Kailasam S, Daneluzzi D, Gangadharam P R
Mycobacteriology Research Laboratories, University of Illinois, Chicago.
Tuber Lung Dis. 1994 Oct;75(5):361-5. doi: 10.1016/0962-8479(94)90082-5.
Poor patient compliance is the serious limiting factor in the chemotherapy of tuberculosis.
To solve this problem we have been developing depot-drug delivery of antimycobacterial drugs. Earlier studies with mice using isoniazid in polylactic-co-glycolic acid (PLGA) co-polymer have shown that a single implant of the polymer could ensure sustained levels of free isoniazid for up to 8 weeks. Similar studies were not undertaken in rabbits.
The biodegradable PLGA polymer rods containing isoniazid were implanted on the back of the rabbits under anaesthesia in an isoniazid dose of 90 mg/kg. Concentrations of isoniazid and acetylisoniazid in serum and urine were determined by the high-performance liquid chromatography (HPLC) method at close intervals up to 96 h to study the burst-size, and later at weekly intervals up to 9 weeks to study the sustained levels.
There was no abnormal release of isoniazid in the earlier periods. Concentrations of isoniazid > or = 0.2 microgram/ml were found both in serum and urine up to 63 days after implant. Urine specimen obtained at 6 weeks after giving the implant inhibited the growth of Mycobacterium tuberculosis in vitro as measured by the radiometric (Bactec) method. These findings in non-rodent animal species confirm the usefulness of the depot-drug delivery method of drug administration and warrant hopes for the successful treatment of tuberculosis avoiding the problem of non-compliance.
患者依从性差是结核病化疗的严重限制因素。
为解决这一问题,我们一直在研发抗分枝杆菌药物的长效给药方式。早期用聚乳酸-乙醇酸共聚物(PLGA)包裹异烟肼对小鼠进行的研究表明,单次植入该聚合物可确保游离异烟肼持续8周维持在一定水平。尚未在兔身上进行类似研究。
将含异烟肼的可生物降解PLGA聚合物棒在麻醉下以90mg/kg的异烟肼剂量植入兔背部。采用高效液相色谱(HPLC)法在96小时内每隔一段时间测定血清和尿液中异烟肼和乙酰异烟肼的浓度,以研究突释量,之后在9周内每周测定一次,以研究持续水平。
早期异烟肼无异常释放。植入后63天内血清和尿液中异烟肼浓度均≥0.2μg/ml。植入后6周采集的尿液标本,通过放射性测量法(Bactec)测定,在体外可抑制结核分枝杆菌生长。在非啮齿动物物种中的这些发现证实了长效给药方式在药物给药方面的有效性,并为成功治疗结核病、避免依从性问题带来了希望。