[Similarity of biotechnology-derived drugs: regulatory framework and specificity]. / Similarité des médicaments issus des biotechnologies : cadre réglementaire et spécificité

Directive 2004/27/EC, issued by the European commission specifies the conditions by which marketing approval can be awarded for a biosimilar drug, whose structure is the closest possible to that of an already marketed biotechnology-drug. This specific regulation differs in more than one point from that applied to classical generic products. Others conditions beyond the sole demonstration of in vivo bioequivalence should be satisfied to ensure prudent, i.e., without risk to the patient, therapeutic substitution.

[DNA vaccines]. / Les vaccins à ADN.

DNA vaccination is a new vaccine approach used to induce an immune response to an antigen protein expressed in vivo. It is based on the introduction, via intramuscular injections, particle bombardment, or nasal spray, of a purified DNA plasmid encoding for the polypeptide sequence. The resulting in situ protein synthesis involves biosynthetic processing and post-translational modifications. The effectiveness of DNA vaccines has been demonstrated in many animal models. Cell-mediated immunity (Th1 and Th2 responses) and humoral immunity can be obtained. B-cell production of antibodies is generally weaker than induced by traditional vaccines. Various approaches to boost the immune response have been studied, including co-administration of cytokines, co-stimulation with specific genes, and addition of targeting molecules. Research with animal models has shown that DNA vaccines are safe. Deleterious immune responses, such as autoimmunity and development of tolerance in response to persistent expression of a foreign antigen, have not been observed. Phase I and Phase II clinical trials with DNA vaccines have been conducted for HIV, HBV, HVC, HSV, tuberculosis, and malaria. Clinical trials are also in hand for cancer and the treatment of allergies. This new approach of DNA vaccination offers new hope because of their low cost and manufacturing stability at ambient temperature.

Protein feeding pattern does not affect protein retention in young women.

This study was undertaken to determine whether a pulse protein feeding pattern was more efficient than a spread pattern to improve protein anabolism in young women as was already shown in elderly women. After a 15-d adaptive period [1.2 g protein/(kg fat-free mass. d)], 16 young women (age 26 +/- 1 y) were given a 14-d diet providing 1.7 g protein/(kg fat-free mass. d), using either a pulse pattern (protein consumed mainly in one meal, n = 8), or a spread pattern (spreading daily protein intake over four meals, n = 8). Nitrogen balance was determined at the end of both the 15-d adaptive and the 14-d experimental periods. Whole-body protein turnover was determined at the end of the 14-d experimental period using [(15)N]glycine as an oral tracer. Nitrogen balance was 17 +/- 5 mg N/(kg fat-free mass. d) during the adaptive period. It was higher during the experimental period, but not significantly different in the women fed the spread or the pulse patterns [59 +/- 12 and 36 +/- 8 mg N/(kg fat-free mass. d) respectively]. No significant effects of the protein feeding pattern were detected on either whole-body protein turnover [5.5 +/- 0.2 vs. 6.1 +/- 0.3 g protein/(kg fat-free mass. d) for spread and pulse pattern, respectively] or whole-body protein synthesis and protein breakdown. Thus, in young women, these protein feeding patterns did not have significantly different effects on protein retention.

Response of leucine metabolism to hyperinsulinemia in hypothyroid patients before and after thyroxine replacement.

We have investigated the effect of hypothyroidism and insulin on protein metabolism in humans. Six hypothyroid patients were studied in a postabsorptive state before and after 5 months of regular treatment for hypothyroidism (153 +/- 17 microg/day of L-T4). The effect of insulin was assessed under hyperinsulinemic euglycemic and eukalemic conditions. Insulin was infused for 140 min at 0.0063 +/- 0.0002 nmol/kg x min. An amino acid infusion was used to blunt insulin-induced hypoaminoacidemia. Whole body protein turnover was measured using L-[1-13C] leucine. When compared to L-T4-induced subclinical thyrotoxic state, hypothyroidism induced a significant decrease (P < 0.05) in leucine endogenous appearance rate (a reflection of proteolysis; 0.89 +/- 0.09 vs. 1.33 +/- 0.05 micromol/kg x min), oxidation (0.19 +/- 0.02 vs. 0.25 +/- 0.03 micromol/kg x min), and nonoxidative disposal (a reflection of protein synthesis; 0.87 +/- 0.11 vs. 1.30 +/- 0.05 micromol/ kg x min). Insulin lowered proteolysis during both the subclinical thyrotoxic and hypothyroid states. Hypothyroidism impaired the antiproteolytic effects of insulin. Thyroid hormones are, therefore, essential for the normal antiproteolytic action of insulin.

Protein pulse feeding improves protein retention in elderly women.

BACKGROUND: Adequate protein nutrition could be used to limit gradual body protein loss and improve protein anabolism in the elderly. OBJECTIVE: We tested the hypothesis that an uneven protein feeding pattern was more efficient in improving protein anabolism than was an even pattern. DESIGN: After a controlled period, 15 elderly women (mean age: 68 y) were fed for 14 d either a pulse diet (n = 7), providing 80% of the daily protein intake at 1200, or a spread diet (n = 8), in which the same daily protein intake was spread over 4 meals. Both diets provided 1.7 g protein x kg fat-free mass (FFM)(-1) x d(-1). Protein accretion and daily protein turnover were determined by using the nitrogen balance method and the end product method (ammonia and urea) after an oral dose of [15N]glycine. RESULTS: Nitrogen balance was more positive with the pulse than with the spread diet (54 +/- 7 compared with 27 +/- 6 mg N x kg FFM(-1) x d(-1); P < 0.05). Protein turnover rates were also higher with the pulse than with the spread diet (5.58 +/- 0.22 compared with 4.98 +/- 0.17 g protein x kg FFM(-1) x d(-1); P < 0.05), mainly because of higher protein synthesis in the pulse group (4.48 +/- 0.19 g protein x kg FFM(-1) x d(-1)) than in the spread group (3.75 +/- 0.19 g protein x kg FFM(-1) x d(-1)) (P < 0.05). CONCLUSION: A protein pulse-feeding pattern was more efficient than was a protein spread-feeding pattern in improving, after 14 d, whole-body protein retention in elderly women.

Effect of glucocorticoid excess on skeletal muscle and heart protein synthesis in adult and old rats.

This study was carried out to analyse glucocorticoid-induced muscle wasting and subsequent recovery in adult (6-8 months) and old (18-24 months) rats because the increased incidence of various disease states results in hypersecretion of glucocorticoids in ageing. Adult and old rats received dexamethasone in their drinking water for 5 or 6 d and were then allowed to recover for 3 or 7 d. As dexamethasone decreased food intake, all groups were pair-fed to dexamethasone-treated old rats (i.e. the group that had the lowest food intake). At the end of the treatment, adult and old rats showed significant increases in blood glucose and plasma insulin concentrations. This increase disappeared during the recovery period. Protein synthesis of different muscles was assessed in vivo by a flooding dose of [13C]valine injected subcutaneously 50 min before slaughter. Dexamethasone induced a significant decrease in protein synthesis in fast-twitch glycolytic and oxidative glycolytic muscles (gastrocnemius, tibialis anterior, extensor digitorum longus). The treatment affected mostly ribosomal efficiency. Adult dexamethasone-treated rats showed an increase in protein synthesis compared with their pair-fed controls during the recovery period whereas old rats did not. Dexamethasone also significantly decreased protein synthesis in the predominantly oxidative soleus muscle but only in old rats, and increased protein synthesis in the heart of adult but not of old rats. Thus, in skeletal muscle, the catabolic effect of dexamethasone is maintained or amplified during ageing whereas the anabolic effect in heart is depressed. These results are consistent with muscle atrophy occurring with ageing.

Influence of protein intake on whole body and splanchnic leucine kinetics in humans.

The influence of the protein content of the meal on protein turnover was investigated in the splanchnic bed and in the remaining parts of the body in humans. Two groups of five subjects consumed every 20 min a liquid formula providing either 1.5 g protein x kg(-1) x day(-1) (P) or no protein (PF). L-[1-(13)C]leucine and L-[5,5,5-(2)H3]leucine were administered by vein and gut, respectively. An open two-pool model was developed to calculate leucine kinetics in both compartments, with the assumption that the enrichment of the tracers incorporated into very low density lipoprotein apolipoprotein B100 at isotopic steady state could reflect the leucine labeling in the splanchnic region. Nonsplanchnic uptake and release of leucine were not significantly different in the two groups. Within the splanchnic area, leucine uptake was 2.1 times higher in the P than in the PF group (P < 0.01), whereas leucine release was reduced but not significantly (-19%) in the P group compared with the PF group. Moreover, data derived from this model showed that protein intake induced an increase in whole body protein synthesis and no change in whole body protein breakdown. Albumin synthesis, as well as its contribution to whole body protein synthesis, was significantly enhanced by protein intake.

Contribution of proteolysis and de novo synthesis to alanine production in diabetic rat skeletal muscle: a 15N/1H nuclear magnetic resonance study.

To assess the role of leucine as a precursor of alanine alpha-amino nitrogen in skeletal muscle during diabetes, extensor digitorum longus muscles from control (n = 7 experiments) and streptozotocin-diabetic rats (n = 8 experiments) were isolated and superfused with [15N]leucine (3 mmol/l) in the presence of glucose (10 mmol/l) for 2 h. Muscle perchloric acid extraction was performed at the end of superfusion in order to quantify newly synthesized alanine by 15N/1H nuclear magnetic resonance. Release of [15N]alanine in the superfusion medium was also measured. The pool of newly synthesized [15N]alanine was significantly increased (approximately 40%) in extensor digitorum longus muscles from streptozotocin-diabetic rats. Whereas a significant enhancement of total alanine release from muscle was induced by diabetes (20%), only a slight increase in [15N]alanine release was detectable under our experimental conditions. Consequently, we conclude that streptozotocin-diabetes in growing rats induces in skeletal muscle: 1) an increase in nitrogen exchange between leucine and alanine leading to newly synthesized [15N]alanine; and 2) an increase of total alanine release from muscle originating from both proteolysis and de novo synthesis.

Precursor pool for hepatic protein synthesis in humans: effects of tracer route infusion and dietary proteins.

The estimation of the hepatic protein synthesis precursor pool was investigated through the measurement of very low-density lipoprotein (VLDL) apolipoprotein (apo)B100 labeling in healthy volunteers. L-[1-13C]leucine and L-[5,5,5-2H3]leucine were administered intravenously and intragastrically, respectively. Subjects were continuously fed with isoenergetic meals providing either 16% protein or no protein. The labeling of leucine incorporated into VLDL apoB100 (leucine-apoB) was lower than plasma leucine or alpha-ketoisocaproate (KIC) enrichments with the intravenous tracer. By contrast, with the oral tracer, leucine-apoB enrichment was higher than either plasma free leucine or KIC labeling. The KIC and leucine-apoB enrichments relative to plasma leucine enrichment were not affected by protein intake. Albumin or fibrinogen synthesis rates were similar whatever the administration route of the tracer when leucine-apoB was used to indicate the precursor, which was not the case for plasma leucine or KIC. The present data suggest that leucine-apoB enrichment represents a reliable indicator of the hepatic precursor pool for protein synthesis. The effect of dietary protein on the calculated rates of albumin and fibrinogen synthesis is also reported in relation to the choice of the precursor.

Whole-body protein turnover and hepatic protein synthesis are increased by vaccination in man.

1. The ability of diphtheria-tetanus-poliomyelitis-typhoid vaccination to induce modifications in protein metabolism was investigated in post-absorptive healthy humans. 2. Seven subjects were studied before and 2 days after vaccination. They underwent an intravenous primed constant infusion of L-[1-13C]leucine for 4h. Plasma protein concentrations, whole-body amino acid fluxes and acute-phase protein synthesis were determined. 3. Plasma concentrations of fibrinogen, alpha 1-acid glycoprotein, haptoglobin and alpha 1-antitrypsin were significantly elevated 2 days after vaccination (P < 0.05). Leucine oxidation was unaffected but whole-body protein synthesis and breakdown were both increased (P < 0.05), by 25 and 16% respectively, in subjects who had an elevated body temperature (n = 5). Albumin synthesis was unchanged, but hepatic synthesis of fibrinogen was 56% higher after vaccination. 4. The present investigation indicates that diphtheria-tetanus-poliomyelitis-typhoid vaccination could induce a sustained acute-phase reaction. Moreover, protein metabolism appeared to be extremely sensitive to a mild stress since leucine kinetics and fibrinogen synthesis were affected. Therefore, diphtheria-tetanus-poliomyelitis-typhoid vaccination might represent an attractive model for studying the inflammatory process in humans.

Response of leucine metabolism to hyperinsulinemia under amino acid replacement in experimental hyperthyroidism.

We investigated the responsiveness of protein metabolism to insulin as a mediator of the protein catabolic response to hyperthyroidism in humans. Six healthy volunteers were studied in a postabsorptive state before and after oral intake of thyroid hormones (2 micrograms.kg-1.day-1 L-thyroxine for 6 wk along with 1 microgram.kg-1.day-1 triiodothyronine for the last 2 wk). Insulin was infused at 7.14 nmol.kg-1.min-1 for 140 min under euglycemic and eukalemic clamps. An appropriate amino acid infusion was used to blunt insulin-induced hypoaminoacidemia. Leucine kinetics were assessed using a primed continuous infusion of L-[1-13C]leucine. Hyperthyroidism induced a significant increase (P < 0.05) in leucine endogenous appearance rate (a reflection of proteolysis; 2.15 +/- 0.06 vs. 1.76 +/- 0.03 mumol.kg-1.min-1 in the control state), oxidation (0.54 +/- 0.04 vs. 0.47 +/- 0.07), and nonoxidative disposal (a reflection of protein synthesis; 1.80 +/- 0.06 vs. 1.45 +/- 0.06). Insulin lowered proteolysis. Further hyperthyroidism improved the ability of insulin to inhibit proteolysis, whether considered as an absolute decrease (-0.57 +/- 0.02 vs. -0.45 +/- 0.05 mumol.kg-1.min-1, P < 0.05) or related to insulinemia [1.59 +/- 0.11 vs. 1.01 +/- 0.08 mumol leucine.kg-1.min-1/(nmol insulin/l), P < 0.05]. Insulin also moderately (but significantly P < 0.05) lowered protein synthesis in both control and hyperthyroid states. These changes in insulin action may provide a mechanism to save body protein during hyperthyroidism.

Altered response of protein synthesis to nutritional state and endurance training in old rats.

This study was undertaken to determine whether the loss of muscle protein mass during aging could be explained by a reduced sensitivity of muscle protein synthesis to feeding and exercise. Male Wistar rats aged 12 and 24 mo were exercised by treadmill running for 4 mo. Protein synthesis was measured by the flooding dose method in tibialis anterior, soleus, and liver of conscious rested, trained rats and age-matched controls in the postprandial or in the postabsorptive state. No marked change with age could be detected in basal muscle protein synthesis. In contrast, protein synthesis was stimulated in adult but not in old rats by feeding in tibialis anterior and by exercise in soleus. In liver, protein synthesis was not modified by age but was stimulated by feeding and by exercise, which improved the response to feeding. We conclude that the impact of nutrition on muscle protein synthesis is blunted in old age, which could contribute to the age-related loss of nutrition-sensitive muscle proteins.

Recombinant porcine somatotropin and dietary protein enhance protein synthesis in growing pigs.

The effects of a daily porcine somatotropin injection on protein synthesis rate in muscle (longissimus), liver and intestine, as influenced by dietary protein, were investigated in 17 pigs. The measurements were made at wk 3 of treatment following 1 wk for adaptation to the diet and 1 wk for determination of nitrogen balance. The fractional rates of protein synthesis in the muscle, liver and intestine were measured using a flooding dose of L-[1-13C]valine. Positive responses of weight gain and nitrogen balance were observed, primarily at higher dietary protein intake, after porcine somatotropin treatment. As expected, porcine somatotropin-treated pigs had a higher proportion of muscle and less fat. Fractional protein synthesis rate was 16% higher in the liver of porcine somatotropin-treated pigs (P < 0.05). In the longissimus muscle fractional protein synthesis rate increased with porcine somatotropin dose from 3.2 to 3.7%/d and from 4.1 to 5.1%/d at low and high protein intake, respectively (P < 0.05). The effect of dietary protein on fractional protein synthesis rate in longissimus was significant, but there was no porcine somatotropin x protein interaction. Ribonucleic acid concentration followed the same pattern as fractional protein synthesis rate in liver and longissimus. In the duodenal tissue, porcine somatotropin treatment depressed fractional protein synthesis rate (P < 0.05) without an effect of dietary protein and RNA concentration did not change. In porcine somatotropin compared with placebo-treated pigs, plasma glucose, insulin and insulin-like growth factor-I concentrations were elevated whereas plasma thyroxine was depressed and plasma triiodothyronine remained constant. There was no clear effect of dietary protein on plasma hormones. We concluded that, in pigs fed an adequate level of protein, porcine somatotropin stimulates protein synthesis in the liver and the muscle, primarily through increased ribosomal capacity.

Altered partition of threonine metabolism in pigs by protein-free feeding or starvation.

Kinetic aspects of threonine (Thr) metabolism were examined in growing pigs fed a well-balanced diet (C), an isocaloric protein-free diet (PF), or starved (S) for 48 h. With the use of continuous simultaneous infusion of L-[1-13C]Thr, [1-14C]sarcosine, and 2-[1-14C]ketobutyrate (KB) for 10 h, estimates were made of rates of Thr incorporated into protein (S), released from body proteins (B), and oxidized through the catabolic pathways of L-Thr 3-dehydrogenase (TDG) and threonine dehydratase (TDH). In the C group S was 185, B was 138, Thr disposal to glycine (DRThr-Gly) was 47, and Thr disposal to KB (DRThr-KB) was 7 mumol.h-1.kg-1. Consequently, Thr balance was +48 mumol.h-1.kg-1. In the PF-fed pigs, S, B, DRThr-Gly, and DRThr-KB were significantly reduced by 38, 15, 74, and 75%, respectively. In the S group, S, B, and DRThr-Gly were significantly reduced by 47, 17, and 55%, respectively, but DRThr-KB was similar to the C group. DRThr-Gly in all groups was highly correlated with TDG enzyme activity measured in liver homogenates. By contrast with in vivo results, TDH enzyme activity was increased by 88% (P less than 0.05) in the S group and decreased by 27% (not significant) in the PF group compared with the C group. The TDH pathway accounted for 13, 12, and 27% of total Thr oxidation in the C, PF, and S groups, respectively. These results suggest that Thr conservation in protein-depleted states (PF and S groups) occurred mainly by a decrease of Thr oxidation and that the partition through these pathways was only altered when energy was completely withdrawn.

Assessment of threonine metabolism in vivo by gas chromatography/mass spectrometry and stable isotope infusion.

The fractional contributions (FC) of threonine to glycine and 2-ketobutyrate (KB) fluxes in fed pigs have been assessed by the constant infusion of L-[1-13C]-threonine. The analysis of the enantiomeric purity of labeled threonine by gas chromatography/mass spectrometric (GC/MS) analysis is reported as the N-TFA isopropyl ester derivative. The commercially available [1-13C]threonine comprised 98.7% of the L-enantiomer, enriched at 99 atom percentage excess (APE), and 1.3% of L-allo-threonine contaminant, also enriched at 99 APE. The enantiomeric purity of threonine in plasma of pigs infused for 10 h with [1-13C]threonine showed that the L-allo contaminant did not accumulate. The t-butyl dimethylsilyl derivatives of threonine, glycine, and 2-aminobutyrate (ABA) were used to measure the enrichment of these compounds in plasma and liver samples by GC/MS/selected ion monitoring analysis. Analyses were performed on between 1 and 5 nmol of each amino acid extracted from biological fluids and a 1:10 split injection. GC/MS parameters were assessed with standards at similar quantities and found to be satisfactory; e.g., injection of 1-10 nmol of glycine did not significantly alter the slope and the precision of the standard curve. The coefficient of variation of enrichment determination was less than 10% for standards enriched at 0.4 APE or more and biological samples enriched at 0.6 APE or greater. Within-animal coefficients of variation for four plasma samples obtained at equal intervals between 8 and 10 h of [1-13C]threonine infusion were 4, 21, and 24% for threonine, ABA, and glycine, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Protein metabolism in the newborn lamb. IV. Consequences of amino acid and lactose ingestion]. / Métabolisme protéique de l'agneau nouveau-né. IV. Conséquences de l'ingestion d'acides aminés et de lactose.

A study was made on protein metabolism and hormonal changes following birth in newborn lambs fed amino acids alone or in combination with lactose. Eight newborn lambs taken from their mother immediately after birth were fed hourly for 8 h, either with a solution of peptides and free amino acids obtained by mild hydrolysis of whey proteins (4 lambs; diet AP) or with the same solution + lactose (4 lambs; diet APL). L-[4,5-3H] leucine was continuously perfused into a jugular vein for 6 h when the lambs were 2 h 30 min old. Plasma glucose and insulin levels increased after birth in APL lambs whereas they decreased in the AP; these differences were significantly different. Plasma cortisol levels remained unchanged throughout the experiment. Free essential amino acid levels did not vary when lambs were older than 4.5 h; they depended on the corresponding amino acid intakes. Plasma free threonine, valine, isoleucine, leucine, tyrosine and lysine were lower in APL than in AP lambs. The plasma leucine irreversible loss and leucine oxidation were higher in AP than in APL lambs. The plasma flux of leucine from whole body protein breakdown was lower in APL than in AP lambs inasmuch as the plasma flux of dietary leucine may be estimated by the amounts of leucine ingested in both cases. No significant difference was found for the fractional synthesis rates of tissue proteins such as liver, skin, skeletal muscle, lung, brain and whole body. These rates for skin, muscle and whole body were close to those previously measured in colostrum fed lambs. The increase in whole body protein accretion resulting from lactose feeding in combination with amino acids seemed to result from a decreased protein breakdown that could be mediated by the insulin response.

[Digestion of milk proteins and metabolism of methionine in the newborn lamb]. / Digestion des protéines de lait et métabolisme de la méthionine chez l'agneau nouveau-né.

Methionine absorption and catabolism were studied in 4 newborn lambs during the first 8 h after birth. Lambs were hourly fed 50 ml goat milk labelled with 35S-methionine and 35S-cysteine. The free amino acid levels and the specific activity of free methionine were measured in jugular blood samples collected 1 h (just before the first meal), 4, 6 and 8 h after birth and in the portal blood 8 h after birth. Specific activities of protein-bound methionine and cysteine were measured in the milk and then in the abomasal and intestinal contents as well as in the liver, intestine and whole body proteins, 8 h after birth. The jugular blood levels of free valine, isoleucine, leucine, phenylalanine and histidine increased significantly between 1 and 8 h whereas the levels of free alanine, serine, glycine, citrulline and 3-methylhistidine decreased. The concentrations of most free amino acids were 30% higher in portal than in jugular blood. In the abomasal contents, the specific activities of methionine and cysteine were 96 and 168%, respectively of that of ingested milk and in the intestinal contents the corresponding values were 24 and 31% (table 1). In the jugular blood, the specific activity of methionine reached a plateau before 5 h after the first meal; in the portal blood 8 h after birth it represented 75% of the specific activity entering the small intestine. The blood methionine flux was calculated according to two methods: from whole-body protein synthesis rates and methionine catabolism and from the irreversible loss of blood methionine (table 2).(ABSTRACT TRUNCATED AT 250 WORDS)