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Gennemark, P.

Publications and source records attributed to Gennemark, P..

9 recordsLinked to original sources

An Integrated Analysis of GLP-1R Agonist Mechanisms: Addressing Study Variations in Heterogeneous Cell Systems

Experimental cell systems support the development of pharmacological therapies such as glucagon-like peptide-1 receptor agonists (GLP-1RAs). However, their utility in drug discovery is limited due to study variability, which complicates formation of unified conclusions based on all available data. To address this, we conducted a comprehensive analysis of the GLP-1RA exenatide, incorporating 16 new and five pre-existing mono- or co-culture studies of human liver and pancreatic models. We employed a new pragmatic model-based approach designed to handle the common situation of heterogeneous in vitro datasets with few replicates per condition. All studies are jointly explained (disagreement<{chi}{superscript 2}-limit; 542<732), thereby providing a unified conclusion based on all studies. This work links in vitro biology to clinically relevant mechanisms, such as exenatides effect on glucose-insulin interplay, and predicts previously undescribed inter-study variabilities. Independent validation confirms predictive performance (64<83). Our new integrative approach enhances the utility of experimental cell systems in preclinical drug discovery.

systems biology↗

Reversible peptide self-assembly enables sustained drug delivery with tuneable pharmacokinetics

Therapeutic peptides combine high target specificity with potent biological activity.1 However, treatment success is often limited by rapid clearance and the need for frequent injections.2, 3 This challenge is particularly acute for therapeutic peptides used in obesity, where clinical benefit must be balanced against dose-dependent adverse effects. In nature, these constraints are overcome by storing hormones as reversible fibrils,4 but pharmacokinetic control is essential for widespread adoption of bio-inspired self-assembled depots for therapeutic peptides. Here, we show that tuneable pharmacokinetics can be achieved and modelled by mapping the fundamental chemical parameters of reversibly self-assembly in vitro. We demonstrate this approach for the amylin analogue pramlintide. Amylin analogues are under development for the next generation of diabetes and obesity treatments, with improved mechanism of action e.g. preserving lean body mass.5-8 Pramlintide is an approved drug with a well-established safety profile, however, it has a comparable half-life to native amylin.8-12 In a pilot study, we achieve in vitro-in vivo correlation, increasing the half-life of pramlintide 20-82-fold in rats, while controlling burst release. These findings demonstrate that the optimisation of pharmacokinetics can be decoupled from peptide engineering, establishing a generalisable framework for generating long-acting peptide formulations by emulating native storage mechanisms.

biophysics↗

M4 drug discovery: human drug predictions from integrated pre-clinical insights exemplified with a GLP1-R agonist

A major recent breakthrough in the treatment of type 2 diabetes has been the development of glucagon-like peptide-1 receptor agonists (GLP-1RAs). However, current translational frameworks struggle to predict the clinical outcomes of these drugs from preclinical data. There are several reasons for this struggle, which are generic for many drugs: GLP-1RAs act through multi-timescale mechanisms in which short-term effects propagate into long-term changes; no single preclinical system can capture all their effects in humans; and mechanistic extrapolation requires modelling numerous whole-body biological processes. To address this gap, we present a new extrapolation approach, M4 drug discovery, and retrospectively apply it to the GLP-1RA exenatide in a manner that is generalisable to other drugs. The method integrates: Multi-level data (cellular to whole-body), Multi-timescale data (minutes to months), Multi-species data (e.g., rodents to humans), and Mechanistic knowledge. In this study, we integrate human cell and animal data with drug-free human studies to successfully predict human pharmacokinetics (cost < {chi}2, p=0.05; 64 < 97) and the outcomes of a 30-week clinical trial (36 < 45). We found that integrating information across the four M4 axes improved predictive performance and physiological relevance: multi-species data inform pharmacokinetics, human cell data provide human population- and donor-specific potency estimates, animal data reveal additional drug effects not observable in cell cultures, and the multi-timescale mathematical modelling enables short-term effects of exenatide and meals to inform long-term changes in insulin sensitivity. This work provides new tools for drug extrapolations, supporting the community towards safer and more informed preclinical-to-clinical drug extrapolations.

systems biology↗

Diseased human pancreas and liver microphysiological system for preclinical diabetes research

Current research on metabolic disorders such as type 2 diabetes relies on animal models because multi-organ diseases cannot be well studied with the standard in vitro assays. Here, we connect models of key metabolism organs, pancreas and liver, on a microfluidic chip to enable diabetes research in a human-based preclinical system. Aided by mechanistic mathematical modelling, we developed a two-organ microphysiological system (MPS) that replicates clinically-relevant phenotypes of diabetic dysregulation both in the liver and pancreas compartments. Exposure to hyperglycemia and high cortisone created a diseased pancreas-liver MPS which displayed beta-cell dysfunction, steatosis, elevated ketone-body secretion, increased glycogen storage, and upregulated gluconeogenic machinery. In turn, normoglycemia and physiological cortisone concentration maintained glucose tolerance and stable liver and beta-cell functions. This method was evaluated for repeatability in two laboratories and was effective in multiple pancreatic islet donors. The model also provides a platform to identify new therapeutic targets as demonstrated with a liver-secreted IL-1R2 protein that induced islet proliferation.

cell biology↗

3D Cell Cultures Amplify Diffusion Signals

Biophysical models can predict the behavior of cell cultures including 3D cell aggregates (3DCAs), thereby reducing the need for costly and time-consuming experiments. Specifically, mass transfer models enable studying the transport of nutrients, oxygen, signaling molecules, and drugs in 3DCA. These models require the defining of boundary conditions (BC) between the 3DCA and surrounding medium. However, accurately modeling the BC that relates the inner and outer boundary concentrations at the border between the 3DCA and the medium remains a challenge that this paper addresses using both theoretical and experimental methods. The provided biophysical analysis indicates that the concentration of molecules inside boundary is higher than that at the outer boundary, revealing an amplification factor that is confirmed by a particle-based simulator (PBS). Due to the amplification factor, the PBS confirms that when a 3DCA with a low concentration of target molecules is introduced to a culture medium with a higher concentration, the molecule concentration in the medium rapidly decreases. The theoretical model and PBS simulations were used to design a pilot experiment with liver spheroids as the 3DCA and glucose as the target molecule. Experimental results agree with the proposed theory and derived properties. Author summaryThe primary objective of our research was to enable the development of reliable biophysical models for three-dimensional cell aggregates (3DCAs). To achieve this goal, we employed a combination of theoretical and experimental methods to derive and characterize the amplification boundary condition (BC), which represents the relation of inner and outer boundary concentrations at the border between a 3DCA and its surrounding medium. By understanding the amplificaiton BC, we can better comprehend the transport and diffusion processes that occur within 3DCAs. The significance of our research lies in its potential to advance the understanding of 3DCAs and their underlying biophysical processes. This knowledge is crucial for a wide range of applications, including drug design and analysis of drug dosages within tissues. This factor may provide insight into the mechanisms behind tumor development and morphogenesis. In particular, the packed structure of cancer tumors enables them to receive and trap a higher concentration of nutrients and oxygen molecules based on the amplification factor. Thus, this study could contribute to the development of novel approaches to manage and treat cancerous tissues.

biophysics↗

A multi-scale digital twin for adiposity-driven insulin resistance in humans: diet and drug effects

AimsThe increased prevalence of insulin resistance is one of the major health risks in society today. Insulin resistance involves both short-term dynamics, such as altered meal responses, and long-term dynamics, such as development of type 2 diabetes. Insulin resistance also occurs on different physiological levels, ranging from disease phenotypes to organ-organ communication and intracellular signaling. To better understand the progression of insulin resistance, an analysis method is needed that can combine different timescales and physiological levels. One such method is digital twins, consisting of combined mechanistic multi-scale and multi-level mathematical models. We have previously developed a multi-level model for short-term glucose homeostasis and intracellular insulin signaling, and there exists long-term weight regulation models. However, no one has combined these kinds of models into an interconnected, multi-level and multi-timescale digital twin model. Herein, we present a first such multi-scale digital twin for the progression of insulin resistance in humans. MethodsThe model is based on ordinary differential equations representing biochemical and physiological processes, in which unknown parameters were fitted to data using a MATLAB toolbox. ResultsThe connected twin correctly predicts independent data from a weight increase study, both for weight-changes, for fasting plasma insulin and glucose levels, as well as for intracellular insulin signaling. Similarly, the model can predict independent weight-change data in a weight loss study, involving diet and the weight loss drug topiramate. These independent validation tests are confirmed by a chi-square test (() = 4.8 < 21 = 2, (12,0.05)). In both these cases, the model can also predict non-measured variables, such as activity of intracellular intermediaries, glucose tolerance responses, and organ fluxes. ConclusionsWe present a first multi-level and multi-timescale model, describing dynamics on the whole-body, organ and cellular levels, ranging from minutes to years. This model constitutes the basis for a new digital twin technology, which in the future could potentially be used to aid medical pedagogics and increase motivation and compliance and thus aid in prevention and treatment of insulin resistance.

systems biology↗

Digital twin predicting diet response before and after long-term fasting

Today, there is great interest in diets proposing new combinations of macronutrient compositions and fasting schedules. Unfortunately, there is little consensus regarding the impact of these different diets, since available studies measure different sets of variables in different populations, thus only providing partial, non-connected insights. We lack an approach for integrating all such partial insights into a useful and interconnected big picture. Herein, we present such an integrating tool. The tool uses a novel mathematical model that describes mechanisms regulating diet-response and fasting metabolic fluxes, both for organ-organ crosstalk, and inside the liver. The tool can mechanistically explain and integrate data from several clinical studies, and correctly predict new independent data, including data from a new clinical study. Using this model, we can predict non-measured variables, e.g. hepatic glycogen and gluconeogenesis, and we can quantify personalized expected differences in outcome for any diet. This constitutes a new digital twin technology.

systems biology↗

Integrated experimental-computational analysis of a liver-islet microphysiological system for human-centric diabetes research

Microphysiological systems (MPS) are powerful tools for emulating human physiology and replicating disease progression in vitro. MPS could be better predictors of human outcome than current animal models, but mechanistic interpretation and in vivo extrapolation of the experimental results remain significant challenges. Here, we address these challenges using an integrated experimental-computational approach. This approach allows for in silico representation and predictions of glucose metabolism in a previously reported MPS with two organ compartments (liver and pancreas) connected in a closed loop with circulating medium. We developed a computational model describing glucose metabolism over 15 days of culture in the MPS. The model was calibrated on an experiment-specific basis using data from seven experiments, where single-liver or liver-islet cultures were exposed to both normal and hyperglycemic conditions resembling high blood glucose levels in diabetes. The calibrated models reproduced the fast (i.e. hourly) variations in glucose and insulin observed in the MPS experiments, as well as the long-term (i.e. over weeks) decline in both glucose tolerance and insulin secretion. We also investigated the behavior of the system under hypoglycemia by simulating this condition in silico, and the model could correctly predict the glucose and insulin responses measured in new MPS experiments. Last, we used the computational model to translate the experimental results to humans, showing good agreement with published data of the glucose response to a meal in healthy subjects. The integrated experimental-computational framework opens new avenues for future investigations toward disease mechanisms and the development of new therapies for metabolic disorders.

systems biology↗

A multi-scale in silico mouse model for insulin resistance and humanoid type 2 diabetes

Insulin resistance (IR) causes compensatory insulin production, which in humans eventually progresses to beta-cell failure and type 2 diabetes (T2D). This disease progression involves multi-scale processes, ranging from intracellular signaling to organ-organ and whole-body level regulations, on timescales from minutes to years. T2D progression is commonly studied using overfed and genetically modified rodents. However, rodents do not exhibit human T2D progression, with IR-driven beta-cell failure, and available multi-scale data is too complex to fully comprehend using traditional analysis. To help resolve these issues, we here present an in silico mouse model. This is the first mathematical model that simultaneously explains multi-scale mouse IR data on all three levels - cells, organs, body - ranging from minutes to months. The model correctly predicts new independent multi-scale validation data and provides insights into non-measured processes. Finally, we present a humanoid in silico mouse exhibiting disease progression from IR to IR-driven T2D.

systems biology↗