Skip to main content

Preclinical Safety Evaluation

  • Chapter
  • First Online:
Microbicides for Prevention of HIV Infection

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 383))

Abstract

Before pharmaceutical products are evaluated in humans, it is essential that they undergo a rigorous safety assessment using in vitro models and studies in preclinical species. Once products progress into the clinic, additional preclinical studies are needed to support further clinical testing. Although regulatory guidelines provide a good framework for the types of studies that should be performed, there are some areas where it is unclear how these should be applied to microbicides, what study designs should be used, whether certain tests are relevant or if additional assays are appropriate. In this chapter we provide an overview of the key issues for the preclinical development of microbicides, and describe the purpose of each of the tests along with the key considerations to be taken into account when designing the individual safety studies as well as the overall preclinical program.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, Kharsany ABM, Sibeko S, Mlisana KP, Omar Z, Gengiah TN, Maarschalk S, Arulappan N, Mlotshwa M, Morris L, Taylor D (2010) Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science 329:1168–1174

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Adriaens E, Remon JP (2002) Evaluation of an alternative mucosal irritation test using slugs. Toxicol Appl Pharmacol 182:169–175

    Article  CAS  PubMed  Google Scholar 

  • Adriaens E, Remon JP (2008) Mucosal irritation potential of personal lubricants relates to product osmolality as detected by the slug mucosal irritation assay. Sex Transm Dis 35:512–516

    Article  CAS  PubMed  Google Scholar 

  • Aravantinou M, Singer R, Derby N, Calenda G, Mawson P, Abraham C, Menon R, Seidor S, Goldman D, Kenney J, Villegas G, Gettie A, Blanchard J, Lifson J, Piatak M, Fernandez-Romero JA, Zydowsky T, Teleshova N, Robbiani M (2012) The NNRTI MIV-160 delivered from an intravaginal ring, but not from a carrageenan gel, protects against SHIV-RT infection. AIDS Res Hum Retroviruses 28(11):1467–1475

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Auletta CS (1999) Routes of exposure. In: Weiner ML, Kotkoskie LA (eds) Excipient toxicity and safety. Marcel Dekker Ltd, New York

    Google Scholar 

  • Barberini F, Correr S, De Santis F, Motta PM (1991) The epithelium of the rabbit vagina: a microtopographical study by light, transmission and scanning electron microscopy. Arch Histol Cytol 54(4):365–378

    Article  CAS  PubMed  Google Scholar 

  • Beer BE, Doncel GF, Krebs FC, Shattock RJ, Fletcher PS, Buckheit RW Jr, Watson K, Dezzutti CS, Cummins JE, Bromley E, Richardson-Harman N, Pallansch LA, Lackman-Smith C, Osterling C, Mankowski M, Miller SR, Catalone BJ, Welsh PA, Howett MK, Wigdahl B, Turpin JA, Reichelderfer P (2006) In vitro preclinical testing of nonoxynol-9 as potential anti-human immunodeficiency virus microbicide: a retrospective analysis of results from five laboratories. Antimicrob Agents Chemother 50(2):713–723

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Boffito M, Back DJ, Blaschke TF, Rowland M, Bertz RJ, Gerber JG, Miller V (2003) Protein binding in antiretroviral therapies. AIDS Res Hum Retroviruses 19(9):825–835

    Article  CAS  PubMed  Google Scholar 

  • Buehler EV (1965) Delayed contact hypersensitivity in the guinea pig. Arch Dermatol 91:171–177

    Article  CAS  PubMed  Google Scholar 

  • Clark MR, Kiser PF, Loxley A, McConville C, Malcolm RK, Friend DR (2011) Pharmacokinetics of UC781-loaded intravaginal ring segments in rabbits: a comparison of polymer matrices. Drug Deliv Transl Res 1(3):238–246

    Article  CAS  Google Scholar 

  • Committee for Medicinal Products for Human Use (CHMP) (2008) Guideline on the non-clinical development of fixed combinations of medicinal products. http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2009/10/WC500003976.pdf. Accessed 18 Dec 2012

  • Cone RA, Hoen T, Wong XX, Abusuwwa R, Anderson DJ, Moench TR (2006) Vaginal microbicides: detecting toxicities in vivo that paradoxically increase pathogen transmission. BMC Infect Dis 6:90

    Article  PubMed Central  PubMed  Google Scholar 

  • Costin GE, Raabe HA, Priston R, Evans E, Curren RD (2011) Vaginal irritation models: the current status of available alternative and in vitro tests. Altern Lab Anim 39(4):317–337

    CAS  PubMed  Google Scholar 

  • D’Cruz OJ, Waurzyniak B, Uckun FM (2004) Mucosal toxicity studies of a gel formulation of native pokeweed antiviral protein. Toxicol Pathol 32(2):212–221

    Article  PubMed  Google Scholar 

  • Dezzutti CS, James VN, Ramos A, Sullivan ST, Siddig A, Bush TJ, Grohskopf LA, Paxton L, Subbarao S, Hart CE (2004) In vitro comparison of topical microbicides for prevention of human immunodeficiency virus type 1 transmission. Antimicrob Agents Chemother 48(10):3834–3844

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Doncel GF (1994) Vaginal chemical contraceptives: preclinical evaluation. In: Mauck CK, Gabelnick HL, Rivera R, Spieler JS, Cordero M (eds) Barrier contraceptives: current status and future prospects. Wiley, New York

    Google Scholar 

  • Doncel GF, Chandra N, Fichorova RN (2004) Preclinical assessment of the proinflammatory potential of microbicide candidates. J Acquir Immune Defic Syndr 37(Suppl. 3):S174–S180

    PubMed  Google Scholar 

  • Doncel GF, Clark MR (2010) Preclinical evaluation of anti-HIV microbicide products: new models and biomarkers. Antiviral Res 88(S1):S10–S18

    Google Scholar 

  • Draize JH, Woodward G, Calvery HO (1944) Methods for the study of irritation and toxicity of substances applied topically to the skin and mucous membranes. J Pharmacol Exp Ther 82:377–390

    CAS  Google Scholar 

  • Eckstein P, Jackson MC, Millman N, Sobrero AJ (1969) Comparison of vaginal tolerance tests of spermicidal preparations in rabbits and monkeys. J Reprod Fertil 20:85–93

    Article  CAS  PubMed  Google Scholar 

  • Fichorova RN, Rheinwald JG, Anderson DJ (1997) Generation of papillomavirus-immortalized cell lines from normal human ectocervical, endocervical, and vaginal epithelium that maintain expression of tissue-specific differentiation proteins. Biol Reprod 57(4):847–855

    Article  CAS  PubMed  Google Scholar 

  • Fichorova RN, Bajpai M, Chandra N, Hsiu JG, Spangler M, Ratnam V, Doncel GF (2004) Interleukins IL-1, IL-6 and IL-8 predict mucosal toxicity of vaginal microbicidal contraceptives. Biol Reprod 71:761–769

    Article  CAS  PubMed  Google Scholar 

  • Fichorova RN, Zhou F, Ratnam V, Atanassova V, Jiang S, Strick N, Neurath AR (2005) Anti-human immunodeficiency virus type 1 microbicide cellulose acetate 1,2-benzenedicarboxylate in a human in vitro model of vaginal inflammation. Antimicrob Agents Chemother 49(1):323–335

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Fichorova RN, Yamamoto HS, Delaney ML, Onderdonk AB, Doncel GF (2011) Novel vaginal microflora colonization model providing new insight into microbicide mechanism of action. MBio 2(6):e00168–11

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Freeman EE, Weiss HA, Glynn JR, Cross PL, Whitworth JA, Hayes RJ (2006) Herpes simplex virus 2 infection increases HIV acquisition in men and women: Systematic review and meta-analysis of longitudinal studies. AIDS 20:73–83

    Article  PubMed  Google Scholar 

  • Friend DR (2012) Drug delivery in multiple indication (multipurpose) prevention technologies: systems to prevent HIV-1 transmission and unintended pregnancies or HSV-2 transmission. Expert Opin Drug Deliv 9(4):417–427

    Article  CAS  PubMed  Google Scholar 

  • Gad SC (2008) Irritation and local tolerance studies in pharmaceutical safety assessment. In: Gad SC (ed) Preclinical development handbook: Toxicology. Wiley, Hoboken

    Google Scholar 

  • Gali Y, Delazay O, Brouwers K, Addad N, Augustins P, Bourlet T, Hamzeh-Cognasse H, Arien KK, Pozzetto B, Vanham G (2010) In vitro evaluation of viability, integrity and inflammation in genital epithelia upon exposure to pharmaceutical excipients and candidate microbicides. Antimicrob Agents Chemother 54(12):5105–5114

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Galvin SR, Cohen MS (2004) The role of sexually transmitted diseases in HIV transmission. Nat Rev Microbiol 2(1):33–42

    Article  CAS  PubMed  Google Scholar 

  • Garg S, Tambwekar KR, Vermani K, Garg A, Kaul CL, Zaneveld LJD (2001) Compendium of pharmaceutical excipients for vaginal formulations. Pharm Technol 25:14–24

    Google Scholar 

  • Gray RH, Wawer MJ, Sewankambo N, Serwadda D (1997) HIV-1 infection associated with abnormal vaginal flora morphology and bacterial vaginosis. The Lancet 350(9093):1780

    Article  CAS  Google Scholar 

  • Holt J, Cameron D, Oostebring F, Muntendam A, Rohan L, Nuttall J (2012) Determination of vaginal tissue penetration of dapivirine and tenofovir: an in vivo study in sheep. Microbicides 2012, Sydney, Australia, 15–18 April 2012

    Google Scholar 

  • International Conference on Harmonization (1994) Detection of toxicity to reproduction for medicinal products and toxicity to male fertility (S5(R2)). http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S5_R2/Step4/S5_R2__Guideline.pdf. Accessed 18 Dec 2012

  • International Conference on Harmonization (1995) Guideline on the need for carcinogenicity studies of pharmaceuticals (S1A). http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S1A/Step4/S1A_Guideline.pdf. Accessed 18 Dec 2012

  • International Conference on Harmonization (1997) Testing for carcinogenicity of pharmaceuticals (S1B). http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S1B/Step4/S1B_Guideline.pdf. Accessed 18 Dec 2012

  • International Conference on Harmonization (2000) Safety pharmacology studies for human pharmaceuticals (S7A). http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S7A/Step4/S7A_Guideline.pdf. Accessed 18 Dec 2012

  • International Conference on Harmonization (2008) Dose selection for carcinogenicity studies of pharmaceuticals (S1C(R2)). http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S1C_R2/Step4/S1C_R2__Guideline.pdf. Accessed 18 Dec 2012

  • International Conference on Harmonization (2009) Guidance on nonclinical safety studies for the conduct of human clinical trials and marketing authorization for pharmaceuticals (M3(R2)). http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Multidisciplinary/M3_R2/Step4/M3_R2__Guideline.pdf. Accessed 18 Dec 2012

  • International Conference on Harmonization (2011) Guidance on genotoxicity testing and data interpretation for pharmaceuticals intended for human use (S2(R1)). http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S2_R1/Step4/S2R1_Step4.pdf. Accessed 18 Dec 2012

  • ISO (2002) ISO 10993–10, biological evaluation of medical devices—Part 10: tests for irritation and delayed-type sensitivity. International Organization for Standardization, Geneva

    Google Scholar 

  • Johnson TJ, Srinivasan P, Albright TH, Watson-Buckheit K, Rabe L, Martin A, Pau CP, Hendry RM, Otten R, McNicholl J, Buckheit R Jr, Smith J, Kiser PF (2012) Safe and sustained vaginal delivery of pyrimidinedione HIV-1 inhibitors from polyurethane intravaginal rings. Antimicrob Agents Chemother 56(3):1291–1299

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Kaminsky M, Szivos MM, Brown KR, Willigan DA (1985) Comparison of the sensitivity of the vaginal mucous membranes of the albino rabbit and laboratory rat to nonoxynol-9. Food Chem Toxicol 23(7):705–708

    Article  CAS  PubMed  Google Scholar 

  • Kenney J, Aravantinou M, Singer R, Hsu M, Rodriguez A, Kizima L, Abraham CJ, Menon R, Seidor S, Chudolij A, Gettie A, Blanchard J, Lifson JD, Piatak M Jr, Fernández-Romero JA, Zydowsky TM, Robbiani M (2011) An antiretroviral/zinc combination gel provides 24 hours of complete protection against vaginal shiv infection in macaques. PLoS ONE 6(1):e15835

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Kimber I, Dearman RJ, Scholes EW, Basketter DA (1994) The local lymph node assay: developments and applications. Toxicology 93:12–31

    Google Scholar 

  • Kiser PF, Johnson TJ, Clark JT (2012) State of the art in intravaginal ring technology for topical prophylaxis of HIV infection. AIDS Rev 14:62–77

    PubMed  Google Scholar 

  • Kreiss J, Ngugi E, Holmes K, Ndinya-Achola J, Waiyaki P, Roberts PL, Ruminjo I, Sajabi R, Kimata J, Fleming TR, Anzala A, Holton D, Plummer F (1992) Efficacy of nonoxynol 9 contraceptive sponge use in preventing heterosexual acquisition of HIV in Nairobi prostitutes. JAMA 268(4):477–482

    Article  CAS  PubMed  Google Scholar 

  • Kroner BA (2002) Common drug pathways and interactions. Diabetes Spectr 15(4):249–255

    Article  Google Scholar 

  • Kumar S, Sharma R, Roychowdhury A (2012) Modulation of cytochrome-P450 inhibition (CYP) in drug discovery: A medicinal chemistry perspective. Curr Med Chem 19(21):3605–3621

    Article  CAS  PubMed  Google Scholar 

  • Lard-Whiteford SL, Matecka D, O’Rear JJ, Yuen IS, Litterst C, Reichelderfer P, International Working Group on Microbicides (2004) Recommendations for the nonclinical development of topical microbicides for prevention of HIV transmission: an update. J Acquir Immune Defic Syndr 36(1):541–552

    Article  Google Scholar 

  • Lederman MM, Offord RE, Hartlet O (2006) Microbicides and other topical strategies to prevent vaginal transmission of HIV. Nat Rev Immunol 6:371–382

    Article  CAS  PubMed  Google Scholar 

  • Luft J, Bode G (2002) Integration of safety pharmacology endpoints into toxicology studies. Fundam Clin Pharmacol 16:91–103

    Article  CAS  PubMed  Google Scholar 

  • Magnusson B, Kligman AM (1969) The identification of contact allergens by animal assay: the guinea pig maximization test. J Invest Dermatol 52:268–276

    CAS  PubMed  Google Scholar 

  • Major I, Boyd P, Kilbourne-Brook M, Saxon G, Cohen J, Malcolm RK (2012) A modified SILCS contraceptive diaphragm for controlled release of the HIV microbicide dapivirine (in press)

    Google Scholar 

  • Malcolm RK, Veazey RS, Geer L, Lowry D, Fetherston SM, Murphy DJ, Boyd P, Major I, Shattock RJ, Klasse PJ, Doyle LA, Rasmussen KK, Goldman L, Ketas TJ, Moore JP (2012) Sustained release of the CCR5 inhibitors CMPD167 and maraviroc from vaginal rings in rhesus macaques. Antimicrob Agents Chemother 56(5):2251–2258

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Martinsson T, Ljung T, Rubio C, HellstroM PM (1999) Beneficial effects of ropivacaine in rat experimental colitis. J Pharmacol Exp Ther 291(2):642–647

    CAS  PubMed  Google Scholar 

  • Mayaud P, McCormick D (2001) Interventions against sexually transmitted infections (STI) to prevent HIV infection. Br Med Bull 58:129–153

    Article  CAS  PubMed  Google Scholar 

  • Mesquita PMM, Cheshenko N, Wilson SS, Mhatre M, Guzman E, Fakioglu E, Keller MJ, Herold BC (2009) Disruption of tight junctions by cellulose sulfate facilitates HIV infection: model of microbicide safety. J Infect Dis 200:599–608

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Mesquita PMM, Rastogi R, Segarra TJ, Teller RS, Torres NM, Huber AM, Kiser PF, Herold BC (2012) Intravaginal ring delivery of tenofovir disoproxil fumarate for prevention of HIV and herpes simplex virus infection. J Antimicrob Chemother 67:1730–1738

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Moodley P, Connolly C, Sturma AW (2002) Interrelationships among Human Immunodeficiency Virus Type 1 infection, bacterial vaginosis, trichomoniasis, and the presence of yeasts. J Infect Dis 185(1):69–73

    Article  PubMed  Google Scholar 

  • Moss JA, Malone AM, Smith TJ, Kennedy S, Kopin E, Nguyen C, Gilman J, Butkyavichene I, Vincent KL, Motamedi M, Friend DR, Clark MR, Baum MM (2012) Simultaneous delivery of tenofovir and acyclovir via an intravaginal ring. Antimicrob Agents Chemother 56(2):875–882

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • National Institute of Environmental Health Sciences (1999) The murine local lymph node Assay: A test method for assessing the allergic contact dermatitis potential of chemicals/compounds: The results of an independent peer review evaluation coordinated by the interagency coordinating committee on the validation of alternative methods (ICCVAM) and the national toxicology program center for the evaluation of alternative toxicological methods (NICETAM). NIH Publication No: 99-4494, Research Triangle Park. (http://iccvam.niehs.nih.gov)

  • Nel A, Smythe S, Young K, Malcolm K, McCoy C, Rosenberg Z, Romano J (2009) Safety and pharmacokinetics of dapivirine delivery from matrix and reservoir intravaginal rings to HIV-negative women. J Acquir Immune Defic Syndr 51(4):416–423

    Article  CAS  PubMed  Google Scholar 

  • Newmann EA, Buehler EV, Parker RD (1983) Delayed contact hypersensitivity in the vagina and skin of the guinea pig. Fundam Appl Toxicol 3:521–527

    Article  CAS  PubMed  Google Scholar 

  • O’Brien JE, Thoms RK (1955) The in vitro effect of sodium lauryl sulfate on vaginal pathogens. J Am Pharm Assoc 44(4):245–247

    Article  Google Scholar 

  • OECD Guideline for Testing of Chemicals (2001a) Acute oral toxicity: fixed dose procedure (420). http://www.oecd-ilibrary.org/docserver/download/9742001e.pdf?expires=1355871267&id=id&accname=guest&checksum=4233FE49474D3C53B0BE4FCCBE64E5D0. Accessed 18 Dec 2012

  • OECD Guideline for Testing of Chemicals (2001b) Acute oral toxicity: acute toxic class method (423). http://www.oecd.org/chemicalsafety/assessmentofchemicals/1948370.pdf. Accessed 18 Dec 2012

  • OECD Guideline for Testing of Chemicals (2001c) Acute oral toxicity: up-and-down-procedure (UDP) (425). http://www.oecd.org/chemicalsafety/assessmentofchemicals/1948378.pdf. Accessed 18 Dec 2012

  • Ogu CC, Maxa JL (2000) Drug interactions due to cytochrome P450. Proc (Bayl Univ Med Cent) 13(4):421–423

    CAS  Google Scholar 

  • Patton DL, Kidder GG, Sweeney YC, Rabe LK, Hillier SL (1999) Effects of multiple applications of benzalkonium chloride and nonoxynol 9 on the vaginal epithelium in the pigtailed macaque (Macaca nemestrina). Am J Obstet Gynecol 180(5):1080–1087

    Article  CAS  PubMed  Google Scholar 

  • Patton DL, Cosgrove-Sweeney YT, Rabe LK, Hillier SL (2001) The pig-tailed macaque rectal model: microflora and chlamydial infection. Sex Transm Dis 28(7):363–366

    Article  CAS  PubMed  Google Scholar 

  • Patton DL, Sweeney YC, Cummings PK, Meyn L, Rabe LK, Hillier SL (2004) Safety and efficacy evaluations for vaginal and rectal use of BufferGel in the macaque model. Sex Transm Dis 31(5):290–296

    Article  CAS  PubMed  Google Scholar 

  • Patton DL, Cosgrove Sweeney YT, Paul KJ (2009) A summary of preclinical topical microbicide rectal safety and efficacy evaluations in a pigtailed macaque model. Sex Transm Dis 36(6):350–356

    Article  PubMed Central  PubMed  Google Scholar 

  • Piret J, Laforest G, Bussières M, Bergeron MG (2008) Subchronic (26- and 52-week) toxicity and irritation studies of a novel microbicidal gel formulation containing sodium lauryl sulfate in animal models. J Appl Toxicol 28(2):164–174

    Article  CAS  PubMed  Google Scholar 

  • Pirrone V, Thakkar N, Jacobson JM, Wigdahl B, Krebs FC (2011) Combinatorial approaches to the prevention and treatment of HIV-1 infection. Antimicrob Agents Chemother 55(5):1831–1842

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Portsmouth SD, Scott CJ (2007) The renaissance of fixed dose combinations: Combivir. Ther Clin Risk Manag 3(4):579–583

    CAS  PubMed Central  PubMed  Google Scholar 

  • Promadej-Lanier N, Smith JM, Srinivasan P, McCoy CF, Butera S, Woolfson AD, Malcolm RK, Otten RA (2009) Development and evaluation of a vaginal ring device for sustained delivery of HIV microbicides to non-human primates. J Med Primatol 38(4):263–271

    Article  CAS  PubMed  Google Scholar 

  • Robinson S, Delongeas JL, Donald E, Dreher D, Festag M, Kervyn S, Lampo A, Nahas K, Nogues V, Ockert D, Quinn K, Old S, Pickersgill N, Somers K, Stark C, Stei P, Waterson L, Chapman K (2008) A European pharmaceutical company initiative challenging the regulatory requirement for acute toxicity studies in pharmaceutical drug development. Regul Toxicol Pharmacol 50(3):345–352

    Article  PubMed  Google Scholar 

  • Roddy RE, Zekeng L, Ryan KA, Tamoufé U, Weir SS, Wong EL (1998) A controlled trial of nonoxynol 9 film to reduce male-to-female transmission of sexually transmitted diseases. N Engl J Med 339(8):504–510

    Article  CAS  PubMed  Google Scholar 

  • Rohan LC, Moncla BJ, Kunjara Na Ayudhya RP, Cost M, Huang Y, Gai F, Billitto N, Lynam JD, Pryke K, Graebing P, Hopkins N, Rooney JF, Friend D, Dezzutti CS (2010) In vitro and Ex Vivo testing of tenofovir shows it is effective as an HIV-1 microbicide. PLoS ONE 5(2):e9310

    Article  PubMed Central  PubMed  Google Scholar 

  • Rosenstein IJ, Stafford MK, Kitchen VS, Ward H, Weber JN, Taylor-Robinson D (1998) Effect on normal vaginal flora of three intravaginal microbicidal agents potentially active against human immunodeficiency virus type 1. J Infect Dis 177:1386–1390

    Article  CAS  PubMed  Google Scholar 

  • Rytting JH, Fix JA (2006) Drug delivery: rectal route. In: Swarbrick J (ed) Encyclopedia of pharmaceutical technology, 3rd edn. Marcel Deker, New York

    Google Scholar 

  • Shattock R, Herrera C (2013) Mechanisms of action. Curr Top Microbiol Immunol. doi:10.1007/82_2013_326

    PubMed  Google Scholar 

  • Thurman AR, Clark MR, Doncel GF (2011) Multipurpose prevention technologies: biomedical tools to prevent HIV-1, HSV-2, and unintended pregnancies. Infect Dis Obstet Gynecol 2011:429403

    Article  PubMed Central  Google Scholar 

  • Uma S, Balakrishnan P, Murugavel KG, Srikrishnan AK, Kumarasamy N, Cecelia JA, Anand S, Mayer KH, Celentano D, Thyagarajan SP, Solomon S (2005) Bacterial vaginosis in female sex workers in Chennai, India. Sex Health 2(4):261–262

    Article  PubMed  Google Scholar 

  • US Food and Drug Administration (1996) Guidance for industry on single dose acute toxicity testing for pharmaceuticals. http://www.fda.gov/downloads/Drugs/…/Guidances/ucm079270.pdf. Accessed 18 Dec 2012

  • US Food and Drug Administration (2006) Guidance for industry on nonclinical safety evaluation of drug or biologic combinations. http://www.fda.gov/OHRMS/DOCKETS/98fr/05d-0004-gdl0002.pdf. Accessed 18 Dec 2012

  • US Food and Drug Administration (2008) Guidance for industry and review staff on nonclinical safety evaluation of reformulated drug products and products intended for administration by an alternate route. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm079245.pdf. Accessed 18 Dec 2012

  • US Food and Drug Administration (2012) Guidance for industry on vaginal microbicides: development for the prevention of HIV infection. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM328842.pdf. Accessed 18 Dec 2012

  • Van Damme L, Ramjee G, Alary M, Vuylsteke B, Chandeying V, Rees H, Sirivongrangson P, Mukenge-Tshibaka L, Ettiegne-Traore V, Uaheowitchai C, Karim SS, Masse B, Perriens J, Laga M (2002) Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: a randomised controlled trial. Lancet 360:971–977

    Article  PubMed  Google Scholar 

  • Van de Wijgert JH, Chirenje ZM, Iliff V, Mbizvo MT, Mason PR, Gwanzura L, Shiboski S, Padian NS (2000) Effect of intravaginal practices on the vaginal and cervical mucosa of Zimbabwean women. J Acquir Immune Defic Syndr 24:62–67

    Article  PubMed  Google Scholar 

  • Veazey RS (2008) Microbicide safety/efficacy studies in animals -macaques and small animal models. Curr Opin HIV AIDS 3(5):567–573

    Article  PubMed Central  PubMed  Google Scholar 

  • Vermund SH (2004) Prevention of mother-to-child transmission of HIV in Africa. Top HIV Med 12(5):130–134

    PubMed  Google Scholar 

  • Wang L, Schnaare RL, Dezzutti C, Anton PA, Rohan LC (2011) Rectal microbicides: clinically relevant approach to the design of rectal specific placebo formulations. AIDS Res Ther 8:12

    Article  PubMed Central  PubMed  Google Scholar 

  • Wilson SS, Cheshenko N, Fakioglu E, Mesquita PMM, Keller MJ, Herold BC (2009) Susceptibility to genital herpes as a biomarker predictive of increased HIV risk: expansion of a murine model of microbicide safety. Antivir Ther 14(8):1113–1124

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Wood B, Doncel GF, Reddy PRK, Sokal DC (2003) Effect of diltiazem and methylene blue on human sperm motility, viability, and cervical mucus penetration. Contraception 67(3):241–245

    Article  CAS  PubMed  Google Scholar 

  • Zimmermann AE, Pizzoferrato T, Bedford J, Morris A, Hoffman R, Braden G (2006) Tenofovir-associated acute and chronic kidney disease: a case of multiple drug interactions. Clin Infect Dis 42(2):283–290

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathon D. S. Holt .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Holt, J.D.S., Nuttall, J.P. (2013). Preclinical Safety Evaluation. In: Nuttall, J. (eds) Microbicides for Prevention of HIV Infection. Current Topics in Microbiology and Immunology, vol 383. Springer, Berlin, Heidelberg. https://doi.org/10.1007/82_2013_327

Download citation

Publish with us

Policies and ethics