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THE COSTS AND BENEFITS O F
ANIMAL EXPERIMENTS
Andrew Knight
90101
9 780230 243927
I S B N 9 7 8 - 0 - 2 3 0 - 2 4 3 9 2 - 7
www.palgrave.com
PrintedinGreatBritain
Leonid Yastremskiy/dream-
ssuescreateasmuch controversy asinvasiveexperimentson
mescientistsclaim they areessential for combating major
ses,or detecting human toxins.Othersclaim thecontrary,
ousandsof patientsharmed by pharmaceuticals developed
tests.Someclaim all experimentsare
umanely,to high scientificstandards.Yet,awealth of
recently revealedthat laboratory animalssuffer significant
may distort experimental results.
eaking scientificresearch,analysisand experienceto provide
sed answersto akey question:isanimal
ght
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THECOSTSANDBENEFITSOFANIMALEXPERIMENTS
AndrewKnight
Animal Experiments
and Alternatives
    
ANDREW KNIGHTANDREW KNIGHT
DipECAWBM (AWSEL), DACAW,DipECAWBM (AWSEL), DACAW,
PhD, MANZCVS, MRCVS, SFHEAPhD, MANZCVS, MRCVS, SFHEA
Scientific resistance to alternatives
Non-compliance of US researchers with the alternatives
regulations of the Animal Welfare Act:
 Most common: inadequate consideration of alternatives
(600 - 800 research facilities).
 Fourth most common: unnecessary experimental
duplication (~ 250 facilities).
 Others: inadequate justification for animal numbers,
alleged uncertainty of research personnel about signs
indicative of pain and/or distress (USDA-APHIS-AC,
2000).
 Chemical companies submitting test plans often failed to follow minimal
EPA guidance about 3Rs alternatives:
 failed to use existing published data
 failed to avoid duplicative or otherwise unnecessary animal testing
 proposed irrelevant or unnecessary tests (such as acute fish toxicity
tests on water-insoluble chemicals)
 Ignored opportunities to use non-animal tests
 failed to utilise opportunities to combine protocols, sometimes
doubling the number of animals killed
 In its responses to test plan proposals, the EPA frequently failed to
encourage companies to follow basic animal welfare principles (Sandusky
et al., 2006).
High Production Volume (HPV)
test program
Scientific support for
animal experimentation
 Animal experimentation is vital for preventing, curing or
alleviating human diseases (e.g. Brom 2002, Festing 2004).
 The greatest achievements of medicine have been possible
only due to the use of animals (e.g. Pawlik 1998).
 The complexity of humans requires nothing less than the
complexity of laboratory animals to effectively model during
biomedical investigations (e.g. Kjellmer 2002).
 Medical progress would be “severely maimed by prohibition
or severe curtailing of animal experiments,” and
“catastrophic consequences would ensue” (Osswald 1992).
Concordance or discordance?
Drugs causing serious side effects or death in some
laboratory animal species that are harmless to
humans:
 Penicillin
 Morphine
 Aspirin
 …
Drugs released onto the market after passing more rigorous
testing in animals, and very limited testing in humans, that
have caused serious human side effects:
 TGN1412 (UK, 2006)
 Vioxx
 Thalidomide, Eraldin, Chloramphenid, Ibufenac,
Flosint, Zipeprol, Zomax, Accutane, Benedectin,
Phenformin
 Many, many more…
Such adverse drug reactions have been recorded as the 4-6th
leading cause of death in US hospitals, and kill over
10,000 people annually in the UK.
Calls for systematic reviews
Clinicians and the public often consider it axiomatic that
animal research has contributed to human clinical knowledge,
on the basis of anecdotes or unsupported claims.
These constitute an inadequate form of evidence for such a
controversial area of research, particularly given increasing
competition for scarce research resources.
Hence, formal evaluation of existing and future animal
research is urgently required, e.g., via systematic reviews of
existing animal experiments.
- Pound et al. Brit Med J, 2004.
Systematic reviews:
‘gold standard’ evidence
 Critically examine human clinical or toxicological utility of
animal experiments
 Examine large numbers of experiments, usually sourced via
multiple bibliographic databases
 Any subsets of experiments must be selected without bias, via
randomisation or similarly methodical and impartial means
 Studies published in peer-reviewed biomedical journals
- Altern Lab Anim, 2007.
- Rev Recent Clin Trials, 2008.
- Palgrave Macmillan, 2011.
27 systematic reviews of the utility of animal studies in
advancing human clinical outcomes (20), or in deriving human
toxicity classifications (7)
Three different approaches sought to determine the maximum
clinical utility that may be achieved by animal studies…
1. Experiments expected to lead to
medical advances
Lindl et al. (2005 & 2006) examined animal experiments
conducted at three German universities between 1991 and
1993, that had been approved by animal ethics committees
partly on the basis of researcher claims that the experiments
might lead to concrete advances towards the cure of human
diseases.
For 17 experiments meeting the inclusion criteria, citations
were analysed for at least 12 years. 1,183 citations were
evident.
However …
Only 8.2% of all citations (97) were in clinical publications.
Of these, only 0.3% of all citations (4 publications)
demonstrated a direct correlation between the results of animal
experiments and human outcomes.
However, even in these four cases the hypotheses that had
been successfully verified in animals failed when applied to
humans.
None of these 17 experiments led to any new therapies, or
any beneficial clinical impact during the period studied.
2. Clinical utility of
highly cited animal experiments
Animal studies with > 500 citations
Published in the 7 leading scientific journals when ranked by
journal impact factor
76 animal studies were located with a median citation count of
889 (range: 639 - 2,233)
However…
Only 36.8% (28/76) were replicated in human randomised
trials. 18.4% (14/76) were contradicted by randomised trials,
and 44.7% (34/76) had not translated to clinical trials
Ultimately, only 10.5% (8/76) of these medical interventions
were subsequently approved for use in patients
- Hackam & Redelmeier. J Am Med Assoc, 2006.
Even in these cases human benefit cannot be assumed,
because adverse reactions to approved interventions are
the 4th
- 6th
leading cause of death in US hospitals
- Lazarou & Pomeranz. J Am Med Assoc, 1998.
Translation rates of most animal
experiments are much lower
Most experiments are neither highly cited nor published in
leading journals. Many experiments are not published at all.
The selective focusing on positive animal data while ignoring
negative results (optimism bias) is one of several factors
identified that may have increased the likelihood of translation
beyond that scientifically warranted.
Rigorous meta-analysis of all relevant animal experimental
data would probably significantly decrease the translation
rate to clinical trials (Hackam, 2007).
Only 48.7% (37/76) of these highly cited animal studies
published in leading journals were of good methodological
quality
Common deficiences:
lack of random allocation of animals
blinded assessment of outcomes
- Hackam & Redelmeier. J Am Med Assoc, 2006.
Poor methodological quality
3. Invasive chimpanzee research
Passionate calls for increased funding of such research, e.g.
VandeBerg et al. (Nature 2005):
Such research has been of critical importance during struggles
against major human diseases such as AIDS, hepatitis and cancer
The genetic similarities between humans and chimpanzees — our
closest living relatives — makes them ideal biomedical research
models
J Appl Amim Welf Sci, 2007 Philos, Ethics, Humanit Med, 2008
Contributions to biomedical knowledge
749 studies of captive chimpanzees or chimpanzee tissues,
from 1995-2004:
Figure 1: Chimpanzee experiments
1995-2004 (total 749)
48%
42%
3%
3%
2%
2%
Biology (363)
Diseases: virology (311)
Therapeutic
investigations (26)
Diseases: parasitology
(23)
Miscellaneous (14)
Diseases: other (12)
Figure 2: Biology experiments
(363 of 749)
37%
21%
10%
9%
7%
7%
6%
2%
1%
Cognition/Neuroanato
my/Neurology (133)
Behavior/Communicati
on (75)
Immunology (37)
Biochemistry (34)
Reproduction/Endocri
nology (27)
Genetics (25)
Anatomy/Histology (20)
Physiology (9)
Microbiology (3)
21 others: Six: FV. Four: HAV. Two each: GBV – B,
HIV & HV, IV, PIV, Noroviuses. One each:
Bacteriophages, Dengue v., Ebola v., HCMV, HGV,
HMPV, H/S TLV, LCV, Papillomaviruses, RV2,
Rhinovirus, VZV, WMHBV, Unspecified.
Figure 3: Virology experiments
(311 of 749)
31%
31%
9%
4%
4%
3%
3%
2%
2%
11%
HCV (97)
HIV (97)
HBV (29)
RSV (12)
HEV (11)
STLV (9)
HIV & SIV (8)
SIV (7)
TTV (7)
21 others (34)
HCV = hepatitis C v., HIV = human immunodeficiency v., HBV = hepatitis B
v., RSV = respiratory syncytial v., HEV = hepatitis E v., STLV = simian T-cell
lymphotropic v., SIV = simian immunodeficiency v., TTV = transfusion-
transmitted v., FV = foamy v (human and simian FV), HAV = hepatitis A v.,
GBV-B = GB virus B, HV = herpes v., IV = influenza v., PIV = parainfluenza
v., HCMV = human cytomegalovirus, HGV = hepatitis G v., HMPV = human
metapneumovirus, H/S TLV = human/simian T-cell leukemia v., LCV =
lymphocryptoviruses, RV2 = rhadinovirus (or gamma-2-herpesvirus)
genogroup 2, VZV = varicella-zoster v., WMHBV = woolly monkey hepatitis
B v.
Remaining chimpanzee studies
pharmacological and toxicological studies of various
compounds
testing of surgical techniques or prostheses, and
anaesthesiology experiments
investigations of laboratory/husbandry techniques
radiation studies
various disease studies, including endotoxaemia and eight
parasitic species
Implications?
Research on captive chimpanzees or chimpanzee tissue
appears to have contributed towards a large array of
biomedical disciplines.
However, not all knowledge has significant value, nor is
worth the costs that may be incurred.
Figure 4: Citations of
95 randomly selected
published chimpanzee studies
47
34
14
0
10
20
30
40
50
Not subsequently
cited
Cited by other
paper
Cited by medical
paper
Citations by medical papers
63% (17/27) of these medical papers were wide-ranging reviews
of 26 - 300 (median 104) references, to which the cited
chimpanzee study made only a small contribution
No chimpanzee study demonstrated an essential
contribution, or ― in a clear majority of cases ― a
significant contribution of any kind, towards papers
describing well-developed prophylactic, diagnostic or
therapeutic methods for combating human diseases!
27 systematic reviews:
overall results
The authors concluded that the animal models were useful in
advancing human clinical outcomes, or substantially
consistent with human outcomes, in only 2 of 20 studies, and
the conclusion in 1 case was contentious
7 reviews failed to demonstrate reliable predictivity of human
toxicological outcomes such as carcinogenicity and
teratogenicity
- Knight.- Knight. Altern Lab Anim,Altern Lab Anim, 2007.2007.
- Knight.- Knight. Rev Recent Clin Trials,Rev Recent Clin Trials, 2008.2008.
Causes: 1. Interspecies differences
 Altered susceptibility to and progression of diseases
 Differing absorption, tissue distribution, metabolism, and
excretion of pharmaceutical agents and toxins
 Differences in the toxicity and efficacy of pharmaceuticals
 Loss of biological variability or predictivity resulting from
the use of in-bred strains, young animals, restriction to
single genders, and inadequate group sizes.
 Lack of comorbidities (concurrent illnesses) or other human
risk factors.
 Physiological or immunological distortions resulting from
stressful environments and procedures.
2. Stressful environments
and protocols
Most laboratory animals spend most of their lives in
small, relatively barren cages. A review of 110 studies
from the biomedical literature revealed the outcomes:
- Balcombe- Balcombe et al. Lab Animet al. Lab Anim 20062006
Impacts of laboratory housing
 Deleterious neuroanatomical, psychological (eg,
stereotypical behaviour) and physiological effects
 Distortion of many subsequent scientific results
 Even so-called ‘enriched’ environments fail to
ameliorate most of these deficits
- Balcombe- Balcombe et al. Lab Animet al. Lab Anim 20062006
Impacts of common procedures
All common laboratory species suffer marked stress,
fear and possibly distress (indicated by the distortion
of a broad range of physiological parameters) when
subjected to:
 Handling
 Blood sampling
 Gavaging (insertion of an esophageal tube for
the oral administration of test compounds — a
common procedure in toxicity studies)
- Balcombe- Balcombe et al. Contemporary Topics Lab Anim Sciet al. Contemporary Topics Lab Anim Sci 20042004
Animals do not readily habituate to these procedures
over time.
This stressful alteration of normal physiological
parameters also predisposes to a range of pathologies
and distorts scientific results.
- Balcombe- Balcombe et al. Contemporary Topics Lab Anim Sciet al. Contemporary Topics Lab Anim Sci 20042004
3. False positive results of chronic
high dose rodent studies
 Overwhelming of natural physiological defences such as
epithelial shedding, inducible enzymes, DNA and tissue repair
mechanisms, which effectively protect against many naturally
occurring toxins at environmentally relevant levels
 Differences in rodent physiology when compared to humans,
e.g.: increased metabolic and decreased DNA excision repair
rates
 Unnatural elevation of cell division rates during ad libitum (‘at
will’) feeding studies
 Variable, yet substantial, stresses caused by handling and
restraint, and frequently stressful routes of administration, and
subsequent effects on hormonal regulation, immune status and
disease predisposition
4. Poor methodological quality of
animal experiments
 At least 11 systematic reviews demonstrated the poor
methodological quality of many of the animal experiments
examined
 None demonstrated good methodological quality of a majority
of experiments
Common deficiences
Lack of:
sample size calculations
sufficient sample sizes
randomised treatment allocation
blinded drug administration
blinded induction of injury (ischaemia in the case of
stroke models)
blinded outcome assessment
conflict of interest statements
Conclusions
 Historical and contemporary paradigm:
 Animal models are fairly predictive of human outcomes.
 Provides the basis for their widespread use in toxicity testing and
biomedical research aimed at developing cures for human diseases.
 However, their use persists for historical and cultural reasons,
rather than because they have been demonstrated to be
scientifically valid.
 E.g., many regulatory officials “feel more comfortable” with animal
data (O’Connor 1997).
 Some even believe animal tests are inherently valid, simply because
they are conducted in animals (Balls 2004).
 However, most systematic reviews have demonstrated that
animal models are insufficiently predictive of human
outcomes to offer substantial benefit during the development
of clinical interventions, or during human toxicity
assessment.
 Consequently, animal data may not be generally assumed to
be useful for these purposes.
3Rs alternatives
 Replacement
 Reduction
 Refinement
 (Recycling?)
 (Rehabilitation)
Replacement alternatives
Mechanisms to enhance sharing and assessment of
existing data, prior to conducting further studies.
Physicochemical evaluation and computerized modelling,
including the use of structure-activity relationships, and
expert systems.
Allow predictions about toxicity and related biological
outcomes, such as metabolic fate.
Minimally-sentient animals from lower phylogenetic
orders, or early developmental vertebral stages, as well as
microorganisms and higher plants.
A variety of tissue cultures, including immortalised cell
lines, embryonic and adult stem cells, and organotypic
cultures.
 In vitro assays (tests) utilising bacterial, yeast, protozoal,
mammalian or human cell cultures exist for a wide range of
toxic and other endpoints. These may be static, or perfused,
and used individually, or combined within test batteries.
 Human hepatocyte (liver cell) cultures and metabolic
activation systems offer potential assessment of metabolite
(a product of metabolism, usually by the liver) activity — a
very important consideration when assessing toxicity.
cDNA microarrays (‘gene chips’) allow assessment of large
numbers of genes simultaneously. This may allow genetic
expression profiling (detection of up- or down-regulation of
genes, caused by exposure to test compounds). This can
increase the speed of toxin detection, well prior to more
invasive endpoints.
The safety profile and predictivity for diverse human patient
populations of clinical trials should be improved using
microdosing, biomarkers, staggered dosing, more
representative test populations, and longer exposure periods
 Surrogate human tissues and advanced imaging modalities
 Human epidemiological, psychological and sociological
studies
 Particularly when human tissues are used, non-animal models
may generate faster, cheaper results, more reliably predictive
for humans, yielding greater insights into human
biochemical processes
Reduction alternatives
 Improvements in experimental design and statistical
analysis; particularly, adequate sample sizes.
 Minimising animal numbers without unacceptably
compromising statistical power, through decreasing data
variability:
 Environmental enrichment, aimed at decreasing physiological,
psychological or behavioural variation resulting from barren
laboratory housing and stressful procedures.
 Choosing, where possible, to measure variables with low inherent
variability.
 Genetically homogeneous (isogenic or inbred) or specified
pathogen-free animal strains.
 Screening raw data for obvious errors or outliers.
 Meta-analysis (aggregation and statistical analysis
of suitable data from multiple experiments). For
some purposes, treatment and control groups can be
combined, permitting group numbers to be
minimised.
Refinement alternatives
 Analgesics and anaesthetics. (Around 60% of UK
procedures are conducted without anaesthetics).
While such drugs undoubtedly alter normal physiology, claims that such
alterations are sufficiently important to hypotheses under investigation, to
warrant their exclusion, require careful scrutiny.
 Non-invasive imaging modalities.
 Telemetric devices to obtain information remotely.
 Faecal analysis (e.g. faecal cortisol monitoring).
 Training animals (especially primates) to participate (e.g.
presenting arms for blood-sampling), rather than using
physical or chemical restraint.
 Environmental enrichment.
 Socialisation opportunities.
Increasing 3Rs compliance
 Technology reproducibility and transfer: increased
methodology description, e.g., via publicly-accessible
databases, linked to scientific articles.
 Redirection of public funds from animal modelling to
alternatives development/implementation.
 Increased 3Rs compliance should be necessary for research
funding, ethics committee approval, and publication of results.
Would require education and cooperation of funding agencies,
ethics committees and journal editors about the limitations of
animal models, and the potential of alternatives.
 National centres for the development of alternative methods.
 Scientific recognition: awards, career options.
 Greater selection of test models more predictive of human
outcomes
 Increased safety of people exposed to chemicals that have
passed toxicity tests
 Increased efficiency during the development of human
pharmaceuticals and other therapeutic interventions
 Decreased wastage of animal, personnel and financial
resources.
Likely benefits
The scientific and logistical limitations incurred by the use of
animal models of humans within biomedical research and
toxicity testing are substantial, and increasingly recognized.
So is social concern about, and consequent regulatory
restriction of, laboratory animal use.
In defiance of these factors, such use remains enormous.
Increased use of GM animals, and the implementation of
large-scale chemical testing programs, are increasing
laboratory animal use internationally.
Conclusions
These trends clearly demonstrate the need for considerably
greater awareness of, and compliance with, the principles of
the 3Rs.
These principles are universally recognized as essential to
good laboratory animal practice, for animal welfare-related
and ethical reasons, and also, to increase the quality of the
research, and the robustness of subsequent results.
Policy reforms:
1. Animals protected
Regulatory protection should be based on current scientific
knowledge about:
neuroanatomical architecture
cognitive, psychological, and social characteristics
consequent capacity for suffering in laboratory environments
and protocols.
Sufficient scientific evidence exists to warrant the protection of:
all living vertebrates
advanced larval forms and foetal developmental stages
certain invertebrates such as cephalopods
Similar protection is warranted for:
animals used to develop or maintain GM strains
bred for organ or tissue harvesting
bred or intended for laboratory use, including those killed
when surplus to requirements
2. Species and procedures
associated with high welfare risks
Primate sourcing and use
Terminal or surgical procedures
Major physiological challenges
The production of GM animals
Procedures resulting in pain, suffering, or distress likely to be
severe or long-lasting
3. Scrutiny of animal use
Independent scientific and public scrutiny of proposed
protocols
Independent ethical review
Directive 2010/63/EU on the
protection of animals used for
scientific purposes
‘It is essential, both on moral and scientific grounds, to
ensure that each use of an animal is carefully evaluated as
to the scientific or educational validity, usefulness and
relevance of the expected result of that use.’
‘The likely harm to the animal should be balanced
against the expected benefits of the project.’
Thorough searches for replacement, reduction, and refinement
methodologies
Where scientifically suitable alternatives are identified, they
should be used
4. Retrospective evaluation
To assess the degree to which experimental objectives were
successfully met
The extent to which animals suffered
To inform future research strategy
Future experimental licensing decisions
Minimise unwarranted experimental duplication
Cited studies:
www.AnimalExperiments.info
Thank you
for your attention!
www.Palgrave.com

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Animal Experiments and Alternatives

  • 1. THE COSTS AND BENEFITS O F ANIMAL EXPERIMENTS Andrew Knight 90101 9 780230 243927 I S B N 9 7 8 - 0 - 2 3 0 - 2 4 3 9 2 - 7 www.palgrave.com PrintedinGreatBritain Leonid Yastremskiy/dream- ssuescreateasmuch controversy asinvasiveexperimentson mescientistsclaim they areessential for combating major ses,or detecting human toxins.Othersclaim thecontrary, ousandsof patientsharmed by pharmaceuticals developed tests.Someclaim all experimentsare umanely,to high scientificstandards.Yet,awealth of recently revealedthat laboratory animalssuffer significant may distort experimental results. eaking scientificresearch,analysisand experienceto provide sed answersto akey question:isanimal ght of animal experimentsto humanhealthcare,whichhave THECOSTSANDBENEFITSOFANIMALEXPERIMENTS AndrewKnight Animal Experiments and Alternatives      ANDREW KNIGHTANDREW KNIGHT DipECAWBM (AWSEL), DACAW,DipECAWBM (AWSEL), DACAW, PhD, MANZCVS, MRCVS, SFHEAPhD, MANZCVS, MRCVS, SFHEA
  • 2. Scientific resistance to alternatives Non-compliance of US researchers with the alternatives regulations of the Animal Welfare Act:  Most common: inadequate consideration of alternatives (600 - 800 research facilities).  Fourth most common: unnecessary experimental duplication (~ 250 facilities).  Others: inadequate justification for animal numbers, alleged uncertainty of research personnel about signs indicative of pain and/or distress (USDA-APHIS-AC, 2000).
  • 3.  Chemical companies submitting test plans often failed to follow minimal EPA guidance about 3Rs alternatives:  failed to use existing published data  failed to avoid duplicative or otherwise unnecessary animal testing  proposed irrelevant or unnecessary tests (such as acute fish toxicity tests on water-insoluble chemicals)  Ignored opportunities to use non-animal tests  failed to utilise opportunities to combine protocols, sometimes doubling the number of animals killed  In its responses to test plan proposals, the EPA frequently failed to encourage companies to follow basic animal welfare principles (Sandusky et al., 2006). High Production Volume (HPV) test program
  • 4. Scientific support for animal experimentation  Animal experimentation is vital for preventing, curing or alleviating human diseases (e.g. Brom 2002, Festing 2004).  The greatest achievements of medicine have been possible only due to the use of animals (e.g. Pawlik 1998).  The complexity of humans requires nothing less than the complexity of laboratory animals to effectively model during biomedical investigations (e.g. Kjellmer 2002).  Medical progress would be “severely maimed by prohibition or severe curtailing of animal experiments,” and “catastrophic consequences would ensue” (Osswald 1992).
  • 5. Concordance or discordance? Drugs causing serious side effects or death in some laboratory animal species that are harmless to humans:  Penicillin  Morphine  Aspirin  …
  • 6. Drugs released onto the market after passing more rigorous testing in animals, and very limited testing in humans, that have caused serious human side effects:  TGN1412 (UK, 2006)  Vioxx  Thalidomide, Eraldin, Chloramphenid, Ibufenac, Flosint, Zipeprol, Zomax, Accutane, Benedectin, Phenformin  Many, many more… Such adverse drug reactions have been recorded as the 4-6th leading cause of death in US hospitals, and kill over 10,000 people annually in the UK.
  • 7. Calls for systematic reviews Clinicians and the public often consider it axiomatic that animal research has contributed to human clinical knowledge, on the basis of anecdotes or unsupported claims. These constitute an inadequate form of evidence for such a controversial area of research, particularly given increasing competition for scarce research resources. Hence, formal evaluation of existing and future animal research is urgently required, e.g., via systematic reviews of existing animal experiments. - Pound et al. Brit Med J, 2004.
  • 8. Systematic reviews: ‘gold standard’ evidence  Critically examine human clinical or toxicological utility of animal experiments  Examine large numbers of experiments, usually sourced via multiple bibliographic databases  Any subsets of experiments must be selected without bias, via randomisation or similarly methodical and impartial means  Studies published in peer-reviewed biomedical journals
  • 9. - Altern Lab Anim, 2007. - Rev Recent Clin Trials, 2008. - Palgrave Macmillan, 2011.
  • 10. 27 systematic reviews of the utility of animal studies in advancing human clinical outcomes (20), or in deriving human toxicity classifications (7) Three different approaches sought to determine the maximum clinical utility that may be achieved by animal studies…
  • 11. 1. Experiments expected to lead to medical advances Lindl et al. (2005 & 2006) examined animal experiments conducted at three German universities between 1991 and 1993, that had been approved by animal ethics committees partly on the basis of researcher claims that the experiments might lead to concrete advances towards the cure of human diseases. For 17 experiments meeting the inclusion criteria, citations were analysed for at least 12 years. 1,183 citations were evident. However …
  • 12. Only 8.2% of all citations (97) were in clinical publications. Of these, only 0.3% of all citations (4 publications) demonstrated a direct correlation between the results of animal experiments and human outcomes. However, even in these four cases the hypotheses that had been successfully verified in animals failed when applied to humans. None of these 17 experiments led to any new therapies, or any beneficial clinical impact during the period studied.
  • 13. 2. Clinical utility of highly cited animal experiments Animal studies with > 500 citations Published in the 7 leading scientific journals when ranked by journal impact factor 76 animal studies were located with a median citation count of 889 (range: 639 - 2,233) However…
  • 14. Only 36.8% (28/76) were replicated in human randomised trials. 18.4% (14/76) were contradicted by randomised trials, and 44.7% (34/76) had not translated to clinical trials Ultimately, only 10.5% (8/76) of these medical interventions were subsequently approved for use in patients - Hackam & Redelmeier. J Am Med Assoc, 2006.
  • 15. Even in these cases human benefit cannot be assumed, because adverse reactions to approved interventions are the 4th - 6th leading cause of death in US hospitals - Lazarou & Pomeranz. J Am Med Assoc, 1998.
  • 16. Translation rates of most animal experiments are much lower Most experiments are neither highly cited nor published in leading journals. Many experiments are not published at all. The selective focusing on positive animal data while ignoring negative results (optimism bias) is one of several factors identified that may have increased the likelihood of translation beyond that scientifically warranted. Rigorous meta-analysis of all relevant animal experimental data would probably significantly decrease the translation rate to clinical trials (Hackam, 2007).
  • 17. Only 48.7% (37/76) of these highly cited animal studies published in leading journals were of good methodological quality Common deficiences: lack of random allocation of animals blinded assessment of outcomes - Hackam & Redelmeier. J Am Med Assoc, 2006. Poor methodological quality
  • 18. 3. Invasive chimpanzee research Passionate calls for increased funding of such research, e.g. VandeBerg et al. (Nature 2005): Such research has been of critical importance during struggles against major human diseases such as AIDS, hepatitis and cancer The genetic similarities between humans and chimpanzees — our closest living relatives — makes them ideal biomedical research models
  • 19. J Appl Amim Welf Sci, 2007 Philos, Ethics, Humanit Med, 2008
  • 20. Contributions to biomedical knowledge 749 studies of captive chimpanzees or chimpanzee tissues, from 1995-2004: Figure 1: Chimpanzee experiments 1995-2004 (total 749) 48% 42% 3% 3% 2% 2% Biology (363) Diseases: virology (311) Therapeutic investigations (26) Diseases: parasitology (23) Miscellaneous (14) Diseases: other (12)
  • 21. Figure 2: Biology experiments (363 of 749) 37% 21% 10% 9% 7% 7% 6% 2% 1% Cognition/Neuroanato my/Neurology (133) Behavior/Communicati on (75) Immunology (37) Biochemistry (34) Reproduction/Endocri nology (27) Genetics (25) Anatomy/Histology (20) Physiology (9) Microbiology (3)
  • 22. 21 others: Six: FV. Four: HAV. Two each: GBV – B, HIV & HV, IV, PIV, Noroviuses. One each: Bacteriophages, Dengue v., Ebola v., HCMV, HGV, HMPV, H/S TLV, LCV, Papillomaviruses, RV2, Rhinovirus, VZV, WMHBV, Unspecified. Figure 3: Virology experiments (311 of 749) 31% 31% 9% 4% 4% 3% 3% 2% 2% 11% HCV (97) HIV (97) HBV (29) RSV (12) HEV (11) STLV (9) HIV & SIV (8) SIV (7) TTV (7) 21 others (34) HCV = hepatitis C v., HIV = human immunodeficiency v., HBV = hepatitis B v., RSV = respiratory syncytial v., HEV = hepatitis E v., STLV = simian T-cell lymphotropic v., SIV = simian immunodeficiency v., TTV = transfusion- transmitted v., FV = foamy v (human and simian FV), HAV = hepatitis A v., GBV-B = GB virus B, HV = herpes v., IV = influenza v., PIV = parainfluenza v., HCMV = human cytomegalovirus, HGV = hepatitis G v., HMPV = human metapneumovirus, H/S TLV = human/simian T-cell leukemia v., LCV = lymphocryptoviruses, RV2 = rhadinovirus (or gamma-2-herpesvirus) genogroup 2, VZV = varicella-zoster v., WMHBV = woolly monkey hepatitis B v.
  • 23. Remaining chimpanzee studies pharmacological and toxicological studies of various compounds testing of surgical techniques or prostheses, and anaesthesiology experiments investigations of laboratory/husbandry techniques radiation studies various disease studies, including endotoxaemia and eight parasitic species
  • 24. Implications? Research on captive chimpanzees or chimpanzee tissue appears to have contributed towards a large array of biomedical disciplines. However, not all knowledge has significant value, nor is worth the costs that may be incurred.
  • 25. Figure 4: Citations of 95 randomly selected published chimpanzee studies 47 34 14 0 10 20 30 40 50 Not subsequently cited Cited by other paper Cited by medical paper
  • 26. Citations by medical papers 63% (17/27) of these medical papers were wide-ranging reviews of 26 - 300 (median 104) references, to which the cited chimpanzee study made only a small contribution No chimpanzee study demonstrated an essential contribution, or ― in a clear majority of cases ― a significant contribution of any kind, towards papers describing well-developed prophylactic, diagnostic or therapeutic methods for combating human diseases!
  • 27. 27 systematic reviews: overall results The authors concluded that the animal models were useful in advancing human clinical outcomes, or substantially consistent with human outcomes, in only 2 of 20 studies, and the conclusion in 1 case was contentious 7 reviews failed to demonstrate reliable predictivity of human toxicological outcomes such as carcinogenicity and teratogenicity - Knight.- Knight. Altern Lab Anim,Altern Lab Anim, 2007.2007. - Knight.- Knight. Rev Recent Clin Trials,Rev Recent Clin Trials, 2008.2008.
  • 28. Causes: 1. Interspecies differences  Altered susceptibility to and progression of diseases  Differing absorption, tissue distribution, metabolism, and excretion of pharmaceutical agents and toxins  Differences in the toxicity and efficacy of pharmaceuticals
  • 29.  Loss of biological variability or predictivity resulting from the use of in-bred strains, young animals, restriction to single genders, and inadequate group sizes.  Lack of comorbidities (concurrent illnesses) or other human risk factors.  Physiological or immunological distortions resulting from stressful environments and procedures.
  • 30. 2. Stressful environments and protocols Most laboratory animals spend most of their lives in small, relatively barren cages. A review of 110 studies from the biomedical literature revealed the outcomes: - Balcombe- Balcombe et al. Lab Animet al. Lab Anim 20062006 Impacts of laboratory housing
  • 31.  Deleterious neuroanatomical, psychological (eg, stereotypical behaviour) and physiological effects  Distortion of many subsequent scientific results  Even so-called ‘enriched’ environments fail to ameliorate most of these deficits - Balcombe- Balcombe et al. Lab Animet al. Lab Anim 20062006
  • 32. Impacts of common procedures All common laboratory species suffer marked stress, fear and possibly distress (indicated by the distortion of a broad range of physiological parameters) when subjected to:  Handling  Blood sampling  Gavaging (insertion of an esophageal tube for the oral administration of test compounds — a common procedure in toxicity studies) - Balcombe- Balcombe et al. Contemporary Topics Lab Anim Sciet al. Contemporary Topics Lab Anim Sci 20042004
  • 33. Animals do not readily habituate to these procedures over time. This stressful alteration of normal physiological parameters also predisposes to a range of pathologies and distorts scientific results. - Balcombe- Balcombe et al. Contemporary Topics Lab Anim Sciet al. Contemporary Topics Lab Anim Sci 20042004
  • 34. 3. False positive results of chronic high dose rodent studies  Overwhelming of natural physiological defences such as epithelial shedding, inducible enzymes, DNA and tissue repair mechanisms, which effectively protect against many naturally occurring toxins at environmentally relevant levels  Differences in rodent physiology when compared to humans, e.g.: increased metabolic and decreased DNA excision repair rates
  • 35.  Unnatural elevation of cell division rates during ad libitum (‘at will’) feeding studies  Variable, yet substantial, stresses caused by handling and restraint, and frequently stressful routes of administration, and subsequent effects on hormonal regulation, immune status and disease predisposition
  • 36. 4. Poor methodological quality of animal experiments  At least 11 systematic reviews demonstrated the poor methodological quality of many of the animal experiments examined  None demonstrated good methodological quality of a majority of experiments
  • 37. Common deficiences Lack of: sample size calculations sufficient sample sizes randomised treatment allocation blinded drug administration blinded induction of injury (ischaemia in the case of stroke models) blinded outcome assessment conflict of interest statements
  • 38. Conclusions  Historical and contemporary paradigm:  Animal models are fairly predictive of human outcomes.  Provides the basis for their widespread use in toxicity testing and biomedical research aimed at developing cures for human diseases.  However, their use persists for historical and cultural reasons, rather than because they have been demonstrated to be scientifically valid.  E.g., many regulatory officials “feel more comfortable” with animal data (O’Connor 1997).  Some even believe animal tests are inherently valid, simply because they are conducted in animals (Balls 2004).
  • 39.  However, most systematic reviews have demonstrated that animal models are insufficiently predictive of human outcomes to offer substantial benefit during the development of clinical interventions, or during human toxicity assessment.  Consequently, animal data may not be generally assumed to be useful for these purposes.
  • 40. 3Rs alternatives  Replacement  Reduction  Refinement  (Recycling?)  (Rehabilitation)
  • 41. Replacement alternatives Mechanisms to enhance sharing and assessment of existing data, prior to conducting further studies.
  • 42. Physicochemical evaluation and computerized modelling, including the use of structure-activity relationships, and expert systems. Allow predictions about toxicity and related biological outcomes, such as metabolic fate.
  • 43. Minimally-sentient animals from lower phylogenetic orders, or early developmental vertebral stages, as well as microorganisms and higher plants.
  • 44. A variety of tissue cultures, including immortalised cell lines, embryonic and adult stem cells, and organotypic cultures.
  • 45.  In vitro assays (tests) utilising bacterial, yeast, protozoal, mammalian or human cell cultures exist for a wide range of toxic and other endpoints. These may be static, or perfused, and used individually, or combined within test batteries.  Human hepatocyte (liver cell) cultures and metabolic activation systems offer potential assessment of metabolite (a product of metabolism, usually by the liver) activity — a very important consideration when assessing toxicity.
  • 46. cDNA microarrays (‘gene chips’) allow assessment of large numbers of genes simultaneously. This may allow genetic expression profiling (detection of up- or down-regulation of genes, caused by exposure to test compounds). This can increase the speed of toxin detection, well prior to more invasive endpoints.
  • 47. The safety profile and predictivity for diverse human patient populations of clinical trials should be improved using microdosing, biomarkers, staggered dosing, more representative test populations, and longer exposure periods
  • 48.  Surrogate human tissues and advanced imaging modalities  Human epidemiological, psychological and sociological studies  Particularly when human tissues are used, non-animal models may generate faster, cheaper results, more reliably predictive for humans, yielding greater insights into human biochemical processes
  • 49. Reduction alternatives  Improvements in experimental design and statistical analysis; particularly, adequate sample sizes.  Minimising animal numbers without unacceptably compromising statistical power, through decreasing data variability:  Environmental enrichment, aimed at decreasing physiological, psychological or behavioural variation resulting from barren laboratory housing and stressful procedures.  Choosing, where possible, to measure variables with low inherent variability.  Genetically homogeneous (isogenic or inbred) or specified pathogen-free animal strains.  Screening raw data for obvious errors or outliers.
  • 50.  Meta-analysis (aggregation and statistical analysis of suitable data from multiple experiments). For some purposes, treatment and control groups can be combined, permitting group numbers to be minimised.
  • 51. Refinement alternatives  Analgesics and anaesthetics. (Around 60% of UK procedures are conducted without anaesthetics). While such drugs undoubtedly alter normal physiology, claims that such alterations are sufficiently important to hypotheses under investigation, to warrant their exclusion, require careful scrutiny.
  • 52.  Non-invasive imaging modalities.  Telemetric devices to obtain information remotely.  Faecal analysis (e.g. faecal cortisol monitoring).  Training animals (especially primates) to participate (e.g. presenting arms for blood-sampling), rather than using physical or chemical restraint.  Environmental enrichment.  Socialisation opportunities.
  • 53. Increasing 3Rs compliance  Technology reproducibility and transfer: increased methodology description, e.g., via publicly-accessible databases, linked to scientific articles.  Redirection of public funds from animal modelling to alternatives development/implementation.
  • 54.  Increased 3Rs compliance should be necessary for research funding, ethics committee approval, and publication of results. Would require education and cooperation of funding agencies, ethics committees and journal editors about the limitations of animal models, and the potential of alternatives.  National centres for the development of alternative methods.  Scientific recognition: awards, career options.
  • 55.  Greater selection of test models more predictive of human outcomes  Increased safety of people exposed to chemicals that have passed toxicity tests  Increased efficiency during the development of human pharmaceuticals and other therapeutic interventions  Decreased wastage of animal, personnel and financial resources. Likely benefits
  • 56. The scientific and logistical limitations incurred by the use of animal models of humans within biomedical research and toxicity testing are substantial, and increasingly recognized. So is social concern about, and consequent regulatory restriction of, laboratory animal use. In defiance of these factors, such use remains enormous. Increased use of GM animals, and the implementation of large-scale chemical testing programs, are increasing laboratory animal use internationally. Conclusions
  • 57. These trends clearly demonstrate the need for considerably greater awareness of, and compliance with, the principles of the 3Rs. These principles are universally recognized as essential to good laboratory animal practice, for animal welfare-related and ethical reasons, and also, to increase the quality of the research, and the robustness of subsequent results.
  • 58. Policy reforms: 1. Animals protected Regulatory protection should be based on current scientific knowledge about: neuroanatomical architecture cognitive, psychological, and social characteristics consequent capacity for suffering in laboratory environments and protocols.
  • 59. Sufficient scientific evidence exists to warrant the protection of: all living vertebrates advanced larval forms and foetal developmental stages certain invertebrates such as cephalopods
  • 60. Similar protection is warranted for: animals used to develop or maintain GM strains bred for organ or tissue harvesting bred or intended for laboratory use, including those killed when surplus to requirements
  • 61. 2. Species and procedures associated with high welfare risks Primate sourcing and use Terminal or surgical procedures Major physiological challenges The production of GM animals Procedures resulting in pain, suffering, or distress likely to be severe or long-lasting
  • 62. 3. Scrutiny of animal use Independent scientific and public scrutiny of proposed protocols Independent ethical review
  • 63. Directive 2010/63/EU on the protection of animals used for scientific purposes ‘It is essential, both on moral and scientific grounds, to ensure that each use of an animal is carefully evaluated as to the scientific or educational validity, usefulness and relevance of the expected result of that use.’ ‘The likely harm to the animal should be balanced against the expected benefits of the project.’
  • 64. Thorough searches for replacement, reduction, and refinement methodologies Where scientifically suitable alternatives are identified, they should be used
  • 65. 4. Retrospective evaluation To assess the degree to which experimental objectives were successfully met The extent to which animals suffered To inform future research strategy Future experimental licensing decisions Minimise unwarranted experimental duplication

Editor's Notes

  1. Chemical companies submitting High Production Volume (HPV) test plans to the US EPA have often failed to follow even minimal EPA guidance about 3Rs alternatives.
  2. However, such claims are hotly contested (e.g., Greek & Greek 2002a), and the right of humans to experiment on animals has also been strongly contested philosophically (e.g., Singer 1990, La Follette & Shanks 1994). A growing body of empirical evidence also casts doubt upon their scientific utility as experimental models of humans, e.g. TGN1412 & other case studies.
  3. Until recently, debates about the necessity of animal experimentation have mainly utilised two approaches. Historical accounts of the extent to which animal experiments have or have not contributed towards cures for various human diseases are sometimes disputed, and in any case provide few clues as to how research might have developed instead, had alternative avenues such as human-based studies been more vigorously pursued, using redirected funding. Or they’ve relied on lists of tested drugs for which animal and human outcomes have been concordant or discordant.
  4. Scientists from 3 British universities and Yale University (US) called for systematic reviews of the efficacy of animal experiments. After searching the literature they located six existing reviews examining the efficacy of animal experiments in specific fields of medicine, which they briefly reviewed. Animal experiments are intended to be conducted prior to human clinical trials in case toxicity becomes evident. However, a very different picture emerged from these reviews… The UK Nuffield Council on Bioethics stated that “it would … be desirable to undertake further systematic reviews and meta-analyses to evaluate more fully the predictability and transferability of animal models.” They called for these to be undertaken by the UK Home Office in collaboration with major funders of research, industry associations and animal protection groups (Nuffield Council on Bioethics 2005, p.xxxiii).
  5. Experiments were included only where previous studies had shown that the applications of related animal research had confirmed the hypotheses of the researchers, and where the experiments had achieved publication in biomedical journals.
  6. These results warrant serious, rather than cursory, evaluations of the likely benefits of animal experiments by animal ethics committees and related authorities, and for a reversal of the current paradigm in which animal experiments are near-routinely approved. Instead of approving experiments because of the possibility that benefits may accrue, where significant doubt exists about such benefits, laboratory animals should receive the benefit of that doubt, and such experiments should not, in fact, be approved.
  7. Yet it is well established that studies that lack randomization or blinding often over-estimate the magnitude of treatment effects (Poignet et al. 1992, Aronowski et al. 1996, Marshall et al. 2000). Accordingly, Hackam & Redelmeier cautioned patients and physicians about extrapolating the findings of even highly cited animal research to the care of human disease.
  8. Such costs include the suffering and loss of life of the animals used, substantial consumption of scientific and financial resources, and arguably even adverse impacts on patients and consumers, when human results differ from those predicted by animal studies.
  9. Statistically-significant subset of 95 chimpanzee studies: 49.5% (47/95) were not cited by any future papers. Given that much research of lesser value is not published… True conclusion: The majority of chimpanzee experiments generate data of questionable value, which makes little obvious contribution toward the advancement of biomedical knowledge. Only 14.7% (14/95) of chimpanzee studies were cited by a total of 27 papers that appeared to describe prophylactic, diagnostic or therapeutic methods with sound potential for combating human diseases.
  10. Most laboratory animals spend the majority of their lives confined in small, barren cages, often in social isolation, in an attempt to ‘standardize’ and minimize the experimental effects of environmental variables, and for reasons of economy…
  11. Neuroanatomical defecits: decreased cerebrocortical thickness, weight, decreased cognitive and memory abilities and behavioral stereotypies — repetitive, unvarying and apparently functionless behavior patterns commonly seen in animals kept in close confinement, and believed to reflect animal suffering. These are common, occurring, for instance, in some 50% of all laboratory housed mice. Given that the vast majority of animal experiments measure physiological or behavioural parameters, the inevitable outcome is the distortion of many experimental results.
  12. The sensitivity of animal models to a range of human toxicities (ability to identify them) highlighted by Olsen et al. (1998) is generally maximised by the use of very high, and often, maximal tolerated doses (MTDs). Unfortunately, this generally appears to result in poor human specificity (ability to correctly identify human non-toxins), resulting in a high incidence of false positive results. … Such factors render profoundly difficult any attempts to accurately extrapolate human carcinogenic hazards from animal data (Knight et al. 2006b).
  13. Many animal studies lacked randomized treatment allocation and blinded outcome assessments. Some studies also used anaesthetics that may have altered experimental outcomes, and substantial variation was evident in the parameters assessed.
  14. Animal experiments may sometimes be followed by a concordant human outcome. However, they are a highly inefficient means of advancing human health. Additionally, they accord insufficient ethical weighting to the interests of other species. Animals were not placed on Earth as tools for fulfilling human ends. Like us, they are sentient creatures capable of experiencing complex mental and emotional lives, including suffering and pleasure. Like us, they have interests, and it is incumbent on us to respect those interests if we are to consider ourselves ethical agents. In particular, we may not sacrifice the most basic and essential interests of animals, such as the interests in remaining alive, free from artificially-induced suffering, and, arguably, free of confinement, to fulfil human interests, particularly where trivial, such as the interest in developing a new consumer product. For that tiny proportion of consumer products that are arguably life-saving, such as pharmaceuticals, the animal experiments ought to be reasonably expected to make a significant and valuable contribution towards their development. However, as an increasing number of large-scale systematic reviews are demonstrating, animals are not generally sufficiently predictive of human outcomes to make a substantially useful contribution towards the development of methods for combating human diseases.
  15. SARs: predict biological activity such as toxicity on the basis of structure Expert systems: seek to mimic the judgment of expert toxicologists, by using known rules about factors affecting toxicity, in combination with physicochemical or other information about a specific compound
  16. We live in a democratic society, in which many people are legitimately concerned about the laboratory animal use primarily funded by their tax contributions. Those people have a right to be informed about laboratory animal use, to scrutinise it, and to see that the research community is serious about the 3Rs. Annual conferences and speeches are not a sufficient means of demonstrating that commitment. Concrete measures are necessary.
  17. First, the species protected should be broadened beyond the basic inclusion of living vertebrates to protect all additional categories that raise significant ethical concerns. Some countries currently fall far short of international norms. In the US, the denial of protection to mice, rats, birds, fish, reptiles, and amphibians under the AWA excludes well over 90 per cent of animals used in scientific procedures.
  18. In recognition of the evolving state of scientific knowledge, where significant doubts remain about the level of development of morally relevant characteristics, such species should be afforded the benefit of the doubt until their status is clarified.
  19. Neither their use nor their killing should be excluded from the ethical review and regulatory control afforded to other laboratory animals.
  20. The advanced psychological and social characteristics of great apes such as chimpanzees render it impossible in practical terms to provide laboratory environments that satisfactorily meet their minimum psychological and behavioural requirements, which include family preservation, ample opportunities for climbing, exploring, problem solving, and playing, and considerable space (Balls 1995, DeGrazia 1996, Smith & Boyd 2002). Accordingly, the use of great apes should be prohibited, and remaining primate use very carefully scrutinised… In particular, animal use should be prohibited where pain, suffering, or distress is likely to be severe or long-lasting. It must be remembered that the stress caused by such procedures is also likely to substantially alter the animals’ physiology and any dependent scientific outcomes.
  21. The societal values attached to laboratory animal lives and the health and safety of patients and consumers are considerable, and the corresponding public interest is substantial. Given that most large-scale systematic reviews have demonstrated minimal human clinical or toxicological benefit from invasive animal experimentation – even when expected to produce concrete advances in human healthcare, the likely human benefits of scientific animal use should be scrutinised far more critically than is currently the norm, and more accurately weighed against the animal, human, and financial costs incurred.
  22. Therefore, an impartial project evaluation independent of those involved in the study should be carried out as part of the authorisation process of projects involving the use of live animals. Too often, however, expected human benefits are based on unrealistic assumptions.
  23. Consistent with legitimate public interest, study results should be made publicly available in a timely fashion. Retrospective evaluation should be mandatory where experiments are likely to result in significant animal harm, financial costs, or human benefits.