet Med Assoc. 2021 Nov 1;259(9):1025-1031. doi: 10.2460/javma.259.9.1025.
OBJECTIVE: To compare intraocular pressures (IOPs) estimated by rebound and applanation tonometry for dogs with lens instability.
ANIMALS: 66 dogs.
PROCEDURES: Medical records of dogs examined between September 2012 and July 2018 were reviewed for diagnoses of anterior (ALL) or posterior (PLL) lens luxation or lens subluxation.
RESULTS: Estimates of IOP obtained with rebound and applanation tonometry significantly differed from each other for all types of lens instability considered collectively (mean ± SE difference between tonometric readings, 8.1 ± 1.3 mm Hg) and specific types of lens instability considered individually (mean ± SE difference between tonometric readings: ALL, 12.8 ± 2.5 mm Hg; PLL, 5.9 ± 1.7 mm Hg; subluxation, 2.8 ± 0.8 mm Hg). Median (range) differences between rebound and applanation tonometer readings for dogs with ALL was 5 mm Hg (-9 to 76 mm Hg), with PLL was 3 mm Hg (-1 to 19 mm Hg), and with lens subluxation was 3 mm Hg (-9 to 18 mm Hg). In eyes with ALL, rebound tonometer readings exceeded applanation tonometer readings on 44 of 60 (73%) occasions.
CONCLUSIONS AND CLINICAL RELEVANCE: Rebound tonometry yielded higher estimates of IOP than did applanation tonometry in eyes with ALL and with all types of lens luxation considered collectively. Estimates of IOP in eyes with lens instability should ideally be obtained with both rebound and applanation tonometers. Veterinarians with only one type of tonometer should interpret results for dogs with lens instability concurrent with physical examination findings.
PMID:34647480 | DOI:10.2460/javma.259.9.1025
Arrhythmogenic and antiarrhythmic actions of late sustained sodium current in the adult human heart
Sci Rep. 2021 Jun 8;11(1):12014. doi: 10.1038/s41598-021-91528-1.
Late sodium current (late INa) inhibition has been proposed to suppress the incidence of arrhythmias generated by pathological states or induced by drugs. However, the role of late INa in the human heart is still poorly understood. We therefore investigated the role of this conductance in arrhythmias using adult primary cardiomyocytes and tissues from donor hearts. Potentiation of late INa with ATX-II (anemonia sulcata toxin II) and E-4031 (selective blocker of the hERG channel) slowed the kinetics of action potential repolarization, impaired Ca2+ homeostasis, increased contractility, and increased the manifestation of arrhythmia markers. These effects could be reversed by late INa inhibitors, ranolazine and GS-967. We also report that atrial tissues from donor hearts affected by atrial fibrillation exhibit arrhythmia markers in the absence of drug treatment and inhibition of late INa with GS-967 leads to a significant reduction in arrhythmic behaviour. These findings reveal a critical role for the late INa in cardiac arrhythmias and suggest that inhibition of this conductance could provide an effective therapeutic strategy. Finally, this study highlights the utility of human ex-vivo heart models for advancing cardiac translational sciences.
PMID:34103608 | PMC:PMC8187365 | DOI:10.1038/s41598-021-91528-1
Evaluation of the effect of disposable tonometer cover brand on performance of Tono-Pen Vet in canine eyes
Vet Ophthalmol. 2021 Mar;24 Suppl 1(Suppl 1):194-198. doi: 10.1111/vop.12877. Epub 2021 Feb 27.
PRIMARY OBJECTIVE: To evaluate the effect of latex tip cover manufacturer on accuracy and repeatability of Tono-Pen Vet™ in canine eyes.
ANIMAL STUDIED: Twelve enucleated globes from six dogs.
PROCEDURES: The anterior chamber was cannulated and connected to a calibrated manometer. Intraocular pressure (IOP) measurements were obtained using the Tono-Pen Vet and TONOVET Plus at manometric IOP ranging from 5 to 80 mmHg. At each IOP, the Tono-Pen Vet was used with a new Ocu-Film™ latex tip cover (the only manufacturer-approved brand of cover) followed by a new Softips™ latex tip cover. For comparison, the TONOVET Plus was also used at each IOP with a new disposable rebound probe. Measured IOP values were analyzed by linear regression and intraclass correlation coefficient (ICC).
RESULTS: Tono-Pen Vet accuracy was unaffected by tip cover manufacturer or by frequent change in cover. Using ICC analysis, repeatability of measurements using either tonometer was good to excellent at physiologic IOP levels but variably decreased with both devices at supraphysiologic IOP.
CONCLUSIONS: Neither tip cover manufacturer nor frequent changes in tip cover adversely affect Tono-Pen Vet accuracy. Measurement repeatability with Tono-Pen Vet and TONOVET Plus is widely variable at supraphysiologic IOP. Therefore, minor changes in IOP >25 mmHg should not be used to make clinical decisions without considering this variability.
PMID:33638927 | PMC:PMC9710742 | DOI:10.1111/vop.12877
Cardiotoxic Potential of Hydroxychloroquine, Chloroquine and Azithromycin in Adult Human Primary Cardiomyocytes
Toxicol Sci. 2021 Apr 12;180(2):356-368. doi: 10.1093/toxsci/kfaa194.
Substantial efforts have been recently committed to develop coronavirus disease-2019 (COVID-19) medications, and Hydroxychloroquine alone or in combination with Azithromycin has been promoted as a repurposed treatment. Although these drugs may increase cardiac toxicity risk, cardiomyocyte mechanisms underlying this risk remain poorly understood in humans. Therefore, we evaluated the proarrhythmia risk and inotropic effects of these drugs in the cardiomyocyte contractility-based model of the human heart. We found Hydroxychloroquine to have a low proarrhythmia risk, whereas Chloroquine and Azithromycin were associated with high risk. Hydroxychloroquine proarrhythmia risk changed to high with low level of K+, whereas high level of Mg2+ protected against proarrhythmic effect of high Hydroxychloroquine concentrations. Moreover, therapeutic concentration of Hydroxychloroquine caused no enhancement of elevated temperature-induced proarrhythmia. Polytherapy of Hydroxychloroquine plus Azithromycin and sequential application of these drugs were also found to influence proarrhythmia risk categorization. Hydroxychloroquine proarrhythmia risk changed to high when combined with Azithromycin at therapeutic concentration. However, Hydroxychloroquine at therapeutic concentration impacted the cardiac safety profile of Azithromycin and its proarrhythmia risk only at concentrations above therapeutic level. We also report that Hydroxychloroquine and Chloroquine, but not Azithromycin, decreased contractility while exhibiting multi-ion channel block features, and Hydroxychloroquine's contractility effect was abolished by Azithromycin. Thus, this study has the potential to inform clinical studies evaluating repurposed therapies, including those in the COVID-19 context. Additionally, it demonstrates the translational value of the human cardiomyocyte contractility-based model as a key early discovery path to inform decisions on novel therapies for COVID-19, malaria, and inflammatory diseases.
PMID:33483756 | PMC:PMC7928616 | DOI:10.1093/toxsci/kfaa194
Determination of a No Observed Effect Level (NOEL) for Beta Glucans following a Single Intravitreal Administration to Female Dutch Belted Rabbits
Investigative Ophthalmology & Visual Science, 62(8), pp.201-201
Observation of silicone oil within the vitreous and sclera following intravitreal administration of biotherapeutics using insulin syringes in cynomolgus monkeys
Toxicologic Pathology, 49(3), pp.590-597
Observation of Silicone Oil Within the Vitreous and Sclera Following Intravitreal Administration of Biotherapeutics Using Insulin Syringes in Cynomolgus Monkeys
Toxicol Pathol. 2021 Apr;49(3):590-597. doi: 10.1177/0192623320966543. Epub 2020 Dec 4.
Silicone oil droplets have been reported in the eyes of human patients following intravitreous (IVT) injections with several marketed biotherapeutic products. Intravitreous administration of a novel biotherapeutic in a 14-week cynomolgus monkey study using insulin syringes was associated with 2, non-test-article-related phenomena: "vitreous floater/clear sphere" on indirect ophthalmoscopy and intrascleral "foreign material near injection track" on histopathology. Retrospective analysis of 81 other preclinical studies of IVT administration of novel biotherapeutics found a greater frequency of clear spheres in monkey IVT studies using insulin syringes and formulations containing polysorbate. We were able to correlate microscopic findings of clear circular to oval areas in the sclera near the injection track with an energy-dispersive X-ray spectroscopy (EDS) signal for silicon at the same location in the sclera. These observations provide further evidence that silicone lubricant in insulin syringes/needles is the source of clear spheres noted in the vitreous and foreign material noted near the injection track in the sclera. Although considered inert and toxicologically insignificant, silicone deposition within the eye should form part of the risk-benefit equation in a clinical setting.
PMID:33272095 | DOI:10.1177/0192623320966543
Medical anti-glaucoma therapy: Beyond the drop
Vet Ophthalmol. 2021 Mar;24 Suppl 1:2-15. doi: 10.1111/vop.12843. Epub 2020 Nov 9.
Barriers to effective medical therapy are numerous and include difficulties with effective and sustained control of intraocular pressure (IOP) and adherence to prescribed anti-glaucoma drop regimens. In an effort to circumvent these challenges, a number of new anti-glaucoma therapies with sustained effects have emerged. Methods for sustained delivery of prostaglandin analogs are being intensely investigated and many are in human clinical trials. Intracameral devices include the following: Allergan's Durysta™ Bimatoprost SR, Envisia Therapeutics' ENV515 travoprost implant, Glaukos' iDose™ , Ocular Therapeutix's OTX-TIC travoprost implant, and Santen's polycaprolactone implant with PGE2-derivative DE-117. Other prostaglandin-based technologies include Allergan's bimatoprost ring (placed in the conjunctival fornix), Ocular Therapeutics' OTX-TP intracanalicular travoprost implant, subconjunctival latanoprost in a liposomal formulation, and the PGE2 derivative PGN 9856-isopropyl ester that is applied to the periorbital skin. Exciting breakthroughs in gene therapy include using viral vectors to correct defective genes such as MYOC or to modulate gonioimplant fibrosis, CRISPR technology to edit MYOC or to alter aquaporin to reduce aqueous humor production, and siRNA technology to silence specific genes. Stem cell technology can repopulate depleted tissues or, in the case of Neurotech's Renexus® NT-501 intravitreal implant, serve as a living drug delivery device that continuously secretes neurotrophic factors. Other unique approaches involve nanotechnology, nasal sprays that deliver drug directly to the optic nerve and noninvasive alternating current stimulation of surviving cells in the optic nerve. Over time these modalities are likely to challenge the preeminent role that drops currently play in the medical treatment of glaucoma in animals.
PMID:33164328 | DOI:10.1111/vop.12843
Discovery and characterization of ORM-11372, a novel inhibitor of the sodium-calcium exchanger with positive inotropic activity
Br J Pharmacol. 2020 Dec;177(24):5534-5554. doi: 10.1111/bph.15257. Epub 2020 Nov 10.
BACKGROUND AND PURPOSE: The lack of selective sodium-calcium exchanger (NCX) inhibitors has hampered the exploration of physiological and pathophysiological roles of cardiac NCX 1.1. We aimed to discover more potent and selective drug like NCX 1.1 inhibitor.
EXPERIMENTAL APPROACH: A flavan series-based pharmacophore model was constructed. Virtual screening helped us identify a novel scaffold for NCX inhibition. A distinctively different NCX 1.1 inhibitor, ORM-11372, was discovered after lead optimization. Its potency against human and rat NCX 1.1 and selectivity against other ion channels was assessed. The cardiovascular effects of ORM-11372 were studied in normal and infarcted rats and rabbits. Human cardiac safety was studied ex vivo using human ventricular trabeculae.
KEY RESULTS: ORM-11372 inhibited human NCX 1.1 reverse and forward currents; IC50 values were 5 and 6 nM respectively. ORM-11372 inhibited human cardiac sodium 1.5 (INa ) and hERG KV 11.1 currents (IhERG ) in a concentration-dependent manner; IC50 values were 23.2 and 10.0 μM. ORM-11372 caused no changes in action potential duration; short-term variability and triangulation were observed for concentrations of up to 10 μM. ORM-11372 induced positive inotropic effects of 18 ± 6% and 35 ± 8% in anaesthetized rats with myocardial infarctions and in healthy rabbits respectively; no other haemodynamic effects were observed, except improved relaxation at the lowest dose.
CONCLUSION AND IMPLICATIONS: ORM-11372, a unique, novel, and potent inhibitor of human and rat NCX 1.1, is a positive inotropic compound. NCX inhibition can induce clinically relevant improvements in left ventricular contractions without affecting relaxation, heart rate, or BP, without pro-arrhythmic risk.
PMID:32959887 | PMC:PMC7707092 | DOI:10.1111/bph.15257
Multiparametric Mechanistic Profiling of Inotropic Drugs in Adult Human Primary Cardiomyocytes
Sci Rep. 2020 May 6;10(1):7692. doi: 10.1038/s41598-020-64657-2.
Effects of non-cardiac drugs on cardiac contractility can lead to serious adverse events. Furthermore, programs aimed at treating heart failure have had limited success and this therapeutic area remains a major unmet medical need. The challenges in assessing drug effect on cardiac contractility point to the fundamental translational value of the current preclinical models. Therefore, we sought to develop an adult human primary cardiomyocyte contractility model that has the potential to provide a predictive preclinical approach for simultaneously predicting drug-induced inotropic effect (sarcomere shortening) and generating multi-parameter data to profile different mechanisms of action based on cluster analysis of a set of 12 contractility parameters. We report that 17 positive and 9 negative inotropes covering diverse mechanisms of action exerted concentration-dependent increases and decreases in sarcomere shortening, respectively. Interestingly, the multiparametric readout allowed for the differentiation of inotropes operating via distinct mechanisms. Hierarchical clustering of contractility transient parameters, coupled with principal component analysis, enabled the classification of subsets of both positive as well as negative inotropes, in a mechanism-related mode. Thus, human cardiomyocyte contractility model could accurately facilitate informed mechanistic-based decision making, risk management and discovery of molecules with the most desirable pharmacological profile for the correction of heart failure.
PMID:32376974 | PMC:PMC7203129 | DOI:10.1038/s41598-020-64657-2
Functional expression and pharmacological modulation of TRPM3 in human sensory neurons
Br J Pharmacol. 2020 Jun;177(12):2683-2695. doi: 10.1111/bph.14994. Epub 2020 Mar 5.
BACKGROUND AND PURPOSE: The transient receptor potential (TRP) ion channel TRPM3 functions as a noxious heat sensor, plays a key role in acute pain sensation and inflammatory hyperalgesia in rodents. Despite its potential as a novel analgesic drug target, little is known about the expression, function and modulation in the humans.
EXPERIMENTAL APPROACH: We studied TRPM3 in freshly isolated human dorsal root ganglion (hDRG) neurons and human stem cell-derived sensory (hSCDS) neurons. Expression was analysed at the mRNA level using RT-qPCR. Channel function was assessed using Fura-2-based calcium imaging and whole-cell patch-clamp recordings.
KEY RESULTS: TRPM3 was detected at the mRNA level in both hDRG and hSCDS neurons. The TRPM3 agonists pregnenolone sulphate (PS) and CIM0216 evoked robust intracellular Ca2+ responses in 52% of hDRG and 58% of hSCDS neurons. Whole-cell patch-clamp recordings in hSCDS neurons revealed pregnenolone sulphate (PS)- and CIM0216-evoked currents exhibiting the characteristic current-voltage relation of TRPM3. PS-induced calcium responses in hSCDS neurons were reversed in a dose-dependent manner by the flavonoid isosakuranetin and by antiseizure drug primidone. Finally, the μ-opioid receptor agonist DAMGO and the GABAB receptor agonist baclofen inhibited PS-evoked TRPM3 responses in a subset of hSCDS neurons.
CONCLUSION AND IMPLICATIONS: These results provide the first direct evidence of functional expression of the pain receptor TRPM3 in human sensory neurons, largely mirroring the channel's properties observed in mouse sensory neurons. hSCDS neurons represent a valuable and readily accessible in vitro model to study TRPM3 regulation and pharmacology in a relevant human cellular context.
PMID:31985045 | PMC:PMC7236075 | DOI:10.1111/bph.14994
Effects of 0.02% netarsudil ophthalmic solution on intraocular pressure of normotensive dogs
Vet Ophthalmol. 2021 Mar;24 Suppl 1:87-95. doi: 10.1111/vop.12736. Epub 2020 Jan 7.
OBJECTIVES: To evaluate the effect of QD or BID 0.02% netarsudil ophthalmic solution (Aerie Pharmaceuticals) on intraocular pressure (IOP) in normotensive dogs and to describe any adverse effects.
ANIMALS STUDIED: Normotensive Labrador retriever dogs were included in this study: 10 received netarsudil in one eye and artificial tears in the contralateral eye QD, and 10 received netarsudil in one eye and artificial tears in the contralateral eye BID.
PROCEDURES: Intraocular pressure curves were acquired over a 3-day acclimation period, 5-day dosing period (QD or BID-10 dogs/group), and 3-day recovery period. Toxicity was assessed daily using slit-lamp biomicroscopy and the semiquantitative preclinical ocular toxicology scoring system.
RESULTS: Once-daily dosing did not lower IOP over the entire 5-day dosing period (95% CI 0.1 to -0.9 mm Hg, P = .20) or on the last day of dosing (95% CI 0.4 to -0.9 mm Hg, P = .65). Twice-daily dosing resulted in a statistically significant, but clinically unimportant, IOP reduction over the entire 5-day dosing period (-0.6 mm Hg; 95% CI 0.05 to -1.1 mm Hg, P = .02) and on the last day of dosing (-0.9 mm Hg; 95% CI 0.2 to -1.5 mm Hg, P = .003). Adverse events were limited to transient mild-to-moderate conjunctival hyperemia during the dosing phase in eyes receiving netarsudil vs control (P < .0001).
CONCLUSIONS: Netarsudil 0.02% ophthalmic solution twice daily resulted in a small, statistically significant, but clinically unimportant, IOP reduction in normotensive dogs. Future studies should investigate efficacy in glaucomatous dogs.
PMID:31908139 | DOI:10.1111/vop.12736
Wound leakage rates of ex vivo uniplanar versus biplanar phacoemulsification clear corneal incisions in dogs
Vet Ophthalmol. 2020 Mar;23(2):325-330. doi: 10.1111/vop.12729. Epub 2019 Dec 4.
OBJECTIVE: The purpose of this study was to compare the leakage rates of perilimbal uniplanar and biplanar clear corneal incisions in dogs when subjected to increased intraocular pressure (IOP) both from within the eye and via external pressure.
PROCEDURE: Uniplanar clear corneal incisions were created in eight freshly enucleated canine eyes using a 3.2 mm straight slit knife while 8 fellow eyes received a biplanar clear corneal incision consisting of an approximately 300 μm deep groove followed by a 3.2 mm straight slit knife entry into the anterior chamber. Both wounds were reapposed using three simple interrupted 8-0 polyglactin 910 sutures. Eyes were cannulated with two 25 g needles: One connected to a pressure transducer, and the other connected to a reservoir of isotonic saline. The IOP at which the wound leaked was recorded when the intraocular pressure was increased internally by raising the height of the fluid bag, and again when the cornea was externally compressed. Kaplan-Meier survival curves compared incision types for each method of increasing IOP and were evaluated using Mantel-Cox log-rank analysis.
RESULTS: Both wound types resisted leakage at IOP in the physiologically achievable range and no significant differences were observed between clear corneal incisions when pressure was applied externally (P = .353) or was increased from within the globe (P = .615).
CONCLUSION: Ex vivo uniplanar and biplanar clear corneal incisions in dogs are equally strong, with no significant differences in leakage rates when IOP is increased internally or externally.
PMID:31799807 | DOI:10.1111/vop.12729
Human Heart Cardiomyocytes in Drug Discovery and Research: New Opportunities in Translational Sciences
Curr Pharm Biotechnol. 2020;21(9):787-806. doi: 10.2174/1389201021666191210142023.
In preclinical drug development, accurate prediction of drug effects on the human heart is critically important, whether in the context of cardiovascular safety or for the purpose of modulating cardiac function to treat heart disease. Current strategies have significant limitations, whereby, cardiotoxic drugs can escape detection or potential life-saving therapies are abandoned due to false positive toxicity signals. Thus, new and more reliable translational approaches are urgently needed to help accelerate the rate of new therapy development. Renewed efforts in the recovery of human donor hearts for research and in cardiomyocyte isolation methods, are providing new opportunities for preclinical studies in adult primary cardiomyocytes. These cells exhibit the native physiological and pharmacological properties, overcoming the limitations presented by artificial cellular models, animal models and have great potential for providing an excellent tool for preclinical drug testing. Adult human primary cardiomyocytes have already shown utility in assessing drug-induced cardiotoxicity risk and helping in the identification of new treatments for cardiac diseases, such as heart failure and atrial fibrillation. Finally, strategies with actionable decision-making trees that rely on data derived from adult human primary cardiomyocytes will provide the holistic insights necessary to accurately predict human heart effects of drugs.
PMID:31820682 | DOI:10.2174/1389201021666191210142023
The West coast regional safety pharmacology society meeting update: Filling translational gaps in safety assessment
J Pharmacol Toxicol Methods. 2019 Jul-Aug;98:106582. doi: 10.1016/j.vascn.2019.106582. Epub 2019 May 9.
The Safety Pharmacology Society (SPS) held a West Coast Regional Meeting in Foster City, CA on November 14, 2018 at the Gilead Sciences Inc. site. The meeting was attended by scientists from the pharmaceutical and biotechnology industry, contract research organizations (CROs) and academia. A variety of scientific topics were presented by speakers, covering a broad variety of topics in the fields of safety risk assessment; from pro-arrhythmia and contractility risk evaluation, to models of heart failure and seizure in-a-dish; and discovery sciences; from stem cells and precision medicine, to models of inherited cardiomyopathy and precision cut tissue slices. The present review summarizes the highlights of the presentations and provides an overview of the high level of innovation currently underlying many frontiers in safety pharmacology.
PMID:31077805 | DOI:10.1016/j.vascn.2019.106582
Bimatoprost sustained-release intracameral implant reduces episcleral venous pressure in dogs
Vet Ophthalmol. 2018 Jul;21(4):376-381. doi: 10.1111/vop.12522. Epub 2018 Feb 19.
OBJECTIVE: To determine the effect of a bimatoprost sustained-release intracameral implant (Bimatoprost SR) on episcleral venous pressure (EVP) in normal dogs.
METHODS: Normotensive beagle dogs were randomized to receive Bimatoprost SR 30 μg (n = 7) or sham injection (needle insertion only, n = 7) in one eye on day 1. EVP was measured with an episcleral venomanometer through day 65. Episcleral aqueous outflow vessels were identified using fluorescence imaging following intracameral injection of indocyanine green in one additional animal. A separate cohort of dogs that had been trained for conscious intraocular pressure (IOP) measurements received Bimatoprost SR 30 μg (n = 8) in one eye; IOP was evaluated through day 66.
RESULTS: Baseline mean EVP was 10.0 mmHg in the Bimatoprost SR group and 10.4 mmHg in the sham group. Eyes treated with Bimatoprost SR exhibited a transient increase in mean EVP that peaked at day 8, followed by a decrease to levels below baseline. From day 29 to day 65, the change in mean EVP from baseline ranged from -2.4 to -3.9 mmHg (P < 0.05 vs. sham). Baseline mean IOP in eyes treated with Bimatoprost SR was 14.9 mmHg, and a steady IOP reduction was maintained through day 66. Bimatoprost SR-treated eyes exhibited a selective, sustained dilation of aqueous outflow vessels that was not observed in sham-treated eyes.
CONCLUSIONS: In normal dogs, Bimatoprost SR was associated with a transient increase in EVP followed by a sustained decrease. Changes in EVP were accompanied by a sustained dilation of aqueous outflow vessels.
PMID:29457333 | DOI:10.1111/vop.12522
Label-free imaging of atherosclerotic plaques using third-harmonic generation microscopy
Biomed Opt Express. 2017 Dec 13;9(1):214-229. doi: 10.1364/BOE.9.000214. eCollection 2018 Jan 1.
Multiphoton microscopy using laser sources in the mid-infrared range (MIR, 1,300 nm and 1,700 nm) was used to image atherosclerotic plaques from murine and human samples. Third harmonic generation (THG) from atherosclerotic plaques revealed morphological details of cellular and extracellular lipid deposits. Simultaneous nonlinear optical signals from the same laser source, including second harmonic generation and endogenous fluorescence, resulted in label-free images of various layers within the diseased vessel wall. The THG signal adds an endogenous contrast mechanism with a practical degree of specificity for atherosclerotic plaques that complements current nonlinear optical methods for the investigation of cardiovascular disease. Our use of whole-mount tissue and backward scattered epi-detection suggests THG could potentially be used in the future as a clinical tool.
PMID:29359098 | PMC:PMC5772576 | DOI:10.1364/BOE.9.000214
Action Potential Recording and Pro-arrhythmia Risk Analysis in Human Ventricular Trabeculae
Front Physiol. 2018 Jan 5;8:1109. doi: 10.3389/fphys.2017.01109. eCollection 2017.
To assess drug-induced pro-arrhythmic risk, especially Torsades de Pointe (TdP), new models have been proposed, such as in-silico modeling of ventricular action potential (AP) and stem cell-derived cardiomyocytes (SC-CMs). Previously we evaluated the electrophysiological profile of 15 reference drugs in hESC-CMs and hiPSC-CMs for their effects on intracellular AP and extracellular field potential, respectively. Our findings indicated that SC-CMs exhibited immature phenotype and had the propensity to generate false positives in predicting TdP risk. To expand our knowledge with mature human cardiac tissues for drug-induced pro-arrhythmic risk assessment, human ventricular trabeculae (hVT) from ethically consented organ donors were used to evaluate the effects of the same 15 drugs (8 torsadogenic, 5 non-torsadogenic, and 2 discovery molecules) on AP parameters at 1 and 2 Hz. Each drug was tested blindly with 4 concentrations in duplicate trabeculae from 2 hearts. To identify the pro-arrhythmic risk of each drug, a pro-arrhythmic score was calculated as the weighted sum of percent drug-induced changes compared to baseline in various AP parameters, including AP duration and recognized pro-arrhythmia predictors such as triangulation, beat-to-beat variability and incidence of early-afterdepolarizations, at each concentration. In addition, to understand the translation of this preclinical hVT AP-based model to clinical studies, a ratio that relates each testing concentration to the human therapeutic unbound Cmax (Cmax) was calculated. At a ratio of 10, for the 8 torsadogenic drugs, 7 were correctly identified by the pro-arrhythmic score; 1 was mislabeled. For the 5 non-torsadogenic drugs, 4 were correctly identified as safe; 1 was mislabeled. Calculation of sensitivity, specificity, positive predictive value, and negative predictive value indicated excellent performance. For example, at a ratio of 10, scores for sensitivity, specificity, positive predictive value and negative predictive values were 0.88, 0.8, 0.88 and 0.8, respectively. Thus, the hVT AP-based model combined with the integrated analysis of pro-arrhythmic score can differentiate between torsadogenic and non-torsadogenic drugs, and has a greater predictive performance when compared to human SC-CM models.
PMID:29354071 | PMC:PMC5760531 | DOI:10.3389/fphys.2017.01109
Adult Human Primary Cardiomyocyte-Based Model for the Simultaneous Prediction of Drug-Induced Inotropic and Pro-arrhythmia Risk
Front Physiol. 2017 Dec 19;8:1073. doi: 10.3389/fphys.2017.01073. eCollection 2017.
Cardiac safety remains the leading cause of drug development discontinuation. We developed a human cardiomyocyte-based model that has the potential to provide a predictive preclinical approach for simultaneously predicting drug-induced inotropic and pro-arrhythmia risk. Methods: Adult human primary cardiomyocytes from ethically consented organ donors were used to measure contractility transients. We used measures of changes in contractility parameters as markers to infer both drug-induced inotropic effect (sarcomere shortening) and pro-arrhythmia (aftercontraction, AC); contractility escape (CE); time to 90% relaxation (TR90). We addressed the clinical relevance of this approach by evaluating the effects of 23 torsadogenic and 10 non-torsadogenic drugs. Each drug was tested separately at four multiples of the free effective therapeutic plasma concentration (fETPC). Results: Human cardiomyocyte-based model differentiated between torsadogenic and non-torsadogenic drugs. For example, dofetilide, a torsadogenic drug, caused ACs and increased TR90 starting at 10-fold the fETPC, while CE events were observed at the highest multiple of fETPC (100-fold). Verapamil, a non-torsadogenic drug, did not change TR90 and induced no AC or CE up to the highest multiple of fETPCs tested in this study (222-fold). When drug pro-arrhythmic activity was evaluated at 10-fold of the fETPC, AC parameter had excellent assay sensitivity and specificity values of 96 and 100%, respectively. This high predictivity supports the translational safety potential of this preparation and of the selected marker. The data demonstrate that human cardiomyocytes could also identify drugs associated with inotropic effects. hERG channel blockers, like dofetilide, had no effects on sarcomere shortening, while multi-ion channel blockers, like verapamil, inhibited sarcomere shortening. Conclusions: Isolated adult human primary cardiomyocytes can simultaneously predict risks associated with inotropic activity and pro-arrhythmia and may enable the generation of reliable and predictive data for assessing human cardiotoxicity at an early stage in drug discovery.
PMID:29311989 | PMC:PMC5742250 | DOI:10.3389/fphys.2017.01073
Ocular Safety of AAV2. 7m8-ChrimsonR-tdTomato (GS030-DP) following intravitreous injection and exposure to 595 nm LED light in blind rd1 mice
Investigative Ophthalmology & Visual Science, 59(9), pp.5658-5658
The SPOTS System: An Ocular Scoring System Optimized for Use in Modern Preclinical Drug Development and Toxicology
J Ocul Pharmacol Ther. 2017 Dec;33(10):718-734. doi: 10.1089/jop.2017.0108.
PURPOSE: To present a semiquantitative ocular scoring system comprising elements and criteria that address many of the limitations associated with systems commonly used in preclinical studies, providing enhanced cross-species applicability and predictive value in modern ocular drug and device development.
METHODS: Revisions to the ocular scoring systems of McDonald-Shadduck and Hackett-McDonald were conducted by board-certified veterinary ophthalmologists at Ocular Services On Demand (OSOD) over the execution of hundreds of in vivo preclinical ocular drug and device development studies and general toxicological investigations. This semiquantitative preclinical ocular toxicology scoring (SPOTS) system was driven by limitations of previously published systems identified by our group's recent review of slit lamp-based scoring systems in clinical ophthalmology, toxicology, and vision science.
RESULTS: The SPOTS system provides scoring criteria for the anterior segment, posterior segment, and characterization of intravitreal test articles. Key elements include: standardized slit lamp settings; expansion of criteria to enhance applicability to nonrabbit species; refinement and disambiguation of scoring criteria for corneal opacity, fluorescein staining severity, and aqueous flare; introduction of novel criteria for scoring of aqueous and anterior vitreous cell; and introduction of criteria for findings observed with drugs/devices targeting the posterior segment. A modified Standardization of Uveitis Nomenclature (SUN) system is also introduced to facilitate accurate use of SUN's criteria in laboratory species.
CONCLUSIONS: The SPOTS systems provide criteria that stand to enhance the applicability of semiquantitative scoring criteria to the full range of laboratory species, in the context of modern approaches to ocular therapeutics and drug delivery and drug and device development.
PMID:29239680 | DOI:10.1089/jop.2017.0108
Slit Lamp-Based Ocular Scoring Systems in Toxicology and Drug Development: A Literature Survey
J Ocul Pharmacol Ther. 2017 Dec;33(10):707-717. doi: 10.1089/jop.2017.0021. Epub 2017 Nov 7.
PURPOSE: To present a survey of the features of published slit lamp-based scoring systems and their applicability in the context of modern ocular toxicology and drug development.
METHODS: References describing original or modified slit lamp-based scoring systems for human or veterinary clinical patients or in investigative or toxicologic research were collected following a comprehensive literature review using textbooks and online publication searches. Each system's indications and features were compiled to facilitate comparison.
RESULTS: Literature review identified 138 original or modified scoring systems. Most (48%) were published for evaluation of the ocular surface, 34% for the general anterior segment, and 18% for the lens. Most systems were described for assessment of human patients (50%) and small albino laboratory species such as rabbits (19%), rats (12%), and mice (8%). Systems described for pigmented laboratory species and for larger species such as dogs, cats, pigs, and nonhuman primates (NHPs) were comparatively underrepresented. No systems described a lens scoring scheme specific to the dog, cat, pig, or NHP. Scoring schemes for aqueous and vitreous cells were infrequently described for laboratory species.
CONCLUSIONS: Many slit lamp-based scoring systems have been published, but the features of each differ and complicate translation of findings between different species. Use and interpretation of any scoring system in toxicology and drug development must be done with awareness of the limitations of the system being used.
PMID:29111862 | DOI:10.1089/jop.2017.0021
Nonclinical Safety Assessment of Anti-Factor D: Key Strategies and Challenges for the Nonclinical Development of Intravitreal Biologics
J Ocul Pharmacol Ther. 2018 Jan/Feb;34(1-2):204-213. doi: 10.1089/jop.2017.0063. Epub 2017 Nov 17.
PURPOSE: The nonclinical toxicology program described here was designed to characterize the safety profile of anti-factor D (AFD; FCFD4514S, lampalizumab) to support intravitreal (ITV) administration in patients with geographic atrophy (GA).
METHODS: The toxicity of AFD was assessed in a single-dose and 6-month repeat-dose study in monkeys at doses up to 10 mg/eye. Toxicity was assessed by clinical ophthalmic examinations, intraocular pressure measurements, ocular photography, electroretinography, fluorescein angiography, optical coherence tomography, and anatomic pathology.
RESULTS: Systemic exposure to AFD generally increased with the increase in dose level. The increases in mean maximal concentration and area under the curve values were roughly dose proportional. No accumulation of AFD was observed following 10 doses, and drug exposures were not affected by anti-drug antibodies. AFD was locally and systemically well tolerated in monkeys following ITV doses of up to 10 mg/eye. Ocular effects associated with AFD were limited to transient, reversible, dose-related, aqueous cell responses and injection-related, mild, vitreal cell responses. In the 6-month repeat-dose study, 2 monkeys had a nonspecific immune response to AFD that resulted in severe ocular inflammation, attributed to administration of a heterologous (humanized) protein.
CONCLUSIONS: The comprehensive toxicology program in monkeys described here was designed to evaluate the safety profile of AFD and to support multiple ITV injections in the clinic. Administration of a heterologous (humanized) protein presents a challenge, and immunogenicity in nonclinical species is not predictive of immunogenicity in humans. Taken together, the results of the nonclinical program described here support the use of AFD in patients with GA.
PMID:29148965 | DOI:10.1089/jop.2017.0063
INTRAOCULAR PRESSURE AND EXAMINATION FINDINGS IN THREE SPECIES OF CENTRAL AND SOUTH AMERICAN TREE FROGS (CRUZIOHYLA CRASPEDOPUS, CRUZIOHYLA CALCARIFER, AND ANOTHECA SPINOSA)
J Zoo Wildl Med. 2017 Sep;48(3):688-693. doi: 10.1638/2016-0243.1.
The purpose of this prospective study was to describe intraocular pressure (IOP) and examination findings in three tree frog species (Cruziohyla craspedopus [fringe leaf frog], Cruziohyla calcarifer [splendid leaf frog], and Anotheca spinosa [spiny-headed or coronated tree frog]). Thirty-one C. craspedopus, four C. calcarifer, and five A. spinosa were weighed, sexed based on phenotype where possible, and examined using slit-lamp biomicroscopy and indirect ophthalmoscopy. IOP was measured using the TonoVet and TonoLab rebound tonometers while the frogs were held two ways (unrestrained, then restrained). Statistical differences were determined using one-way analysis of variance (ANOVA) and t-tests. Mean ± SD IOP (TonoVet and TonoLab, respectively) was 15.1 ± 2.5 mmHg and 15.6 ± 4.1 mmHg in C. craspedopus; 14.8 ± 1.5 mmHg and 18.8 ± 3.1 mmHg in C. calcarifer; and 9.1 ± 2.1 mmHg and 10.8 ± 1.4 mmHg in A. spinosa. There was no significant difference in IOP in C. craspedopus by eye (Right vs Left), tonometer, or restraint method. IOP in female C. craspedopus was 1-3 mm Hg higher than in males with both devices (P < 0.05). IOP was statistically significantly different between all species for the TonoLab and between Cruziohyla genus frogs and A. spinosa for the TonoVet (P < 0.05). There was no difference in IOP measurements between the TonoVet and TonoLab in C. craspedopus. IOP varied by gender in C. craspedopus and between species, but not by tonometer. Ocular abnormalities were minimal in this group of captive bred frogs.
PMID:28920794 | DOI:10.1638/2016-0243.1
Quantitative Comparison of Effects of Dofetilide, Sotalol, Quinidine, and Verapamil between Human <em>Ex vivo</em> Trabeculae and <em>In silico</em> Ventricular Models Incorporating Inter-Individual Action Potential Variability
Front Physiol. 2017 Aug 18;8:597. doi: 10.3389/fphys.2017.00597. eCollection 2017.
Background:In silico modeling could soon become a mainstream method of pro-arrhythmic risk assessment in drug development. However, a lack of human-specific data and appropriate modeling techniques has previously prevented quantitative comparison of drug effects between in silico models and recordings from human cardiac preparations. Here, we directly compare changes in repolarization biomarkers caused by dofetilide, dl-sotalol, quinidine, and verapamil, between in silico populations of human ventricular cell models and ex vivo human ventricular trabeculae. Methods and Results:Ex vivo recordings from human ventricular trabeculae in control conditions were used to develop populations of in silico human ventricular cell models that integrated intra- and inter-individual variability in action potential (AP) biomarker values. Models were based on the O'Hara-Rudy ventricular cardiomyocyte model, but integrated experimental AP variability through variation in underlying ionic conductances. Changes to AP duration, triangulation and early after-depolarization occurrence from application of the four drugs at multiple concentrations and pacing frequencies were compared between simulations and experiments. To assess the impact of variability in IC50 measurements, and the effects of including state-dependent drug binding dynamics, each drug simulation was repeated with two different IC50 datasets, and with both the original O'Hara-Rudy hERG model and a recently published state-dependent model of hERG and hERG block. For the selective hERG blockers dofetilide and sotalol, simulation predictions of AP prolongation and repolarization abnormality occurrence showed overall good agreement with experiments. However, for multichannel blockers quinidine and verapamil, simulations were not in agreement with experiments across all IC50 datasets and IKr block models tested. Quinidine simulations resulted in overprolonged APs and high incidence of repolarization abnormalities, which were not observed in experiments. Verapamil simulations showed substantial AP prolongation while experiments showed mild AP shortening. Conclusions: Results for dofetilide and sotalol show good agreement between experiments and simulations for selective compounds, however lack of agreement from simulations of quinidine and verapamil suggest further work is needed to understand the more complex electrophysiological effects of these multichannel blocking drugs.
PMID:28868038 | PMC:PMC5563361 | DOI:10.3389/fphys.2017.00597
Evaluation of the Toxicity of Intravitreally Injected PLGA Microspheres and Rods in Monkeys and Rabbits: Effects of Depot Size on Inflammatory Response
Invest Ophthalmol Vis Sci. 2017 Aug 1;58(10):4274-4285. doi: 10.1167/iovs.16-21334.
PURPOSE: Poly(lactic-co-glycolic) acid (PLGA) inserts have been successfully developed for the treatment of posterior eye disease as a means of reducing injection frequency of intravitreally administered therapeutics. PLGA microspheres are also of interest for the delivery of intravitreal drugs, since they offer the advantage of being easily injected without surgical procedures or large injectors.
METHODS: In the current study, the toxicity of PLGA microspheres and rods was investigated in nonhuman primates (NHPs) and rabbits. An in vitro assessment of cytokine responses to PLGA in peripheral blood mononuclear cells (PBMCs) and macrophages was also performed.
RESULTS: Intravitreal administration of 3, 10, or 12.5 mg/eye of PLGA microspheres in NHPs resulted in a severe immune response characterized by a foreign body response. Follow-up studies in the rabbit confirmed this finding for PLGA microspheres ranging in size from 20 to 100 μm. In contrast, administration of PLGA rod implants with a similar PLGA mass did not elicit a significant immune response. In vitro assays in PBMCs and macrophages confirmed proinflammatory cytokine release upon treatment with PLGA microspheres but not PLGA rods.
CONCLUSIONS: These data demonstrate a lack of tolerability of PLGA microspheres upon intravitreal injection, and suggest that the size, shape, and/or surface area of PLGA depots are critical attributes in determining ocular toxicity.
PMID:28850638 | DOI:10.1167/iovs.16-21334
MEASURING INTRAOCULAR PRESSURE IN WHITE'S TREE FROGS (LITORIA CAERULEA) BY REBOUND TONOMETRY: COMPARING DEVICE, TIME OF DAY, AND MANUAL VERSUS CHEMICAL RESTRAINT METHODS
J Zoo Wildl Med. 2017 Jun;48(2):413-419. doi: 10.1638/2016-0268R.1.
Ocular diseases reported in frogs include uveitis and glaucoma, which are associated with changes in intraocular pressure (IOP). The objectives of this study were to characterize the normal IOP for White's tree frogs ( Litoria caerulea ) using two types of rebound tonometers, and to assess whether time of day or method of restraint affected IOP. Eighteen conscious, unrestrained, ophthalmologically normal frogs were used to measure IOP using TonoVet® and TonoLab® tonometers, at three time points during the day. In a subset of 12 frogs, IOP was measured while under manual restraint using the TonoVet. Anesthesia was induced in 9 frogs using two different concentrations of MS-222 (0.5 g/L and 2 g/L) in order to evaluate for changes in IOP with the TonoVet. Mean (± SD) IOP values for the TonoLab (16.8 ± 3.9 mm Hg) were significantly higher than TonoVet values (14.7 ± 1.6 mm Hg; P < 0.01). TonoVet IOP values did not significantly change with time of day. TonoLab values were significantly lower in the evening (1600-1800; 14.5 ± 3.1 mm Hg), compared with morning and midday measurements (0800-1000 and 1200-1400; 18.0 ± 3.8 mm Hg; P < 0.01). Manually restrained frogs had significantly lower IOP (13.4 ± 1.5 mm Hg) compared with unrestrained frogs (15.3 ± 1.2 mm Hg; P < 0.01). Chemical restraint did not cause significant changes in IOP. Intraocular pressure can be measured with both types of rebound tonometers in White's tree frogs, but time of day and manual restraint can affect IOP values.
PMID:28749263 | DOI:10.1638/2016-0268R.1
Determination of a No-Observable Effect Level for Endotoxin Following a Single Intravitreal Administration to Dutch Belted Rabbits
Invest Ophthalmol Vis Sci. 2017 Mar 1;58(3):1545-1552. doi: 10.1167/iovs.16-21356.
PURPOSE: The purpose of this study was to characterize the inflammatory response and determine a no-observable effect level (NOEL) in rabbit eyes after endotoxin intravitreal (ITV) injection.
METHODS: Fifty-three naïve male Dutch Belted rabbits were treated with a single 50-μL ITV injection ranging from 0.01 to 0.75 endotoxin units/eye (EU/eye) and monitored for up to 42 days post treatment. Ophthalmic examination included slit-lamp biomicroscopy and indirect ophthalmoscopy. Laser flare photometry was performed in a subset of animals. On days 2, 8, 16, and 43, a subset of animals was necropsied and eyes processed for histopathological evaluation.
RESULTS: Intravitreal injection of endotoxin at ≥0.05 EU/eye resulted in a dose-related anterior segment inflammation response. No aqueous flare or cell response was noted in the 0.01 EU/eye dose group. A more delayed posterior segment response characterized by vitreal cell response was observed beginning on day 5, peaking on day 9, and decreasing starting on day 16 that persisted at trace to a level of 1+ on day 43. Microscopy findings of infiltrates of minimal mixed inflammatory cells in the vitreous and subconjunctiva and proteinaceous fluid in the anterior chamber and/or vitreous were observed in eyes given ≥0.1 EU/eye.
CONCLUSIONS: We defined the NOEL for ITV endotoxin to be 0.01 EU/eye, suggesting that the vitreal cavity is more sensitive to the effects of endotoxin than the anterior segment and aqueous chamber. These data highlight the importance of assessing endotoxin level in intravitreal formulations, as levels as low as 0.05 EU/eye may confound the safety evaluations of intravitreal therapeutics in rabbits.
PMID:28282486 | DOI:10.1167/iovs.16-21356
The SPOTS system: an ocular scoring system optimized for use in modern preclinical drug development and toxicology
Journal of Ocular Pharmacology and Therapeutics, 33(10), pp.718-734
Calibration of the TonoVet and Tono‐Pen Vet tonometers in the porcine eye
Veterinary ophthalmology, 20(6), pp.571-573
Preliminary tolerability of iPSC-Derived RPE on PLGA scaffold implantation in RNU Nude Rats
American Society of Gene & Cell Therapy Annual Meeting. Mol Ther; 25(5S1)
Evaluation of potential risk factors for development of primary angle-closure glaucoma in Bouviers des Flandres
J Am Vet Med Assoc. 2017 Jan 1;250(1):60-67. doi: 10.2460/javma.250.1.60.
OBJECTIVE To evaluate potential risk factors for development of primary angle-closure glaucoma (PACG) in Bouviers des Flandres. DESIGN Prospective, observational study. ANIMALS 98 Bouviers des Flandres. PROCEDURES All dogs underwent slit-lamp biomicroscopy, indirect ophthalmoscopy, gonioscopy, applanation tonometry, streak retinoscopy, and A-scan, B-scan, and high-resolution ultrasonography. Iridocorneal angles and degree of pectinate ligament dysplasia sheeting were graded, and an angle index was mathematically derived for each eye on the basis of these values. Ciliary clefts evaluated by high-resolution ultrasonography were classified as open, narrow, or closed. Owners were contacted by telephone 7 to 9 years after the initial examination to determine whether dogs had a subsequent diagnosis of PACG. Relationships between previously recorded variables and the development of PACG were evaluated by logistic regression methods. Available pedigrees were reviewed to assess genetic relationships among affected dogs. RESULTS 9 of 92 (9.8%) dogs with follow-up information available developed PACG. An angle index < 1 and presence of a narrow or closed ciliary cleft in 1 or both eyes were each significantly associated with development of PACG. Odds of developing PACG for dogs with an angle index < 1 (indicating marked reduction in outflow capacity through the iridocorneal angle), a narrow or closed ciliary cleft in > 1 eye, or both findings were 13, 20, and 28 times those for dogs that did not have these findings, respectively. All dogs that developed PACG shared 1 common male sire or grandsire. CONCLUSIONS AND CLINICAL RELEVANCE Several anatomic factors were significant risk factors for development of PACG in this population of dogs. Results also suggested a genetic component for the disease.
PMID:28001106 | DOI:10.2460/javma.250.1.60
Calibration of the TonoVet and Tono-Pen Vet tonometers in the porcine eye
Vet Ophthalmol. 2017 Nov;20(6):571-573. doi: 10.1111/vop.12445. Epub 2016 Nov 24.
OBJECTIVE: The pig has an increasingly important role in ocular drug delivery models, but the most accurate tonometer in this species is unknown. The purpose of this study was to evaluate the accuracy of TonoVet and Tono-Pen Vet tonometers in the ex vivo porcine eye.
PROCEDURE: Four freshly enucleated normal porcine eyes were cannulated with two 25-gauge needles; one connected via tubing to a mercury manometer calibrated continuous physiologic recorder and the other connected to a reservoir of lactated Ringer's solution on an adjustable stand. Triplicate IOP readings were taken with the TonoVet and then the Tono-Pen Vet at 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80 mmHg.
RESULTS: Linear regression showed strong linear trends for both the TonoVet (r2 = 0.969) and Tono-Pen Vet (r2 = 0.983). The TonoVet slightly underestimated IOP at lower pressures and slightly overestimated IOP at higher pressures (y = 1.092x - 4.0, where y = tonometer reading, x = manometer reading, and 4.0 = intercept). The Tono-Pen Vet consistently underestimated IOP (y = 0.773x - 2.1). These differences were statistically significant (P = <0.001, one-way repeated-measures ANOVA).
CONCLUSION: As in other species, both the TonoVet and Tono-Pen Vet tonometers do not measure true IOP in the porcine eye; however, the TonoVet more closely approximated true IOP in the normal porcine eye than the Tono-Pen Vet and may be the tonometer of choice for this species.
PMID:27882675 | DOI:10.1111/vop.12445
Bilateral Uveitis and Hyphema in a Catalina Macaw (Ara ararauna × Ara macao ) With Multicentric Lymphoma
J Avian Med Surg. 2016 Jun;30(2):172-8. doi: 10.1647/2015-105.
A 20-year-old, female Catalina macaw (Ara ararauna × Ara macao ) was presented with bilateral uveitis and hyphema. The hyphema initially improved with 0.12% prednisolone acetate ophthalmic drops (1 drop OU q4h for 7 days), but the hyphema recurred after the drops were tapered. The bird subsequently developed inappetance, weight loss, regurgitation, and lethargy and was euthanatized 24 days after initial presentation. Necropsy revealed marked splenomegaly and hepatomegaly, with significant mucosal ulcerations of the proventriculus and petechiation associated with both kidneys. Histopathologic examination revealed multicentric lymphoma, with neoplastic cells observed in ocular, splenic, hepatic, renal, proventricular, intestinal, pancreatic, and choanal tissue. Neoplastic lymphocytes effaced the iris, ciliary body, and the choroid of the eyes, and neoplastic lymphocytes were attached to the corneal endothelium and infiltrated the sclera, episclera, and conjunctivae. Immunohistochemical results indicated that the neoplastic lymphocytes were CD3(+) and CD79a(-), which is consistent with T-cell lymphoma.
PMID:27315386 | DOI:10.1647/2015-105
Human ex-vivo action potential model for pro-arrhythmia risk assessment
J Pharmacol Toxicol Methods. 2016 Sep-Oct;81:183-95. doi: 10.1016/j.vascn.2016.05.016. Epub 2016 May 25.
While current S7B/E14 guidelines have succeeded in protecting patients from QT-prolonging drugs, the absence of a predictive paradigm identifying pro-arrhythmic risks has limited the development of valuable drug programs. We investigated if a human ex-vivo action potential (AP)-based model could provide a more predictive approach for assessing pro-arrhythmic risk in man. Human ventricular trabeculae from ethically consented organ donors were used to evaluate the effects of dofetilide, d,l-sotalol, quinidine, paracetamol and verapamil on AP duration (APD) and recognized pro-arrhythmia predictors (short-term variability of APD at 90% repolarization (STV(APD90)), triangulation (ADP90-APD30) and incidence of early afterdepolarizations at 1 and 2Hz to quantitatively identify the pro-arrhythmic risk. Each drug was blinded and tested separately with 3 concentrations in triplicate trabeculae from 5 hearts, with one vehicle time control per heart. Electrophysiological stability of the model was not affected by sequential applications of vehicle (0.1% dimethyl sulfoxide). Paracetamol and verapamil did not significantly alter anyone of the AP parameters and were classified as devoid of pro-arrhythmic risk. Dofetilide, d,l-sotalol and quinidine exhibited an increase in the manifestation of pro-arrhythmia markers. The model provided quantitative and actionable activity flags and the relatively low total variability in tissue response allowed for the identification of pro-arrhythmic signals. Power analysis indicated that a total of 6 trabeculae derived from 2 hearts are sufficient to identify drug-induced pro-arrhythmia. Thus, the human ex-vivo AP-based model provides an integrative translational assay assisting in shaping clinical development plans that could be used in conjunction with the new CiPA-proposed approach.
PMID:27235787 | PMC:PMC5042841 | DOI:10.1016/j.vascn.2016.05.016
α-Conotoxin Vc1.1 inhibits human dorsal root ganglion neuroexcitability and mouse colonic nociception via GABA<sub>B</sub> receptors
Gut. 2017 Jun;66(6):1083-1094. doi: 10.1136/gutjnl-2015-310971. Epub 2016 Feb 17.
OBJECTIVE: α-Conotoxin Vc1.1 is a small disulfide-bonded peptide from the venom of the marine cone snail Conus victoriae. Vc1.1 has antinociceptive actions in animal models of neuropathic pain, but its applicability to inhibiting human dorsal root ganglion (DRG) neuroexcitability and reducing chronic visceral pain (CVP) is unknown.
DESIGN: We determined the inhibitory actions of Vc1.1 on human DRG neurons and on mouse colonic sensory afferents in healthy and chronic visceral hypersensitivity (CVH) states. In mice, visceral nociception was assessed by neuronal activation within the spinal cord in response to noxious colorectal distension (CRD). Quantitative-reverse-transcription-PCR, single-cell-reverse-transcription-PCR and immunohistochemistry determined γ-aminobutyric acid receptor B (GABABR) and voltage-gated calcium channel (CaV2.2, CaV2.3) expression in human and mouse DRG neurons.
RESULTS: Vc1.1 reduced the excitability of human DRG neurons, whereas a synthetic Vc1.1 analogue that is inactive at GABABR did not. Human DRG neurons expressed GABABR and its downstream effector channels CaV2.2 and CaV2.3. Mouse colonic DRG neurons exhibited high GABABR, CaV2.2 and CaV2.3 expression, with upregulation of the CaV2.2 exon-37a variant during CVH. Vc1.1 inhibited mouse colonic afferents ex vivo and nociceptive signalling of noxious CRD into the spinal cord in vivo, with greatest efficacy observed during CVH. A selective GABABR antagonist prevented Vc1.1-induced inhibition, whereas blocking both CaV2.2 and CaV2.3 caused inhibition comparable with Vc1.1 alone.
CONCLUSIONS: Vc1.1-mediated activation of GABABR is a novel mechanism for reducing the excitability of human DRG neurons. Vc1.1-induced activation of GABABR on the peripheral endings of colonic afferents reduces nociceptive signalling. The enhanced antinociceptive actions of Vc1.1 during CVH suggest it is a novel candidate for the treatment for CVP.
PMID:26887818 | PMC:PMC5532460 | DOI:10.1136/gutjnl-2015-310971
Species differences in the geometry of the anterior segment differentially affect anterior chamber cell scoring systems in laboratory animals
Journal of Ocular Pharmacology and Therapeutics 32(1), pp 28-37
Species Differences in the Geometry of the Anterior Segment Differentially Affect Anterior Chamber Cell Scoring Systems in Laboratory Animals
J Ocul Pharmacol Ther. 2016 Jan-Feb;32(1):28-37. doi: 10.1089/jop.2015.0071. Epub 2015 Nov 5.
PURPOSE: To determine the impact of anterior segment geometry on ocular scoring systems quantifying anterior chamber (AC) cells in humans and 7 common laboratory species.
METHODS: Using normative anterior segment dimensions and novel geometric formulae, ocular section volumes measured by 3 scoring systems; Standardization of Uveitis Nomenclature (SUN), Ocular Services On Demand (OSOD), and OSOD-modified SUN were calculated for each species, respectively. Calculated volumes were applied to each system's AC cell scoring scheme to determine comparative cell density (cells/mm(3)). Cell density values for all laboratory species were normalized to human values and conversion factors derived to create modified scoring schemes, facilitating interspecies comparison with each system, respectively.
RESULTS: Differences in anterior segment geometry resulted in marked differences in optical section volume measured. Volumes were smaller in rodents than dogs and cats, but represented a comparatively larger percentage of AC volume. AC cell density (cells/mm(3)) varied between species. Using the SUN and OSOD-modified SUN systems, values in the pig, dog, and cat underestimated human values; values in rodents overestimated human values. Modified normalized scoring systems presented here account for species-related anterior segment geometry and facilitate both intra- and interspecies analysis, as well as translational comparison.
CONCLUSIONS: Employment of modified AC cell scoring systems that account for species-specific differences in anterior segment anatomy would harmonize findings across species and may be more predictive for determining ocular toxicological consequences in ocular drug and device development programs.
PMID:26539819 | PMC:PMC4742968 | DOI:10.1089/jop.2015.0071
Clinical Signs and Diagnosis of the Canine Primary Glaucomas
Vet Clin North Am Small Anim Pract. 2015 Nov;45(6):1183-212, vi. doi: 10.1016/j.cvsm.2015.06.006.
The diagnosis of glaucoma is highly dependent on a working understanding of the clinical signs and available diagnostic procedures. Clinical signs may be attributable to increased intraocular pressure and/or complex alterations in the physiology or molecular biology of the anterior segment, retinal ganglion cells, and optic nerve. Many diagnostic procedures seek to more fully characterize these alterations and to identify which clinical features increase the risk of overt primary angle closure glaucoma (PACG) occurring. Considerable progress has been made in identifying the anatomic features that predispose an eye to PACG, and in elucidating the role of reverse pupillary block.
PMID:26456752 | PMC:PMC4862370 | DOI:10.1016/j.cvsm.2015.06.006
Functional and Structural Effects of Subretinal Dose Delivery in Mice
Investigative Ophthalmology & Visual Science, 56(7), pp.245-245
Evaluation of rebound tonometry in red-eared slider turtles (Trachemys scripta elegans)
Vet Ophthalmol. 2014 Jul;17(4):261-7. doi: 10.1111/vop.12114. Epub 2013 Nov 6.
OBJECTIVE: To evaluate feasibility and accuracy of intraocular pressure (IOP) measurement by rebound tonometry in adult red-eared slider turtles and determine the effects of manual and chemical restraint on IOP.
ANIMAL STUDIED: Seventeen adult red-eared slider turtles.
PROCEDURES: Intraocular pressure was measured with TonoLab® and TonoVet® tonometers in conscious, unrestrained turtles. To evaluate the effects of manual restraint, turtles were restrained by digital pressure on the rostral head or proximal neck. The effect of two chemical restraint protocols (dexmedetomidine, ketamine, midazolam [DKM] and dexmedetomidine, ketamine [DK] subcutaneously) on IOP was evaluated. Triplicate TonoLab® and TonoVet® readings were compared with direct manometry in three ex vivo turtle eyes.
RESULTS: TonoLab® correlated better with manometry at IOPs < 45 mmHg than TonoVet® (linear regression slopes of 0.89 and 0.30, respectively). Mean (±SD) IOP in unrestrained conscious turtles was significantly lower (P < 0.01) with TonoLab® (10.02 ± 0.66 mmHg) than with TonoVet® (11.32 ± 1.57 mmHg). Manual neck restraint caused a significant increase in IOP (+6.31 ± 5.59 mmHg), while manual rostral head restraint did not. Both chemical restraint protocols significantly reduced IOP (DKM: −1.0 ± 0.76 mmHg; DK: −1.79 ± 1.17) compared with measurements in conscious unrestrained turtles.
CONCLUSIONS: Chemical and manual neck restraint affected IOP. Rostral head restraint had no significant effect on IOP and is, therefore, recommended as the appropriate restraint technique in red-eared slider turtles. TonoLab® measurements estimated actual IOP more accurately, within physiologic range, than measurements obtained using the TonoVet®.
PMID:25097909 | PMC:PMC4124514 | DOI:10.1111/vop.12114
Investigation of ocular events associated with taprenepag isopropyl, a topical EP2 agonist in development for treatment of glaucoma
J Ocul Pharmacol Ther. 2014 Jun;30(5):429-39. doi: 10.1089/jop.2013.0222. Epub 2014 Apr 10.
PURPOSE: Taprenepag isopropyl is an EP2 receptor agonist that is in development for the treatment of glaucoma. Iritis, photophobia, and increased corneal thickness observed in a Phase 2 clinical trial with taprenepag isopropyl were not previously observed in topical ocular toxicity studies in rabbits and dogs. In vivo studies using cynomolgus monkeys and in vitro models were used to elucidate the mechanisms underlying these ocular events.
METHODS: Monkeys were dosed daily for 28 days in 1 eye with taprenepag and in the other with vehicle control. Complete ophthalmic examinations were performed at baseline and weekly thereafter. Serial sections of eyes were examined histopathologically at the end of the study. Recovery after the discontinuation of taprenepag was assessed for 28 days in the monkeys in the high-dose group. In vitro studies evaluated cell viability, paracellular permeability, and cytokine induction with human corneal epithelial or endothelial cell cultures.
RESULTS: Monkeys demonstrated a dose-related incidence of iritis and increased corneal thickness that resolved within 28 days of discontinuing taprenepag. There was no evidence in vivo of taprenepag toxicity to the corneal endothelium or epithelium. Cell viability of stratified epithelial cells was primarily affected by excipients and was similar to Xalatan(®). The viability of HCEC-12 cells was not affected by taprenepag at concentrations up to 100 μM.
CONCLUSIONS: The lack of in vivo or in vitro endothelial cytotoxicity and the reversibility of the increase in corneal thickness and iritis in the monkey provide confidence to permit further clinical development of taprenepag.
PMID:24720348 | DOI:10.1089/jop.2013.0222
Iridocorneal angle measurements in mammalian species: normative data by optical coherence tomography
Veterinary ophthalmology, 16(2), pp.163-166
The effect of topical latanoprost on anterior segment anatomic relationships in normal dogs
Vet Ophthalmol. 2013 Sep;16(5):370-6. doi: 10.1111/vop.12011. Epub 2012 Dec 10.
OBJECTIVE: Topical latanoprost 0.005% is commonly used in dogs with primary angle closure glaucoma (PACG), and marked miosis has been reported in the literature. To further explore the effect of topical latanoprost on anterior segment anatomy, we performed iridocorneal angle biometrics in normal beagle dogs.
METHODS: Thirty-five normal female beagle dogs were assessed using anterior segment optical coherence tomography (AS-OCT). One eye of each dog was scanned with the AS-OCT in the superotemporal quadrant. One drop of latanoprost 0.005% was applied topically, and the OCT scan was repeated 30 min later. Images were imported into ImageJ, and pupil diameter, anterior chamber angle, angle opening distance, angle recess area (ARA), anterior chamber hemifield, and anterior chamber depth were measured.
RESULTS: A single drop of latanoprost resulted in marked miosis, anterior bowing of the peripheral iris, narrowing of the iridocorneal angle, and shallowing of the anterior chamber. The anterior segment parameters demonstrated a significant reduction (P-value ≤ 0.001) from baseline following latanoprost with the exception of the ARA (P = 0.07).
CONCLUSIONS: Latanoprost significantly decreases pupil diameter and narrows the iridocorneal angle in normal female beagle dogs. Therefore, the utility of latanoprost as a prophylactic treatment for PACG in fellow eyes may be limited. Studies using quantitative iridocorneal angle measurements in goniodysgenic dogs are warranted to understand the changes in iridocorneal angle morphology that occur in PACG in response to topical application of latanoprost.
PMID:23227993 | DOI:10.1111/vop.12011
Iridocorneal angle measurements in mammalian species: normative data by optical coherence tomography
Vet Ophthalmol. 2013 Mar;16(2):163-6. doi: 10.1111/j.1463-5224.2012.01030.x. Epub 2012 May 22.
Objective Gonioscopy provides limited quantitative information to compare the iridocorneal anatomy across different species. In addition, the anatomic relationships by histologic examination are altered during processing. As a result, the comparative anatomy of the iridocorneal angle across several mammalian species was evaluated by Optical Coherence Tomography (OCT). Methods Cats, beagle dogs, minipigs, owl monkeys, cynomolgus monkeys, and rhesus monkeys (n = 6 or 7 per species) were evaluated. Imaging was performed using the OCT. The anterior chamber angle (ACA), angle opening distance (AOD), and the angle recess area (ARA) were evaluated. Results AC angle: cat (63 ± 6°) > owl monkey (54 ± 4°) > beagle dog (42 ± 4°) > minipig (40 ± 3°) > rhesus monkey (36 ± 1°) > cynomolgus monkey (34 ± 2°). AOD: cat (3.3 ± 0.5 mm) > owl monkey (2.05 ± 0.2 mm) > beagle dog (1.08 ± 0.1 mm) > rhesus monkey (0.92 ± 0.06 mm) > minipig (0.64 ± 0.04 mm) > cynomolgus monkey (0.43 ± 0.03 mm). ARA: cat (3.5 ± 0.1 mm(2) ) > owl monkey (1.41 ± 0.2 mm(2) ) > dog (0.88 ± 0.1 mm(2) ) > rhesus monkey (0.62 ± 0.06 mm(2) ) > minipig (0.21 ± 0.05 mm(2) ) > cynomolgus monkey (0.15 ± 0.01 mm(2) ). Conclusions This study benchmarks the normative iridocorneal angle measurements across different mammalian species by OCT. These data can be useful to compare iridocorneal angle measurements in disease states as OCT evolves as a common diagnostic tool in veterinary ophthalmic research and practice.
PMID:22612298 | DOI:10.1111/j.1463-5224.2012.01030.x
Topical application of 0.005% latanoprost increases episcleral venous pressure in normal dogs
Vet Ophthalmol. 2012 Mar;15 Suppl 1:71-8. doi: 10.1111/j.1463-5224.2011.00970.x. Epub 2011 Nov 30.
INTRODUCTION: Episcleral venous pressure (EVP) has an important role in intraocular pressure (IOP) homeostasis and accounts for more than 70% of the IOP in the normal dog. A frequently used species in glaucoma research is the normotensive dog especially when evaluating the efficacy of prostaglandin analogues and prostamides; however, aqueous humor dynamic studies in normal dogs are lacking, and the effect of 0.005% latanoprost on canine EVP is not known. We sought to determine the effects to the EVP of topically applied 0.005% latanoprost in the normotensive beagle dog.
METHODS: Female beagle dogs (n = 14) were used and each had a normal ophthalmic examination on study entry. EVP was determined using a standard episcleral venomanometer. Animals were dosed in one eye with 0.005% latanoprost, and the effects on EVP were compared with the averaged baseline EVP's determined in the predosing phase and the fellow nondosed eye. The Mixed Model Repeated Measures method was used to analyze the EVP data.
RESULTS: During the dosing phase of the study with topical 0.005% latanoprost, the mean EVPs of dosed eyes were significantly higher than that of nondosed eyes (P < 0.0001).
CONCLUSIONS: The increase in EVP in the dog with exposure to topical 0.005% latanoprost has not been observed in other species that have been studied, such as in the mouse and in humans, where the drug had no significant effect on the EVP. This response may be unique to dogs and suggests that dogs may not fully mimic human aqueous humor dynamics with topical 0.005% latanoprost. Although frequently performed in human studies, EVP should not be regarded to be a constant value in aqueous humor dynamic studies in the normal beagle dog.
PMID:22129101 | DOI:10.1111/j.1463-5224.2011.00970.x
Subretinal Administration of Fluorescent Microspheres in the Minipig
Investigative Ophthalmology & Visual Science, 52(14), pp.1358-1358.
Safety And Tolerability Of Retinostat®, A Lentiviral-vector Based Gene Therapy Product For The Treatment Of Wet Age-related Macular Degeneration, In Rabbits And Monkeys
Investigative Ophthalmology & Visual Science, 52(14), pp.488-488
Commotio retinae and paraocular gland necrosis in rabbits associated with medial ear artery catheters
Investigative Ophthalmology & Visual Science, 52(14), pp.4070-4070
Continuous Monitoring of Intraocular Pressure in New Zealand White Rabbits Using Telemetry
Toxicologist Supplement (2009)
Ocular inflammation in cynomolgus macaques following intravenous administration of a human monoclonal antibody
International journal of toxicology, 28(1), pp.5-16
Prevention of Laser Photocoagulation Induced Choroidal Neovascularization Lesions by Intravitreal Doses of Ranibizumab in Cynomolgus Monkeys
Invest Ophthalmol Vis Sci, – electronic abstract (2009)
Evaluation of EIAV Based Lentiviral Vectors Following Ocular Delivery in the Nonhuman Primate Model: Development of RetinoStat®
Investigative Ophthalmology & Visual Science, 49(13), pp.5340-5340
Pachymetry in New Zealand White Rabbits, Beagle Dogs, and Cynomolgus Monkeys.
Investigative Ophthalmology & Visual Science, 49(13), pp.645-645
Corneal endothelial cell density measurements using noncontact specular microscopy in rabbits, dogs and monkeys
Investigative Ophthalmology & Visual Science, 49(13), pp.2819-2819
Standardized Full-Field Electroretinography in Cynomolgus Monkeys
Investigative Ophthalmology & Visual Science, 49(13), pp.5816-5816
Safety evaluation of intravitreal administration of VEGF trap in cynomolgus monkeys for 13 weeks.
Investigative Ophthalmology & Visual Science, 47(13), pp.1751-1751.
Evaluation of intra-and interobserver reliability and image reproducibility to assess usefulness of high-resolution ultrasonography for measurement of anterior segment structures of canine eyes
American journal of veterinary research, 66(10), pp.1775-1779.
26-Week Intravitreal Injection Toxicity Study with rhuFab VEGF in Cynomolgus Monkeys with an 8-Week Recovery
Association for Research in Vision and Ophthalmology Annual Meeting. Invest Ophthalmol Vis Sci., 44 – electronic abstract (2003).
Safety Evaluation of Differing Schedules of Intravitreal Administration of rhuFab VEGF in Cynomolgus Monkeys for 2 Months
Toxicologist, 60 (1):97 (2001).
Safety Evaluation of Intravitreal Administration of rhuFab VEGF in Cynomolgus Monkeys for 3 Months
Invest Ophthalmol Vis Sci, 41 (4):S142 (2000).