Key Lab of Drug Metabolism & Pharmacokinetics, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China.
Acta Pharmacol Sin. 2018 Aug;39(8):1373-1385. doi: 10.1038/aps.2017.159. Epub 2017 Nov 30.
Among the somatostatin analogues, octreotide (OCT) is the most commonly used in clinic via intravenous or subcutaneous injection to treat various diseases caused by increased secretion of growth hormone, gastrin or insulin. In order to assesse the feasibility of developing oral formulations of OCT, we conducted systematical pharmacokinetic and pharmacodynamic analyses of OCT in several animal models. The pharmacokinetic studies in rats showed that intragastric administration of OCT had extremely low bioavailability (<0.5%), but it could specifically distribute to the gastric mucosa due to the high expression of somatostatin receptor 2 (SSTR2) in the rat stomach. The pharmacodynamic studies revealed that intragastric administration of OCT dose-dependently protected against gastric mucosal injury (GMI) in mice with WIRS-induced mouse gastric ulcers, which were comparable to those achieved by intravenous injection of OCT, and this effect was markedly attenuated by co-administration of CYN-154806, an antagonist of SSTR2. In pyloric ligation-induced ulcer mice, we further demonstrated that OCT significantly reduced the secretion of gastric acid via down-regulating the level of gastrin, which was responsible for the protective effect of OCT against GMI. Overall, we have provided pharmacokinetic and pharmacodynamic evidence for the feasibility of developing an oral formulation of OCT. Most importantly, the influence of SSTR2 on the pharmacokinetics and pharmacodynamics of OCT suggested that an oral formulation of OCT might be applicable for other clinical indications, including neuroendocrine neoplasms and pituitary adenoma due to the overexpression of SSTR2 on these tumor cells.
在生长抑素类似物中,奥曲肽(OCT)是最常用于通过静脉或皮下注射治疗因生长激素、胃泌素或胰岛素分泌增加而引起的各种疾病的药物。为了评估开发 OCT 口服制剂的可行性,我们在几种动物模型中对 OCT 的药代动力学和药效学进行了系统分析。在大鼠中的药代动力学研究表明,OCT 经胃内给药的生物利用度极低(<0.5%),但由于大鼠胃中生长抑素受体 2(SSTR2)的高表达,OCT 能够特异性分布到胃黏膜。药效学研究表明,OCT 经胃内给药剂量依赖性地保护 WIRS 诱导的小鼠胃溃疡模型中的胃黏膜损伤(GMI),其效果与 OCT 静脉注射相当,并且 SSTR2 拮抗剂 CYN-154806 的共同给药显著减弱了这种作用。在幽门结扎诱导的溃疡小鼠中,我们进一步证明 OCT 通过下调胃泌素水平显著减少胃酸分泌,这是 OCT 对 GMI 保护作用的原因。总之,我们提供了 OCT 开发口服制剂的可行性的药代动力学和药效学证据。最重要的是,SSTR2 对 OCT 的药代动力学和药效学的影响表明,由于这些肿瘤细胞上 SSTR2 的过度表达,OCT 的口服制剂可能适用于其他临床适应症,包括神经内分泌肿瘤和垂体腺瘤。