University of Houston College of Pharmacy, Texas Medical Center Campus, 1441 Moursund Street, Unit 424, Houston, TX 77030, USA.
Antimicrob Agents Chemother. 2010 Mar;54(3):1298-304. doi: 10.1128/AAC.01222-09. Epub 2009 Dec 28.
We compared the kinetics of amphotericin B (AMB) lung accumulation and fungal clearance by liposomal amphotericin B (L-AMB) and amphotericin B lipid complex (ABLC) in a neutropenic murine model of invasive pulmonary mucormycosis (IPM). Immunosuppressed BALB/c mice were inoculated with 1 x 10(6) Rhizopus oryzae spores and administered L-AMB or ABLC at daily intravenous doses of 1, 5, or 10 mg/kg of body weight for 5 days starting 12 h after infection. At a dose of 10 mg/kg/day, both L-AMB and ABLC were effective at reducing the R. oryzae lung fungal burden and achieved lung tissue concentrations exceeding the isolate mean fungicidal concentration (MFC) of 8 microg/ml by 72 h. When ABLC was dosed at 5 mg/kg/day, the ABLC-treated animals had significantly higher AMB lung concentrations than the L-AMB treated animals at 24 h (6.64 and 1.44 microg/g, respectively; P = 0.013) and 72 h (7.49 and 1.03 microg/g, respectively; P = 0.005), and these higher concentrations were associated with improved fungal clearance, as determined by quantitative real-time PCR (mean conidial equivalent of R. oryzae DNA per lung, 4.44 +/- 0.44 and 6.57 +/- 0.74 log(10), respectively; P < 0.001). Analysis of the AMB tissue concentration-response relationships revealed that the suppression of R. oryzae growth in the lung required tissue concentrations that approached the MFC for the infecting isolate (50% effective concentration, 8.19 microg/g [95% confidence interval, 2.81 to 18.1 microg/g]). The rates of survival were similar in the animals treated with L-AMB and ABLC at 10 mg/kg/day. These data suggest that higher initial doses may be required during L-AMB treatment than during ABLC treatment of experimental IPM.
我们比较了两性霉素 B(AMB)肺部积累的动力学和脂质体两性霉素 B(L-AMB)和两性霉素 B 脂质复合物(ABLC)在侵袭性肺部毛霉菌病(IPM)的中性粒细胞减少的鼠模型中的真菌清除率。用 1×10(6)根毛霉孢子接种免疫抑制 BALB/c 小鼠,并在感染后 12 小时开始每天静脉给予 1、5 或 10 mg/kg 体重的 L-AMB 或 ABLC,连续 5 天。在 10 mg/kg/天的剂量下,L-AMB 和 ABLC 均能有效降低 R.oryzae 的肺部真菌负担,并在 72 小时内达到超过分离株平均杀菌浓度(MFC)8μg/ml 的肺组织浓度。当 ABLC 以 5mg/kg/天的剂量给药时,ABLC 治疗的动物在 24 小时(分别为 6.64 和 1.44μg/g;P=0.013)和 72 小时(分别为 7.49 和 1.03μg/g;P=0.005)时肺部的 AMB 浓度明显高于 L-AMB 治疗的动物,并且这些更高的浓度与真菌清除率的提高有关,如定量实时 PCR 测定(每个肺部的 R.oryzae DNA 的平均分生孢子当量,分别为 4.44±0.44 和 6.57±0.74log10;P<0.001)。对 AMB 组织浓度-反应关系的分析表明,抑制肺部 R.oryzae 的生长需要接近感染分离株 MFC 的组织浓度(50%有效浓度为 8.19μg/g[95%置信区间,2.81 至 18.1μg/g])。在每天 10mg/kg 体重接受 L-AMB 和 ABLC 治疗的动物中,存活率相似。这些数据表明,在 L-AMB 治疗期间可能需要比在 ABLC 治疗实验性 IPM 期间更高的初始剂量。