Biologics Flashcards

1
Q

Define biopharmaceutics.

A

Biopharmaceutics are drugs that have biological active ingredient that have a therapeutic effect.

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2
Q

What are some examples of biopharmaceutics in market today (5 examples)?

A

Carbohydrates (low molecular weight heparin)
Protein and peptide hormones (Insulin)
Monoclonal antibodies (Trastuzumab)
Vaccines (Diphtheria-Pertussis-Tetanus vaccine)
Cytokines (Interferons)

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3
Q

What are some of the issues that remain today regarding biopharmaceuticals in relation to the route of administration?

A

Biopharmaceutics have high molecular weights (>5000 Da) and suffer with stability problems upon storage and after administration meaning that they remain unavailable in non-parenteral formulation.
The active structure of biologics make them more likely to induce an immune response.

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4
Q

What are some of the benefits of using biologics?

A

They have a much larger surface area in comparison to smaller molecules and they are able to bind much more specific to their drug target (they are evolved to their drug target).
Ultimately more selective binding results in less induced side effects.

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5
Q

What are some of the drawbacks of using biologics?

A

More complex synthesis
Storage instability
Parenteral formulations only
More likely to be antigenic and evoke an immune response compared to smaller molecules

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6
Q

What are some of the benefits of using small molecules?

A

Small molecules are synthesised using medicinal chemistry techniques which is relatively straight forward and does not have the added complexity of growing the molecules in cell lines.
The manufacturing approach to synthesising small molecules is done at a large production scale with refined techniques in attempt to drive manufacturing costs down.
Small molecules tend to be membrane permeable - even if the drug has increased hydrophilicity- usually small enough to still be uptaken into the cell, or by an alternative route.

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7
Q

What are some of the key differences between small molecules and Biologics?

A

In addition to biologics being much more complex, there are some key differences between the two:

Small molecules are synthesised through a predictable chemical process and form identical copies whereas biologics are synthesised through a cell line; similar but not identical copies are made.

Biologics are much more difficult to characterise than small molecules

Biologics are much more sensitive to degradation so greater consideration is required during handling and storage

Immunogenicity with small molecules is relatively unexpected however with biologics there is a much higher potential for an immune response (many biologics are immune-modulating)

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8
Q

Describe the structure of insulin.

A

Insulin is a peptide consisting of 51 amino acids and has an alpha (21 residues) and beta (30 residues) chain linked by di-sulphide bridges.

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9
Q

Describe how insulin was first manufactured.

A

First insulin was extracted from the pancreas of a cow but the purification process was complex.
Then insulin began to be mass produced by a strategy known as isoelectric precipitation.
However it became apparent that use of animal insulin was inconsistent and causing some adverse reactions within patients.
In the 1970s recombinant DNA technology where cells are re-programmed to produce insulin (synthetic insulin) reducing the need for animal insulin.

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10
Q

Describe in detail the recombinant production of therapeutic proteins in application of insulin.

A

The gene that is response for coding for insulin identified, isolated and amplified before being cloned into complementary DNA, becomes expressed on a plasmid and then transferred into the host cell. The protein becomes expressed following choice of an appropriate cell line has been selected. This protein is then expanded in a fermentation medium (bioreactor) by growth of cells following normal replication.
The protein product in this case insulin is then isolated by centrifugation/filtration and the protein itself is purified by chromatographic techniques.
The protein then needs to undergo post-translational modifications responsible for it’s folding.

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11
Q

Is the recombinant production technique a homologous or heterologous expression?

A

Heterologous expression as the gene has to be inserted into the cell for its expression, the cell doesn’t naturally produce the protein.

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12
Q

What are some examples of host organisms used in the process of recombinant DNA?

A

E coli
Chinese Hamster Ovary cell lines
Yeast cells

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13
Q

What are the advantages of using E coli?

A

Molecular biology is well characterised
High expression of heterologous proteins are possible
Quick and cheap
Possible to scale up large fermentation culture

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14
Q

What are the disadvantages of using E coli?

A

Formation of LPS on the surface of E coli (pyrogenic) provoking an immune response
Heterologous proteins accumulate intracellularly not extracellularly and therefore have to lysis the cell before extracting them
Inability of the cell to undergo post translational modifications but is critical for desired activity of many proteins
Formation of inclusion bodies (insoluble aggregates of partially soluble heterologous proteins)

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15
Q

What are some examples of post-translational modifications?

A

Glycosylation
Phosphorylation
Sulfation

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16
Q

What are post-translational modifications?

A

Any covalent modification of the peptide chain after synthesis, can be critical for the therapeutic activity (may not fold or bind correctly) this is outside of the template of DNA, RNA, mRNA sequence.

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17
Q

What are the steps in the process of creating a functional protein?

A

DNA codes for RNA which codes for mRNA which then codes for the protein. There is a translation of the mRNA sequence on to the ribosome. The protein is then folded and bound to co-factors which provides the molecule with shape and potential sites for binding interactions.

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18
Q

Which type of bonds provide the folding process in the molecule?

A

Normally hydrogen bonds in addition to other non-covalent bonds. These are not the same as the post-translational modifications of the molecule which impact its therapeutic effect which are caused by covalent bonds.

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19
Q

What function does the post-translational modification of glycosylation have to the function of the peptide?

A

Increases the solubility
Alters the biological half life and activity of the molecule

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20
Q

What function does the post-translational modification of phosphorylation have to the function of the peptide?

A

Regulates the activity of many polypeptide hormones

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21
Q

What function does the post-translational modification of sulfation have to the function of the peptide?

A

Regulates activity of some neuropeptides and processing of other polypeptides

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22
Q

Do all proteins rely on glycosylation for its desired activity and therapeutic effect?

A

No, some proteins can be relatively unaffected by the removal of a glycosylation group however some proteins rely on glycosylation for their activity. An example of this is IgG which strongly relies on one glycosylation site for its activity.

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23
Q

What are the two types of glycosylation?

A

N-glycosylation which is more common and O-glycosylation

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24
Q

Where does N-glycosylation occur?

A

It occurs in the rough endoplasmic reticulum

The fully synthesised glycosyl chain is bound into the membrane is transferred to the newly synthesised peptide chain by the enzyme oligosaccharyl transferase.

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25
Q

What is N linked glycosylation ?

A

N linked glycosylation is simply the transfer of an oligosaccharide to a nitrogen atom (specifically the amide nitrogen of an asparagine residue of a protein).

26
Q

What are the two crucial steps of N linked glycosylation?

A

Assembly or synthesis of the lipid linked oligosaccharide
The transfer of this oligosaccharide to the asparagine residues of the peptide

27
Q

Where does the synthesis of LLO (lipid linked oligosaccharide) occur and what does it involve?

A

Both sides of the endoplasmic reticulum membrane. It involves several glycosyltransferases that catalyse the assembly of branched oligosaccharides.

28
Q

What enzyme is responsible for the transfer of the oligosaccharide to the nitrogen on the asparagine residue?

A

Oligosaccharide transferase is responsible for the formation of the N-glyosidic linkeage between the amide of asparagine and the oligosaccharide. The enzyme is also responsible for recognising and selecting the specific sequences containing asparagine that are appropriate.

29
Q

Is there a sequence specificity for N-linked glycosylation?

A

Either Asparaginine - Any amino acid (except proline) - Serine or Threonine

30
Q

Explain the process of oligosaccharide trimming?

A

It is the process of once the glycosylation has occurred, other enzymes will come in and remove sequences of the peptide. Commonly after glycosylation, three glucose and one mannose is removed in the endoplasmic reticulum.

31
Q

What are one of the main difficulties with post-translational modifications?

A

It is not a template driven process for example there is no nucleic acid acid coding for whether the glycosylation is going to occur at one site or the other or for sugar residues in a glycan unlike the recombinant DNA process.

32
Q

What is the core motif that is always maintained in the oligosaccharide substituent?

A

Man3 GIc NAc2

33
Q

Where does the O linked glycosylation occur?

A

In the endoplasmic reticulum / golgi

34
Q

Which type of proteins tend to undergo O linked glycosylation?

A

Mucines (found in the GI tract, mucosa)

35
Q

Is there any sequence specificity for O linked glycosylation?

A

Yes either a serine or a threonine

36
Q

How many core structures can be formed by O linked glycosylation?

A

Up to 8 different structures can be formed that have the same peptide sequence. This is determined by how it is exposed to the enzymes.

37
Q

Briefly outline the assembly of oligosaccharide chains.

A

There must be a sugar donor (sugar nucleotide such as UDP-glucose) and a sugar acceptor (nascent protein or oligosaccharide).
It is not template driven
Instead occurs due to availability of the enzyme or the donor

38
Q

How do glycoforms arise?

A

Due to variations of proteins that have the same peptide sequence but different glycosylation patterns

39
Q

What are some of the pharmacokinetic and pharmacological effects of glycoforms?

A

Leads to variations in:
Solubility
Half life - bioavailability
Immunogenicity
Stability - due to differences in conformation, resistance to proteases
Activity

40
Q

Taking into account the effects of glycoforms why is it crucial in control the one produced?

A

Controlling the produced glycoform can have a significant impact on the therapeutic effect of the drug.

41
Q

Taking into account, utilisation of prokaryotes and eukaryotes for recombinant DNA processing which is better?

A

It is heavily dependent of if the peptide requires post-translational modifications for its activity as use of prokaryotes can produce an identical peptide sequence to eukaryotes but can have no therapeutic effect as prokaryotes do not have the internal machinery in order to produce glycoforms or other post-translational modifications.

42
Q

What are some examples of eukaryotes used?

A

Chinese Hamster Ovary or Human embryonic kidney cells

43
Q

What manufacturing technique was first used in production of monoclonal antibodies at a large scale?

A

Hybridoma technology

44
Q

What was the major initial problem with use of monoclonal antibodies?

A

Development of self immungenicity
Initially mouse antibodies, however they were not as effective as the manufacturers first hoped as it lead to patients developing an immune response and antibodies to the injected mouse antibodies. This was known as HAMA (Human Anti-Mouse antibody).

45
Q

What was the solution to the HAMA problem?

A

Development of humanised antibodies (which contain only mouse or foreign sequences coding for the antigen binding region, in hypervariation region, rest of the antibdy including the Fc region is human) and fully human antibodies.

46
Q

Outline the steps involved in hybridoma technology in the production of monoclonal antibodies.

A

Mouse is immunised with specific antigens
Isolation of antibody producing plasma B cells
The plasma cells are then mixed with immortal myeloma and fused with PEG (polyethylene glycol) so that they will continue to grow
Cells are then grow in a HAT medium but is selective and only the fused plasma cells producing the antibodies are grown.
Out of those cells those with a high antibody production are diluted down to one cell on a well with the highest antibody production and this cell is expanded and grown in large numbers

47
Q

How does the term hybridoma come into this process?

A

A hybridoma is formed by fusion of the plasma cell that has been injected with the antigens and a myeloma (immortal) cell. You want these to fuse so that you get one cell with both of these properties (instead or two of one type fusing or an unfused cell). Therefore you are selecting out cell types that either consist of just plasma cells (will have a short lifespan) and just myeloma cells (will not produce the antibodies). Provides a good yield of antibodies over a long period of time.

48
Q

What machinery is used in hybridoma technology?

A

There is a large sealed vessel, full of growth medium. Cells then have to be extracted.

49
Q

What are the isolation and purification techniques used depend on?

A

Whether the monoclonal antibody is secreted or found intracellularly

50
Q

What are some of the purification techniques used extraction of monoclonal antibodies?

A

Treating with chemical such as detergents
Altering the pH, alkaline disruts the cell membrane
Sonification- sounds waves
Agitation- breaking things up

Purified by chromatographic techniques
Affinity chromatography
Ion exchange
Gel filtration

51
Q

Describe what happens when a patent expires for a generic small molecule drug.

A

Any company can then produce/ manufacturer the drug and as long as that drug then meets the biological standards (certain pharmacokinetic parameters) it can then be licensed, driving prices down.

52
Q

Describe what happens when a patent expires for biological drugs.

A

Due to the complexities associated with the manufacturing of these biological drugs (extracting from living cells and alterations in glycoforms and other post-translational modifications) this has to be treated as a drug in its own right, it can’t be treated as a generic - known as a biosimilar.

53
Q

What are the properties of biosimilars?

A

Same protein sequence and fold needs to be reproducedbut different post-translational modifications.

They can not be deemed as interchangeable until further testing.

54
Q

How long is patent life?

A

About 20 years

55
Q

Why is it difficult for other drug companies to produce the exact same biological drug?

A

They do not have access to the manufacturing information so it is impossible. Instead companies aim to produce a drug which is biologically and clinically comparable.

56
Q

What are the major issues when regarding biosimilar interchangeability?

A

Safety
Immunogenicity
Clinical efficacy

Prescribing a biosimilar should be seen as a new therapeutic intervention

57
Q

What increases the risk of immunogenicity regarding a biological drug?

A

Presence of impurities arising from inadequate storage
Route of administration (IV is less than IM/ s/c)
Previous exposure
Age
Presence of HLA
Co-morbidities

58
Q

What is the European Medicine Agency guidelines for licensing biosimilars?

A

They receive guidelines that require that the:
Pharmacokinetic
Pharmacology
Toxicology
Clinical studies
Should have no meaningful difference in a double blinded clinical trial of a substantial size

59
Q

What does MCID mean and what does it stand for?

A

Minimal difference in a meaningful clinical endpoint between two treatments beyond which regulatory bodies would consider the two drugs to be non-equivalent.

60
Q

Is the MCID the same for all drugs?

A

No it is specific to the drug bsed on clinical grounds.
For example for the biosimilar of Filgrastim the MCID was plus/minus the day of severe neutropenia following myelosuppressive chemo.

61
Q

What is the MCID for monoclonal antibodies?

A

Being in a state of disease free, progression free or survival

62
Q

What were some of the pharmacokinetic differences between Filgrastim and Pegfilgrastim?

A

Pegfilgrastim has reduced renal clearance and prolonged persistence in vivo by the addition of a polyethlene glycol (PEG) molecule to Filgrastim.