OBJECTIVES: To characterize the formation of anti-vatreptacog alfa ADAs in hemophilia patients with inhibitors.
METHODS/PATIENTS: This was a post hoc analysis of adept(™) 2. Immunoglobulin isotype determination, specificity analysis of rFVIIa cross-reactive antibodies, epitope mapping of rFVIIa single mutant analogs and pharmacokinetic (PK) profiling were performed to characterize the ADAs.
RESULTS: Immunoglobulin isotyping indicated that the ADAs were of the immunoglobulin G subtype. In epitope mapping, none of the rFVIIa single mutant analogs (V158D, E296V or M298Q) contained the complete antibody epitope, confirming that the antibodies were specific for vatreptacog alfa. In two patients, for whom PK profiling was performed both before and after the development of ADAs, vatreptacog alfa showed a prolonged elimination phase following ADA development. During the follow-up evaluation, the rFVIIa cross-reactivity disappeared after the last vatreptacog alfa exposure, despite continued exposure to rFVIIa as part of standard care.
CONCLUSIONS: Results from the vatreptacog alfa phase III trial demonstrate that the specific changes made, albeit relatively small, to the FVIIa molecule alter its clinical immunogenicity.
MATERIAL AND METHOD: The total phenolic content (TPC), 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging and ferric-ion reducing power (FRAP) were used to evaluate their antioxidant capacity. Tyrosinase inhibition effect was measured using mushroom tyrosinase inhibition assay.
RESULT: Ethyl acetate extract of P. macrocarpa's stem exhibited highest total phenolic content, DPPH free radical scavenging and ferric reducing power. Meanwhile, chloroform extracts of leaves and fruits demonstrated potent anti-tyrosinase activities as compared to a well-known tyrosinase inhibitor, kojic acid.
CONCLUSION: Since chloroform extracts of leaves and fruits have low antioxidant capacities, the tyrosinase inhibition effect observed are antioxidant independent. This study suggests direct tyrosinase inhibition by chloroform extracts of Phaleria macrocarpa.