胎盘绒毛模型人灌流胎盘中转染奥司他韦及其代谢产物。
Transplacental transfer of oseltamivir and its metabolite using the human perfused placental cotyledon model.
机构信息
Clinical Research Unit, Institut National de la Santé et de la Recherche Médicale, Cochin Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, France.
出版信息
Am J Obstet Gynecol. 2012 Jan;206(1):92.e1-6. doi: 10.1016/j.ajog.2011.07.023. Epub 2011 Jul 22.
OBJECTIVE
Given the lack of data regarding the use of oseltamivir (Tamiflu) during pregnancy, we aimed to evaluate the placental transfer of oseltamivir phosphate and its active metabolite oseltamivir carboxylate, using the perfused placental cotyledon model.
STUDY DESIGN
Cotyledons were coperfused with oseltamivir phosphate and oseltamivir carboxylate using the maximal concentrations described with a 75 mg, twice-daily oral dose. Main transfer parameters such as fetal transfer rate (FTR) and clearance index (CI) were assessed.
RESULTS
Five placentas were coperfused with oseltamivir phosphate and oseltamivir carboxylate. The median FTR of oseltamivir phosphate was 8.5% (range, 5.0-11.6%) and the median CI was 0.3 (range, 0.2-0.6). Regarding oseltamivir carboxylate transplacental transfer, the median FTR was 6.6% (range, 3.9-9.7%), whereas the median CI was 0.2 (range, 0.2-0.5).
CONCLUSION
A transplacental transfer of oseltamivir phosphate and its metabolite oseltamivir carboxylate was detected and might have clinical relevance. Clinicians should be encouraged to report oseltamivir treatment outcomes during pregnancy.
目的
鉴于有关奥司他韦（达菲）在怀孕期间使用的数据缺乏，我们旨在使用灌注胎盘绒毛模型来评估奥司他韦磷酸盐及其活性代谢物奥司他韦羧酸酯向胎盘的转移。
研究设计
使用描述的最大浓度（75mg，每日两次口服剂量），将绒毛共同灌注奥司他韦磷酸盐和奥司他韦羧酸酯。评估了主要转移参数，如胎儿转移率（FTR）和清除指数（CI）。
结果
共对 5 个胎盘进行了奥司他韦磷酸盐和奥司他韦羧酸酯的共同灌注。奥司他韦磷酸盐的中位数 FTR 为 8.5％（范围，5.0-11.6％），中位数 CI 为 0.3（范围，0.2-0.6）。关于奥司他韦羧酸酯的胎盘转移，中位数 FTR 为 6.6％（范围，3.9-9.7％），中位数 CI 为 0.2（范围，0.2-0.5）。
结论
检测到奥司他韦磷酸盐及其代谢物奥司他韦羧酸酯向胎盘的转移，可能具有临床意义。应鼓励临床医生报告怀孕期间奥司他韦治疗的结果。
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