ABSTRACT
Von Willebrand factor (VWF) is cleaved by the plasma metalloprotease ADAMTS13 (a d isintegrin and m etalloproteinase with t hrombos pondin repeats, number 13) that regulates the hemostatic activity of VWF by limiting
its multimeric size in the human system. In vitro and ex vivo studies have shown that
human recombinant VWF (rVWF) is virtually resistant to the proteolytic activity of
murine ADAMTS13. In contrast, rabbit and cynomolgus ADAMTS13 is able to cleave human
rVWF. These findings were consistent with in vivo results showing distinct pharmacological
behavior of human rVWF depending on the cleaving capacity of ADAMTS13 present in the
species tested.
Studies were performed using three mouse strains (ADAMTS13 deficient, C57BL/6J [wild
type], VWF deficient), rats, rabbits, and cynomolgus monkeys. All animals were infused
once with different doses of human rVWF and, in addition, 14 daily doses were given
to rats and cynomolgus monkeys. Exaggerated pharmacological effects were observed
in mice, with the ADAMTS13 knockout mouse being the most sensitive strain. Similar
findings with decreased incidence and severity were seen in normal C57BL/6J mice and
also in VWF-deficient mice, where they were least pronounced. In rats, exaggerated
pharmacological effects were observed only after 14 doses. Rabbits and cynomolgus
monkeys showed no exaggerated pharmacological effects.
These differences between species and between mouse strains suggest that the efficiency
of ADAMTS13 to cleave rVWF determines the severity of clinical, laboratory and pathohistological
findings. These observations highlight the importance of evaluating species' suitability
for the generation of meaningful preclinical data for determining the therapeutic
safety margins for human patients. Only animals with a sufficient rVWF cleavage capacity
by endogenous ADAMTS13 (rabbits and cynomolgus monkeys) are considered appropriate
animal models for preclinical evaluation of the rVWF product.
KEYWORDS
Recombinant von Willebrand factor - rVWF - species suitability - ADAMTS13 cleavage
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Hans Peter SchwarzM.D.
Baxter Innovations GmbH
Industriestrasse 67, 1220, Vienna, Austria
Email: schwarh@baxter.com