Tang Lisa, Persky Adam M, Hochhaus Günther, Meibohm Bernd
Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, 874 Union Avenue, Suite 5p, Memphis, Tennessee 38163, USA.
J Pharm Sci. 2004 Sep;93(9):2184-204. doi: 10.1002/jps.20125.
In recent years, biotechnologically derived peptide and protein-based drugs have developed into mainstream therapeutic agents. Peptide and protein drugs now constitute a substantial portion of the compounds under preclinical and clinical development in the global pharmaceutical industry. Pharmacokinetic and exposure/response evaluations for peptide and protein therapeutics are frequently complicated by their similarity to endogenous peptides and proteins as well as protein nutrients. The first challenge frequently comes from a lack of sophistication in various analytical techniques for the quantification of peptide and protein drugs in biological matrices. However, advancements in bioassays and immunoassays--along with a newer generation of mass spectrometry-based techniques--can often provide capabilities for both efficient and reliable detection. Selection of the most appropriate route of administration for biotech drugs requires comprehensive knowledge of their absorption characteristics beyond physicochemical properties, including chemical and metabolic stability at the absorption site, immunoreactivity, passage through biomembranes, and active uptake and exsorption processes. Various distribution properties dictate whether peptide and protein therapeutics can reach optimum target site exposure to exert the intended pharmacological response. This poses a potential problem, especially for large protein drugs, with their typically limited distribution space. Binding phenomena and receptor-mediated cellular uptake may further complicate this issue. Elimination processes--a critical determinant for the drug's systemic exposure--may follow a combination of numerous pathways, including renal and hepatic metabolism routes as well as generalized proteolysis and receptor-mediated endocytosis. Pharmacokinetic/pharmacodynamic (PK/PD) correlations for peptide and protein-based drugs are frequently convoluted by their close interaction with endogenous substances and physiologic regulatory feedback mechanisms. Extensive use of pharmacokinetic and exposure/response concepts in all phases of drug development has in the past been identified as a crucial factor for the success of a scientifically driven, evidence-based, and thus accelerated drug development process. Thus, PK/PD concepts are likely to continue and expand their role as a fundamental factor in the successful development of biotechnologically derived drug products in the future.
近年来,生物技术衍生的肽类和蛋白质类药物已发展成为主流治疗药物。肽类和蛋白质类药物目前在全球制药行业临床前和临床开发的化合物中占很大比例。肽类和蛋白质治疗药物的药代动力学和暴露/反应评估常常因其与内源性肽、蛋白质以及蛋白质营养素的相似性而变得复杂。第一个挑战通常来自于用于定量生物基质中肽类和蛋白质药物的各种分析技术不够成熟。然而,生物测定和免疫测定的进展——以及新一代基于质谱的技术——通常能够提供高效可靠的检测能力。为生物技术药物选择最合适的给药途径需要全面了解其吸收特性,而不仅仅是物理化学性质,包括在吸收部位的化学和代谢稳定性、免疫反应性、穿过生物膜的情况以及主动摄取和外排过程。各种分布特性决定了肽类和蛋白质治疗药物是否能够达到最佳靶点暴露以发挥预期的药理反应。这带来了一个潜在问题,尤其是对于大型蛋白质药物,其分布空间通常有限。结合现象和受体介导的细胞摄取可能会使这个问题更加复杂。消除过程——药物全身暴露的关键决定因素——可能遵循多种途径的组合,包括肾脏和肝脏代谢途径以及普遍的蛋白水解和受体介导的内吞作用。肽类和蛋白质类药物的药代动力学/药效学(PK/PD)相关性常常因其与内源性物质和生理调节反馈机制的密切相互作用而变得复杂。过去,在药物开发的各个阶段广泛使用药代动力学和暴露/反应概念被认为是科学驱动、基于证据从而加速药物开发过程取得成功的关键因素。因此,PK/PD概念在未来生物技术衍生药物产品的成功开发中可能会继续并扩大其作为基本因素的作用。