Biology subjects

Metcalf, D.

Publications and source records attributed to Metcalf, D..

3 recordsLinked to original sources

bioRxiv2026

Nonclinical pharmacokinetics and relative efficacy of the first 25 novel tuberculosis drug combinations from the PAN-TB consortium: Use of the BALB/c relapsing mouse model and combination pharmacokinetics within a modeling-based framework

The Project to Accelerate New Treatments for Tuberculosis (PAN-TB) aims to accelerate development of shorter, simpler and safer pan-TB combinations, effective for use in both Drug Susceptible (DS)- and Drug Resistant (DR)- TB patients. Towards this aim, bactericidal and sterilizing activity of 25 priority 4-drug combinations was evaluated at doses targeting clinically relevant exposures, in the BALB/c relapsing mouse model of TB. The combinations comprised 8 PAN-TB drugs and candidates: bedaquiline (B), pretomanid (Pa), delamanid (Del), quabodepistat (Q), sutezolid (Sut), GSK2556286 (286), GSK3211830 (830) and ganfeborole (GSK3036656, (656)). Combination PK studies in infected mice enabled dose selection and a population-PK approach guided dosing so that compounds should achieve mean AUC0-24 within 2-fold of their clinical target exposures during the efficacy studies. All test combinations showed time-dependent bactericidal activity, with six regimens reducing lung bacterial burdens below the limit of detection with 8 weeks treatment, similar to the comparator BPaMZ (M is moxifloxacin and Z as pyrazinamide). Cure/Relapse data were modelled to derive population time to cure 90% mice (T90) values. Fifteen PAN-TB combinations had T90s of less than 5 months, sterilizing mice faster than the standard of care for drug susceptible TB, RHZE/RH. The best-performing PAN-TB combinations, BPa830Sut, BPa286Sut and BQSut286, cured 90% of mice in less than 3 months. These 3 top-ranked 4-drug combinations are all centered on a diarylquinoline (B)/oxazolidinone (Sut) core, together with the nitroimidazole (Pa) or a DprE1 inhibitor (Q) plus a novel agent such as the LeuRS inhibitor (830) or the Rv1625c agonist (286).

microbiology↗

bioRxiv2025

A modeling-based framework to evaluate forgiveness of TB drug combinations in a BALB/c relapsing mouse model.

Tuberculosis (TB) remains a leading cause of death due to an infectious agent. Adherence to long and complex TB treatments is supported by methods including directly observed therapy. The negative impact of missed drug doses on clinical outcomes is well-established, highlighting both the importance of adherence support and methods to quantify the ability of a regimen to continue exerting a biologic effect, during gaps in dosing known as "forgiveness" property. To explore the value of the BALB/c Relapsing Mouse Model of TB in evaluating treatment forgiveness, we assessed the impact of weekend dose holidays on the bactericidal, including RS ratio(R), and sterilizing efficacy of RHZE/RH and BPaMZ in perspective of each drug exposure. The cure/relapse data from this study plus multiple historical studies were used to identify a nonlinear mixed-effects Emax model that was used to estimate time to cure 50% and derive time to cure 90% mice (T90). Expected time-dependent bactericidal activity and reductions in RS ratio were observed for both treatments, with more rapid decreases for the BPaMZ groups. The weekend dosing holiday significantly decreased reductions in lung CFU and RS ratio earlier in RHZE/RH treatment, but no such effect was observed for BPaMZ. Similarly, the predicted T90 was significantly greater for RHZE/RH (but not BPaMZ), with weekend doses omitted. No major drug exposure difference was observed between the 2 dosing schedules. Our results suggest BPaMZ is more forgiving of missed doses than RHZE/RH and suggests utility of this methodology to support evaluation of TB treatment forgiveness.

pharmacology and toxicology↗

bioRxiv2024

A multi-track landscape of haematopoiesis informed by cellular barcoding and agent-based modelling

In classic ball-and-stick models of haematopoiesis the implicit assumption is that all cells within each defined stem or progenitor cell population are equivalent in their fate. Instead, more recent models suggest a haematopoietic stem and progenitor cell (HSPC) continuum of lineage bias and commitment, which is largely inferred through snapshot analysis of single cell gene expression or clonal fate. However, the dynamic assessment of lineage commitment of specific HSPC populations and their clonal output over time in vivo is still lacking but is essential to fully inform accurate models of haematopoiesis. Here, using cellular barcoding we compare the single cell output of long-term haematopoietic stem cells (LT-HSCs), short-term HSCs (ST-HSCs), multipotent progenitors (LMPPs), common myeloid progenitors (CMPs), common lymphoid progenitors (CLPs), and macrophage/dendritic cell progenitors (MDPs). Each population was assessed for their output to multiple haematopoietic cell types spanning a subset of time points from 9 to 112 days of haematopoiesis after transplantation. These analyses revealed a wide range of clonal fate patterns that were inconsistent with their eponymous labels, i.e. stem and multipotent progenitors were rarely multi- or equipotent, and common progenitors were often highly restricted in their fate. To better describe how these clonal patterns integrate into a revised landscape, a novel agent-based mathematical modelling approach that explicitly accounts for haematopoiesis at a clonal level was developed to allow the simulation of growth, timing and branching of clonal trajectories that underlie the process. Rather than a continuum, the proposed model is suggestive of multiple tracks down which clonal trajectories progress, and where fate can branch to a track of lower potency at multiple points down the entire cascade of haematopoiesis. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=101 SRC="FIGDIR/small/587126v1_ufig1.gif" ALT="Figure 1"> View larger version (32K): org.highwire.dtl.DTLVardef@b09137org.highwire.dtl.DTLVardef@de064org.highwire.dtl.DTLVardef@10705e3org.highwire.dtl.DTLVardef@139b6f_HPS_FORMAT_FIGEXP M_FIG C_FIG In a multi-track model, while some HSPCs are multipotent and branch into daughters with committed fate (left trajectory), other HSPCs may already committed or biased to a certain lineage such that their daughters inherit and maintain it in subsequent divisions during haematopoiesis. However, this commitment/fate bias is not evident through current phenotypic definitions of HSPC subsets (background colour) but occurs through putative expression of transcription factors, epigenetic programming or other factor that is currently unresolved (as indicated by the coloured fate potential triangles inside cells).

immunology↗