1 Department of Clinical Pharmacokinetics, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Hyogo, Japan.
2 Department of Pathophysiology, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Hyogo, Japan.
JPEN J Parenter Enteral Nutr. 2017 Nov;41(8):1356-1365. doi: 10.1177/0148607116661030. Epub 2016 Jul 27.
Soybean oil-based intravenous lipid emulsion (SO-ILE) has clinical utility as an energy source and in lipid rescue therapy. However, an excessive infusion rate of SO-ILE in routine use and in lipid rescue therapy may cause serious side effects. There is little information about plasma triglyceride (TG) kinetics following SO-ILE administration. The present study aimed to develop a population semiphysiologic kinetic model of TG and to predict the TG kinetics even at extremely high concentrations in rats.
TG concentration profiles after intravenous bolus (0.1, 0.25, 0.5, 1.0, 1.5, and 2.0 g/kg) or infusion (3.0 g/kg/h for 1 hour) of SO-ILE to rats were analyzed by a kinetic model constructed with 4 pathways: apolipoprotein acquisitions, zero-order catabolism, first-order uptake to storage sites, and zero-order secretion from storage sites. The developed model was subjected to internal and external validation.
Plasma TG concentrations appeared to decline in a biphasic manner with nonlinear TG kinetics. The developed kinetic model was well validated and found to accurately predict the external validation data.
The proposed kinetic model accurately described TG concentrations after SO-ILE administration at various infusion rates, including a lipid rescue regimen. The maximum acceptable infusion rate of SO-ILE in routine use should correspond to the maximum velocity of the apolipoprotein acquisition: 0.619 g/kg/h in rats. The prediction of TG kinetics at extremely high concentrations will provide useful information for lipid rescue therapy.
大豆油基静脉内脂肪乳剂(SO-ILE)作为能量源和在脂质解救治疗中具有临床效用。然而,在常规使用和脂质解救治疗中,SO-ILE 的输注率过高可能会引起严重的副作用。关于 SO-ILE 给药后血浆甘油三酯(TG)动力学的信息很少。本研究旨在开发 TG 的群体半生理动力学模型,并预测大鼠中甚至在极高浓度下的 TG 动力学。
通过构建具有 4 种途径的动力学模型来分析大鼠静脉内推注(0.1、0.25、0.5、1.0、1.5 和 2.0 g/kg)或输注(3.0 g/kg/h 持续 1 小时)SO-ILE 后 TG 浓度曲线:载脂蛋白获取、零级代谢、一级摄取到储存部位和零级从储存部位分泌。开发的模型进行了内部和外部验证。
血浆 TG 浓度似乎呈双相下降趋势,具有非线性 TG 动力学。所开发的动力学模型得到了很好的验证,并准确预测了外部验证数据。
所提出的动力学模型准确描述了在不同输注率下,包括脂质解救方案后 SO-ILE 给药后的 TG 浓度。常规使用中 SO-ILE 的最大可接受输注率应与载脂蛋白获取的最大速度相对应:大鼠中为 0.619 g/kg/h。极高浓度下 TG 动力学的预测将为脂质解救治疗提供有用的信息。