Wahl R L, Barrett J, Geatti O, Liebert M, Wilson B S, Fisher S, Wagner J G
University of Michigan Medical Center, Department of Internal Medicine, Ann Arbor 48109-0028.
Cancer Immunol Immunother. 1988;26(3):187-201. doi: 10.1007/BF00199929.
The i.p. delivery of murine monoclonal antibody was compared with i.v. delivery in normal mice and rats, in normal nude mice and in those with i.p. human ovarian carcinoma xenografts. In normal rats, all classes of antibodies and antibody fragments evaluated were cleared from the peritoneal cavity at comparable rates. The regional delivery (Rd1) advantage to the peritoneal cavity following i.p. delivery was thus most dependent on the rate of clearance of the antibody or fragment from the blood stream. Determining the exact i.p. delivery advantage was problematic due to the difficulty in reliably obtaining peritoneal fluid later than 9-10 h after i.p. injection in normal animals. During the first 9 h following i.p. injection, the Rd(0-9/0-9) was, for a murine IgG2ak Fab greater than F(ab')2 greater than IgG (at 13.6 greater than 10 greater than 7.9). Two murine IgMs evaluated differed in Rd(0-9) at 27.1 and 9.2 respectively. When blood levels were extrapolated to infinity, these Rd (0-9/affinity) values were considerably lower with the Fab having the highest Rd at 4.67. The i.p. Rd advantage was almost solely due to the i.p. antibody levels seen in the first 24 h after injection, as after that time, blood levels become comparable to those seen following i.v. injection. Normal tissues obtained at sacrifice 5-7 days after i.p. injection. Normal tissues obtained at sacrifice 5-7 days after i.p. or i.v. injection in rats showed comparable levels of radioantibody activity, whether the injection was i.p. or i.v. (except for higher diaphragmatic levels following i.p. delivery). In nude mice with i.p. human-derived ovarian tumors, intact IgG clearance from the peritoneal cavity to the blood was considerably slower than in normal animals, and early i.p. tumor uptake of specific antibody was significantly higher than that following i.v. antibody delivery. With higher early tumor uptake and lower systemic exposure, early tumor/nontumor ratios were significantly greater than those for i.v. delivery, though not beyond 48 h after i.p. injection. This study demonstrates the pharmacokinetic rationale for i.p. monoclonal antibody delivery, especially for agents cleared rapidly from the blood, such as antibody fragments. In addition, definite i.p. delivery benefit for antibody specific to i.p. tumors in the i.p. ovarian cancer system was shown soon after injection. These data regarding i.p. antibody delivery should be useful in rationally planning diagnostic and therapeutic studies involving the i.p. delivery of unmodified and immunoconjugated monoclonal antibodies.
在正常小鼠、大鼠、正常裸鼠以及患有腹腔人卵巢癌异种移植瘤的小鼠中,比较了鼠单克隆抗体腹腔注射与静脉注射的情况。在正常大鼠中,所评估的各类抗体和抗体片段从腹腔清除的速率相当。因此,腹腔注射后腹腔的区域递送(Rd1)优势主要取决于抗体或片段从血流中的清除速率。由于在正常动物腹腔注射9 - 10小时后难以可靠地获取腹腔液,确定确切的腹腔注射优势存在问题。在腹腔注射后的前9小时内,对于鼠IgG2ak Fab,其Rd(0 - 9/0 - 9)大于F(ab')2大于IgG(分别为13.6大于10大于7.9)。所评估的两种鼠IgM的Rd(0 - 9)分别为27.1和9.2。当将血药浓度外推至无穷大时,这些Rd(0 - 9/亲和力)值中Fab的最高,为4.67,但也相当低。腹腔注射的Rd优势几乎完全归因于注射后最初24小时内腹腔内的抗体水平,因为在此之后,血药浓度变得与静脉注射后的相当。在腹腔注射5 - 7天后处死动物获取正常组织。在大鼠中,腹腔或静脉注射5 - 7天后处死动物获取的正常组织显示,无论注射途径是腹腔注射还是静脉注射,放射性抗体活性水平相当(腹腔注射后膈肌水平较高除外)。在患有腹腔人源卵巢肿瘤的裸鼠中,完整IgG从腹腔向血液的清除比正常动物慢得多,并且腹腔内特异性抗体的早期肿瘤摄取显著高于静脉注射抗体后的摄取。由于早期肿瘤摄取较高且全身暴露较低,早期肿瘤/非肿瘤比值显著高于静脉注射给药,不过在腹腔注射后48小时内并非如此。本研究证明了腹腔注射单克隆抗体的药代动力学原理,特别是对于从血液中快速清除的药物,如抗体片段。此外,在卵巢癌腹腔系统中,注射后不久就显示出腹腔注射对腹腔肿瘤特异性抗体有明确的递送益处。这些关于腹腔注射抗体的数据对于合理规划涉及未修饰和免疫缀合单克隆抗体腹腔注射的诊断和治疗研究应是有用的。