Müller W, Panse P, Brand S, Staubli A
Z Rheumatol. 1983 Nov-Dec;42(6):355-61.
37 patients suffering from osteoarthritis and 10 arthritic patients received intramuscular (i.m.), partly also intraarticular (i.ac.) injections of GAGPS; whereupon pharmacokinetics in serum, synovial fluid, urine, and cartilage were investigated. Cartilage was obtained during endoprosthetic hip surgery. The concentrations were determined by radiochemistry, partly after gel chromatography and electrophoresis respectively. Serum levels in patients with osteoarthritis after i.m. administration of 50 mg were 0.55 microgram/ml 3 hrs later, and 0.11 microgram/ml 24 hrs later. Patients with arthritis showed similar serum levels which were slightly higher after i.ac. injection, and which rose proportionally when the dosage was increased to 125 mg. With the arthritic patients, also the concentrations in the synovium were comparable, in the cases with osteoarthritis concentrations were slightly higher, which in both cases suggests that the synovial membrane is promptly penetrated. However, the concentrations in cartilage following a dosage of 50 mg within 24 hours rose as high as 1.45 micrograms/g which corresponds roughly to three times the serum level 3 hours after application. According to biochemical data, injections of 1 to 2 micrograms/ml should yield chondroprotective effects. Hitherto therapy has relied mainly on i.ac. injections; it may now be expanded by the i.m. route of administration. GAGPS was bound to serum proteins, in the synovia, however, it was found unbound. The main portion of the compound excreted via urine within 12 hrs (30 to 40 percent) was mainly unaltered; later, a partial degradation of the chain length and of the degree of sulfation was observed. Animal experiments on rats showed an increased affinity of GAGPS to inflamed tissues (Freund's adjuvant, carageenan edema).
37例骨关节炎患者和10例关节炎患者接受了硫酸软骨素蛋白聚糖(GAGPS)的肌肉注射(i.m.),部分患者还接受了关节内注射(i.ac.);随后对血清、滑液、尿液和软骨中的药代动力学进行了研究。软骨是在髋关节置换手术期间获取的。浓度分别通过放射化学法测定,部分在凝胶色谱法和电泳法之后测定。骨关节炎患者肌肉注射50毫克后3小时血清水平为0.55微克/毫升,24小时后为0.11微克/毫升。关节炎患者显示出相似的血清水平,关节内注射后略高,当剂量增加到125毫克时血清水平成比例上升。对于关节炎患者,滑膜中的浓度也相当,在骨关节炎病例中浓度略高,这在两种情况下都表明滑膜能迅速被穿透。然而,24小时内50毫克剂量后软骨中的浓度高达1.45微克/克,大致相当于给药后3小时血清水平的三倍。根据生化数据,1至2微克/毫升的注射量应产生软骨保护作用。迄今为止,治疗主要依赖关节内注射;现在可以通过肌肉注射途径扩大治疗范围。GAGPS与血清蛋白结合,但在滑膜中发现其未结合。12小时内通过尿液排泄的化合物主要部分(30%至40%)基本未改变;后来,观察到链长度和硫酸化程度有部分降解。对大鼠的动物实验表明GAGPS对炎症组织(弗氏佐剂、角叉菜胶水肿)的亲和力增加。