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顺铂在糖尿病兔体内的药代动力学及其肾毒性

Cisplatin pharmacokinetics and its nephrotoxicity in diabetic rabbits.

作者信息

Najjar T A, Saad S Y

机构信息

Clinical Pharmacy Department, College of Pharmacy, P.O. Box 2457, King Saud University, Riyadh 11451, Saudi Arabia.

出版信息

Chemotherapy. 2001 Mar-Apr;47(2):128-35. doi: 10.1159/000048512.

Abstract

BACKGROUND

This study was designed to investigate the relationship between the attenuation of cisplatin (CDDP)-induced nephrotoxicity in experimental diabetic rabbits and the plasma pharmacokinetics of the free ultrafilterable and total plasma platinum (Pt) levels.

METHODS

Two groups of age-matched male New Zealand white rabbits were used; the first group consisted of rabbits with streptozotocin-induced diabetes (single i.v. bolus dose of streptozotocin of 65 mg/kg in citrate buffer, pH 4.6), and the second group of nondiabetic rabbits treated with the same volume of citrate buffer. Both groups were treated with CDDP (5 mg/kg, single i.v. bolus dose) 3 days after induction of the diabetic state in the first group. The plasma Pt levels were followed for 4 h after CDDP administration, in which the free ultrafilterable and total plasma Pt concentrations were determined by atomic absorption spectrometry. The pharmacokinetic parameters of free ultrafilterable plasma Pt were determined using a noncompartment pharmacokinetic model of analysis.

RESULTS

The total plasma Pt levels declined in a biphasic manner and were adequately described by a two-compartment model. No significant change was observed in the pharmacokinetics of either the free ultrafilterable or total plasma Pt levels in the diabetic group in comparison with the control nondiabetic group (p > 0.05). However, 4 h after CDDP administration, the total plasma Pt level of the nondiabetic group was significantly higher than that of the diabetic rabbits (p < 0.001). Indices of nephrotoxicity were determined 7 days after CDDP administration. The results revealed that the diabetic state protected against CDDP-induced nephrotoxicity. The nondiabetic rabbits exhibited highly significant elevations in the serum creatinine and urea levels and a decrease in the serum albumin level (p < 0.001) in comparison with the diabetic group.

CONCLUSIONS

These findings might suggest that the reduction in CDDP-induced nephrotoxicity in diabetic rabbits is not due to a change in the plasma pharmacokinetic profile within the drug follow-up period. It could be anticipated that the rapid decline in the total plasma Pt level after CDDP administration to diabetic rabbits, as well as the reduction in the terminal elimination half-life of the total plasma Pt level might be responsible for the reduction in CDDP-induced nephrotoxicity. Also, alterations in the how kidneys of diabetics deal with the renal excretion of Pt and reduction of its accumulation in kidney tissue are not excluded.

摘要

背景

本研究旨在探讨实验性糖尿病兔中顺铂(CDDP)诱导的肾毒性减弱与游离可超滤血浆铂(Pt)水平及总血浆铂水平的血浆药代动力学之间的关系。

方法

使用两组年龄匹配的雄性新西兰白兔;第一组由链脲佐菌素诱导的糖尿病兔组成(在pH 4.6的柠檬酸盐缓冲液中静脉注射单次大剂量65 mg/kg链脲佐菌素),第二组为用相同体积柠檬酸盐缓冲液处理的非糖尿病兔。在第一组诱导糖尿病状态3天后,两组均接受CDDP(5 mg/kg,静脉注射单次大剂量)治疗。在CDDP给药后4小时监测血浆Pt水平,其中通过原子吸收光谱法测定游离可超滤血浆Pt浓度和总血浆Pt浓度。使用非房室药代动力学分析模型确定游离可超滤血浆Pt的药代动力学参数。

结果

总血浆Pt水平呈双相下降,并用二室模型进行了充分描述。与对照非糖尿病组相比,糖尿病组游离可超滤血浆Pt水平或总血浆Pt水平的药代动力学未观察到显著变化(p>0.05)。然而,在CDDP给药后4小时,非糖尿病组的总血浆Pt水平显著高于糖尿病兔(p<0.001)。在CDDP给药7天后测定肾毒性指标。结果显示糖尿病状态可预防CDDP诱导的肾毒性。与糖尿病组相比,非糖尿病兔的血清肌酐和尿素水平显著升高,血清白蛋白水平降低(p<0.001)。

结论

这些发现可能表明糖尿病兔中CDDP诱导的肾毒性降低并非由于药物随访期内血浆药代动力学特征的改变。可以预期,CDDP给药后糖尿病兔总血浆Pt水平的快速下降以及总血浆Pt水平终末消除半衰期的缩短可能是CDDP诱导的肾毒性降低的原因。此外,不排除糖尿病患者肾脏处理Pt肾排泄方式的改变及其在肾组织中蓄积的减少。

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