Idiosyncratic drug reactions (IDRs) represent a significant medical problem and pose a great challenge to drug development. Circumstantial evidence suggests that, in most cases, reactive metabolites of the drug are responsible. The major focus of this thesis is the identification of reactive metabolites and the synthesis of analogs required to test several hypotheses related to involvement of metabolism and covalent binding in the mechanisms of IDRs. Minocycline is unique among tetracyclines in causing a significant incidence of a lupus-like syndrome and autoimmune hepatitis. In this study, we demonstrated that minocycline is oxidized to reactive intermediates by myeloperoxidase/H2O2/Cl-, HOCl, horseradish peroxidase/H2O2, or hepatic microsomes. When trapped with N-acetylcysteine (NAC), two adducts with protonated molecular ions at m/z 619 were isolated and analyzed by NMR. One represents attack of the aromatic D ring by NAC meta to the N, N-dimethylamino group, implying that the reactive intermediate was a quinone iminium ion. The other adduct, which was not observed when minocycline was oxidized by hepatic microsomes, indicates that the NAC is attached at the junction of the B and C rings, suggesting that the HOCl added across the double bond of the B ring leading to a reactive molecule, and then NAC displaced the chloride ion. Nevirapine, an anti-HIV drug, is associated with idiosyncratic skin rashes in humans. The goal of this project was to investigate whether the 12-hydroxylation pathway is responsible for the skin rash. To test a part of this hypothesis, 12-trideuteronevirapine, 12-OH-NVP sulfate, and several other analogs of nevirapine were synthesized. D-penicillamine is known to cause idiosyncratic autoimmune reactions in humans. The goal of this project was to test whether D-penicillamine covalently binds to macrophages and triggers downstream events leading to autoimmunity. To test a part of this hypothesis, D-penicillamine conjugated to biotin was synthesized. In summary, reactive metabolites of minocycline were found that likely explain why minocycline has an IDR profile unique among the tetracyclines. In addition, analogs of nevirapine and D-penicillamine required for mechanistic studies of nevirapine and D-penicillamine-induced IDRs were synthesized. These studies provide additional support for the involvement of reactive metabolites in the mechanisms of IDRs.

Idiosyncratic drug reactions (IDRs) represent a significant medical problem and pose a great challenge to drug development. Circumstantial evidence suggests that, in most cases, reactive metabolites of the drug are responsible. The major focus of this thesis is the identification of reactive metabolites and the synthesis of analogs required to test several hypotheses related to involvement of metabolism and covalent binding in the mechanisms of IDRs. Minocycline is unique among tetracyclines in causing a significant incidence of a lupus-like syndrome and autoimmune hepatitis. In this study, we demonstrated that minocycline is oxidized to reactive intermediates by myeloperoxidase/H2O2/Cl-, HOCl, horseradish peroxidase/H2O2, or hepatic microsomes. When trapped with N-acetylcysteine (NAC), two adducts with protonated molecular ions at m/z 619 were isolated and analyzed by NMR. One represents attack of the aromatic D ring by NAC meta to the N, N-dimethylamino group, implying that the reactive intermediate was a quinone iminium ion. The other adduct, which was not observed when minocycline was oxidized by hepatic microsomes, indicates that the NAC is attached at the junction of the B and C rings, suggesting that the HOCl added across the double bond of the B ring leading to a reactive molecule, and then NAC displaced the chloride ion. Nevirapine, an anti-HIV drug, is associated with idiosyncratic skin rashes in humans. The goal of this project was to investigate whether the 12-hydroxylation pathway is responsible for the skin rash. To test a part of this hypothesis, 12-trideuteronevirapine, 12-OH-NVP sulfate, and several other analogs of nevirapine were synthesized. D-penicillamine is known to cause idiosyncratic autoimmune reactions in humans. The goal of this project was to test whether D-penicillamine covalently binds to macrophages and triggers downstream events leading to autoimmunity. To test a part of this hypothesis, D-penicillamine conjugated to biotin was synthesized. In summary, reactive metabolites of minocycline were found that likely explain why minocycline has an IDR profile unique among the tetracyclines. In addition, analogs of nevirapine and D-penicillamine required for mechanistic studies of nevirapine and D-penicillamine-induced IDRs were synthesized. These studies provide additional support for the involvement of reactive metabolites in the mechanisms of IDRs.

La 3,4-metilenodioximetanfetamina (MDMA, éxtasis) es una anfetamina sustituida de consumo frecuente y abusivo. La enzima principal que participa en el metabolismo de fase I de la MDMA, la isoforma 2D6 (CYP2D6) del citocromo P450, resulta también inhibida por la MDMA. Además, ésta es a la vez metabolizada por otras isoformas de CYP, por ejemplo la CYP1A2. La contribución de esta enzima y los posibles cambios en su actividad tras una administración de MDMA nunca han sido estudiados in-vivo. En consecuencia, se realizó un ensayo clínico donde los marcadores, dextrometorfano y cafeína se administraron tras una dosis oral de MDMA. En base a la farmacocinética de ambos marcadores se evaluaron posibles cambios en la actividad de las enzimas. En base al ratio metabólico urinario de dextrometorfano i dextrorfano (MR) se calculó la vida-media de degradación de CYP2D6. Tras una dosis de MDMA, el Cmax i AUC del dextrometorfano aumentó aproximadamente 10 veces con la correspondiente disminución en los parámetros farmacocineticos de dextrorfano. Se aumentó el MR casi 100 veces después de una dosis de MDMA, con un 67% de los sujetos superando la antimoda de 0.3 para la asignación del fenotipo de metabolizador lento de CYP2D6. La actividad de CYP2D6 se recuperó después de 10 días con una vida media de degradación de CYP2D6 de 46.6 h. La farmacocinética de la cafeína y sus metabolitos no fue afectada por la MDMA. Se debería avisar los consumidores de MDMA de las consecuencias de tal inhibición. A pesar de que hay muchas evidencias en animales sugiriendo que el MDMA es una neurotoxina serotonergica, todavía hay mucho debate sobre cuál es la causa de estos cambios cerebrales a largo plazo. La investigación apunta a la producción excesiva de especies reactivos de oxigeno (ROS) en el cerebro después de la administración de MDMA. La MDMA induce hipertermia, la liberación excesiva de dopamina cerebral y lleva a la desregulación energética del metabolismo. Conjuntamente, el metabolismo de MDMA produce un catecol reactivo, cuyos productos causan neurotoxicidad serotonergica en ratas. Cualquiera de los factores anteriores podrían ser la causa de la excesiva producción de ROS y los consecuentes cambios serotonergicos. A tenor de estas hipótesis, se investigó si diferentes temperaturas corporales afectarían el metabolismo de MDMA. Se administró MDMA a ratas a tres temperaturas ambientales distintas con el fin de prevenir o exacerbar la hipertermia inducida por MDMA. Se determinaron las concentraciones plasmáticas de MDMA y sus metabolitos principales durante las 6 h posteriores a la administración de la droga. Después de siete días, se sacrificaron los animales y se determinaron las cantidades de índoles cerebral. La administración de MDMA a 15ºC bloqueó la respuesta hipertermica y la disminución a largo plazo de 5-HT encontrada en ratas administradas a 21.5 ºC. A 15ºC, las concentraciones plasmáticas de MDMA aumentaron significativamente mientras que las concentraciones de sus metabolitos disminuyeron en comparación con ratas administradas a 21.5ºC. En contraste, la hipertermia y las deficiencias de indoles fueron exacerbadas en ratas tratadas a 30ºC. Se observó que las concentraciones plasmáticas de metabolitos de MDMA aumentaron significativamente en estos animales. La depleción a largo plazo de 5-HT no estuvo potenciada por la perfusión intrastriatal de MDMA después de una dosis sistémica de MDMA. Además, la interferencia del metabolismo de MDMA con la administración del inhibidor de catecol-o-metiltransferasa, entacapona, potenció la neurotoxicidad de MDMA, indicando que los metabolitos que son sustratos para este enzima podrían contribuir a la neurotoxicidad. Estos resultados tienen implicaciones tanto con el papel de la temperatura en el mecanismo del desarrollo de la neurotoxicidad del MDMA como en el abuso en humanos donde la hipertermia esta asociado con casos de toxicidad aguda. Se ha sugerido también que la causa de la depleción de 5-HT por MDMA es debido a un aumento de niveles de tirosina en el cerebro, cuyo hidroxilación no enzimática conduce a la formación de radicales libres derivados de la dopamina. En consecuencia, se propuso que el metabolismo de MDMA en compuestos pro-oxidantes fuera el paso limitante del proceso. En una serie de experimentos se encontraron niveles más altos de hipertermia aguda, concentraciones plasmáticas de tirosina, MDMA y sus metabolitos después de una dosis toxica de MDMA (15 mg/kg i.p.) versus una dosis no-toxica (7.5 mg/kg i.p.). La administración de una dosis no-toxica de MDMA (7.5 mg/kg i.p.) en conjunto con L-tirosina (0.2 mmol/kg i.p.) produció un aumento similar de niveles de tirosina en el suero con los niveles encontrados tras una dosis toxica de MDMA, sin embargo, los niveles de 5-HT cerebral permanecieron en niveles normales. Una dosis no-toxica de MDMA en combinación con una dosis alta de tirosina (0.5 mmol/kg i.p.) causó depleciones a largo plazo en ratas administradas a 21.5ºC pero no a 15ºC, condiciones conocidas por disminuir el metabolismo de MDMA. Al mismo tiempo, la perfusión estriatal de MDMA en combinación con tirosina (0.5 mmol/kg i.p.) en ratas hipertermicas no causaron depleciones de 5-HT. En contraste, se observaron reducciones significativas en 5-HT cerebral tras la administración de una dosis no-toxica de MDMA en ratas en condiciones de hipertermia en combinación con entacapona o acivisina, compuestos capaces de interferir con el metabolismo de MDMA o aumentar la disponibilidad de sus metabolitos en el cerebro, respectivamente. En conjunto estos datos indican que a pesar de que la tirosina y la hipertermia pueden contribuir a la neurotoxicidad inducida por la MDMA, el metabolismo de la droga parece ser el paso limitante.

No description available.

No description available.

Pharmacogenetics is the study of variability in drug response attributed to genetic variation. Olanzapine (OLA) is a widely used antipsychotic drug for schizophrenia treatment. The pharmacokinetics of OLA display large inter-individual variation leading to multiple-fold differences in drug exposure between patients at a given dose. This variation in turn gives rise to the need of individualized dosing in order to avoid concentration-dependent adverse effects and therapeutic failure. The observed variability has been partially explained by environmental and physiological factors. Genetically determined differences in drug metabolism represent a less studied source of variability. Precluded contribution by cytochrome P450 (CYP) 2D6 calls for evaluation of the other major OLA metabolizing enzymes. The objective of this thesis was to study pharmacogenetic influence of flavin-containing monooxygenase (FMO) 1 and 3, CYP1A2 and uridine diphosphate-glucuronosyltransferase (UGT) 1A4 on therapeutic OLA exposure. We conducted genetic association studies applying gene re-sequencing and genotyping of candidate and tagging SNPs. Patients carrying the FMO1*6 allele displayed increased dose-adjusted concentrations (C/Ds) of OLA, in serum as well as cerebrospinal fluid. Patients who were homozygous for the FMO3 K158-G308 compound variant showed reduced C/Ds of OLA N-oxide metabolite, but no alteration in OLA exposure. This compound variant is expected to have clinical relevance primarily for non-African populations, since low frequencies were detected among native Africans. Deviation in OLA exposure was observed in carrier of a rare FMO3 mutation, predicted in silico to affect gene splicing. Reduced OLA exposure was observed in UGT1A4*3 carriers. The CYP1A2 -163(A) (CYP1A2*1F) variant was not associated with increase in CYP1A2-catalyzed OLA metabolism or reduction in OLA exposure. Correlations were detected for two cis-acting variants within the inter-genetic region of the CYP1A cluster and a trans-acting variant located upstream the locus encoding aryl hydrocarbon receptor. The inconsistent data reported for CYP1A2*1F could be explained by presence of ethnic specific haplotype structures incorporating the -163(A) variant. A continuously improved understanding of the wide range of factors that can influence pharmacokinetics and pharmacodynamics will increase the likelihood of achieving optimal treatment response for individual patients.

Orientador: Sara Teresinha Olalla Saad / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T16:46:11Z (GMT). No. of bitstreams: 1 Palodetto_Bruna_M.pdf: 1523635 bytes, checksum: 0dc5f0194b2dd973ee8eaeac9a384983 (MD5) Previous issue date: 2012 / Resumo: As síndromes mielodisplásicas (SMD) são um grupo heterogêneo de doenças hematopoiéticas caracterizadas pela hematopoiese ineficaz resultando em citopenia no sangue periférico; cerca de 30% das SMDs evolui para leucemia mielóide aguda secundária. Leucemias agudas (LA) são doenças malignas do sangue caracterizadas por acúmulo de blastos podendo ser classificadas em mielóide agudas (LMA), quando há envolvimento de mieloblastos, ou linfóides agudas (LLA), quando há envolvimento de linfoblastos. A sobrevida média dos pacientes com leucemia aguda ainda é muito baixa e muitos deles são resistentes ao tratamento ou apresentam recaída. O melhor entendimento sobre os mecanismos de progressão da mielodisplasia e da resposta ao tratamento em leucemias agudas poderia melhorar a taxa de resposta ao tratamento e aumentar a sobrevida dos pacientes. O metabolismo e o efluxo de drogas são mecanismos de defesa responsáveis pela proteção contra agentes tóxicos e estão envolvidos na biotransformação de diversos xenobióticos. O metabolismo de drogas pode ser divido em duas fases (Fase I: Oxidação; Fase II: Conjugação), sendo ambas mediadas por enzimas metabolizadoras de drogas. O efluxo de drogas é outro mecanismo de proteção contra tóxicos, similar ao metabolismo de drogas, porém mediado por proteínas de membrana. Essas proteínas são polimórficas e esses polimorfismos alteram a atividade enzimática, podendo modificar a resposta ao tratamento e a sua resistência. O gene CYP2B6 codifica uma enzima da fase I do metabolismo responsável pela ativação dos fármacos. Esse gene possui o polimorfismo G15631T onde há troca do aminoácido (Gln172His) resultando em perda da atividade enzimática. Os genes GSTM1, GSTT1 e NQO1 codificam enzimas da fase II do metabolismo, responsáveis pela conjugação com outras substâncias para facilitar a excreção. Os genes GSTM1 e GSTT1 possuem um polimorfismo que causa deleção homozigota do gene; e o gene NQO1 possui o polimorfismo C609T que resulta em troca do aminoácido codificado (Pro187Ser). Esses polimorfismos levam a perda da atividade enzimática. O gene MDR-1 codifica a P-glicoproteína que é uma proteína de membrana responsável pelo efluxo de drogas. Esse gene possui o polimorfismo C3435T que apesar de ser silencioso (Ile1142Ile) diminui a expressão de P-glicoproteína. Assim, o objetivo deste estudo foi identificar a influência dos polimorfismos CYP2B6 G15631T, GSTT1, GSTM1, NQO1 C609T e MDR-1 C3435T no risco de leucemias agudas e SMD, na progressão de SMD e resposta ao tratamento de leucemia aguda. Foram analisados 90 pacientes com leucemia aguda (66 LMA e 24 LLA), 68 pacientes com SMD e 100 controles normais utilizando os métodos de PCR-RFLP e Multiplex. Não houve diferença estatística na freqüência dos polimorfismos entre pacientes e grupo controle. Em SMD encontramos maior frequência de deleções de GST em pacientes que progrediram comparados aos pacientes que não progrediram: 50% e 21% (P=0,019). Também encontramos menor frequência do alelo polimórfico T do polimorfismo MDR-1 C3435T em pacientes que progrediram comparada a dos pacientes que não progrediram: 50% e 81% (P=0,012). Na resposta ao tratamento de leucemias agudas, encontramos uma tendência à maior frequência do polimorfismo NQO1 C609T em pacientes com falha de indução quando comparados a pacientes com remissão em leucemias agudas, em geral, (P=0,093) e pacientes somente com LMA (P=0,125); e quando comparamos falha de indução com o grupo controle em leucemias agudas, em geral, (P=0,101) e somente em LMA (P=0,08). Observamos a mesma tendência quando comparamos a frequência do polimorfismo NQO1 C609T em pacientes com óbito precoce versus a população normal (P=0,058). Em conclusão, estes resultados sugerem que os polimorfismos não estão relacionados ao risco de leucemia aguda e SMD, embora a amostra aqui analisada possa ter sido insuficiente; as deleções GST e o polimorfismo MDR-1 C3435T estão envolvidos na progressão de SMD e o polimorfismo NQO1 C609T tem uma tendência a estar relacionado à falha de indução e ao óbito precoce em pacientes com leucemias agudas, em geral, e somente LMA / Abstract: Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic disorders characterized by ineffective hematopoiesis resulting in peripheral blood cytopenia, about 30% of MDS patients progresses to acute myeloid leukemia. Acute leukemia (AL) are malignant blood diseases characterized by accumulation of blasts and they can be classified into acute myeloid (AML), when there is myeloblasts involvement or acute lymphoid (ALL), when there is lymphoblasts involvement. The median survival of acute leukemia patients is very low and many of them are resistant to treatment or relapsed. The better understanding of the myelodysplasia progression mechanisms and the acute leukemia response to treatment could improve the treatment response rate and patients survival. The metabolism and drug efflux are defense mechanisms responsible for protection against toxic agents and are involved in the biotransformation of various xenobiotics. The drug metabolism can be divided into two phases (Phase I: Oxidation; Phase II: Conjugation), both being mediated by drug metabolizing enzymes. The drug efflux is a similar mechanism of protection but is mediated by membrane proteins. These enzymes are polymorphic and these polymorphisms alter the enzyme activity and may modify treatment response and resistance. The CYP2B6 gene encodes a phase I enzyme responsible for drug activation. This gene has the G15631T polymorphism where there is exchange of the amino acid (Gln172His) resulting in loss of enzyme activity. The GSTM1, GSTT1 and NQO1 genes encoding phase II metabolizing enzymes that are responsible for combining with other substances to facilitate drug excretion. GSTM1 and GSTT1 genes have a polymorphism that causes homozygous deletion of the gene; and the NQO1 gene has the C609T polymorphism that results in amino acid changes (Pro187Ser). These polymorphisms lead to loss of enzyme activity. The MDR-1 gene encodes P-glycoprotein (P-gp) which is a membrane protein responsible for drug efflux. This gene has the C3435T polymorphism that despite being silent (Ile1142Ile) leads to lower P-gp expression. The aim of this study was to identify the influence of CYP2B6 G15631T, GSTT1, GSTM1, NQO1 C609T and MDR-1 C3435T polymorphisms in acute leukemia and MDS risk, MDS progression and acute leukemia response to treatment. We analyzed 90 patients with acute leukemia (66 AML and 24 ALL), 68 MDS patients and 100 normal controls using the PCRRFLP and Multiplex methods. There was no statistical difference in the frequency of polymorphisms between patients and control group. In MDS we found higher frequency of GST deletions in patients who progressed compared to patients who did not progress: 50% and 21% (P = 0.019). We also found less frequently polymorphic allele T of MDR-1 C3435T polymorphism in patients who progressed compared to patients who did not progress: 50% and 81% (P = 0.012). In acute leukemia response to the treatment, we found a trend toward a higher frequency of NQO1 C609T polymorphism in patients with induction failure compared to patients in remission, with acute leukemia in general, (P = 0.093) and AML patients only (P = 0.125); and induction failure when compared with the control group in acute leukemia in general (P = 0.101) and only in AML patients (P = 0.08). We observed the same trend when comparing the frequency of NQO1 C609T polymorphism in patients with early death versus normal population (P = 0.058). In conclusion, these results suggest that theses polymorphisms are not related to acute leukemia and MDS risk, although the sample analyzed here may have been insufficient; GST deletions and MDR-1 C3435T polymorphism are involved in MDS progression and NQO1 C609T polymorphism has a tendency to be related to induction failure and early death in patients with acute leukemia, in general, and AML only / Mestrado / Biologia Estrutural, Celular, Molecular e do Desenvolvimento / Mestre em Fisiopatologia Médica

Abstract Metabolism is a major determinant of the pharmacokinetic properties of most drugs and is often behind bioavailability problems, drug-drug interactions, and metabolic idiosyncrasies. Cytochrome P450 (CYP) enzymes are a superfamily of microsomal hemoproteins catalysing the metabolic reactions of several exogenous compounds. The majority of crucial steps within drug metabolism are in connection with CYP enzymes. In the present study, in vivo, in vitro, and in silico approaches were applied and characterised to evaluate the effects of chemical entities on CYP-mediated metabolism. CYP2B6 was used as a target enzyme for these studies. For evaluation of the CYP inhibition potential of new chemical entities, a novel in vitro test system utilising the n-in-one approach was developed. This method proved to be robust and applicable to screening purposes. Validation of the n-in-one assay was done by comparing its performance to commonly used in vitro techniques using six structurally diverse drugs. All assay types yield remarkably similar results with the majority of the CYP forms tested. Several chemicals were screened in vitro and in silico in order to find potent and selective chemical inhibitors for CYP2B6. Ticlopidine, thioTEPA and 4-(4-chlorobenzylpyridine) were found to be highly effective inhibitors of CYP2B6. The selectivity of thioTEPA proved to be very high, whereas ticlopidine and 4-(4-chlorobenzylpyridine) also inhibited other CYPs. At a concentration level of 1 μM for ticlopidine and 0.1 μM for 4-(4-chlorobenzylpyridine), the inhibitory effect towards other CYPs was negligible. Due to wide clinical use and relevance, clopidogrel and ticlopidine were selected for further in vivo interaction studies. Both clopidogrel and ticlopidine significantly inhibited the CYP2B6-catalysed bupropion hydroxylation and patients receiving either clopidogrel or ticlopidine are likely to need dose adjustments when treated with drugs primarily metabolised by CYP2B6. The effect of impaired kidney function on CYP2B6 activity and on bupropion pharmacokinetics was also explored. In patients with kidney disease, the bupropion AUC and Cmax were significantly higher and the apparent oral clearance of bupropion was notably lower compared to healthy controls. The present results indicate that the in silico and in vitro methods used are helpful in predicting in vivo drug-drug interactions. The effective utilisation of these models in the early phases of drug discovery could therefore help to target the in vivo studies and to eliminate metabolically unfavourable drug candidates.

Although conventional two-dimensional (2D) cell culture is convenient for routine work, researchers are turning to three-dimensional (3D) cell culture for more accurate, physiologically representative information on the way their cells behave and respond to stimuli. Cells can now be routinely cultured in the many commercially available 3D formats. In this study, we developed non-woven scaffolds for 3D cell culture and enhanced cell function. By making use of methods that measure the behaviour of liver cells in the 3D system we were able to demonstrate, compared to standard 2D systems, significantly higher expression of key liver enzymes involved in drug metabolism and albumin production (specifically cytochrome P450). Cell proliferation on the various scaffolds was comparable to that of a commercially available hydrogel 3D cell culture system, AlgimatrixTM. When culturing cells in 3D, the means by which cells are harvested or extracted from the 3D scaffold for downstream applications is more challenging than in 2D. For this reason, many of the 3D scaffolds currently manufactured are either bio-degradable or require the use of salts to dissolve the scaffold which may negatively impact on the cells they contain. By grafting the non-woven scaffolds with the thermoresponsive polymer, poly(N-isopropylacrylamide) (PNIPAAm), we demonstrated that cells growing on the scaffolds are able to be released from the scaffold in a 3D conformation, non-enzymatically, through temperature changes. Selected thermoresponsive non-woven fabrics were also tested in an automated cell culture device for cell proliferation and thermally induced harvesting. One of the applications of a 3D cell culturing system would be in exploration of the many diseases plaguing mankind, in particular malaria which is still responsible for severe disease and mortality, especially in Africa. Most available antimalarials are designed to target the pathogenic blood stages in humans and to address the constant threat of drug resistance. However, to meet the objective of malaria eradication, medicines that block parasite transmission also need to be developed. Molecules that efficiently target the parasite stages in the liver would prevent pathogenesis, symptoms and transmission. Equipped with the knowledge that the infectious sporozoites traverse several hepatocytes prior to cell infection, it may be physiologically limiting to culture the exo-erythrocytic stage in vitro in a 2D cell culture system where the hepatocytes are in an unnatural flat conformation, distinctly different to their in vivo counterparts. Moreover, monolayer cell cultures lose their tissue-related functions rapidly, greatly impairing the predictive power of such assays. Thus, the second aim of this thesis was to establish if hepatocytes that have been cultured on 3D non-woven scaffolds improve in vitro sporozoite invasion compared to conventional 2D systems. Sporozoite invasion was detected in the conventional 2D monolayers using a TaqMan® assay but not in the hepatocytes growing in 3D. Future studies beyond the scope of this thesis will include modifications to the 3D scaffold to attempt achieving superior sporozoite invasion in this model system. / Thesis (PhD)--University of Pretoria, 2013. / Biochemistry / unrestricted

Philosophiae Doctor - PhD / Tuberculosis (TB) remains a global epidemic despite the fact that treatment has been available since the 1950’s. This disease is highly contagious and spreads via transmission of the Mycobacterium Tuberculosis (MTB) tubercle via coughing, sneezing and spitting. The disease has various side effects including weight loss, fatigue and even death. To date no cure has been found for TB and thus optimisation of treatment is a constant focus in health related research. TB is highly prevalent in South Africa due to the increased level of patients who are co-infected with HIV. Treatment for TB consists of first line drugs including isoniazid (INH), ethambutol (ETH), pyrazinamide (PYR) and rifampicin (RIF). These drugs are highly effective but also produce many adverse drug reactions (ADR’s) over the 6-month course of treatment. These reactions lead to patients not completing the course, losing quality of life and ultimately adding to the development of drug resistant strains of TB. A method of minimising these ADR’s is the development of a phenotype sensor, which is able to determine the metabolic profile of patients. Metabolic profiles play a huge role in the efficacy of treatment by tailoring treatment in order for patients to stay within the therapeutic range of treatment. This would in turn minimise both toxicity and ineffective treatment. Various methods for the quantification of drugs have been developed such as high performance liquid chromatography (HPLC), mass spectrometry (MS) and ultra-violet visible spectroscopy (UV-vis). / 2023-12-01