Boswell G W, Bekersky I, Buell D, Hiles R, Walsh T J
Fujisawa USA, Inc., Deerfield, Illinois 60015-2548, USA.
Antimicrob Agents Chemother. 1998 Feb;42(2):263-8. doi: 10.1128/AAC.42.2.263.
AmBisome (ABLP) is a unilamellar liposomal preparation of amphotericin B that has demonstrated an improved safety profile compared to conventional amphotericin B. Single- and multiple-dose pharmacokinetics were determined by using noncompartmental methods for rats administered ABLP at 1, 3, 9, and 20 mg/kg/day. The toxicological profile was evaluated following 30 consecutive days of intravenous ABLP administration. Mean plasma amphotericin B concentrations reached 500 and 380 microg/ml (males and females, respectively) following 30 days of ABLP administration at 20 mg/kg. The overall apparent half-life was 11.2+/-4.5 h (males) or 8.7+/-2.2 h (females), and the overall clearance (CL) was 9.4+/-5.5 ml/h/kg (males) or 10.2+/-4.1 ml/h/kg (females). ABLP appears to undergo saturable disposition, resulting in a non-dose-proportional amphotericin B area under the curve and a lower CL at higher doses. Histopathological examination revealed dose-related transitional-cell hyperplasia in the transitional epithelium of the urinary tract (kidney, ureters, and urinary bladder) and moderate hepatocellular necrosis at the 20 mg/kg/day dose. Administration of ABLP in doses of up to 20 mg/kg/day resulted in 100-fold higher plasma amphotericin B concentrations, with significantly lower toxicity than that reported with conventional amphotericin B therapy.
安必素(ABLP)是两性霉素B的单层脂质体制剂,与传统两性霉素B相比,其安全性已得到改善。采用非房室方法测定了大鼠分别以1、3、9和20mg/kg/天的剂量给予ABLP后的单剂量和多剂量药代动力学。在连续30天静脉注射ABLP后评估其毒理学特征。以20mg/kg的剂量给予ABLP 30天后,平均血浆两性霉素B浓度分别达到500和380μg/ml(雄性和雌性)。总体表观半衰期为11.2±4.5小时(雄性)或8.7±2.2小时(雌性),总体清除率(CL)为9.4±5.5ml/h/kg(雄性)或10.2±4.1ml/h/kg(雌性)。ABLP似乎具有饱和性处置,导致两性霉素B曲线下面积与剂量不成比例,且在较高剂量下CL较低。组织病理学检查显示,在20mg/kg/天的剂量下,尿路(肾脏、输尿管和膀胱)的移行上皮出现与剂量相关的移行细胞增生,肝细胞出现中度坏死。给予高达20mg/kg/天剂量的ABLP后,血浆两性霉素B浓度升高了100倍,毒性明显低于传统两性霉素B治疗报告的毒性。