Advanced in vitro models for studying drug induced toxicity

Bringing safe medicines to the market has remained a major challenge to the pharmaceutical industry. Recent years have seen increased drug attrition rates due to toxicity - even after rigorous testing in both in vitro and in vivo test models. This is partly due to poor prediction of human-specific responses in these models. This thesis aims to address the issue by developing advanced in vitro models and methods that can complement and improve the predictive power of in vitro assays at preclinical level. Liver and kidneys are often susceptible to drug insult due to their respective roles in drug metabolism and reabsorption. We have developed a robust 3D in vitro model for liver toxicity studies, this model shows many hallmarks of in vivo hepatocytes, is applied in a 384-micro-well format and is compatible with standard medium- and high-throughput lab infrastructure for routine drug screening. This thesis also discusses the role of immune mediators in aggravating kidney toxicity and use of sophisticated high-content screening approach to measure apoptosis and necrosis in real time. These models are promising new tools for preclinical drug safety testingNetherlands Toxicogenomics centre (NTC) via Netherlands Genomics InitiativeUBL - phd migration 201

High-throughput confocal imaging of differentiated 3D liver-like spheroid cellular stress response reporters for identification of drug-induced liver injury liability

Adaptive stress response pathways play a key role in the switch between adaptation and adversity, and are important in drug-induced liver injury. Previously, we have established an HepG2 fluorescent protein reporter platform to monitor adaptive stress response activation following drug treatment. HepG2 cells are often used in high-throughput primary toxicity screening, but metabolizing capacity in these cells is low and repeated dose toxicity testing inherently difficult. Here, we applied our bacterial artificial chromosome-based GFP reporter cell lines representing Nrf2 activation (Srxn1-GFP and NQO1-GFP), unfolded protein response (BiP-GFP and Chop-GFP), and DNA damage response (p21-GFP and Btg2-GFP) as long-term differentiated 3D liver-like spheroid cultures. All HepG2 GFP reporter lines differentiated into 3D spheroids similar to wild-type HepG2 cells. We systematically optimized the automated imaging and quantification of GFP reporter activity in individual spheroids using high-throughput confocal microscopy with a reference set of DILI compounds that activate these three stress response pathways at the transcriptional level in primary human hepatocytes. A panel of 33 compounds with established DILI liability was further tested in these six 3D GFP reporters in single 48 h treatment or 6 day daily repeated treatment. Strongest stress response activation was observed after 6-day repeated treatment, with the BiP and Srxn1-GFP reporters being most responsive and identified particular severe-DILI-onset compounds. Compounds that showed no GFP reporter activation in two-dimensional (2D) monolayer demonstrated GFP reporter stress response activation in 3D spheroids. Our data indicate that the application of BAC-GFP HepG2 cellular stress reporters in differentiated 3D spheroids is a promising strategy for mechanism-based identification of compounds with liability for DILI