Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal.
CIBIT/ICNAS - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.
Pharm Res. 2020 Mar 25;37(4):74. doi: 10.1007/s11095-020-02786-z.
Zonisamide clinical indications are expanding beyond the classic treatment of epileptic seizures to Parkinson's disease and other neurodegenerative diseases. However, the systemic safety profile of zonisamide may compromise its use as a first-line drug in any clinical condition. Since zonisamide is marketed as oral formulations, the present study aimed at exploring the potential of the intranasal route to centrally administer zonisamide, evaluating the systemic bioavailability of zonisamide and comparing its brain, lung and kidney pharmacokinetics after intranasal, oral and intravenous administrations.
In vitro cell studies demonstrated that zonisamide and proposed thermoreversible gels did not affect the viability of RPMI 2650 or Calu-3 cells. Thereafter, male CD-1 mice were randomly administered with zonisamide by oral (80 mg/kg), intranasal or intravenous (16.7 mg/kg) route. At predefined time points, animals were sacrificed and plasma and tissues were collected to quantify zonisamide and describe its pharmacokinetics.
Intranasal route revealed a low absolute bioavailability (54.95%) but the highest value of the ratio between the area under the curve (AUC) between brain and plasma, suggesting lower systemic adverse events and non-inferior effects in central nervous system comparatively to intravenous and oral routes. Furthermore, drug targeting efficiency and direct transport percentage into the brain were 149.54% and 33.13%, respectively, corroborating that a significant fraction of zonisamide suffers direct nose-to-brain transport. Lung and kidney exposures obtained after intranasal administration were lower than those observed after intravenous injection.
This pre-clinical investigation demonstrates a direct nose-to-brain delivery of zonisamide, which may be a promising strategy for the treatment of central diseases.
佐尼沙胺的临床适应证正在从癫痫发作的经典治疗扩展到帕金森病和其他神经退行性疾病。然而,佐尼沙胺的全身安全性可能会影响其在任何临床情况下作为一线药物的使用。由于佐尼沙胺以口服制剂销售,本研究旨在探索经鼻途径向中枢给药的潜力,评估佐尼沙胺的系统生物利用度,并比较其在经鼻、口服和静脉给药后的脑、肺和肾药代动力学。
体外细胞研究表明,佐尼沙胺和拟议的热可逆凝胶不会影响 RPMI 2650 或 Calu-3 细胞的活力。此后,雄性 CD-1 小鼠随机通过口服(80mg/kg)、经鼻或静脉(16.7mg/kg)途径给予佐尼沙胺。在预定的时间点,处死动物并收集血浆和组织以定量佐尼沙胺并描述其药代动力学。
经鼻途径显示出低的绝对生物利用度(54.95%),但脑-血浆曲线下面积(AUC)比值最高,表明与静脉和口服途径相比,全身不良反应较低,对中枢神经系统的非劣效作用。此外,药物靶向效率和直接向脑转运的百分比分别为 149.54%和 33.13%,这表明佐尼沙胺的很大一部分直接通过鼻-脑转运。经鼻给药后肺和肾的暴露量低于静脉注射后观察到的暴露量。
这项临床前研究证明了佐尼沙胺的直接鼻-脑递药,这可能是治疗中枢疾病的有前途的策略。