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皮内注射葡甲胺锑治疗皮肤利什曼病期间的血浆锑含量测定。

Plasma antimony determination during cutaneous leishmaniasis treatment with intralesional infiltration of meglumine antimoniate.

机构信息

Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

Trop Med Int Health. 2018 Oct;23(10):1110-1117. doi: 10.1111/tmi.13130. Epub 2018 Aug 14.


DOI:10.1111/tmi.13130
PMID:30053341
Abstract

OBJECTIVES: To evaluate the antimony (Sb) in plasma of patients who underwent a standardised meglumine antimoniate (MA) intralesional infiltration protocol for cutaneous leishmaniasis treatment. METHODS: The level of Sb in plasma was determined by atomic absorption spectroscopy, before and 1, 2, 4 and 6 hours after the first intralesional infiltration of MA to determine the parameters peak concentrations (C ) area under curve of drug concentration in plasma from zero to 6 h (AUC ) and elimination half-life (t½) of Sb. Blood samples were also collected weekly during the treatment period, always before infiltration. RESULTS: Fourteen patients underwent MA intralesional infiltration with doses ranging from 0.8 to 9 mg Sb/kg at the first infiltration. The C ranged from 3850 to 47 095 mg × h/L and was the highest concentration obtained for 11 of 14 patients after the first intralesional infiltration of MA. A rapid initial phase of distribution lasting up to 4 h (2.6 ± 0.34 h) was followed by a slower elimination phase. Total skin lesion area, C and AUC were related to the dose of Sb infiltered (P < 0.05). Plasma Sb in samples collected weekly before the infiltration revealed antimony concentrations below the quantification limit (15.0 μg Sb/l) during the treatment period. CONCLUSIONS: Sb is quickly absorbed and eliminated after intralesional administration of MA, in a pattern similar to that reported with the Sb systemic administration. Using a therapeutic schedule limited to weekly intralesional infiltration of doses <10 mg Sb/kg does not result in plasma Sb accumulation.

摘要

目的:评估接受标准化葡甲胺锑(MA)瘤内渗透方案治疗皮肤利什曼病的患者血浆中的锑(Sb)含量。

方法:在第一次 MA 瘤内渗透前、后 1、2、4 和 6 小时,通过原子吸收光谱法测定血浆中 Sb 的水平,以确定峰值浓度(C)、血浆药物浓度从 0 到 6 小时的曲线下面积(AUC)和 Sb 的消除半衰期(t½)等参数。在治疗期间,每次渗透前也每周采集血液样本。

结果:14 名患者接受 MA 瘤内渗透治疗,剂量范围为 0.8 至 9 mg Sb/kg。C 范围为 3850 至 47095 mg × h/L,14 名患者中有 11 名在第一次 MA 瘤内渗透后获得最高浓度。快速分布初始阶段持续 4 小时(2.6 ± 0.34 小时),随后是较慢的消除阶段。总皮肤病变面积、C 和 AUC 与渗透的 Sb 剂量相关(P < 0.05)。在渗透前每周采集的血浆 Sb 样本中,在治疗期间发现 Sb 浓度低于定量下限(15.0 μg Sb/l)。

结论:MA 瘤内给药后,Sb 迅速吸收和消除,其模式与 Sb 全身给药相似。使用每周一次、剂量<10 mg Sb/kg 的瘤内渗透治疗方案不会导致血浆 Sb 积累。

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[1]
Plasma antimony determination during cutaneous leishmaniasis treatment with intralesional infiltration of meglumine antimoniate.

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[3]
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[5]
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[7]
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[10]
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引用本文的文献

[1]
Cardiovascular Effects of Environmental Metal Antimony: Redox Dyshomeostasis as the Key Pathogenic Driver.

Antioxid Redox Signal. 2023-4

[2]
Inductively coupled plasma mass spectrometry method for plasma and intracellular antimony quantification applied to pharmacokinetics of meglumine antimoniate.

Bioanalysis. 2021-4

[3]
An overview of the treatment of cutaneous leishmaniasis.

Fac Rev. 2020-12-22

[4]
A retrospective cohort study of the effectiveness and adverse events of intralesional pentavalent antimonials in the treatment of cutaneous leishmaniasis.

Int J Parasitol Drugs Drug Resist. 2020-12

[5]
"Cheaper and better": Societal cost savings and budget impact of changing from systemic to intralesional pentavalent antimonials as the first-line treatment for cutaneous leishmaniasis in Bolivia.

PLoS Negl Trop Dis. 2019-11-6

[6]
Pharmacokinetics of neutron-irradiated meglumine antimoniate in -infected BALB/c mice.

J Venom Anim Toxins Incl Trop Dis. 2019-3-11

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