Paliwal Pankaj, Dash Debabrata, Krishnamurthy Sairam
Neurotherapeutics Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, 221005, India.
Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
Eur J Drug Metab Pharmacokinet. 2018 Apr;43(2):205-213. doi: 10.1007/s13318-017-0435-9.
Cerebral ischemia affects hepatic enzymes and brain permeability extensively. Piracetam was investigated up to phase III of clinical trials and there is lack of data on brain penetration in cerebral ischemic condition. Thus, knowledge of the pharmacokinetics and brain penetration of piracetam during ischemic condition would aid to improve pharmacotherapeutics in ischemic stroke.
Focal cerebral ischemia was induced by middle cerebral artery occlusion for 2 h in male Wistar rats followed by reperfusion. After 24 h of middle cerebral artery occlusion or 22 h of reperfusion, piracetam was administered for pharmacokinetic, brain penetration, and pharmacological experiments. In pharmacokinetic study, blood samples were collected at different time points after 200-mg/kg (oral) and 75-mg/kg (intravenous) administration of piracetam through right external jugular vein cannulation. In brain penetration study, the cerebrospinal fluid, systemic blood, portal blood, and brain samples were collected at pre-designated time points after 200-mg/kg oral administration of piracetam. In a separate experiment, the pharmacological effect of the single oral dose of piracetam in middle cerebral artery occlusion was assessed at a dose of 200 mg/kg.
All the pharmacokinetic parameters of piracetam including area under curve (AUC), maximum plasma concentration (C ), time to reach the maximum plasma concentration (t ), elimination half-life (t ), volume of distribution (V ), total body clearance, mean residence time, and bioavailability were found to be similar in ischemic stroke condition except for brain penetration. Piracetam exposure (AUC) in brain and CSF were found to be 2.4- and 3.1-fold higher, respectively, in ischemic stroke compared to control rats. Piracetam significantly reduced infarct volume by 35.77% caused by middle cerebral artery occlusion.
There was no change in the pharmacokinetic parameters of piracetam in the ischemic stroke model except for brain penetration. This indicates that variables influencing brain penetration may not be limiting factors for use of piracetam in ischemic stroke.
脑缺血会广泛影响肝酶和脑通透性。吡拉西坦已进行到临床试验的III期,但缺乏其在脑缺血状态下脑内渗透的数据。因此,了解吡拉西坦在缺血状态下的药代动力学和脑内渗透情况将有助于改善缺血性中风的药物治疗。
雄性Wistar大鼠通过大脑中动脉闭塞2小时诱导局灶性脑缺血,随后再灌注。在大脑中动脉闭塞24小时或再灌注22小时后,给予吡拉西坦进行药代动力学、脑内渗透和药理学实验。在药代动力学研究中,通过右颈外静脉插管以200mg/kg(口服)和75mg/kg(静脉注射)给予吡拉西坦后,在不同时间点采集血样。在脑内渗透研究中,在口服200mg/kg吡拉西坦后的预先指定时间点采集脑脊液、全身血液、门静脉血和脑样本。在另一项实验中,以200mg/kg的剂量评估单次口服吡拉西坦对大脑中动脉闭塞的药理作用。
除脑内渗透外,吡拉西坦的所有药代动力学参数,包括曲线下面积(AUC)、最大血浆浓度(C)、达到最大血浆浓度的时间(t)、消除半衰期(t)、分布容积(V)全身清除率、平均驻留时间和生物利用度,在缺血性中风状态下均相似。与对照大鼠相比,缺血性中风时脑和脑脊液中吡拉西坦的暴露量(AUC)分别高出2.4倍和3.1倍。吡拉西坦可使大脑中动脉闭塞所致梗死体积显著减少35.77%。
除脑内渗透外,缺血性中风模型中吡拉西坦的药代动力学参数无变化。这表明影响脑内渗透的变量可能不是吡拉西坦用于缺血性中风的限制因素。