Infantile hemangiomas (IHs), benign vascular lesions present on the surface of the skin of children, are treated with systemic or topical beta-adrenergic antagonists (known as “beta-blockers”). However, systemic beta-blocker therapy is associated with serious adverse events in pediatric patients, and there are currently no topical formulations optimized for the skin. The objectives of this work were to 1) evaluate the local skin concentrations and drug permeation through the skin using novel beta-blocker formulations, and 2) characterize the epidermal properties and skin surface inflammatory mediators of IH skin. Skin concentrations and drug permeation through the skin from current topical treatment options were quantified in vitro; these data served as benchmarks to which other treatment paradigms in later studies were compared. Microneedle (MN)-mediated delivery of two beta-blockers, propranolol and timolol, was evaluated in vitro using solid MNs and two dissolving MN array formulations. Solid MNs increased skin concentrations of timolol compared to intact skin, while producing similar skin concentrations of propranolol. Drug permeation through the skin was increased for both drugs after MN pretreatment. Both formulations of dissolving MN arrays were ineffective at increasing local skin concentrations compared to intact skin. This was likely due to the small loading capacity of drug into the array. Drug-loaded microemulsions (ME) of varying composition were formulated and characterized. All ME formulations had solubilization properties, and water rich MEs had the greatest cumulative release through a homogenous membrane compared to surfactant rich MEs. Drug-loaded MEs did not increase local skin concentrations in vitro compared to a drug solution; however, water rich ME formulations produced greater skin-to-receiver ratio of drug concentration, indicating their potential for skin accumulation. MN pretreatment increased the skin-to-receiver ratios for surfactant rich formulations but not for water rich formulations, indicating this enhancement in skin retention after MN pretreatment is formulation dependent. These results demonstrate the potential for topical treatment of IHs upon further optimization of delivery and formulation parameters. The epidermal properties and skin surface mediators of IH skin were compared to normal, unaffected skin. Significant differences in barrier function and color, as well as chemokine and growth factor concentrations, were observed between the two sites. These results provide a greater understanding of the IH properties that have previously not been quantified. Similar changes in lesion color, which correlate to efficacy, were observed after beginning treatment with oral propranolol or topical timolol, while changes in barrier function were similar between the two treatment groups. These results indicate topical timolol may be a safe alternative for systemic treatment for superficial IHs without a loss of efficacy.

Clinical trial simulation (CTS) and modelling are techniques which play an important role in clinical pharmacology and drug development. The goal of this thesis is to apply techniques in CTS and modelling for studying disease progression and the pharmacokinetics and pharmacodynamics of levodopa in Parkinson's disease. Three components of levodopa response can be identified in patients with Parkinson's disease; a transient short-duration response, a sustained long-duration response to exogenous levodopa, and diurnally varying endogenous levodopa synthesis. A pharmacokinetic-pharmacodynamic model was developed to describe the individual components of levodopa response. Twenty-one previously untreated (de novo) patients with Parkinson's disease and 12 patients who had received levodopa orally for 9.7 ± 4.0 years were investigated. Twenty de novo patients were examined at 6, 12, 24 and 48 months. No systematic changes in levodopa pharmacokinetics were found in the first 4 years of long-term levodopa treatment. A lowered baseline motor response and an increase in efficacy with time result in an exaggerated short-duration response which might be key contributors to the development of motor fluctuations with long-term levodopa treatment. The capability of CTS to generate typical responses was evaluated. If progression rate of bradykinesia is influenced by age then it should be possible to detect this effect using reasonable clinical trial designs. The ELLDOPA trial aims to determine if levodopa slows or accelerates the rate of disease progression of Parkinson's disease. The power of the ELLDOPA trial design was evaluated using a clinical pharmacology model. The simulation results suggested that the short washout period for levodopa symptomatic effect could lead to a false conclusion about the nature of the levodopa treatment effect. This thesis has shown that pharmacodynamic or disease progression factors rather than pharmacokinetic changes are responsible for the development of motor fluctuations in Parkinson's disease. It has quantified the unexpected development of increased efficacy of levodopa over time. Clinical trials designed to evaluate disease progression without recognising washout of the long-duration response of levodopa can lead to misinterpretation of trial outcomes. However, model based approaches can disentangle these confounding factors and dissect the underlying effects of drug action on disease progression.

A number of studies have demonstrated directed migration of neural progenitor cells to sites of brain injury and disease. However, a detailed examination of when a cell is “born” in relation to injury induction and the migratory response of that cell has not previously been determined. This study therefore examined the temporal correlation between progenitor cell proliferation (“birth”) and neuroblast migratory response into the damaged striatum following quinolinic acid (QA) lesioning of the adult rat striatum. Retroviral labeling of subventricular zone (SVZ)–derived progenitor cells demonstrated that cell loss in the QA-lesioned striatum increased progenitor cell migration through the rostral migratory stream for up to 30 days. In addition, a population of dividing cells originating from the SVZ generated doublecortin positive neuroblasts that migrated into the damaged striatum in response to cell loss invoked by the QA lesion. The majority of doublecortin positive neuroblasts present in the damaged striatum were generated from progenitor cells dividing within two days prior to, or on the day of QA lesioning. In contrast, cells dividing two or more days following QA lesioning, migrated into the striatum and exhibited a glial phenotype. These results demonstrate that directed migration of SVZ-derived cells and neuroblast differentiation in response to QA lesioning of the striatum is acute and transient. We subsequently demonstrated a role for the chemokines MCP-1, MIP-1α and GRO-α in directing adult SVZ-derived progenitor cell migration following striatal cell death. MCP-1, MIP-1α and GRO-α were significantly upregulated in the striatum 2-3 days following QA-induced lesioning, correlating with maximum SVZ-derived progenitor cell recruitment into the lesioned striatum. We established that SVZ-derived progenitor cells express receptors for each chemokine, and demonstrated MCP-1, MIP-1α and GRO-α to be potent chemoattractants for SVZ-derived progenitor cells in vitro. Immunofluorescence revealed MCP-1, MIP-1α and GRO-α are predominantly expressed in the striatum by NG2-positive cells that appear to infiltrate from the bloodstream 6 hours following QA lesioning. These results indicate that upregulation of MCP-1, MIP-1α, GRO-α following striatal cell death leads to chemoattraction of SVZ-derived progenitor cells into the damaged striatum and raises a potential role for blood-derived cells in directing the recruitment of SVZ progenitor cells following brain injury. / Whole document restricted, but available by request, use the feedback form to request access.

Mon sujet de thèse repose sur une observation initiale réalisée sur le panel de 60 lignées cellulaires tumorales humaines du National Cancer Institute (NCI) et concerne des polymorphismes de gènes impliqués dans la réponse aux agents anticancéreux, les gènes ERCC2 et ERCC5 ( à l'origine des protéines XPD et XPG) qui interviennent dans la réparation de l'ADN par le mécanisme du Nucléotide Excicion Repair (NER). Nous avons identifié une association entres ces polymorphismes et la cytotoxicité in vitro d'agents anticancéreux, en particulier celle des taxanes. A partir de ce travail initial, nos recherches se sont établies dans deux directions : (1) une approche clinique visant à chercher un lien significatif entre ces deux polymorphismes et la sensibilité aux taxanes chez des patients traités par chimiothérapie; (2) une approche biochimique visant à comprendre les mécanismes moléculaires expliquant l'association entre ces deux polymorphismes et la sensibilité cellulaire aux taxanes. Ce travail a permis de montrer que le niveau d'expression de ERCC2 modifié par le polymorphisme du codon 751, ainsi que la variation protéique entrainée par le polymorphisme du codon 1104 de ERCC5, étaient impliqués dans la régulation du cycle cellulaire par modification de l'activité CDK1. La réponse au paclitaxel se trouve ainsi modifiée du fait de ce mécanisme. A défaut d'être définitifs, nos résultats de l'étude clinique sont encourageants et montrent une tendance à une probabilité de réponse plus élevée chez les patientes de génotype ERCC2 homozygote variant et chez les patientes de génotype ERCC5 homozygote sauvage ou hétéroygote lorsque la chimiothérapie contient un taxane, le docetaxel.

Au cours de la dernière décennie, les radiotraceurs peptidiques sont devenus importants en Médecine Nucléaire pour le diagnostic et/ou la thérapie. Le développement de ces radiopharmaceutiques nécessite la recherche de nouveaux vecteurs spécifiques mais aussi leur évaluation physico-chimique et pharmacologique après radiomarquage.<br />Ces travaux concernent la mise au point et l'optimisation du radiomarquage au technetium-99m, à l'indium-111 et à l'iode-125 de nouveaux radiotraceurs peptidiques, destinés à l'imagerie in vivo de deux processus pathologiques : la néoangiogenèse tumorale et la plaque d'athérome vulnérable, et au suivi de la thérapie d'une maladie autoimmune : le lupus érythémateux disséminé. Le radiomarquage au technétium a été effectué par l'intermédiaire d'un petit synthon tricarbonyle (Isolink), l'indium a été fixé par une macromolécule DOTA et la radioiodation a été réalisée par substitution électrophile. Les paramètres de chaque réaction ont été définis afin que la réaction de marquage présente un haut rendement et une haute activité spécifique. Les réactions sont rapides et reproductibles et la mise en forme compatible avec une utilisation in vivo. Les propriétés physico-chimiques et pharmacologiques (lipophilie, stabilité de marquage in vitro et in vivo, fixation protéique, métabolisation et biodistribution) ont été mesurées. Ces études ont permis de sélectionner les radioligands présentant les meilleurs critères pour une utilisation in vivo en imagerie.

La stabilisation des émulsions peut être assurée par des particules solides plutôt qu'avec des molécules d'émulsifiant. Les émulsions stabilisées par des particules solides sont aussi appelées “les émulsions de Pickering”. Ce travail est divisé en deux parties : <br />1) l'étude des aspects physico-chimiques des émulsions ; 2) l'évaluation des émulsions stabilisées par des solides pour l'application cutanée. <br />Les émulsions ont été stabilisées avec des nanoparticules de silice de caractère hydrophobe varié. Les émulsions huile-dans-eau obtenues avec de la silice partiellement hydrophobe ont été caractérisées en termes de stabilité, rhéologie et de quantité optimale de particules nécessaires pour la stabilisation. Les particules de silice hydrophile stabilisent les émulsions H/E avec des huiles très polaires. Le rôle de l'agrégation des particules en présence d'huile et d'électrolyte dans la stabilisation des émulsions a été souligné. Dans un deuxième temps, nous avons étudié l'absorption de principes actifs dans la peau, à partir des émulsions de Pickering, et nous avons comparé les résultats avec les émulsions classiques stabilisées par les tensioactifs. Les émulsions H/E et E/H avec des principes actifs modèles (rétinol comme molécule lipophile et caféine comme molécule hydrophile) ont été étudiées en terme d'absorption dans la peau. L'absorption des principes actifs a été significativement différente pour les émulsions stabilisées par des particules solides et pour les émulsions stabilisées par des molécules de tensioactif. Les émulsions de Pickering constituent une nouvelle formulation pour l'application cutanée.

Les Leishmanioses du nouveau monde sont des parasitoses aux conséquences socio-économiques lourdes. En effet les traitements disponibles requièrent pour la plus part des administrations parentérales et sont coûteux pour les populations concernées. La recherche de nouvelles molécules actives est donc une nécessité. Pour contribuer à l'effort de recherche d'alternative thérapeutiques, nous nous sommes intéressés d'une part aux pharmacopées traditionnelles de populations vivant en zone d'endémie (deux ethnies de l'Amazonie péruvienne : Chayahuita et Yanesha) et d'autre part, nous avons également étudiés l'activité de drogues synthétisées sur la base de molécules ayant un certain degré d'activité antiparasitaire. Nous avons également contribué à l'amélioration éthique de nos modèles biologiques afin d'optimiser le criblage de composés leishmanicides potentiels en développant un modèle remplaçant l'utilisation de souris pour l'extraction de macrophages par des cellules Thp1.

<p>Thrombosis is associated with the occlusion of a blood vessel and can be triggered by a number of types of injury, such as the rupture of an atherosclerotic plaque on the artery wall, changes in blood composition, or blood stasis. The resulting thrombosis can cause major diseases such as myocardial infarction, stroke, and venous thromboembolic disorders that, collectively, account for the most common cause of death in the developed world. Anticoagulants are used to treat and prevent these thrombotic diseases in a number of clinical and surgical settings. Although commonly prescribed, currently approved anticoagulants have a major limitation of severe drug-induced bleeding that contributes to the high levels of morbidity and mortality associated with use. The "holy grail" for antithrombotic therapy is to identify a drug that inhibits thrombus formation without promoting bleeding. Understanding the differences between thrombosis and hemostasis in the vascular system is critical to developing these safe and effective anticoagulants, as this depends on striking the correct balance between inhibiting thrombus formation (efficacy) and reducing the risk of severe bleeding (safety). While it is commonly thought that the same factors play a similar role in hemostasis and thrombosis, recent evidence points to differing functions for FXI and FXII in each of these settings. Importantly, these factors seem to contribute to pathological thrombus formation without being involved in normal hemostasis.</p><p> The overall goal of this project was to evaluate the inhibition of the intrinsic pathway of coagulation as a potential anticoagulant strategy utilizing the aptamer platform. Aptamers are short, highly structured nucleic acids that act as antagonists by binding to large surface areas on their target protein and thus tend to inhibit protein-protein interactions. High affinity binding aptamers have been isolated that specifically target a diverse range of proteins, including transcription factors, proteases, viral proteins, and growth factors, as well as other coagulation factors. As synthetic molecules, aptamers have a small molecular weight, are highly amenable to modifications that can control their bioavailability, and have not been found to elicit an immune response, thus making them ideal drug candidates. Importantly, aptamers can be rapidly and effectively reversed with either a sequence specific antidote that recognizes the primary sequence of the aptamer or a universal antidote that binds to their backbone and reverses all aptamer activity independent of sequence. This ability lends itself well to their therapeutic application in coagulation, as rapid reversal of a drug upon the onset of bleeding is a key property for increasing the safety of this class of drugs.</p><p> Aptamers targeting FXI/FXIa and FXII/FXIIa were isolated in two separate SELEX (systematic evolution of ligands by exponential enrichment) procedures: the FXII aptamer was isolated in a convergent SELEX approach and the FXIa aptamer was isolated from a purified protein selection. In both processes, 2'fluoropyrimindine modified RNA with a 40-nucleotide random region was incubated with either the plasma proteome (in initial rounds of the convergent SELEX) or the purified protein target (FXII or FXIa). The nucleic acids that did not bind to the target were separated from those that bound, and these molecules were then amplified to generate an enriched pool with increased binding affinity for the target. This process was repeated under increasingly stringent conditions to isolate the aptamer that bound with the highest affinity to the purified target protein. Utilizing biochemical and in vitro coagulation assays, specific, high-affinity binding and functional anticoagulant aptamers were identified for both protein targets, and the mechanism of anticoagulation was ascertained for each aptamer. </p><p> Overall, both aptamers bound to an exosite on their target protein that was able to inhibit downstream activation of the next protein in the coagulation cascade. In order to specifically examine aptamer effects on several parameters of thrombin generation, a new assay was developed and fully characterized using aptamer anticoagulants targeting other coagulation factors. Aptamer inhibition of both FXI and FXII was able to decrease thrombin generation in human plasma. However, limited cross-reactivity in other animal species by both aptamers hindered our ability to assess aptamer inhibition in an in vivo setting. Moving forward, screening aptamers against a larger selection of animal plasmas will hopefully allow us to identify an animal species in which we can analyze aptamer inhibition of the intrinsic pathway for effectiveness and safety in inhibiting thrombosis. The further characterization and use of these aptamers in plasma and blood based settings will allow us to study the diverging functions of the intrinsic pathway in thrombosis and hemostasis.</p><p> A critical need exists for safe and effective anticoagulants to treat and prevent numerous thrombotic procedures and diseases. An ideal anticoagulant is one that strikes the correct balance between inhibiting thrombus formation and reducing drug-induced bleeding. Inhibition or depletion of factors XI and XII of the intrinsic pathway of coagulation have shown reduced thrombus formation without interruption of normal hemostasis in several models of thrombosis. By developing novel RNA aptamer anticoagulants to these factors, we have set the stage for evaluating the net therapeutic benefit of intrinsic pathway inhibition to effectively control coagulation, manage thrombosis, and improve patient outcome. As well as developing a safe anticoagulation, these agents can lead to important biological discoveries concerning the fundamental difference between hemostasis and thrombosis.</p> / Dissertation

The UPPER (Unified Physicochemical Property Estimation Relationships) model uses additive and non-additive parameters to estimate 21 biologically and environmentally important physicochemical properties of organic compounds. Thermodynamically sound relationships are used to predict boiling and melting points, aqueous and octanol solubilities, vapor pressure and the air-octanol, air-water and octanol-water partition coefficients. These properties determine the distribution and fate of organic compounds in biological and environmental systems. The model has been validated on a data set of 2000 hydrocarbons and polyhalogenated hydrocarbons, provides a simple and accurate method to predict the properties studied.

Preformulation studies of two naturally occurring compounds, sulforaphane and myricetin, are presented. Both compounds have shown promise as chemoprevention agents throughout the literature. Despite this evidence, minimal information is available to guide the progression of formulations designed for future drug development. The presented work describes solubility, stability, and solid-state characterization of these compounds. Additionally, a mathematical model based on the ideal solubility equation, which reasonably estimates the solubility of a hydrate is described. This model accounts for the dehydration energetics of the solute as it transforms from hydrate to anhydrous prior to melting and conversion to a hypothetical super-cooled liquid (HSL). This model will lend itself to the appreciation of the solubility differences that can exist between hydrate and anhydrous drug forms. By improving the accuracy of solubility estimation, drug development studies involving hydrates can be designed more accurately.