Abstract

The staggering cost of bringing a drug to market coupled with the extremely high failure rate of prospective compounds in early phase clinical trials due to unexpected human toxicity makes it imperative that more relevant human models be developed to better predict drug toxicity. Drug–induced nephrotoxicity remains especially difficult to predict in both pre-clinical and clinical settings and is often undetected until patient hospitalization. Current pre-clinical methods of determining renal toxicity include 2D cell cultures and animal models, both of which are incapable of fully recapitulating the in vivo human response to drugs, contributing to the high failure rate upon clinical trials. We have bioengineered a 3D kidney tissue model using immortalized human renal cortical epithelial cells with kidney functions similar to that found in vivo. These 3D tissues were compared to 2D cells in terms of both acute (3 days) and chronic (2 weeks) toxicity induced by Cisplatin, Gentamicin, and Doxorubicin using both traditional LDH secretion and the pre-clinical biomarkers Kim-1 and NGAL as assessments of toxicity. The 3D tissues were more sensitive to drug-induced toxicity and, unlike the 2D cells, were capable of being used to monitor chronic toxicity due to repeat dosing. The inclusion of this tissue model in drug testing prior to the initiation of phase I clinical trials would allow for better prediction of the nephrotoxic effects of new drugs.

Highlights

  • It is estimated that it takes 9 years and costs between 0.8 and 1.7 billion dollars to bring a drug through clinical trials [1,2]

  • To examine the ability of the NKi-2 cells to function as renal proximal tubule cells, they were subjected to multiple functional assays including adenylate cyclase activity, hydrolase activity, and glucose uptake [21,22]

  • Renal proximal tubule cells respond to parathyroid hormone (PTH) by upregulating adenylate cyclase activity producing cyclic AMP

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Summary

Introduction

It is estimated that it takes 9 years and costs between 0.8 and 1.7 billion dollars to bring a drug through clinical trials [1,2]. Compounded upon the cost and time, only about 8% of drugs entering Phase I clinical trial testing make it to market [2] This low rate is due to numerous factors including the lack of wellestablished testing methods capable of accurately predicting clinical usefulness and drug toxicity during pre-clinical development. The FDA’s Critical Path Initiative calls for the development of better tools to improve the success of drug candidates that proceed from pre-clinical testing to clinical trials [2]. Included in this process is the development of human tissue models better capable of predicting human in vivo responses, including organ toxicity. Current pre-clinical testing methods are not rigorous enough to predict the human response to most drugs

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