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BACKGROUND We have recently reported on a recombinant von Willebrand factor (VWF) D'D3 albumin fusion protein (rD'D3-FP) developed to extend the half-life of coagulation factor VIII (FVIII) for the treatment of hemophilia A. Based on predictive modelling presented in this study, we hypothesized that modifying rD'D3-FP to improve FVIII interaction would reduce exchange with endogenous VWF and provide additional FVIII half-life benefit. OBJECTIVES The aim of this study was to identify novel rD'D3-FP variants with enhanced therapeutic efficacy in extending FVIII half-life. METHODS Through both directed mutagenesis and random mutagenesis using a novel mammalian display platform, we identified novel rD'D3-FP variants with increased affinity for FVIII (rVIII-SingleChain) under both neutral and acidic conditions and assessed their ability to extend FVIII half-life in vitro and in vivo. RESULTS In rat preclinical studies, rD'D3-FP variants with increased affinity for FVIII displayed enhanced potency, with reduced dose levels required to achieve equivalent rVIII-SingleChain half-life extension. In cell-based imaging studies in vitro, we also demonstrated reduced dissociation of rVIII-SingleChain from the rD'D3-FP variants within acidic endosomes and more efficient co-recycling of the rD'D3-FP/rVIII-SingleChain complex via the FcRn recycling system. CONCLUSIONS In summary, at potential clinical doses, the rD'D3-FP variants provide marked benefits with respect to dose levels and half-life extension of co-administered FVIII, supporting their development for use in the treatment of hemophilia A.

Hemophilia A and hemophilia B are X-linked inherited bleeding disorders caused by a deficiency of coagulation factor VIII and IX, respectively. Standard of care is prophylactic factor replacement therapy; however, the development of neutralizing antibodies against these factors represents serious complications underlining the need for alternative treatment approaches. Human coagulation factor X has a central role within the blood coagulation system making it an attractive target for the development of alternative treatment strategies for patients with hemophilia. This study focuses on a modified variant of the human coagulation factor X with enhanced hemostatic bypass activity due to insertion of a factor IX derived activation sequence. This molecule design leads to the direct activation of the modified factor X protein by factor XIa allowing it to bypass the need for coagulation factor VIIIa/factor IXa. The modified variant was able to correct in-vitro activated partial prothrombin time of human and murine factor VIII/factor IX deficient plasma. Furthermore, reduced blood loss in factor VIII knock-out mice was observed after intravenous application of the modified factor X variant. In conclusion, these data suggest that the factor X variant described here could potentially serve as a bypassing agent independent of the inhibitor status of hemophilia patients. However, more research is needed to further investigate the potential of this molecule.

A novel mechanism for extending the circulatory half-life of coagulation factor VIII (FVIII) has been established and evaluated preclinically. The FVIII binding domain of von Willebrand factor (D′D3) fused to human albumin (rD′D3-FP) dose dependently improved pharmacokinetics parameters of coadministered FVIII in all animal species tested, from mouse to cynomolgus monkey, after IV injection. At higher doses, the half-life of recombinant FVIII (rVIII-SingleChain) was calculated to be increased 2.6-fold to fivefold compared with rVIII-SingleChain administered alone in rats, rabbits, and cynomolgus monkeys, and it was increased 3.1-fold to 9.1-fold in mice. Sustained pharmacodynamics effects were observed (ie, activated partial thromboplastin time and thrombin generation measured ex vivo). No increased risk of thrombosis was observed with coadministration of rVIII-SingleChain and rD′D3-FP compared with rVIII-SingleChain alone. At concentrations beyond the anticipated therapeutic range, rD′D3-FP reduced the hemostatic efficacy of coadministered rVIII-SingleChain. This finding might be due to scavenging of activated FVIII by the excessive amount of rD′D3-FP which, in turn, might result in a reduced probability of the formation of the tenase complex. This observation underlines the importance of a fine-tuned balance between FVIII and its binding partner, von Willebrand factor, for hemostasis in general.

Cost efficient power generation from low temperature heat sources requires an optimal usage of the available heat. In addition to the ORC (Organic Rankine Cycles), cycles with ammonia and water as working fluid show promising results regarding efficiency. Due to their non-isothermal phase change, mixtures can adapt well to a liquid heat source temperature profile and reduce the exergetic losses. In this analysis thermodynamic calculations on the layouts of two existing ammonia–water cycles are compared: a geothermal power plant based on a Siemens’ patent and a modified lab plant based on a patent invented by Kalina (KCS-34). The difference between the two cycles is the position of the internal heat recovery. Cycle simulations were carried out at defined boundary conditions in order to identify optimal operation parameters. For the selected heat source of 393.15 K (hot water) the ammonia mass fraction between 80% and 90% results in the best performance in both configurations. In general, the layout of Siemens achieves a slightly better efficiency compared to the KCS-34. Compared to an ORC using R245fa as working fluid, the exergetic efficiency can be increased by the ammonia/water based cycles by approximately 25%.

Summary Background Recombinant factor VIIa (rFVIIa) is approved for use in controlling bleeding episodes in people with hemophilia who have developed inhibitors to replacement therapy. Due to its short half-life (t½), frequent injections are required, limiting its use as a prophylactic treatment. A novel, recombinant fusion protein linking coagulation factor VIIa with albumin (rVIIa-FP) has been developed to extend the t½ of rFVIIa. Objectives The aim of our studies was to investigate the pharmacokinetic/pharmacodynamic characteristics of rVIIa-FP in preclinical animal species. Methods Pharmacokinetic (PK) parameters were derived after single intravenous dosing in hemophilia A mice, rats, rabbits and monkeys. PK analysis was based on human FVII plasma levels determined by measuring FVII antigen levels by ELISA in mice and rats, and FVIIa activity using STACLOT® VIIa-rTF in rabbits and monkeys. Induction of thrombin generation was investigated in mice, while hemostatic activity was assessed by thrombus formation in rabbits. Results Compared with rFVIIa, rVIIa-FP displayed a prolonged t½, enhanced in vivo recovery and reduced clearance in all species investigated. In mice, 16 h after treatment with rVIIa-FP, thrombin levels were quantifiable, indicating prolonged efficacy, whereas values had approached baseline at this time after treatment with rFVIIa. After 12 h, hemostatic efficacy was negligible in rFVIIa-treated rabbits, but sustained in animals receiving rVIIa-FP. Conclusions These studies indicate that the longer t½ of rVIIa-FP compared with rFVIIa translates into extended activity. These findings suggest that rVIIa-FP has the potential to be administered less frequently than rFVIIa-containing concentrates in clinical use.

SummaryThe prophylactic treatment of haemophilia B and the management of haemophilia A or B with inhibitors demand frequent administrations of coagulation factors due to the suboptimal half-lives of the products commercially available and currently in use, e.g. recombinant factor IX (rFIX) and recombinant factor VIIa (rFVIIa), respectively. The extension of the half-lives of rFIX and rFVIIa could allow for longer intervals between infusions and could thereby improve adherence and clinical outcomes and may improve quality of life. Albumin fusion is one of a number of different techniques currently being examined to prolong the half-life of rFIX and rFVIIa. Results from a phase I clinical trial demonstrated that the recombinant fusion protein linking FIX to albumin (rIX-FP) has a five-times longer half-life than rFIX, and preclinical studies with the recombinant fusion protein linking FVIIa to albumin (rVIIa-FP) suggest that rVIIa-FP possesses a significantly extended half-life versus rFVIIa. In this review, we describe albumin fusion technology and examine the recent progress in the development of rIX-FP and rVIIa-FP.

SummaryHaemophilia B is a X-chromosome linked disease characterised by a deficiency of functionally active coagulation Factor IX (FIX). Patients with severe haemophilia B at risk of recurrent bleeding are treated approximately twice a week in a prophylactic setting by application of FIX concentrates.To increase convenience and compliance of the therapy it is desirable to reduce the dosing frequency by improving the pharmacokinetic properties of FIX. Here a concept of rFIX (recombinant factor IX) albumin fusion proteins (rIX-FPs) with cleavable linker peptides derived from the FIX activation sequence is presented. Constructs of the genetic fusion of FIX to albumin via cleavable linkers were expressed in mammalian cells and characterised after purification. In vitro activation studies with FXIa demonstrated that cleavage of the linker and the activation peptide proceeded comparably well. In a clotting assay the rIX-FPs with cleavable linker showed a 10- to 30-fold increase in the molar specific clotting activity compared to fusion proteins with non-cleavable linkers. Furthermore, in-vivo recovery, terminal half-life and the AUC of rIX-FPs in rats and rabbits as determined by FIX antigen measurements were significantly increased compared to rFIX (BeneFIX®). In FIX deficient (FIX−/−) mice the in-vivo recovery and the AUC were also significantly increased.The efficacy in reducing bleeding time was shown in FIX−/−mice by a tail tip bleeding model. The results suggest that rIX-FPs with a cleavable linker between FIX and albumin are a promising concept that may support the use of the albumin fusion technology to extend the half-life of FIX.

SummaryFor the treatment of haemophilia patients with inhibitors, recombinant factor VIIa (rFVIIa) is available as a therapeutic option to control bleeding episodes with a good balance of safety and efficacy. However, the short in-vivo half-life of approximately 2.5 hours makes multiple injections necessary, which is inconvenient for both physicians and patients. Here we describe the generation of a recombinant FVIIa molecule with an extended half-life based on genetic fusion to human albumin. The recombinant FVII albumin fusion protein (rVII-FP) was expressed in mammalian cells and upon activation displayed a FVII activity close to that of wild type FVIIa. Pharmacokinetic studies in rats demonstrated that the half-life of the activated recombinant FVII albumin fusion protein (rVIIa-FP) was extended six- to sevenfold compared with wild type rFVIIa. The in-vitro and in-vivo efficacy was evaluated and was found to be comparable to a commercially available rFVIIa (NovoSeven®). The results of this study demonstrate that it is feasible to develop a half-life extended FVIIa molecule with haemostatic properties very similar to the wild-type factor.

Background and purpose Ischemic stroke provokes severe brain damage and remains a predominant disease in industrialized countries. The coagulation factor XII (FXII)-driven contact activation system plays a central, but not yet fully defined pathogenic role in stroke development. Here, we investigated the efficacy of the FXIIa inhibitor rHA-Infestin-4 in a rat model of ischemic stroke using both a prophylactic and a therapeutic approach. Methods For prophylactic treatment, animals were treated intravenously with 100 mg/kg rHA-Infestin-4 or an equal volume of saline 15 min prior to transient middle cerebral artery occlusion (tMCAO) of 90 min. For therapeutic treatment, 100 mg/kg rHA-Infestin-4, or an equal volume of saline, was administered directly after the start of reperfusion. At 24 h after tMCAO, rats were tested for neurological deficits and blood was drawn for coagulation assays. Finally, brains were removed and analyzed for infarct area and edema formation. Results Within prophylactic rHA-Infestin-4 treatment, infarct areas and brain edema formation were reduced accompanied by better neurological scores and survival compared to controls. Following therapeutic treatment, neurological outcome and survival were still improved although overall effects were less pronounced compared to prophylaxis. Conclusions With regard to the central role of the FXII-driven contact activation system in ischemic stroke, inhibition of FXIIa may represent a new and promising treatment approach to prevent cerebral ischemia/reperfusion injury.

Haemostasis including blood coagulation is initiated upon vessel wall injury and indispensable to limit excessive blood loss. However, unregulated pathological coagulation may lead to vessel occlusion, causing thrombotic disorders, most notably myocardial infarction and stroke. Furthermore, blood exposure to foreign surfaces activates the intrinsic pathway of coagulation. Hence, various clinical scenarios, such as extracorporeal membrane oxygenation, require robust anticoagulation consequently leading to an increased bleeding risk. This study aimed to further assess the antithrombotic efficacy of the activated factor XII (FXIIa) inhibitor, rHA-Infestin-4, in several thrombosis models. In mice, rHA-Infestin-4 decreased occlusion rates in the mechanically-induced arterial (Folt's) and the FeCl3 -induced venous thrombosis model. rHA-Infestin-4 also protected from FeCl3 -induced arterial thrombosis and from stasis-prompted venous thrombosis in rabbits. Furthermore, rHA-Infestin-4 prevented occlusion in the arterio-venous shunt model in mice and rabbits where thrombosis was induced via a foreign surface. In contrast to heparin, the haemostatic capacity in rabbits was unaffected by rHA-Infestin-4. Using rodent and non-rodent species, our data demonstrate that the FXIIa inhibitor rHA-Infestin-4 decreased arterial, venous and foreign surface-induced thrombosis without affecting physiological haemostasis. Hence, we provide further evidence that targeting FXIIa represents a potent yet safe antithrombotic treatment approach, especially in foreign surface-triggered thrombosis.

The G534E polymorphism (Marburg I [MI]) of factor VII–activating protease (FSAP) is associated with carotid stenosis and cardiovascular disease. We have previously demonstrated that FSAP is present in atherosclerotic plaques and it is a potent inhibitor of vascular smooth muscle proliferation and migration in vitro. The effect of wild-type (WT)- and MI-FSAP on neointima formation in the mouse femoral artery after wire-induced injury was investigated. Local application of WT-FSAP led to a 70% reduction in the neointima formation, and this effect was dependent on the protease activity of FSAP. MI-FSAP did not inhibit neointima formation in vivo. This is due to a reduced proteolytic activity of MI-FSAP, compared to WT-FSAP, toward platelet-derived growth factor BB, a key mediator of neointima development. The inability of MI-FSAP to inhibit vascular smooth muscle accumulation explains the observed linkage between the MI-polymorphism and increased cardiovascular risk. Hence, FSAP has a protective function in the vasculature, and analysis of MI polymorphism is likely to be clinically relevant in restenosis.

Photocycloadditions of phenanthrenequinone 1 and acenaphthenequinone 16 to 3,4,6-tri- O -acetyl- d -glucal proceeded with distinctly different regioselectivities: 1 preferentially adds with both carbonyl oxygens to give the [4+2] cycloadduct, a 1- O ,2- O -annelated α- d -glucoside (50% [ Chem. Ber. 1952 , 85 , 531]), while 16 reacts with only one carbonyl group to exclusively yield the [2+2] addition product, a 1- C ,2- O -oxetano-α- d -glucoside (86%). 2-Hydroxyglucal esters 11 and 12 also undergo photoadditions with 1 to give the cis -1,4-dioxane-fused cycloadducts 13 and 14 , whilst 16 fails to react. Structural and configurational assignments rest on NMR data and an X-ray analysis of spiro-pyranooxetane 18 .

The complexity of Nucleic acid Amplification Technology (NAT(1)), comprising sample preparation, amplification and detection methods, requires specific design considerations for both the laboratory and the procedures utilized in such testing. The purpose of this paper is to establish technical considerations for the performance of NAT. These include the collection, handling and assay of specimens and the design of laboratories to routinely and reliably detect low levels of nucleic acid sequences. The sensitivity of NAT due to the exponential amplification of nucleic acids makes contamination a major concern from specimen collection to sample detection. Therefore, laboratories need to be designed to prevent and control contamination through adequate equipment and appropriate workflow. These technical considerations should provide a basis for establishing a robust and reproducible NAT system.

In this paper, the renewable energy vectors liquid hydrogen (LH 2 ) and methanol generated from atmospheric CO 2 are compared with the conventional crude oil-gasoline system. Both renewable concepts, liquid hydrogen and methanol, lead to a drastic CO 2 reduction compared to the fossil-based system. The comparison between the LH 2 and methanol vector for the transport sector shows nearly the same fuel cost and energy efficiency but strong infrastructure advantages for methanol.

Introduction rVIII-SingleChain (CSL627), a novel recombinant coagulation factor VIII (FVIII), is under investigation in a phase I/III clinical programme (AFFINITY) for the treatment of haemophilia A. Non-clinical studies were conducted to investigate the pharmacokinetic/pharmacodynamic profile of rVIII-SingleChain in comparison with full-length recombinant FVIII. Materials and Methods Binding affinity of rVIII-SingleChain for von Willebrand factor was investigated by surface plasmon resonance analysis. The pharmacokinetic profile of rVIII-SingleChain was compared with a marketed full-length recombinant FVIII concentrate (Advate ® ) in haemophilia A mice, von Willebrand factor knock-out mice, Crl:CD (SD) rats, rabbits and cynomolgus monkeys. Systemic FVIII activity or antigen levels were recorded. Procoagulant activity was measured in an FeCl 3 -induced arterial occlusion model and by recording thrombin generation activity (ex vivo) after administration of 200–250IU/kg rVIII-SingleChain or full-length FVIII to haemophilia A mice. Results rVIII-SingleChain displayed a high affinity for von Willebrand factor (K D =44pM vs. 139 pM for full-length recombinant FVIII). In all animal species tested, rVIII-SingleChain had more favourable pharmacokinetic properties than full-length recombinant FVIII: clearance was decreased and area under the curve and terminal half-life were enhanced vs. full-length recombinant FVIII, while in vivo recovery and volume of distribution were equivalent. rVIII-SingleChain showed a prolonged thrombin generation potential and prolonged procoagulant activity vs. full-length recombinant FVIII in an FeCl 3 -induced arterial occlusion model. Conclusions rVIII-SingleChain had a higher affinity for von Willebrand factor than full-length recombinant FVIII and displayed favourable pharmacokinetic/pharmacodynamic properties in non-clinical models.

Methanol is a promising liquid energy carrier for the storage of renewable energy. The comparison with hydrogen shows a lower total energy efficiency for methanol. But methanol is easy to handle within the existing transport and storage capacities of the petrol industry. Therefore it causes low investment costs for the infrastructure of a global renewable energy network. For the storage of small amounts of energy like in individual traffic and for the distribution of energy in low populated regions methanol is even the most efficient alternative. Beside hydrogen, a basic component for the synthesis of methanol is CO2. The recovery of CO2 from atmosphere will avoid an infrastructure for CO2-transport to the place where methanol is generated. With solar energy as the energy source a lower energy demand for the recovery of CO2 from atmosphere than from combustion fluegases can be achieved. An integration of biomass as basic product for the synthesis of methanol improves the conversion efficiency from solar energy to methanol.

A method is described for the determination of plasmid copy number (PCN) in the recombinant yeast Saccharomyces cerevisiae producing human coagulation Factor XIII. Southern hybridization of restriction endonuclease HindIII-digested total DNA from yeast transformant with the 32P-labelled URA3 gene as a probe detected two band: one corresponding to the chromosomal URA3 gene and the other corresponding to the recombinant plasmid. Thus, the present method using the genomic URA3 gene as an internal standard allowed an estimation of both the plasmid and the standard simultaneously. Since haploid yeast cells harbour one copy of genomic URA3 gene, the PCN can be determined as the ratio of the amount of plasmid to that of genomic URA3 gene. A linear relationship between the determined PCN and the plasmid content was observed ranging from 0.3 to 200 ng. The method is reproducible and independent of the extraction efficiency for the recombinant plasmid. The present method was successfully used to analyzed the PCN of a centromere-based plasmid YCp50 (= 2.7) and of a 2 microns-based plasmid pEMBLyex4 (= 112).

Experimental results of a combined absorption and electrodialysis process for the CO2 recovery from the atmosphere are presented as the first step in an environmentally neutral fuel production. Furthermore, preliminary results on the electrochemical reduction of CO2 on porous electrodes in aqueous solutions, on mixed oxide electrodes in a high pressure electrochemical cell in liquid CO2 and some aspects of the electrochemical adsorption and reduction of CO2 on Pd-Fe alloys are discussed.

Spiral wound plastic heat exchangers represent an important class of heat exchangers, with high chemical resistance, low dimensions and reasonable costs. However, their design and optimisation are mainly based on practical experience, whereas comprehensive investigations have not been accomplished yet. In this paper, we present the results of the collaborative research performed in the context of the EU-project INTHEAT (Intensified Heat Transfer Technologies for Enhanced Heat Recovery). The focus of this work is to gain a deeper understanding of the fundamental transport phenomena occurring in spiral wound plastic heat exchangers, thus allowing their performance to be improved. The apparatus chosen for the investigation was developed by Makatec GmbH (Makatec). It consists of spiral wound plastic films kept separated by spacer filaments building grid-like arrangements. In addition to the separation function, these arrangements must ensure an efficient mixing and thus an intensified heat transfer in the exchanger, whereas the mixing process strongly depends on the specific filament grid structure. A Computational Fluid Dynamics (CFD) based model is developed that yields a detailed description of the flow and temperature fields in the complex geometric structure of the investigated spiral wound plastic heat exchanger. The simulations are performed for a single-phase liquid flow and for volumetric flow rates used in the Makatec test rig, with the help of the commercial software STAR-CCM+ (CD- adapco).The model is validated against experimental pressure drop data obtained at Makatec. The spacer geometry has then been varied and its influence on the flow behaviour evaluated. Enhanced turbulence is supposed to have a positive impact on the efficiency of the exchanger. Based on the obtained results, new spacer geometries are suggested in order to facilitate the turbulence and thus to achieve a better exchanger performance.

The hepatitis B virus genome encodes a transcriptional transactivator protein designated HBxAg. We have investigated whether this antigen is a target structure for human T-lymphocytes. Using recombinant HBxAg protein, we found HBxAg-specific stimulation of peripheral blood mononuclear cells in patients with acute hepatitis B virus infection (6 of 6) and chronic hepatitis B virus infection (6 of 17) but not in healthy individuals. With HBxAg-specific synthetic polypeptides, several T-cell epitopes were identified. Most were located in the carboxyterminal half of the HBxAg protein. Five T-cell clones specific for a T-cell epitope located at the carboxyterminal region of HBxAg were established and found to belong to the CD2/CD4-positive, CD8-negative subtype. These data establish for the first time HBxAg as an antigen in the cellular immune response. (HEPATOLOGY 1991;13:63–643.)

9 pages, 6 figures, 6 tables.-- Available online Sep 29, 2007., The lime enhanced gasification (LEGS) process uses CaO as a CO2 carrier and consists of two coupled reactors: a gasifier in which CO2 absorption by CaO produces a hydrogen-rich product gas, and a regenerator in which the sorbent is calcined producing a high purity CO2 gas stream suitable for storage. The LEGS process operates at a pressure of 2.0 MPa and temperatures less than 800°C and therefore requires a reactive fuel such as brown coal. The brown coal ash and sulfur are purged from the regenerator together with CaO which is replaced by fresh limestone in order to maintain a steady-state CaO carbonation activity (a(ave)). Equilibrium calculations show the influence of process conditions and coal sulfur content on the gasifier carbon capture (>95% is possible). Material balance calculations of the core process show that the required solid purge of the sorbent cycle is mainly attributed to the necessary removal of ash and CaSO4 if the solid purge is used as a pre-calcined feedstock for cement production. The decay in the CaO capture capacity over many calcination–carbonation cycles demands a high sorbent circulation ratio but does not dictate the purge fraction. A thermodynamic analysis of a LEGS-based combined power and cement production process, where the LEGS purge is directly used in the cement industry, results in an electric efficiency of 42% using a state of the art combined cycle., The work presented here was performed within the framework of two projects funded by the European Commission RFCS and the FP6 programs, through Projects No. RFC-CR-03009 and SES6-CT03-502743.

Introduction: Current state of the art treatment of severe Hemophilia A is prophylactic or on-demand replacement of the deficient factor VIII (FVIII) using plasma derived or recombinant factors [Keeling 2008; Srivastava 2012; Wong 2011]. The compliance to existing therapies is hampered by the short half-life of available FVIII products necessitating multiple intravenous injections per week for adequate prophylaxis [Bjorkman 2009; Sheridan 2011]. Thus, FVIII products with improved pharmacokinetic profiles are currently under development or have recently been made available [Oldenburg 2014]. FVIII's pharmacokinetic (PK) properties are believed to be strongly dictated by its binding to von Willebrand Factor (VWF) [Lenting 2007; Dasgupta 2007; Saenko 2006]. The aim of this study was to compare the binding affinity of different recombinant FVIII (rFVIII) products to plasma derived VWF (pd VWF), and characterize their PK properties in different animal species. Methods: The PK profiles of rVIII-SingleChain (B-domain-truncated, covalently-linked single chain rFVIII; CSL Behring), Advate® (full-length rFVIII; Baxalta), NovoEight® (B-domain-truncated rFVIII; NovoNordisk), Eloctate® (B-domain-deleted rFVIII fused to Fc portion of IgG; Biogen) and Nuwiq® (B-domain-deleted rFVIII; Octapharma) were compared in FVIII knock out mice (FVIII ko), rats and rabbits following intravenous injection of 150 (mice and rabbits) or 400 or 480 (rats) IU/kg rFVIII. Dose levels were administered based on labelled/nominal chromogenic FVIII activity. Plasma samples were obtained up to 72 h (mice), 48 h (rats) and 96 h (rabbits) post-application. FVIII plasma levels were determined based on antigen (FVIII:Ag) using an ELISA technique (ASSERACHROM®, Stago) and/or based on chromogenic FVIII activity (FVIII:C; COAMATIC® FACTOR VIII, Chromogenix). Results: The PK of rFVIII products in three different animal species was compared using the area under the plasma concentration time curve (AUC) as an indicator for exposure. In FVIII ko mice, FVIII:Ag based PK of rVIII-SingleChain was comparable to that of Eloctate® and NovoEight®, and superior over Nuwiq® and Advate® based on AUC. In contrast, FVIII:C based PK data did not achieve significant differences, most likely due to the the higher assay variability. In rats, FVIII:Ag PK of rVIII-SingleChain was superior over all tested rFVIII products, i.e. Nuwiq®, NovoEight®, Eloctate® and Advate® based on AUC. In rabbits, rVIII-SingleChain FVIII:Ag PK was comparable to NovoEight® and superior to all other rFVIII products, i.e. Nuwiq®, Eloctate® and Advate®. Thus, across all animal species tested, a favorable PK profile was shown for rVIII-SingleChain. It was further shown that the binding affinity of rVIII-SingleChain to pd VWF was significantly improved in comparison to the full length molecule Advate® [Zollner 2014]. This higher binding affinity to pd VWF may therefore explain the differences in PK profiles observed. Conclusion: In general, rVIII-SingleChain showed a favorable PK profile as compared to other rFVIII products such as Advate®, NovoEight®, Eloctate® and Nuwiq® across species, i.e. FVIII ko mice, rats and rabbits. This favorable PK profile of rVIII-SingleChain may be explained by its high binding affinity to VWF. Disclosures Pestel: CSL Behring GmbH: Employment. Claar:CSL Behring GmbH: Employment. Müller-Cohrs:CSL Behring GmbH: Employment. Raquet:CSL Behring GmbH: Employment. Peil:CSL Behring GmbH: Employment. Weimer:CSL Behring GmbH: Employment. Herzog:CSL Behring GmbH: Employment.

The complexity of Nucleic acid Amplification Technology (NAT(1)), comprising sample preparation, amplification and detection methods, requires specific design considerations for both the laboratory and the procedures utilized in such testing. The purpose of this paper is to establish technical considerations for the performance of NAT. These include the collection, handling and assay of specimens and the design of laboratories to routinely and reliably detect low levels of nucleic acid sequences. The sensitivity of NAT due to the exponential amplification of nucleic acids makes contamination a major concern from specimen collection to sample detection. Therefore, laboratories need to be designed to prevent and control contamination through adequate equipment and appropriate workflow. These technical considerations should provide a basis for establishing a robust and reproducible NAT system.

Background— Atherothrombosis is a main pathomechanism in the evolution of vessel stenosis and is counteracted by endogenous fibrinolysis. Recently, the plasmatic serine protease “factor seven–activating protease” (FSAP) was recognized as a potent activator of prourokinase in vitro. The Marburg I polymorphism of FSAP impairs this potential and may thus facilitate arterial thrombosis. Methods and Results— This analysis of the Bruneck Study involved 810 men and women aged 40 to 79 years. The ultrasound-based atherosclerosis progression model (5-year follow-up) permits differentiation between early atherogenesis and the advanced stenotic stages of carotid artery disease. The FSAP Marburg I polymorphism was found in 37 subjects (carriage rate 4.4%). Individuals with this genetic variant showed a prominently reduced in vitro capacity to activate prourokinase. No relation was found to exist between the Marburg I polymorphism and early atherogenesis. In contrast, it emerged as a strong and independent risk predictor of incident/progressive carotid stenosis (multivariate odds ratio [95%CI], 6.6 [1.6 to 27.7]). This finding equally applied to subjects with and without co-segregation of the Marburg II polymorphism. The risk profile of advanced atherogenesis further includes cigarette smoking, high lipoprotein(a), the factor V Leiden mutation, low antithrombin III, high fibrinogen, and diabetes. Conclusions— In concert with other genetic and acquired conditions known to interfere with coagulation or fibrinolysis, the Marburg I polymorphism of FSAP, which attenuates its capacity to activate prourokinase, is a significant risk predictor for the evolution and progression of carotid stenosis.

The content of 472U to 472C revertant virus in serotype 3 oral poliomyelitis monovalent bulk vaccines can be quantified by MAPREC (Mutant Analysis by PCR and Restriction Enzyme Cleavage). Besides other wildtype reversions identified in propagated type 3 Sabin strain populations, the 472U to 472C reversion correlates most prominently with neurovirulence in the monkey neurovirulence test. Therefore, the results can be used for the discrimination of 'good' and 'bad' vaccines on the molecular level. In international collaborative studies it has been well established that vaccine lots containing revertant genomes below a critical threshold pass the in vivo monkey neurovirulence test (MNVT), while vaccine lots containing more revertants fail the MNVT. In this communication we show that the MAPREC test is a sensitive tool for quality control and the demonstration of consistency in large scale production. Furthermore, MAPREC offers a possibility to assess the effect of changed production conditions on the rate of reversion and to find conditions for consistent production with low reversion rates.

Abstract 1115 Recombinant factor VIIa (rFVIIa) is approved to control bleeding in hemophilia A and B patients who have developed inhibitory antibodies to replacement therapy and in acquired hemophilia. rFVIIa is rapidly eliminated with a terminal half-life of approximately 2.5 hours in humans. This short half life necessitates frequent injections and considerably limits prophylactic use. A recombinant fusion protein linking activated factor VII with albumin (rVIIa-FP) was engineered to extend the half life of rFVIIa. The present studies were conducted to gather knowledge about the pharmacokinetic and pharmacodynamic (PK/PD) properties of rVIIa-FP in preclinical animals models to enable a more precise estimate of the procoagulant activity of rVIIa-FP for the future clinical use in haemophilia patients with inhibitors to FVIII and FIX. Single intravenous doses of either rVIIa-FP or the licensed rFVIIa comparator, NovoSeven® were administered to mice, rabbits and monkeys. Subsequently, plasma samples were harvested at different time-points after study drug administration and systemic levels of rVIIa-FP or NovoSeven® were assessed either by FVIIa activity measurements using the Staclot® assay system or by FVII antigen measurements using an enzyme linked immunoabsorbance assay (ELISA). When investigating dose responses or duration of hemostatic activity, rVIIa-FP and NovoSeven® were administered to mice or rabbits before tail clip or induction of venous stasis, respectively. Following a single intravenous bolus application the procoagulant activity of both study drugs was assessed in both models at different time points after administration up to 24 hours to proof prolonged procoagulant effects of rVIIa-FP compared to NovoSeven®. Intriguingly, in all animal species tested the systemic bioavailability, clearance and in addition the terminal half-life (t1/2β), of rVIIa-FP were significantly better in comparison to NovoSeven®. Based on FVIIa activity measurements in plasma samples derived from monkeys the 11 fold higher area under the curve (AUC) was accompanied with a 4-fold longer t1/2β, while in vivo recovery (IVR) of rVIIa-FP exceeded that of NovoSeven® by a 70 %. In rabbits the 20 fold higher AUC was associated with a 5-fold longer t1/2β and a 4-fold higher IVR when measuring specific FVIIa activity. In mice measurements of FVII antigen revealed a 11 fold higher AUC, while t1/2β was 4 times longer and IVR was found to be doubled in comparison to NovoSeven®. The assessment of pharmacodynamic activity after dosing based on specific FVIIa activity adjusted by the Staclot® assay revealed, that the procoagulant effect of rVIIa-FP was not different from NovoSeven®, when measuring total blood loss under acute bleeding conditions after tail clip. However, when assessing late time-points after treatment the prolonged systemic availability of rVIIa-FP translated into a longer and sustained hemostatic activity of rVIIa-FP compared to NovoSeven® in both animal models. Intriguingly, ex vivo studies in hemophilia A mice showed that the 4 fold prolonged systemic availability of rVIIa-FP in plasma translates into sustained FVIIa activity when recorded as thrombin generation activity compared to NovoSeven® at 16 hours after treatment. Furthermore in rabbits, the 5 fold longer half-life translated into a significantly greater procoagulant activity as measured by thrombus formation in both jugular veins after venous stasis. In conclusion, the recombinant albumin fusion technology was successfully applied to human recombinant FVIIa for a significantly improved of PK/PD profile as observed in different pre-clinical animal species. Future clinical studies can proof whether the observed improved PK/PD characteristics will also translate into a half-life extension and a longer hemostatic effect in hemophilia patients with inhibitors to FVIII and FIX. Allowed: The entire body of the abstract, including text and tables, must not exceed 3,800 characters. Spaces are not included in this number; title, authors' names, and affiliations are counted separately. Figures are not included in the character count. Disclosures: Zollner: CSL Behring GmbH: Employment. Schuermann:CSL Behring GmbH: Employment. Raquet:CSL Behring GmbH: Employment. Mueller-Cohrs:CSL Behring GmbH: Employment. Weimer:CSL Behring GmbH: Employment. Pragst:CSL Behring GmbH: Employment. Dickneite:CSL Behring GmbH: Employment. Schulte:CSL Behring GmbH: Employment.

The immune response to the X protein of human hepatitis B virus (HBV) was studied by epitope mapping by using a set of MS2-HBx fusion proteins and synthetic peptides. Antibodies in sera of patients with acute and chronic HBV infection showed a multispecific immune response. Each serum contained antibodies to a different set of epitopes, which taken together cover most of the HBx sequence. Some of the epitopes were detectable only by immunoblotting with fusion proteins; others were detectable only by an enzyme-linked immunosorbent assay (ELISA) with synthetic peptides. The carboxy-terminal half of the HBx protein was preferentially recognized by antibodies from patients with chronic hepatitis and contained a short immunodominant antigenic region with at least two major nonoverlapping epitopes. Anti-HBx antibody titers as revealed by peptide ELISAs were highest and most frequent in patients with chronic hepatitis and usually low in acutely infected patients and asymptomatic carriers. The data demonstrate a remarkable qualitative and quantitative heterogeneity of the humoral HBx immune response which can be monitored by HBx-specific peptide ELISAs. Such tests may become useful diagnostic tools.

Antibodies against the RNase H domain of human hepatitis B virus P protein(s) are frequent markers of acute and chronic virus infection (T. Weimer, K. Weimer, Z.-X. Tu, M.-C. Jung, G. R. Pape, and H. Will, J. Immunol. 143:3750-3756, 1989). In the present study, these antibodies were determined in serial serum samples of experimentally infected chimpanzees and naturally infected human patients with acute and chronic hepatitis B virus infection. Anti-P antibodies were found in the sera of both chimpanzees and humans early in infection shortly after the immunoglobulin M anti-HBc response; they persisted in chronic carriers with ongoing viral replication but declined and disappeared at the time of virus clearance from the sera. These data demonstrate that antibodies to the RNase H domain of the hepatitis B virus P protein are early markers of infection and a signal of ongoing virus replication. Falling titers indicate the decline or end of active virus production and may therefore be a prognostic sign of virus elimination in natural infection and after antiviral therapy.

For the treatment of hemophilia patients with inhibitors, recombinant Factor VIIa (rFVIIa) is available as a therapeutic option to control bleeding episodes with a good balance of safety and efficacy. The short in-vivo half-life of approximately 2.5 h requires multiple injections, which is inconvenient for treaters and patients. Here we describe the generation of a half-life extended recombinant FVIIa molecule based on genetic fusion of FVIIa to human albumin. In this fusion protein the design of the linker sequence is important to optimize the effect of the albumin moiety on FVII activity. The recombinant FVII-albumin fusion protein (rVII-FP) was expressed in mammalian cells and upon activation displayed a FVII activity comparable to wild type rFVIIa. Pharmacokinetic studies in rats and rabbits demonstrated that the half-life of the activated recombinant FVII albumin fusion protein (rVIIa-FP) was 6 to 9 fold extended compared to wild type rFVIIa. The in-vitro and in-vivo efficacy was evaluated and found comparable to commercially available rFVIIa (NovoSeven®). The results of this study demonstrate that it is feasible to improve the attributes of a rVIIa molecule by extending its half life, while retaining a molecule with very similar hemostatic properties to the wild type factor.

Following a vascular injury, factor VIII (FVIII) is rapidly activated by thrombin cleavage at arginine (Arg) 372, 740 and 1689. Activated FVIII, an heterotrimer composed by the association of A1, A2 and A3-C1-C2 domains, is rapidly degraded to limit thrombosis risk. Two main phenomenons that account for the disappearence of FVIIIa consist of an intrinsic dissociation of the trimer due to the loss of A2 domain, and the cleavage of the molecule by activated protein C (APC). APC cleaves FVIIIa at Arg 336 and 562. Mutant FVIII molecules were already generated, with one or two arginines substituted, and a subsequent APC cleavage diminished. Since the thrombotic potential of high plasma levels of FVIII has been described, we aimed to generate new factor VIII molecules where the APC cleavage was only modulated. The ultimate goal being to increase in vivo the FVIIIa half-life. Among the two APC cleavage sites, the sequence around the site 562 was the most conserved between species. This region was therefore chosen to be modified with a prior verification that the amino-acids to be modified were not described in any hemophilic phenotype. Subsequently, the six following mutations were realized in a BDD-FVIII cDNA: Q561N, G563A, N564D, N564A, N564Q and I566M as well as the controls R336I, R562K and R336I+R562K. The constructs were transiently expressed in BHK cells to determine the specific activities of the corresponding molecules. The mutant specific activities, as determined by one- and two-stage clotting assays, ranged from 40 to 94 % of the wild-type except for G563A that was almost inactive. CHO clones expressing FVIII molecules were obtained. The mutants and control FVIII molecules were produced, partially purified on heparin column and further analyzed. The comparative specific activities in a two-stage clotting assay were the following (+/− SD; n=6): BDD-FVIII 100 %, Q561N 105 % +/− 45, G563A 6 % +/− 6, N564D 50 % +/− 23, N564A 45 % +/− 21, N564Q 80 % +/− 26, I566M 100 % +/− 41. The one-stage clotting assay gave identical results than the two-stage assay for each mutant. The mutants were then activated by thrombin (1:1) and the occurrence of FVIII activity was monitored. A 20- to 25-fold increase in FVIII activity was measured within 2 minutes following the addition of thrombin for all mutants. The mutants, except for the inactive G563A, were then analyzed for their resistance to APC by three different assays: an APC resistance kit (Coatest, Chromogenix), an in vitro assay that measured APC sensitivity of FVIIIa and an immunoblot assay that visualized the cleavage efficiency of the A2 fragment. These three assays confirmed the APC resistance of the previously published R336I, R562K and R336I+R562K, as compared with wild-type FVIII. They also revealed that the mutants N564D, N564A and I566M behaved similarly to the wild-type FVIII whereas Q561N and N564Q mutants were partially resistant to APC. The APC resistance ratio were the following 2.3 +/− 0.3 for BDD-FVIII, 2.1 +/− 0.4 for N564Q, 1.7 +/− 0,1 for Q561N, 1.6 +/− 0.3 for R562K and 1.3 +/− 0.3 for R336I+R562K. The N564Q and Q561N mutants exhibited a profile intermediate between wild type FVIII and R562K regarding of the loss of FVIIIa activity that was confirmed on the immunoblot profile. In conclusion we have generated new factor VIII molecules that retained their full procoagulant function while possessing a reduced sensitivity to APC cleavage.

A practical, large-scale adaptable four-step procedure has been developed for the conversion of D-glucose into pyranoid enediolone esters with (R,R)-configuration in contiguous chiral centers, involving hydrolysis of the readily accessible bis-acetonide of α-D-ribo-hexos-3-ulose (12) and base-mediated acylation. The sequence provides the acetyl (3), benzoyl (4) and pivaloyl (6) dihydropyranones in overall yields well exceeding 40%, whilst the maltose-derived glucosyloxy-substituted analogue 11 is accessible even more efficiently (69%) by low-temperature benzoylation followed by DMSO/acetic anhydride treatment. – With the tribenzoate 4 as a model simply feasible addition reactions of preparative interest were evaluated, resulting in a unique transfer of chirality from one side of the pyranoid ring to the other upon treatment with methanol/K2CO3 (4 23), in C-branching (4 18) or C-extension (4 19), and in an unusual photoaddition of acetone to an O,O-isopropylidene-dihydropyrane (4 24). Particular attention is given to rationalization of the mechanisms underlying these additions and the regio- and diastereoselectivities attainable. Enantiomerenreine Bausteine aus Zuckern, 10. – 2,3-Dihydropyranone mit benachbarten Chiralitatszentren: Ein praktikabler Weg zu ihrer Darstellung und Ermittlung ihres Reaktionspotentials Ein praktikables, in praparativem Masstab durchfuhrbares Verfahren zur Uberfuhrung von D-Glucose in pyranoide Endiolonester mit (R,R)-Konfiguration in benachbarten Chiralitatszentren wird beschrieben. Die vierstufige Reaktionsfolge beinhaltet Hydrolyse des leicht zuganglichen Bis-acetonids der α-D-ribo-Hexos-3-ulose (12) und Basen-induzierte Acylierung in den beiden letzten Stufen; sie liefert die Acetyl-(3), Benzoyl-(4), und Pivaloyl-Derivate (6) der Dihydropyranone in Gesamtausbeuten uber 40%. Noch einfacher zuganglich ist das von D-Maltose abgeleitete Dihydropyranon 11 (69%), und zwar durch Tieftemperaturbenzoylierung und nachfolgende DMSO/Acetanhydrid-Behandlung. – Mit dem Tribenzoat 4 als Modellverbindung wurden praparativ brauchbare, einfach durchfuhrbare Additionsreaktionen untersucht; sie fuhrten zu einem ungewohnlichen Chiralitatstransfer von einer Seite des pyranoiden Rings auf die andere bei Baseninduzierter Addition von Methanol (4 23), zu C-verzweigten (4 18) bzw. C-extendierten Produkten (4 19) und zu einem eigenartigen Aceton-Photoaddukt mit O,O-Isopropyliden-Gruppe (4 24). Die diesen Additionen zugrundeliegenden Mechanismen sowie die erzielbaren Regio- und Diastereoselektivitaten werden diskutiert.

Introduction The preclinical efficacy and safety of rVIII-SingleChain (CSL627), a novel recombinant single-chain factor VIII, was assessed in a series of animal studies. Materials and Methods In the tail-clip bleeding model, hemophilia A mice were injected with escalating doses (1–150 IU/kg) of rVIII-SingleChain, B-domain deleted (BDD) rFVIII (ReFacto AF ® ), or full-length rFVIII products (Advate ® , Helixate ® ). Total blood loss and the percentage of animals in which hemostasis occurred were assessed in this observer-blinded, randomized study. In a second non-randomized study in hemophilia A mice, thromboelastographic analysis, thrombin generation, and activated partial thromboplastin time assays were performed. General safety and toxicity were assessed in three animal species, including determination of the prothrombotic potential of rVIII-SingleChain in a rabbit venous thrombosis model. Results Under acute bleeding conditions, the effect of rVIII-SingleChain on total blood loss and hemostasis was indistinguishable from BDD and full-length rFVIII. rVIII-SingleChain and full-length rFVIII (both 20 IU/kg) corrected thromboelastographic parameters, activated partial thromboplastin time, and thrombin generation to a similar degree in hemophilia A mice. In a thrombosis model, the effect of rVIII-SingleChain on thrombus incidence was non-significant and comparable to BDD rFVIII at doses up to 500 IU/kg. Treatment with rVIII-SingleChain did not cause anaphylactic reaction or local intolerance in safety and toxicity studies, and demonstrated an excellent overall safety profile. Conclusions rVIII-SingleChain showed convincing hemostatic efficacy and excellent tolerability in animal studies, warranting continued investigation in human Phase I/III trials (AFFINITY).

To study the replication strategy of the human hepatitis B virus, the 5' end of the RNA pregenome and the initiation sites of DNA plus and minus strands have been mapped. The RNA pregenome was found to be terminally redundant by 120 nucleotides; it is initiated within the pre-C region and may also function as mRNA for synthesis of the major core protein and the hepatitis B virus reverse transcriptase. The hepatitis B virus DNA minus strand is initiated within the direct repeat sequence DR1, it contains a terminal redundancy of up to eight nucleotides, and its synthesis does not require any template switch. The DNA plus strand is primed by a short oligoribonucleotide probably derived from the 5' end of the RNA pregenome, and its synthesis is initiated close to the direct repeat sequence DR2. For its elongation to pass the discontinuity in the DNA minus strand an intramolecular template switch occurs using the terminal redundancy of this template. Thus, the route of reverse transcription and DNA replication of hepatitis B viruses is fundamentally different from that of retroviruses.

Integration and transcription of woodchuck hepatitis virus DNA were studied by Southern and Northern blot analysis in 26 hepatocellular carcinomas and in adjacent nontumor tissue of woodchucks (Marmota monax). All liver tissue chronically infected with woodchuck hepatitis virus contained various amounts of episomal and replicative forms of woodchuck hepatitis virus DNA: episomal and replicative forms of woodchuck hepatitis virus DNA without integration were found in six tumors, episomal and integrated woodchuck hepatitis virus DNA was observed in 18 tumors and exclusively integrated woodchuck hepatitis virus DNA was found in two tumors. In most tumors and in all of the liver tissues chronically infected with woodchuck hepatitis virus, two major woodchuck hepatitis virus RNA species (3.7 and 2.1 kilobases) were detected. In tumors of two other animals (HW76 and HW89) with integrated wood-chuck hepatitis virus DNA, only single major transcripts of 3.5 and 2.5 kilobases, respectively, were detected. Hybridization with subcloned woodchuck hepatitis virus DNA probes showed that both aberrant transcripts lacked the C gene and a part of the pre-S1 gene; characterization of corresponding integrated woodchuck hepatitis virus DNA sequences revealed that the C gene was deleted in one tumor, although not in the other. In agreement with the nucleic acid data, we found expression of core protein by Western blotting only in chronically infected liver tissue of these animals, but not in the corresponding tumors. Deletion of the C gene in mRNA may be due to deletion of this gene in the integrated sequences or due to transcriptional regulation.