两性霉素B脂质复合物与两性霉素B脂质体在急性侵袭性肺曲霉病小鼠模型中肺蓄积及真菌清除动力学的比较分析
Comparative analysis of amphotericin B lipid complex and liposomal amphotericin B kinetics of lung accumulation and fungal clearance in a murine model of acute invasive pulmonary aspergillosis.
作者信息
Lewis Russell E, Liao Guangling, Hou Jinggou, Chamilos Georgios, Prince Randall A, Kontoyiannis Dimitrios P
机构信息
The University of Houston College of Pharmacy, Texas Medical Center Campus, 1441 Moursund St., Houston, TX 77030, USA.
出版信息
Antimicrob Agents Chemother. 2007 Apr;51(4):1253-8. doi: 10.1128/AAC.01449-06. Epub 2007 Jan 29.
The reformulation of amphotericin B (AMB) into a lipid complex (AMB lipid complex [ABLC]) or liposomal carrier (liposomal AMB [L-AMB]) changes the rate and extent of drug distribution to the lung. The importance of pharmacokinetic differences among the various lipid AMB formulations in the treatment of invasive pulmonary aspergillosis (IPA) remains unknown. We compared the kinetics of AMB lung accumulation and fungal clearance of ABLC- and L-AMB-treated mice with acute IPA. BALB/c mice were immunosuppressed with cyclophosphamide and cortisone before intranasal inoculation with 1.5x10(6) Aspergillus fumigatus 293 conidia. ABLC or L-AMB was administered in daily intravenous doses (1, 5, or 10 mg/kg of body weight), starting 12 h after infection and continuing until day 5. At predetermined times (0, 24, 72, and 120 h), mice were euthanized, and lungs were harvested for determinations of lung fungal burdens (quantitative PCR) and total AMB lung tissue concentrations. Both ABLC and L-AMB were effective at reducing lung fungal burdens at doses of >or=5 mg/kg/day. Clearance of A. fumigatus during the first 24 h was associated with AMB tissue concentrations of >4 microg/g. At 5 mg/kg/day, ABLC produced a more rapid fungal clearance than did L-AMB, but at the end of therapy, fungal burden reductions were similar for both formulations and were not improved with higher dosages. These data suggest that ABLC delivers active AMB to the lung more rapidly than does L-AMB, resulting in faster Aspergillus clearance in an experimental model of IPA. However, pharmacodynamic differences between the two formulations were less apparent when mice were dosed at 10 mg/kg/day.
两性霉素B(AMB)重新配制为脂质复合物(两性霉素B脂质复合物[ABLC])或脂质体载体(脂质体两性霉素B[L-AMB])会改变药物在肺部的分布速率和程度。不同脂质两性霉素B制剂在侵袭性肺曲霉病(IPA)治疗中的药代动力学差异的重要性仍不清楚。我们比较了用ABLC和L-AMB治疗的急性IPA小鼠的AMB肺蓄积动力学和真菌清除情况。BALB/c小鼠在经鼻接种1.5×10⁶烟曲霉293分生孢子前,先用环磷酰胺和可的松进行免疫抑制。从感染后12小时开始,每天静脉注射ABLC或L-AMB(1、5或10mg/kg体重),持续至第5天。在预定时间(0、24、72和120小时)对小鼠实施安乐死,并采集肺组织以测定肺真菌负荷(定量PCR)和AMB肺组织总浓度。ABLC和L-AMB在剂量≥5mg/kg/天时均能有效降低肺真菌负荷。在最初24小时内烟曲霉的清除与AMB组织浓度>4μg/g有关。在5mg/kg/天时,ABLC比L-AMB产生更快的真菌清除,但在治疗结束时,两种制剂的真菌负荷降低情况相似,且更高剂量并未改善。这些数据表明,ABLC比L-AMB能更快地将活性AMB输送到肺部,在IPA实验模型中导致曲霉清除更快。然而,当小鼠以10mg/kg/天给药时,两种制剂之间的药效学差异不太明显。