Animal Models of IPF

Martin Kolb MD, PhD

Associate Professor, Research Director Animal Models of IPF Proof of Concept in Pharmaceutical Research:

The biggest divide of all is the one between animal and human studies. "In many areas we have relied a bit too much on animal models and fooled ourselves into thinking they tell us exactly what happens“…Now scientists are taking a more skeptical look at their models and trying to find better ways to correlate results in animals to early human findings.

May 2006

Animal Models of IPF –Right or Wrong ?

We have good models of IPF

We have good models of some IPF features

Animal models help to understand the pathogenesis of IPF initiation

Animal models help to understand the pathogenesis of IPF progression

We asses severity and progression of experimental fibrosis correctly Animal models are useful to investigate drug efficacy in a preclinical setting

We use the right animals

Animal Models of Pulmonary Fibrosis

Chua, AJRCMB 2005

FITC induced PF

Gene overexpression/ k.o.

Adoptive cell transfer (UIP fibroblasts)

Dox-inducible TGF-βoverexpression

Lee et al. J. Exp. Med. 2004Moore et al, Am J Physiol 2008

Bleomycin i.t.The AMDCC is an interdisciplinary consortium designed to develop new animal models that closely mimic the human complications of diabetes for the purpose of studying disease pathogenesis, prevention and treatment.

What is “THE”Animal Model of IPF?

IPF is a complex disease!

pathogenesis/ treatment/ modeling …is modeling IPF any easier than diabetes?

Animal Models of IPF –Right or Wrong ? We have good models of IPF

We have good models of some IPF features Animal models help to understand the pathogenesis of IPF initiation Animal models help to understand the pathogenesis of IPF progression

We asses severity and progression of experimental fibrosis correctly Animal models are useful to investigate drug efficacy in a preclinical setting

We use the right animals AdTGF-β1 overexpression/ RAT i.t.AdTGF-β1 overexpression/ MOUSE i.pl.AdTGF-β1 overexpression/ Rhesus Monkey AdIL-1βoverexpression/ RAT i.t.

Human UIP

Animal Models of Pulmonary Fibrosis

Animal Models of IPF –Right or Wrong ?

We have good models of IPF

We have good models of some IPF features

Animal models help to understand the pathogenesis of IPF initiation

Animal models help to understand the pathogenesis of IPF progression

We asses severity and progression of experimental fibrosis correctly

Animal models are useful to investigate drug efficacy in a preclinical setting

We use the right animals

Modeling acute exacerbations of IPF

Kim et al, PATS 2006

Are all our animal models modeling acute exacerbations?

Animal Models of IPF –Right or Wrong ? We have good models of IPF

We have good models of some IPF features

Animal models help to understand the pathogenesis of IPF initiation

Animal models help to understand the pathogenesis of IPF progression

We asses severity and progression of experimental fibrosis correctly

Animal models are useful to investigate drug efficacy in a preclinical setting

We use the right animals Examples for agent classes:?Antioxidants ?ACE Inhibitors ?Angiotensin 2 Rec. Blocker ?Anticoagulants ?Macrolide antibiotics ?Cytokines ?Cytokine antibodies ?Chinese herbs ?Immunosuppressants ?Corticosteroids ?Chelating agents ?Pirfenidone ……and many more ……

almost 200 agents with

antifibrotic effects

~250 published studies

1980 -2006

~90%

”Prevention ”~10%

“Therapy”Antifibrotic Drugs in the Bleomycin Model Moeller et al, Int J Biochem Cell Biol 2008

Drug intervention studies in PF animal models

d 21

d 7 d 14initiation drug Intervention

d 42

d 21d 7 d 14initiation drug Intervention

no drug drug

d 21d 7 d 14initiation drug Intervention

d 28

no drug drug

day 7?

How do we assess a patient with IPF?

symptoms

PFT (FVC/ TLC/ DCO)

exercise (6-min walk)

imaging (CXR/ HRCT)

echo/ RV cath

bronchoscopy How do we assess animals with

experimental PF?

(symptoms) histology/ morphometry

collagen (hydroxyprol/ sircol)

gene expression (ECM genes)

Micro-CT and 3D-

Reconstruction of pulmonary vessels down to microns (Ritman, PATS 2005)Micro ‐CT Bleomycin

Day 7Day 125

Day 27Day 0Day 14Fibrosis in Rat Lungs –3D Imaging

AdTGF-β1

Animal models of IPF: “Clinical Outcome ”Follow same animals over time

-Body condition/weights

-Airway resistance

-Lung function/Lung volumes

-Exercise Test

-Imaging

Quantifiable measurements of lung tissue

-Histology/ Histomorphology -Collagen/ / Elastin

-Hydroxyproline/ Desmosin

-Up/Downregulation of ECM genes/ proteins C linical-P athology-R adiology Score in animals?Induce Pathology Sacrifice

?Treat Animal Models of IPF –Right or Wrong ? We have good models of IPF

We have good models of some IPF features

Animal models help to understand the pathogenesis of IPF initiation Animal models help to understand the pathogenesis of IPF progression

We asses severity and progression of experimental fibrosis correctly Animal models are useful to investigate drug efficacy in a preclinical setting

We use the right animals

Animal Models of IPF –Species

rat mouse

guinea pig

primate

dog

swine

inbred/outbred

rabbit

AGE MATTERS

?Ageing mice develop more fibrosis in response to Bleo,

have more fibrocytes

Xu J. et al. J Gerontol A Biol Sci Med Sci 2009

?MSCs have decreased ability to differentiate

Xu J. et al. J Gerontol A Biol Sci Med Sci 2009

Fibrocytes & Mesenchymal Stem ‐Cells following Bleo Circulating fibrocytes 7 days

after bleomycin injury Migration of bone ‐marrow derived MSC (towards SDF ‐1)

SAMP8 = senescence accelerated mouse prone strain 8

SAMR1 = senescence accelerated mouse resistant strain 1

Animal Models of IPF –Right or Wrong We have a good model of IPF We have good models for some features of IPF Animal models help to understand the pathogenesis of IPF initiation Animal models help to understand the pathogenesis of IPF progression

We asses severity and progression of experimental fibrosis correctly Animal models are useful to investigate drug efficacy in a preclinical setting We use the right animals WRONG

Right

RIGHT WRONG WRONG WRONG WRONG

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