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Research ArticleArticle

Toxicity, Biological Activity, and Pharmacokinetics of TXU (Anti-CD7)-Pokeweed Antiviral Protein in Chimpanzees and Adult Patients Infected with Human Immunodeficiency Virus

Fatih M. Uckun, Kelly Bellomy, Karen O'Neill, Yoav Messinger, Trista Johnson and Chun-Lin Chen
Journal of Pharmacology and Experimental Therapeutics December 1999, 291 (3) 1301-1307;
Fatih M. Uckun
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Kelly Bellomy
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Karen O'Neill
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Yoav Messinger
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Trista Johnson
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Chun-Lin Chen
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Abstract

The purpose of the present study was to evaluate the toxicity and pharmacokinetics of TXU (anti-CD7)-pokeweed antiviral protein (PAP) in human immunodeficiency virus (HIV)-infected chimpanzees and adult patients. At a total dose of 100 μg/kg, TXU-PAP did not cause severe (grade ≥ 3) toxicity in any of the four HIV type 1 (HIV-1)-infected or two healthy chimpanzees. The only side effects were a transient elevation of the liver enzyme alanine aminotransferase between days 2 and 14 without a concomitant rise in total bilirubin levels and a decrease in the serum albumin levels between days 1 and 5 without any concomitant weight gain or peripheral edema. TXU-PAP showed favorable pharmacokinetics in chimpanzees with a plasma elimination half-life of 5.1 to 12.0 h and a systemic clearance of 5.8 to 15.1 ml/h/kg. At 2 months after initiation of the TXU-PAP infusions, the HIV-1 burden was reduced to below-detection levels in three of the four chimpanzees, and in the remaining chimpanzee, the HIV burden was <500 RNA copies/ml at 2 weeks but returned to the pretreatment levels by 2 months. TXU-PAP was well tolerated by HIV-1-infected adult patients who received a single 5 μg/kg i.v. infusion of TXU-PAP. TXU-PAP showed very favorable pharmacokinetics in these patients with a relatively long plasma elimination half-life of 12.4 ± 1.4 h, a mean residence time of 17.9 ± 2.0 h, and a slow systemic clearance of 2.7 ± 0.7 ml/h/kg. Concentrations of TXU-PAP required for effective inhibition of HIV-1 replication in preclinical models were achieved in HIV-1-infected patients at the 5 μg/kg dose level without any adverse reactions, and the mean value for AUC was 3059 ± 721 ng · h/ml. The 1-h postinfusion plasma samples from TXU-PAP-treated patients showed potent anti-HIV activity in vitro and inhibited the replication of HIV in normal peripheral blood mononuclear cells (PBMCs) even at a 1:100 dilution. Although treatment with TXU-PAP at the 5 μg/kg dose level does not provide sustained therapeutic levels, it was capable of reducing the viral burden in six of six patients evaluated. To our knowledge, this is the first report of a clinical pharmacokinetics study of a PAP immunoconjugate in HIV-infected patients. The favorable long plasma elimination half-life of TXU-PAP in combination with its low toxicity provides the basis for further investigation of TXU-PAP as a potential anti-HIV agent.

Footnotes

  • Send reprint requests to: Fatih M. Uckun, M.D., Hughes Institute, 2665 Long Lake Road, Suite 330, St. Paul, MN 55113. E-mail:fatih_uckun{at}ih.org

  • ↵1 This work was supported in part by research grants from the Parker Hughes Trust and the National Institute of Allergy and Infectious Diseases (Grant R01-AI44671 to F.M.U.), National Institutes of Health.

  • Abbreviations:
    PAP
    pokeweed antiviral protein
    HIV
    human immunodeficiency virus
    HIV-1
    human immunodeficiency virus type 1
    NK
    natural killer
    AIC
    Akaike's Information Criterion
    QS
    quantitation standard
    AUC
    area under the concentration-time curve
    ALT
    alanine aminotransferase
    PCR
    polymerase chain reaction
    MRT
    mean residence time
    VLS
    vascular leak syndrome
    PBMC
    peripheral blood mononuclear cell
    PK
    pharmacokinetic
    ELISA
    enzyme-linked immunosorbent assay
    CV
    coefficient of variance
    • Received June 3, 1999.
    • Accepted August 27, 1999.
  • The American Society for Pharmacology and Experimental Therapeutics
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Journal of Pharmacology and Experimental Therapeutics: 291 (3)
Journal of Pharmacology and Experimental Therapeutics
Vol. 291, Issue 3
1 Dec 1999
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Research ArticleArticle

Toxicity, Biological Activity, and Pharmacokinetics of TXU (Anti-CD7)-Pokeweed Antiviral Protein in Chimpanzees and Adult Patients Infected with Human Immunodeficiency Virus

Fatih M. Uckun, Kelly Bellomy, Karen O'Neill, Yoav Messinger, Trista Johnson and Chun-Lin Chen
Journal of Pharmacology and Experimental Therapeutics December 1, 1999, 291 (3) 1301-1307;

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Research ArticleArticle

Toxicity, Biological Activity, and Pharmacokinetics of TXU (Anti-CD7)-Pokeweed Antiviral Protein in Chimpanzees and Adult Patients Infected with Human Immunodeficiency Virus

Fatih M. Uckun, Kelly Bellomy, Karen O'Neill, Yoav Messinger, Trista Johnson and Chun-Lin Chen
Journal of Pharmacology and Experimental Therapeutics December 1, 1999, 291 (3) 1301-1307;
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