Stroe Marina-Stefania, Van Bockstal Lieselotte, Valenzuela Allan, Ayuso Miriam, Leys Karen, Annaert Pieter, Carpentier Sebastien, Smits Anne, Allegaert Karel, Zeltner Adrian, Mulder Antonius, Van Ginneken Chris, Van Cruchten Steven
Comparative Perinatal Development, University of Antwerp, Antwerp, Belgium.
Drug Delivery and Disposition, KU Leuven, Leuven, Belgium.
Front Pediatr. 2023 May 4;11:1163100. doi: 10.3389/fped.2023.1163100. eCollection 2023.
Animal models provide useful information on mechanisms in human disease conditions, but also on exploring (patho)physiological factors affecting pharmacokinetics, safety, and efficacy of drugs in development. Also, in pediatric patients, nonclinical data can be critical for better understanding the disease conditions and developing new drug therapies in this age category. For perinatal asphyxia (PA), a condition defined by oxygen deprivation in the perinatal period and possibly resulting in hypoxic ischemic encephalopathy (HIE) or even death, therapeutic hypothermia (TH) together with symptomatic drug therapy, is the standard approach to reduce death and permanent brain damage in these patients. The impact of the systemic hypoxia during PA and/or TH on drug disposition is largely unknown and an animal model can provide useful information on these covariates that cannot be assessed separately in patients. The conventional pig is proven to be a good translational model for PA, but pharmaceutical companies do not use it to develop new drug therapies. As the Göttingen Minipig is the commonly used pig strain in nonclinical drug development, the aim of this project was to develop this animal model for dose precision in PA. This experiment consisted of the instrumentation of 24 healthy male Göttingen Minipigs, within 24 h of partus, weighing approximately 600 g, to allow the mechanical ventilation and the multiple vascular catheters inserted for maintenance infusion, drug administration and blood sampling. After premedication and induction of anesthesia, an experimental protocol of hypoxia was performed, by decreasing the inspiratory oxygen fraction (FiO) at 15%, using nitrogen gas. Blood gas analysis was used as an essential tool to evaluate oxygenation and to determine the duration of the systemic hypoxic insult to approximately 1 h. The human clinical situation was mimicked for the first 24 h after birth in case of PA, by administering four compounds (midazolam, phenobarbital, topiramate and fentanyl), frequently used in a neonatal intensive care unit (NICU). This project aimed to develop the first neonatal Göttingen Minipig model for dose precision in PA, allowing to separately study the effect of systemic hypoxia versus TH on drug disposition. Furthermore, this study showed that several techniques that were thought to be challenging or even impossible in these very small animals, such as endotracheal intubation and catheterization of several veins, are feasible by trained personnel. This is relevant information for laboratories using the neonatal Göttingen Minipig for other disease conditions or drug safety testing.
动物模型不仅能提供有关人类疾病状况机制的有用信息,还能用于探索影响药物研发中药代动力学、安全性和疗效的(病理)生理因素。此外,对于儿科患者,非临床数据对于更好地了解疾病状况和开发针对该年龄段的新药疗法至关重要。对于围产期窒息(PA),这是一种在围产期因缺氧定义的状况,可能导致缺氧缺血性脑病(HIE)甚至死亡,治疗性低温(TH)联合对症药物治疗是降低这些患者死亡和永久性脑损伤的标准方法。PA和/或TH期间全身性缺氧对药物处置的影响很大程度上未知,动物模型可以提供有关这些协变量的有用信息,而这些信息无法在患者中单独评估。传统猪已被证明是PA的良好转化模型,但制药公司并未用它来开发新药疗法。由于哥廷根小型猪是非临床药物研发中常用的猪种,该项目的目的是开发这种用于PA剂量精准度研究的动物模型。本实验包括对24只健康的雄性哥廷根小型猪在产后24小时内进行仪器植入,这些猪体重约600克,可以进行机械通气,并插入多根血管导管用于维持输液、给药和采血。在给予术前用药和诱导麻醉后,通过使用氮气将吸入氧分数(FiO)降至15%来执行缺氧实验方案。血气分析是评估氧合以及确定全身性缺氧损伤持续时间约1小时的重要工具。在PA情况下,出生后的头24小时模仿人类临床情况,给予四种常用于新生儿重症监护病房(NICU)的化合物(咪达唑仑、苯巴比妥、托吡酯和芬太尼)。该项目旨在开发首个用于PA剂量精准度研究的新生哥廷根小型猪模型,以便分别研究全身性缺氧与TH对药物处置的影响。此外,本研究表明,一些在这些非常小的动物中被认为具有挑战性甚至不可能的技术,如气管插管和多条静脉的导管插入,经过训练的人员是可行的。这对于将新生哥廷根小型猪用于其他疾病状况或药物安全性测试的实验室来说是相关信息。