Project 4 Summary
Exploratory human trials of rectal microbicides.
In this Project, we hypothesize that (1) detailed assessment of mucosal architecture
and immunological function will demonstrate microbicide-associated toxicity that
would not be recognized using visual and symptomatic criteria and (2) that rectal
administration of reverse transcriptase (RT) microbicides will be associated with
quantitative reduction in rectal secretion and mucosal viral load but does not
lead to the development of HIV resistance mutations in the mucosal or systemic
compartments.
A series of experiments are proposed that will characterize the mucosal consequences
of rectal administration of an RT microbicide, determine whether such administration
alters the distribution and bioavailability of these compounds, and what the virological
sequelae are of using an RT compound. UC-781 (Biosyn, Inc., Huntingdon Valley,
PA) has been chosen as the candidate RT microbicide for these experiments. Anne-Marie
Corner, President and CEO of Biosyn, Inc. will be Project Leader, as required
by the PA. After conducting the pre-clinical animal studies needed to file an
Investigational New Drug (IND) application to allow human rectal studies, three
sequential pilot studies of UC-781 will be undertaken. The first will determine
the distribution and bioavailability of UC-781 in the distal rectum following
simulated coitus; the second study will be in HIV-1 seronegative subjects and
will be used to optimize the doses and safety assessment of RT rectal microbicides.
The third study will be in HIV-1 seropositive individuals, characterizing the
virological sequelae of rectal administration of UC-781.
We envisage that the data generated by these studies will allow a streamlining
of the safety and virological assays needed to evaluate candidate microbicides.
They will provide a logical continuation from the pre-clinical / discovery activities
of Project 1, and will be responsive to data on formulation acceptability emerging
from Project 3.
Specific Aim #1. To determine the optimal mucosal safety assessment of rectal
microbicides using UC-781 as a candidate microbicide.
Specific Aim #2. To characterize the virological sequelae of rectal administration
of UC-781 in subjects with HIV.
Project 4 Aims: Milestones
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Project
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Specific Aim
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Milestone Date
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Completion
Anticipated
Before Year 2.5
Review (10/06)
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Project 4
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Aim 1: Preclinical studies
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28 day rat study
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01/05
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Yes
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28 day dog study
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01/05
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Yes
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Complete IND
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02/05
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Yes
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Aim 1: Microbicide distribution study
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Subject enrollment starts
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03/05
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Yes
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Last subject out
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11/05
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Yes
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Preliminary study report completed
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03/06
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Yes
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Aim 1: UC-781 HIV seronegative study
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Subject enrollment starts
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11/05
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Yes
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Last subject out
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01/07
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Preliminary study report completed
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04/07
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Aim 2 : UC-781 HIV seropositive study
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Subject enrollment starts
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12/07
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Last subject out
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02/09
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Preliminary study report completed
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06/09
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