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[动物和人类高脂血症中茶碱的比较药代动力学]

[Comparative pharmacokinetics of theophylline in hyperlipidemia in animals and humans].

作者信息

Górnik W

机构信息

Katedry Farmakologii i Toksykologii Pomorskiej Akademii Medycznej w Szczecinie.

出版信息

Ann Acad Med Stetin. 1996;42:39-50.

PMID:9199125
Abstract

The incidence of hereditary hyperlipidemia amounts to about 8% and rises when secondary causes of lipid metabolism disturbances are taken into consideration. In contemporary literature there is paucity of data on the influence of hyperlipidemia on pharmacokinetics of drugs. That is especially important in the case of drugs characterized by a narrow therapeutic index, such as theophylline, which can be administered to patients affected by an altered lipid status. The investigation was aimed at evaluating the feasibility of an animal model of hyperlipidemia for pharmacokinetic studies of theophylline in humans suffering from lipid metabolism disturbances. The study was carried out on male rabbits divided into two groups: a control and an experimental one, fed on a high-fat diet. Humans were also ascribed to two groups: controls and those affected by primary, mixed-form of hyperlipidemia. The animals were given theophylline intravenously in a single dose of 12 mg/kg, whereas humans received intravenously injected theophylline in a single dose of 3.5 mg/kg. Blood was sampled after 5, 10, 15, 30, 45 minutes and 1, 2, 4, 6, 8, 12, 24 hours following theophylline administration. FPIA method was used to determine blood serum concentrations of theophylline (Tab. 1,3). The two-compartment open model for intravenous administration was applied for calculations. Considerable alterations of theophylline pharmacokinetics in humans suffering from mixed form of hyperlipidemia were observed (Tab. 4), whereas no marked changes were noted in animals with alimentary-induced hyperlipidemia (Tab. 2). In hyperlipidemic rabbits theophylline behaves as lipophilic agent, despite its poor penetration into the adipose tissue. A considerable decrease in area under the concentration-time curve of theophylline, increase in transfer constants as well as accelerated elimination of the drug were observed in humans with mixed form of hyperlipidemia. The behaviour of theophylline in hyperlipidemic rabbits was different from that in patients with mixed form of hyperlipidemia. Comparison of theophylline pharmacokinetics in hyperlipidemic animals and in human subjects revealed that an animal model of hyperlipidemia was inappropriate for studying the effect of lipid metabolism disturbances on pharmacokinetics of drugs as it is shown in the study on theophylline. This can be explained, to some extent, by different mechanisms of hyperlipidemia in rabbits and in humans. Hyperlipidemia in rabbits was induced by alimentary factors, while in humans lipid metabolism disturbances were of primary origin. Basing on the results of the present study it may be suggested that there are no general rules for anticipating the influence of hyperlipidemia on the pharmacokinetics of drugs in various organisms. Therefore, it is most likely that studies on the influence of hyperlipidemia on the pharmacokinetics of drugs should be performed for every particular drug separately.

摘要

遗传性高脂血症的发病率约为8%,若考虑脂质代谢紊乱的继发原因,发病率会更高。当代文献中关于高脂血症对药物药代动力学影响的数据较少。这在治疗指数较窄的药物(如茶碱)的情况下尤为重要,因为这类药物可用于脂质状态改变的患者。本研究旨在评估高脂血症动物模型用于脂质代谢紊乱患者茶碱药代动力学研究的可行性。研究选取雄性兔子分为两组:对照组和实验组,给予高脂饮食。人类也分为两组:对照组和原发性混合型高脂血症患者。给动物静脉注射单剂量12mg/kg的茶碱,而人类静脉注射单剂量3.5mg/kg的茶碱。在给予茶碱后的5、10、15、30、45分钟以及1、2、4、6、8、12、24小时采集血样。采用荧光偏振免疫分析(FPIA)方法测定血清中茶碱浓度(表1,3)。静脉给药的二室开放模型用于计算。观察到混合型高脂血症患者的茶碱药代动力学有显著改变(表4),而饮食诱导性高脂血症动物未观察到明显变化(表2)。在高脂血症兔子中,尽管茶碱对脂肪组织的穿透力较差,但它表现为亲脂性药物。混合型高脂血症患者的茶碱浓度 - 时间曲线下面积显著降低、转运常数增加以及药物消除加速。高脂血症兔子中茶碱的行为与混合型高脂血症患者不同。高脂血症动物和人类受试者的茶碱药代动力学比较表明,如茶碱研究所示,高脂血症动物模型不适用于研究脂质代谢紊乱对药物药代动力学的影响。这在一定程度上可以通过兔子和人类高脂血症的不同机制来解释。兔子的高脂血症是由饮食因素诱导的,而人类的脂质代谢紊乱是原发性的。基于本研究结果,可能表明没有通用规则来预测高脂血症对不同生物体中药物药代动力学的影响。因此,很可能应该针对每种特定药物分别进行高脂血症对药物药代动力学影响的研究。

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