多粘菌素MRX-8在大鼠体内的药代动力学和肾毒性:一种抗耐药革兰氏阴性菌的新型药物

Pharmacokinetics and Nephrotoxicity of Polymyxin MRX-8 in Rats: A Novel Agent against Resistant Gram-Negative Bacteria.

作者信息

Qu Xingyi, Guo Chenxue, Liu Shaojun, Li Xin, Xi Lin, Liu Xiaofen, Zhang Jing

机构信息

Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China.

Key Laboratory of Clinical Pharmacology of Antibiotics, Shanghai 200040, China.

出版信息

Antibiotics (Basel). 2024 Apr 12;13(4):354. doi: 10.3390/antibiotics13040354.

Abstract

MRX-8 is a novel polymyxin for carbapenem-resistant Gram-negative infections that has been recently evaluated in Phase I clinical trials. Herein, its pharmacokinetics (PK) and nephrotoxicity in rats are reported for the first time. This study aimed at pre-clinical PK and safety assessments. An LC-MS/MS method was developed to determine concentrations of MRX-8 and its major deacylation metabolite, MRX-8039, in rat plasma. Animals were administered a single dose of MRX-8 (2, 4, 6, and 8 mg/kg) or comparator polymyxin B (PMB) (4 and 8 mg/kg) to compare the kidney injury known for the polymyxin drug class. Nephrotoxicity was evaluated using serum creatinine, blood urea nitrogen (BUN) biomarkers, and renal histopathology. In rats, MRX-8 displayed linear PK within the range of 2-8 mg/kg, with approximately 4% of MRX-8 converted to MRX-8039. MRX-8 induced only mild increases in serum creatinine and BUN levels, with an apparent decrease in nephrotoxicity within 24 h, in contrast to PMB, which exhibited a significant and more persistent toxicity. Additional nephrotoxicity biomarkers (plasma NGAL and urinary NGAL, KIM-1, and TIMP-1) have confirmed attenuated MRX-8 kidney injury. Histopathology has revealed significantly greater cellular/tissue toxicity for PMB as compared to MRX-8 (variances of = 0.008 and = 0.048 vs. saline control, respectively). Thus, MRX-8 induces a mild and reversible kidney injury in rats compared to PMB. These data support a continued evaluation of the novel polymyxin in human trials.

摘要

MRX-8是一种用于治疗耐碳青霉烯革兰氏阴性菌感染的新型多粘菌素,最近已在I期临床试验中进行了评估。在此,首次报道了其在大鼠体内的药代动力学(PK)和肾毒性。本研究旨在进行临床前PK和安全性评估。开发了一种液相色谱-串联质谱(LC-MS/MS)方法来测定大鼠血浆中MRX-8及其主要脱酰基代谢物MRX-8039的浓度。给动物单次注射MRX-8(2、4、6和8mg/kg)或对照多粘菌素B(PMB)(4和8mg/kg),以比较多粘菌素类药物已知的肾损伤情况。使用血清肌酐、血尿素氮(BUN)生物标志物和肾脏组织病理学评估肾毒性。在大鼠中,MRX-8在2-8mg/kg范围内显示出线性PK,约4%的MRX-8转化为MRX-8039。与PMB相比,MRX-8仅引起血清肌酐和BUN水平轻度升高,且在24小时内肾毒性明显降低,而PMB表现出显著且更持久的毒性。其他肾毒性生物标志物(血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和尿NGAL、肾损伤分子-1(KIM-1)和金属蛋白酶组织抑制因子-1(TIMP-1))已证实MRX-8对肾脏的损伤减轻。组织病理学显示,与MRX-8相比,PMB的细胞/组织毒性明显更大(分别与生理盐水对照相比,差异为 = 0.008和 = 0.048)。因此,与PMB相比,MRX-8在大鼠中引起轻度且可逆的肾损伤。这些数据支持在人体试验中继续评估这种新型多粘菌素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eb2/11047535/4fa33ead2ab6/antibiotics-13-00354-g001.jpg

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