Harvesting Candidate Genes Responsible for Serious Adverse Drug Reactions from a Chemical-Protein Interactome

Identifying genetic factors responsible for serious adverse drug reaction (SADR) is of critical importance to personalized medicine. However, genome-wide association studies are hampered due to the lack of case-control samples, and the selection of candidate genes is limited by the lack of understanding of the underlying mechanisms of SADRs. We hypothesize that drugs causing the same type of SADR might share a common mechanism by targeting unexpectedly the same SADR-mediating protein. Hence we propose an approach of identifying the common SADR-targets through constructing and mining an in silico chemical-protein interactome (CPI), a matrix of binding strengths among 162 drug molecules known to cause at least one type of SADR and 845 proteins. Drugs sharing the same SADR outcome were also found to possess similarities in their CPI profiles towards this 845 protein set. This methodology identified the candidate gene of sulfonamide-induced toxic epidermal necrolysis (TEN): all nine sulfonamides that cause TEN were found to bind strongly to MHC I (Cw*4), whereas none of the 17 control drugs that do not cause TEN were found to bind to it. Through an insight into the CPI, we found the Y116S substitution of MHC I (B*5703) enhances the unexpected binding of abacavir to its antigen presentation groove, which explains why B*5701, not B*5703, is the risk allele of abacavir-induced hypersensitivity. In conclusion, SADR targets and the patient-specific off-targets could be identified through a systematic investigation of the CPI, generating important hypotheses for prospective experimental validation of the candidate genes

J Biomed Inform

We followed a systematic approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify existing clinical natural language processing (NLP) systems that generate structured information from unstructured free text. Seven literature databases were searched with a query combining the concepts of natural language processing and structured data capture. Two reviewers screened all records for relevance during two screening phases, and information about clinical NLP systems was collected from the final set of papers. A total of 7149 records (after removing duplicates) were retrieved and screened, and 86 were determined to fit the review criteria. These papers contained information about 71 different clinical NLP systems, which were then analyzed. The NLP systems address a wide variety of important clinical and research tasks. Certain tasks are well addressed by the existing systems, while others remain as open challenges that only a small number of systems attempt, such as extraction of temporal information or normalization of concepts to standard terminologies. This review has identified many NLP systems capable of processing clinical free text and generating structured output, and the information collected and evaluated here will be important for prioritizing development of new approaches for clinical NLP.CC999999/ImCDC/Intramural CDC HHS/United States2019-11-20T00:00:00Z28729030PMC6864736694

Pharmacovigilance Decision Support : The value of Disproportionality Analysis Signal Detection Methods, the development and testing of Covariability Techniques, and the importance of Ontology

The cost of adverse drug reactions to society in the form of deaths, chronic illness, foetal malformation, and many other effects is quite significant. For example, in the United States of America, adverse reactions to prescribed drugs is around the fourth leading cause of death. The reporting of adverse drug reactions is spontaneous and voluntary in Australia. Many methods that have been used for the analysis of adverse drug reaction data, mostly using a statistical approach as a basis for clinical analysis in drug safety surveillance decision support. This thesis examines new approaches that may be used in the analysis of drug safety data. These methods differ significantly from the statistical methods in that they utilize co variability methods of association to define drug-reaction relationships. Co variability algorithms were developed in collaboration with Musa Mammadov to discover drugs associated with adverse reactions and possible drug-drug interactions. This method uses the system organ class (SOC) classification in the Australian Adverse Drug Reaction Advisory Committee (ADRAC) data to stratify reactions. The text categorization algorithm BoosTexter was found to work with the same drug safety data and its performance and modus operandi was compared to our algorithms. These alternative methods were compared to a standard disproportionality analysis methods for signal detection in drug safety data including the Bayesean mulit-item gamma Poisson shrinker (MGPS), which was found to have a problem with similar reaction terms in a report and innocent by-stander drugs. A classification of drug terms was made using the anatomical-therapeutic-chemical classification (ATC) codes. This reduced the number of drug variables from 5081 drug terms to 14 main drug classes. The ATC classification is structured into a hierarchy of five levels. Exploitation of the ATC hierarchy allows the drug safety data to be stratified in such a way as to make them accessible to powerful existing tools. A data mining method that uses association rules, which groups them on the basis of content, was used as a basis for applying the ATC and SOC ontologies to ADRAC data. This allows different views of these associations (even very rare ones). A signal detection method was developed using these association rules, which also incorporates critical reaction terms.Doctor of Philosoph

Exploring Off-Targets and Off-Systems for Adverse Drug Reactions via Chemical-Protein Interactome — Clozapine-Induced Agranulocytosis as a Case Study

In the era of personalized medical practice, understanding the genetic basis of patient-specific adverse drug reaction (ADR) is a major challenge. Clozapine provides effective treatments for schizophrenia but its usage is limited because of life-threatening agranulocytosis. A recent high impact study showed the necessity of moving clozapine to a first line drug, thus identifying the biomarkers for drug-induced agranulocytosis has become important. Here we report a methodology termed as antithesis chemical-protein interactome (CPI), which utilizes the docking method to mimic the differences in the drug-protein interactions across a panel of human proteins. Using this method, we identified HSPA1A, a known susceptibility gene for CIA, to be the off-target of clozapine. Furthermore, the mRNA expression of HSPA1A-related genes (off-target associated systems) was also found to be differentially expressed in clozapine treated leukemia cell line. Apart from identifying the CIA causal genes we identified several novel candidate genes which could be responsible for agranulocytosis. Proteins related to reactive oxygen clearance system, such as oxidoreductases and glutathione metabolite enzymes, were significantly enriched in the antithesis CPI. This methodology conducted a multi-dimensional analysis of drugs' perturbation to the biological system, investigating both the off-targets and the associated off-systems to explore the molecular basis of an adverse event or the new uses for old drugs

An optimization approach to the study of drug-drug interactions

Drug-drug interaction is one of the important problems of Adverse Drug Reaction (ADR). In this paper we develop an optimization approach for the study of this problem. This approach is based on drug-reaction relationships represented in the form of a vector of weights, which can be defined as a solution to some global optimization problem. Although this approach can be used for solving many ADR problems, we concentrate here only on drug-drug interactions. Based on drug-reaction relationships, we formulate this problem as an optimization problem. The approach is applied to different classes of reactions from the Australian Adverse Drug Reaction Advisory Committee (ADRAC) database

Drug-drug interactions: A machine learning approach

Automatic detection of drug-drug interaction (DDI) is a difficult problem in pharmaco-surveillance. Recent practice for in vitro and in vivo pharmacokinetic drug-drug interaction studies have been based on carefully selected drug characteristics such as their pharmacological effects, and on drug-target networks, in order to identify and comprehend anomalies in a drug\u27s biochemical function upon co-administration.;In this work, we present a novel DDI prediction framework that combines several drug-attribute similarity measures to construct a feature space from which we train three machine learning algorithms: Support Vector Machine (SVM), J48 Decision Tree and K-Nearest Neighbor (KNN) using a partially supervised classification algorithm called Positive Unlabeled Learning (PU-Learning) tailored specifically to suit our framework.;In summary, we extracted 1,300 U.S. Food and Drug Administration-approved pharmaceutical drugs and paired them to create 1,688,700 feature vectors. Out of 397 drug-pairs known to interact prior to our experiments, our system was able to correctly identify 80% of them and from the remaining 1,688,303 pairs for which no interaction had been determined, we were able to predict 181 potential DDIs with confidence levels greater than 97%. The latter is a set of DDIs unrecognized by our source of ground truth at the time of study.;Evaluation of the effectiveness of our system involved querying the U.S. Food and Drug Administration\u27s Adverse Effect Reporting System (AERS) database for cases involving drug-pairs used in this study. The results returned from the query listed incidents reported for a number of patients, some of whom had experienced severe adverse reactions leading to outcomes such as prolonged hospitalization, diminished medicinal effect of one or more drugs, and in some cases, death

Using Big Data Analytics and Statistical Methods for Improving Drug Safety

This dissertation includes three studies, all focusing on utilizing Big Data and statistical methods for improving one of the most important aspects of health care, namely drug safety. In these studies we develop data analytics methodologies to inspect, clean, and model data with the aim of fulfilling the three main goals of drug safety; detection, understanding, and prediction of adverse drug effects.In the first study, we develop a methodology by combining both analytics and statistical methods with the aim of detecting associations between drugs and adverse events through historical patients' records. Particularly we show applicability of the developed methodology by focusing on investigating potential confounding role of common diabetes drugs on developing acute renal failure in diabetic patients. While traditional methods of signal detection mostly consider one drug and one adverse event at a time for investigation, our proposed methodology takes into account the effect of drug-drug interactions by identifying groups of drugs frequently prescribed together.In the second study, two independent methodologies are developed to investigate the role of prescription sequence factor on the likelihood of developing adverse events. In fact, this study focuses on using data analytics for understanding drug-event associations. Our analyses on the historical medication records of a group of diabetic patients using the proposed approaches revealed that the sequence in which the drugs are prescribed, and administered, significantly do matter in the development of adverse events associated with those drugs.The third study uses a chronological approach to develop a network of approved drugs and their known adverse events. It then utilizes a set of network metrics, both similarity- and centrality-based, to build and train machine learning predictive models and predict the likely adverse events for the newly discovered drugs before their approval and introduction to the market. For this purpose, data of known drug-event associations from a large biomedical publication database (i.e., PubMed) is employed to construct the network. The results indicate significant improvements in terms of accuracy of prediction of drug-evet associations compared with similar approaches

Integrative bioinformatics and graph-based methods for predicting adverse effects of developmental drugs

Adverse drug effects are complex phenomena that involve the interplay between drug molecules and their protein targets at various levels of biological organisation, from molecular to organismal. Many factors are known to contribute toward the safety profile of a drug, including the chemical properties of the drug molecule itself, the biological properties of drug targets and other proteins that are involved in pharmacodynamics and pharmacokinetics aspects of drug action, and the characteristics of the intended patient population. A multitude of scattered publicly available resources exist that cover these important aspects of drug activity. These include manually curated biological databases, high-throughput experimental results from gene expression and human genetics resources as well as drug labels and registered clinical trial records. This thesis proposes an integrated analysis of these disparate sources of information to help bridge the gap between the molecular and the clinical aspects of drug action. For example, to address the commonly held assumption that narrowly expressed proteins make safer drug targets, an integrative data-driven analysis was conducted to systematically investigate the relationship between the tissue expression profile of drug targets and the organs affected by clinically observed adverse drug reactions. Similarly, human genetics data were used extensively throughout the thesis to compare adverse symptoms induced by drug molecules with the phenotypes associated with the genes encoding their target proteins. One of the main outcomes of this thesis was the generation of a large knowledge graph, which incorporates diverse molecular and phenotypic data in a structured network format. To leverage the integrated information, two graph-based machine learning methods were developed to predict a wide range of adverse drug effects caused by approved and developmental therapies