Goutal Sébastien, Auvity Sylvain, Legrand Tiphaine, Hauquier Fanny, Cisternino Salvatore, Chapy Hélène, Saba Wadad, Tournier Nicolas
IMIV, CEA, Inserm, CNRS, Univ. Paris-Sud, Université Paris Saclay, CEA-SHFJ, Orsay, France.
IMIV, CEA, Inserm, CNRS, Univ. Paris-Sud, Université Paris Saclay, CEA-SHFJ, Orsay, France; Variabilité de réponse aux psychotropes, INSERM, U1144, 75006 Paris, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France.
J Pharm Biomed Anal. 2016 May 10;123:173-8. doi: 10.1016/j.jpba.2016.02.013. Epub 2016 Feb 15.
In clinical practice, rifampicin exposure is estimated from its concentration in venous blood samples. In this study, we hypothesized that differences in rifampicin concentration may exist between arterial and venous plasma. An HPLC-UV method for determining rifampicin concentration in plasma using rifapentine as an internal standard was validated. The method, which requires a simple protein precipitation procedure as sample preparation, was performed to compare venous and arterial plasma kinetics after a single therapeutic dose of rifampicin (8.6 mg/kg i.v, infused over 30 min) in baboons (n=3). The method was linear from 0.1 to 40 μg mL(-1) and all validation parameters fulfilled the international requirements. In baboons, rifampicin concentration in arterial plasma was higher than in venous plasma. Arterial Cmax was 2.1±0.2 fold higher than venous Cmax. The area under the curve (AUC) from 0 to 120 min was ∼80% higher in arterial plasma, indicating a significant arteriovenous concentration gradient in early rifampicin pharmacokinetics. Arterial and venous plasma concentrations obtained 6h after rifampicin injection were not different. An important arteriovenous equilibration delay for rifampicin pharmacokinetics is reported. Determination in venous plasma concentrations may considerably underestimate rifampicin exposure to organs during the distribution phase.
在临床实践中,利福平暴露量是根据其在静脉血样中的浓度来估算的。在本研究中,我们推测动脉血浆和静脉血浆中的利福平浓度可能存在差异。一种以利福喷汀为内标物测定血浆中利福平浓度的高效液相色谱 - 紫外检测法(HPLC - UV)得到了验证。该方法在样品制备时只需简单的蛋白质沉淀程序,用于比较狒狒(n = 3)单次治疗剂量利福平(8.6 mg/kg静脉注射,30分钟内输注完毕)后的静脉和动脉血浆动力学。该方法在0.1至40 μg mL⁻¹范围内呈线性,所有验证参数均符合国际要求。在狒狒中,动脉血浆中的利福平浓度高于静脉血浆。动脉血药峰浓度(Cmax)比静脉血药峰浓度高2.1±0.2倍。0至120分钟的曲线下面积(AUC)在动脉血浆中约高80%,表明在利福平早期药代动力学过程中存在显著的动静脉浓度梯度。利福平注射6小时后获得的动脉和静脉血浆浓度无差异。报道了利福平药代动力学中重要的动静脉平衡延迟现象。测定静脉血浆浓度可能会显著低估利福平在分布阶段对器官的暴露量。