Zhu Xue-hui, Jiao Jian-jie, Zhang Cai-li, Lou Jian-shi, Liu Chang-xiao
Basic Medical College, Tianjin Medical University, Tianjin 300070, China.
Yao Xue Xue Bao. 2008 Sep;43(9):905-11.
The present study was to evaluate feasibility of a limited sampling strategy (LSS) in the prediction of inhibited hepatic CYP3A activity with systemic clearance of midazolam (MDZ), a hepatic CYP3A activity phenotyping probe. Rats were pretreated with a serial doses of ketoconazole, a selective inhibitor on CYP3A. Blood samples were collected and detected for MDZ at specified time points after intravenous injection of MDZ. Stepwise regression analysis and a Jack-knife validation procedures were performed in one group of rats as training set to establish the most informative LSS model for accurately estimating the clearance of MDZ. Another group of rats with same treatment was used as validation set to estimate the individual clearance based on predictive equations derived from the training set. Bland-Altman plots showed a good agreement between the systemic clearance calculated from DAS (CLobs) and corresponding parameter that was derived from three LSS models (CLest). LSS models derived from two or three sampling time points, including 60, 90 min, 30, 60, 90 min and 30, 60, 120 min, exhibited a good accuracy and acceptable error for estimating the CLobs of MDZ to evaluate hepatic CYP3A activity, especially the 60, 90 min LSS model is most accurate and convenient. The results supported that limited plasma sampling to predict the systemic clearance of MDZ is easier than the usual method for estimating CYP3A phenotyping when the hepatic activity of CYP3A is reduced in the rat. The present study provided theoretical basis and laboratory evidence for LSS to clinically evaluate metabolizing function of liver and
本研究旨在评估一种有限采样策略(LSS)在通过咪达唑仑(MDZ,一种肝脏CYP3A活性表型分析探针)的全身清除率预测肝脏CYP3A活性受抑制情况方面的可行性。大鼠接受了一系列剂量的酮康唑(一种CYP3A的选择性抑制剂)预处理。静脉注射MDZ后,在特定时间点采集血样并检测MDZ。对一组大鼠作为训练集进行逐步回归分析和留一法验证程序,以建立最具信息量的LSS模型,用于准确估计MDZ的清除率。另一组接受相同处理的大鼠作为验证集,根据从训练集得出的预测方程来估计个体清除率。Bland-Altman图显示,由DAS计算得出的全身清除率(CLobs)与从三个LSS模型得出的相应参数(CLest)之间具有良好的一致性。从两个或三个采样时间点(包括60、90分钟;30、60、90分钟;以及30、60、120分钟)得出的LSS模型,在估计MDZ的CLobs以评估肝脏CYP3A活性方面表现出良好的准确性和可接受的误差,尤其是60、90分钟的LSS模型最为准确和便捷。结果支持,当大鼠肝脏CYP3A活性降低时,通过有限的血浆采样来预测MDZ的全身清除率比通常用于估计CYP3A表型的方法更容易。本研究为LSS在临床评估肝脏代谢功能方面提供了理论依据和实验室证据,并且