Changes in tacrolimus distribution in blood and plasma protein binding following liver transplantation

Therapeutic drug monitoring of tacrolimus is complicated by the conflicting evidence of a relationship between trough blood tacrolimus concentration and clinical outcome. This prospective study investigated the blood distribution and protein binding of tacrolimus in liver transplant recipients over the first 60 days after transplantation with a view to identifying possible predictors of clinical outcome. Blood samples were collected from 10 liver transplant recipients on days 1, 7, and 60 after the initiation of tacrolimus therapy, and the distribution of tacrolimus in blood and the plasma protein binding were investigated. The unbound concentration of tacrolimus in plasma was estimated. Graft status was assessed using liver function tests and liver biopsies. The association of tacrolimus with erythrocytes varied significantly (74.4 +/- 5.0% vs 80.4 +/- 3.4%; P = 0.034) from day 1 to day 60. In plasma, tacrolimus mainly associated with lipoprotein-deficient plasma (60.1 +/- 6.5%), followed by high-density lipoproteins (27.2 +/- 6.6%), low-density lipoproteins (10.0 +/- 4.2%), and very low-density lipoproteins (2.8 +/- 1.8%). The percentage of tacrolimus associated with leukocytes (1.10 +/- 0.40% vs 0.40 +/- 0.09%; P = 0.0003) and the unbound concentration of tacrolimus (0.70 +/- 0.19 vs 0.28 +/- 0.04 ng/L; P < 0.0001) were observed to be significantly lower during episodes of rejection. In patients experiencing tacrolimus-related side effects, only the unbound concentration of tacrolimus was found to be significantly higher (0.84 +/- 0.19 vs 0.53 +/- 0.19 ng/L; P < 0.0001), and blood concentrations were not different (9.2 +/- 2.2 vs 8.1 +/- 1.8 ng/mL; P = 0.1). Blood distribution and protein binding of tacrolimus vary significantly over the posttransplantation period, leading to changes in its unbound concentration. A prospective study in a larger cohort of patients is required to establish the role of blood distribution and protein binding of tacrolimus in its therapeutic drug monitoring.     

Characteristics of 2,4,5,2′,4′,5′-hexachlorobiphenyl distribution among lipoproteins in vitro

The uptake, distribution, and transfer of 2,4,5,2',4',5'-hexachlorobiphenyl (6-CB) were examined in vitro with human and rat whole blood, plasma, and lipoprotein fractions. 6-CB distribution between plasma and erythrocytes as well as among lipoproteins was determined following sedimentation of erythrocytes and ultracentrifugal fractionation of plasma. In both rat and human whole blood, 70 to 75% of 6-CB partitioned into plasma and 25 to 30% into erythrocytes. The uptake of 6-CB into plasma was extremely rapid and the rate of uptake was found to be dependent upon temperature. The distribution of 6-CB among lipoproteins was relatively homogeneous with 20 to 30% being distributed in very low-density lipoproteins (VLDL, d = 0.95-1.006 g/ml), 15 to 20% in low-density lipoproteins (LDL, d = 1.006-1.063 g/ml), and 15 to 25% in high-density lipoproteins (HDL, d = 1.063-1.21 g/ml). Over 25% of 6-CB was found in the remaining bottom fraction. In addition, each isolated fraction when incubated alone with 6-CB was shown capable of uptake. The relative proportion of 6-CB among the lipoproteins was independent of the level taken up by plasma. 6-CB was also found to transfer among lipoproteins. This exchange of 6-CB proved to be dependent upon the concentrations of both protein and triacylglycerol in the incubations. Two proteins in the bottom fraction (Bf), albumin and a steroid binding globulin, were capable of competing with the lipoproteins for 6-CB uptake.     

Pharmacokinetics and comparative bioavailability of two terbinafine hydrochloride formulations after single-dose administration in Chinese healthy subjects

The bioavailability of a new terbinafine (CAS 91161-71-6) preparation was compared with a commercially available original preparation (reference) of the drug in 19 Chinese healthy male volunteers. The study was performed in an open, randomized, single blind two-sequence, two-period crossover design. Under fasting conditions, each subject received a single oral dose of 250 mg terbinafine as a test or reference formulation with a 7-day washout period between the two preparations. The plasma concentrations of terbinafine were analyzed by a sensitive liquid chromatography-ultraviolet spectrometry method. The pharmacokinetic parameters included AUC(0-t) AUC(0-infinity), C(max), t1/2, and T(max). The values of AUC(0-t) demonstrated nearly identical bioavailability of terbinafine from the examined formulations. The AUC(0.48) of terbinafine was 5982.85 +/- 2449.17 and 6761.63 +/- 3140.33 ng x h/ml for the test and reference formulation, respectively. The maximum plasma concentration (C(max)) of terbinafine was 1656.25 +/- 623.18 ng/ml for the test and 1552.07 +/- 660.35 ng/ml for the reference product, respectively. No statistical differences were observed for C(max) and the area under the plasma concentration time curve for terbinafine. The 90% confidence limits calculated for C(max) and AUC from zero to infinity (AUC(0-infinity)) of terbinafine were within the bioequivalence range (80%-125% for AUC). This study shows that the test formulation is bioequivalent to the reference formulation of terbinafine.     

Plasma protein binding,lipoprotein distribution and uptake of free and lipid-associated BCL-2 antisense oligodeoxynucleotides (G3139) in human melanoma cells

The objectives of this study were to determine the protein binding and lipoprotein distribution of G3139 and G3139 lipoplexes following incubation in human plasma, assess complement activation of, and the effect of pre-incubation of G3139 and G3139 lipoplexes in human plasma on in vitro cellular uptake of G3139. Effect of concentration and time on incorporation of free and lipid associated (lipoplexes) [3H]Bcl-2 AO (25-600 ng/ml) into normolipidemic human plasma lipoproteins was determined by density gradient ultracentrifugation after incubation at 37 degrees C for 5, 30, 60 and 120 min. Protein binding in the lipoprotein deficient fractions (LPDP) was determined by equilibrium dialysis. Complement interaction was determined by ELISA after exposure of human plasma to AO+/- liposomes prepared in serial dilution. In vitro uptake of G3139 and G3139 lipoplexes into human melanoma cells was assessed qualitatively by fluorescence microscopy after 4-h exposure to G3139 (free or as lipoplexes) with or without pre-incubation of G3139 in normal human plasma. Analysis of Bcl-2 AO-lipoprotein interaction over time and concentration indicated no significant movement of the compound within the different lipoprotein and LPDP fractions. Majority of drug was recovered within LPDP fraction, and more than 85% of drug recovered within LPDP fraction was protein bound. No significant activation of complement was noted for either free AO or lipoplexes. Pre-incubation of free AO or AO-lipoplexes in human plasma resulted in a greater cellular uptake of AO-lipoplexes compared with plasma free controls. These findings suggest that the majority of [3H]Bcl-2 AO is plasma protein bound with little lipoprotein association and no significant movement between different lipoprotein and LPDP fractions. Plasma protein binding other than lipoprotein binding may be responsible for the difference in cellular uptake of free AO vs. cationic lipoplexes.     

The Influence of Hyperlipoproteinemia on <Emphasis Type="Italic">in Vitro</Emphasis> Distribution of Amiodarone and Desethylamiodarone in Human and Rat Plasma

Purpose To study the effect of hyperlipoproteinemia on in vitro distribution of amiodarone (AM) and its prevalent metabolite desethylamiodarone (DEA) in human and rat plasma. Materials and Methods Human and rat normolipidemic (NL) and hyperlipidemic (HL) plasma were spiked with AM and DEA. The fractions (high and low density lipoproteins, triglyceride rich lipoproteins and lipoprotein deficient plasma) were separated using ultracentrifugation. Results Human and rat displayed similar patterns in terms of association of AM and DEA in NL plasma, in which the highest and lowest associations were observed in lipoprotein deficient (LPDP) and triglyceride (TRL) rich plasma fractions, respectively. In HL a substantial shift was observed in partitioning of AM and DEA mostly to TRL. The shift of AM and DEA into TRL fraction of HL plasma was more drastic for rat than human. In HL, association of AM with rat LPDP and HDL fractions were 10 and 26-fold lower than in the corresponding human fractions, respectively. The DEA:AM ratio in rat, but not human, was significantly affected by HL. Conclusion HL caused a major shift of AM and DEA to TRL fraction in both species. The findings were consistent with the higher AM concentrations previously noted in HL rats given the drug.     

ENANTIOSELECTIVE DISTRIBUTION OF VERAPAMIL AND NORVERAPAMIL INTO HUMAN AND RAT ERYTHROCYTES: THE ROLE OF PLASMA PROTEIN BINDING

In this in vitro study, the distribution of the enantiomers of verapamil (VER) and its active metabolite, norverapamil (NOR), into the red blood cells (RBCs) of humans and rats was investigated using a chiral liquid chromatographic assay. When plasma was replaced with buffer, the distribution of VER and NOR enantiomers into both human and rat RBCs was substantial (RBC:blood concentration ratios, 1·39–1·79), non-stereoselective, concentration (125–1000 ng mL⁻¹) linear, and species independent. However, in the presence of plasma, the RBC distribution of VER and NOR was stereoselective, with opposite stereoselectivity for human (S>R) and rat (R>S) blood. Additionally, the presence of plasma caused a reduction in the extent of RBC distribution for both VER and NOR enantiomers and in some cases resulted in nonlinearity in the RBC distribution of the enantiomers. Plasma protein binding studies revealed opposite stereoselectivity in the free fractions in human (S>R) and rat (R>S) plasma for both VER and NOR. These data suggest that the stereoselective protein binding is responsible for the apparent stereoselectivity in the RBC distribution of VER and NOR. The data are also in agreement with the opposite stereoselectivity in the plasma concentrations of VER observed in vivo in rats and humans.     

Apparent stereoselectivity in propafenone uptake by human and rat erythrocytes

The distribution of propafenone (PPF) enantiomers between the plasma and red blood cells (RBCs) was investigated using human and rat blood. In separate experiments, effects of incubation time (15-60 min), blood concentration (100-5000 ng ml-1), and plasma proteins on the RBC uptake of the enantiomers were studied. In both humans and rats, the distribution of propafenone enantiomers into RBCs was rapid, extensive, and stereoselective. However, the extent of RBC uptake and the direction of stereoselectivity were different in these two species. In humans, preferential distribution of (-)-PPF into RBCs resulted in lower plasma concentrations for this enantiomer, whereas in rat plasma, (-)-PPF was the dominant enantiomer. When the plasma was replaced with buffer, the stereoselectivity in the RBC uptake of the enantiomers was abolished. This suggested that stereoselective protein binding may be responsible for this phenomenon. A direct measurement of the extent of binding of PPF enantiomers to rat and human plasma proteins further confirmed this. Moreover, the distribution of the enantiomers in RBCs was not affected by low temperatures or addition of ouabain, suggesting passive diffusion as the underlying mechanism. These results suggest that stereoselective red blood cell uptake may be responsible, at least in part, for the differences in the plasma pharmacokinetics of PPF enantiomers observed after the drug administration to humans and rats.     

A comparison of the binding and distribution of benzo[a]pyrene in human and rat serum

Uptake and distribution of benzo[a]pyrene (B[a]P) in human and rat serum were studied by incubation, gel filtration and ultracentrifugation. A maximum uptake of 230 and 120 micrograms B[a]P/ml was found for human and rat serum, respectively. Of the B[a]P uptake about 1% was irreversibly bound to serum constituents from both species. The uptake of B[a]P by the lipoproteins was 90-95% and 80-85% for human and rat serum, respectively, the remainder being bound to albumin. In human serum B[a]P was mainly associated with low density lipoproteins (44-47%) while in rat serum with high density lipoproteins (40-54%). However, the distribution of B[a]P between the different lipoprotein fractions showed a high correlation with the concentration of cholesterol for both species. The present results demonstrate a serum uptake capacity of B[a]P for both species which exceeds any known occupational exposure. The extensive association between B[a]P and lipoproteins may have implications for the availability of B[a]P for metabolizing organs, an area which should be further investigated. As far as the total serum uptake and distribution of B[a]P are concerned, the rat seems to be an acceptable animal model for extrapolation of in vivo results to man.     

Single-dose cyclosporine pharmacokinetics in various biological fluids of patients receiving allogeneic marrow transplantation

The clinical usefulness of cyclosporine is hampered by dose-limiting toxicities to the kidney that are not predicted by drug levels in serum or whole blood. Because of its lipophilic nature, circulating plasma lipoproteins may play a role in drug disposition. This study characterized the pharmacokinetic parameters of a single 2-mg/kg i.v. infusion of cyclosporine in the whole blood, plasma, high-density (HDL), low-density (LDL), and very low-density (VLDL) lipoprotein fractions of nine patients before bone marrow transplantation. The dose- and protein-corrected area under the concentration-time curve in whole blood; plasma; and HDL, LDL, and VLDL compartments were 44.6 +/- 11.3, 19.2 +/- 2.4; 33.6 +/- 12.3, 49.0 +/- 19.9, and 17.5 +/- 9.0 ng h/ml, respectively. The mean half-life of the drug from the VLDL fraction was significantly less than from the other biologic fluids. The systemic clearance rate of cyclosporine was greater in the total plasma or VLDL fractions compared with whole blood and the HDL and LDL fractions. The HDL-cyclosporine clearance inversely correlated with the serum creatinine (r = -0.71; p less than 0.05) and total bilirubin levels (r = -0.76; p less than 0.05). The plasma half-life and volume of distribution directly correlated with fasting HDL cholesterol levels (r = 0.94 and 0.99; p less than 0.01). Correlations between pharmacokinetic parameters and lipid fractions suggest a role of lipids in the distribution of cyclosporine. These data may be useful in the development of guidelines for therapeutic drug monitoring of cyclosporine in the transplantation population.     

Distribution of toxaphene,DDT, and PCB among lipoprotein fractions in rat and human plasma

The distribution of¹⁴C-toxaphene,¹⁴C-DDT, and¹⁴C-PCB among lipoprotein fractions was studied in vitro and in vivo using rat and human plasma. The association of these substances with rat plasma fractions was similar in both in vitro and in vivo experiments. Thirty-seven to fifty-two per cent of the total radioactivity was associated with the cholesterol-rich high density lipoproteins (HDL₂, d=1.075–1.21 g/ml) and 18–52% was recovered in the albumin-rich bottom fraction (BF, d>1.21 g/ml). A time-dependent redistribution of the radioactivity from the lipoprotein fractions to the BF was also observed in the in vivo studies. In human plasma, the distribution of the three compounds was different and uncorrelated to the cholesterol level of the individual lipoprotein fractions. Toxaphene was almost equally distributed between BF (d>1.21 ml), HDL (d=1.063–1.21 g/ml) and low density lipoproteins (LDL, d=1.006–1.063 g/ml) (26%, 27% and 29%, respectively), while only 18% appeared in the very low density lipoprotein (VLDL, d<1.006) fraction. In contrast, a large proportion of DDT and PCB radidoactivity was recovered in the BF (52% and 62%, respectively) while only 38–48% was present in lipoprotein fractions. The complex nature of the interaction between xenobiotics and plasma lipoproteins is discussed.     

Reversible binding of the novel anti-tumour agent 5,6-dimethylxanthenone-4-acetic acid to plasma proteins and its distribution into blood cells in various species

The plasma protein binding and distribution in blood cells of the novel anti-tumour agent 5,6-dimethylxanthenone-4-acetic acid (DMXAA) has been investigated in-vitro using filtration and an HPLC method to measure DMXAA. DMXAA (500 microM) was extensively bound in plasma from all species with an unbound fraction (fu) of 4.61+/-1.10 (mouse), 2.59+/-0.32 (rat), 2.02+/-0.48 (rabbit) and 2.07+/-0.23% (human). The binding was concentration dependent with DMXAA concentrations > or = 1,000 microM markedly increasing the fu in the plasma from all species. The estimated number of binding sites in plasma were 2.4+/-0.2 (mouse), 1.7+/-0.2 (rat), 0.8+/-0.1 (rabbit) and 2.1+/- 0.2 (human). The major binding protein in human plasma was albumin, with negligible binding to gamma-globulin and alpha1-acid glycoprotein. There was a significant linear relationship between the bound:free DMXAA concentration ratio (Cb/Cu) and albumin concentration in human serum albumin solution (r = 0.955; P < 0.05) and in healthy human plasma (r = 0.998; P< 0.05), but not in plasma from cancer patients (n = 5), nor across species. In cancer patients (n = 5) DMXAA had a significantly higher (P < 0.05) fu (4.60+/- 0.42%) compared with healthy human plasma (2.07+/-0.23%). In human plasma, the fu of DMXAA (500 microM) was significantly reduced by 500 microM diazepam (P < 0.05), but not by warfarin, phenylbutazone, salicylic acid, ibuprofen or clofibric acid at that concentration. DMXAA significantly reduced the binding of dansylsarcosine (a Site-II binder) to HSA, but significantly increased the binding of dansylamide (a Site-I binder). Within species, the blood:plasma concentration ratio (CBL/CP) of DMXAA was relatively constant (mouse, 0.581+/-0.005; rat, 0.667+/-0.025; rabbit, 0.637+/-0.019; human, 0.673+/-0.103) over the range 50-1000 microM, but increased significantly at DMXAA concentrations > 1000 microM in all species except the rabbit. These results indicate that significant alterations in DMXAA plasma binding and distribution into blood cells occur with increasing concentrations of DMXAA in all species, and also that significant interspecies differences exist. It would be more appropriate to compare plasma unbound concentrations when assessing DMXAA exposure in cancer patients or when extrapolating across species.     

Preferential binding of chlordecone to the protein and high density lipoprotein fractions of plasma from humans and other species

The preferential distribution of the relatively nonpolar pesticide chlordecone (CD) to liver rather than to fat tissues in humans suggests that it may be transported in plasma differently from other organochlorine pesticides. The plasma binding of [14C] CD was investigated in vitro in human, rat, and pig plasma and in vivo in rat plasma. Protein and lipoprotein fractions were separated by serial ultracentrifugation. Heparin-manganese precipitation and agarose gel electrophoresis were also carried out to determine whether separation techniques altered CD binding to plasma components. In human plasma, the distribution of [14C] CD among proteins and high density, low density, and very low density lipoproteins (HDL, LDL, and VLDL) was 46, 30, 20, and 6%, respectively. The distribution of cholesterol in the same plasma fractions was 4, 20, 63, and 7%, respectively. In the pig and rat the order of binding was similar to that in humans, with protein greater than or equal to HDL greater than LDL greater than or equal to VLDL. Separation by heparin-Mn precipitation confirmed the results obtained by ultracentrifugation. The distribution of [14C] CD in rat lipoprotein was similar whether the CD was administered in vivo or incubated with plasma in vitro, with approximately 80% bound to HDL, 11% to LDL, and 9% to VLDL in either case. Agarose gel electrophoresis of plasma-bound [14C] CD indicated that albumin was the major component of the protein fraction responsible for CD binding. Preferential binding of CD by albumin and HDL may explain its unusual tissue distribution compared to other organochlorine pesticides such as aldrin and dieldrin, which bind preferentially to VLDL and LDL and distribute preferentially to fat tissues.     

High-performance liquid chromatographic analysis, plasma protein binding and red blood cell partitioning of phenprobamate

A new high-performance liquid chromatographic procedure for the analysis of phenprobamate, a skeletal muscle relaxant in biologic fluids was developed. The method used a C18 reverse phase column, a mobile phase of methanol/acetonitrile/water (33:15:52), and UV detection at 215 nm. The assay procedure was applied to the determination of phenprobamate binding to rat and human plasma proteins using the equilibrium dialysis method. In addition, the red blood cell/plasma partitioning was determined in the whole blood of rats and humans. Phenprobamate exhibited a moderate binding to plasma proteins of rat (74.3 +/- 2.2 per cent) and human (80.5 +/- 1.1 per cent). The protein binding was concentration-independent in the range of 10 to 80 micrograms ml-1. Phenprobamate binding to plasma proteins was also determined in the presence of 10 micrograms ml-1 acetaminophen. The protein binding of phenprobamate was not significantly altered by acetaminophen (74.4 +/- 0.6 per cent for rat plasma; 75.7 +/- 1.6 per cent for human plasma). The distribution ratios of phenprobamate between the red blood cells and plasma were greater than unity, 1.86 and 1.59 in rat and human, respectively, indicating a preferential partitioning of the drug in the red blood cells.     

Cyclosporine A transfer between high- and low-density lipoproteins: independent from lipid transfer protein I-facilitated transfer of lipoprotein-coated phospholipids because of high affinity of cyclosporine a for the protein component of lipoproteins.

The objectives of this study were to determine if lipid transfer protein I (LTP I)-facilitated phospholipid (PC) transfer activity regulates the plasma lipoprotein distribution of cyclosporine (CSA) and if the association of CSA with high-density lipoproteins (HDL) is due to the high protein and/or alterations in coat lipid content of HDL. To assess if LTP I-facilitated PC transfer activity regulates the plasma lipoprotein distribution of CSA, (14)C-PC- or (3)H-CSA-enriched HDL or low-density lipoproteins (LDL) were incubated in T150 buffer [pH 7.4, containing a (14)C-PC- or (3)H-CSA-free lipoprotein counterpart +/- exogenous LTP I (1.0 microg protein/mL)] or in delipidated human plasma that contained 1.0 microg protein/mL of endogenous LTP I in the presence or absence of a monoclonal antibody TP1 (30 microg protein/mL) directed against LTP I for 90 min at 37 degrees C. To assess the influence of HDL subfraction lipid composition and structure on the plasma distribution of CSA, CSA at 1000 ng of drug/mL of plasma was incubated in human plasma pretreated for 24 h with a lecithin:cholesterol acyltransferase (LCAT) inhibitor, dithionitrobenzoate (DTNB; 3 mM). To assess the binding of CSA to apolipoproteins AI, AII, and B, increasing concentrations of CSA were added to a constant concentration of either apolipoprotein AI, AII, or B. Equilibrium dialysis was used to determine free and bound fractions and Scatchard plot analysis was used to determine binding coefficients. To assess the influence of hydrophobic core lipid volume on the plasma distribution of CSA, CSA was incubated in plasma from patients with well-characterized dyslipidemias. The hydrophobic core lipid volume (CE + TG) within each lipoprotein subfraction was correlated to the amount of CSA recovered in each plasma sample from the different human subjects. The percent transfer of PC from LDL to HDL was different than the percent transfer of CSA in T150 buffer or human plasma source. In the presence of TP1, only PC transfer from LDL to HDL decreased. For plasma incubated with CSA and separated into HDL(2) and HDL(3), 35-50% of drug originally incubated was recovered in the HDL(3) fraction, with the remaining drug being found within the other fractions. When CSA was incubated in plasma pretreated with DTNB, the percentage of CSA recovered in the HDL(3) and HDL(2) fractions was not significantly different compared with that in the HDL(3) and HDL(2) fractions from untreated control plasma. CSA distribution into HDL inversely correlated with the hydrophobic core lipid volume of HDL, whereas distribution into LDL and triglyceride-rich lipoproteins directly correlated with their respective hydrophobic core lipid volumes. We further observed that CSA has high binding affinity and multiple binding sites with apolipoproteins AI (k(d) = 188.9 nM; n = 2), AII (k(d) = 184.7 nM; n = 2), and B (k(d) = 191 nM; n = 3). These findings suggest that the transfer of CSA between different lipoprotein particles is not influenced by LTP I-facilitated PC transfer activity probably because of the high affinity of CSA for the protein components of HDL and LDL.     

Validation of methods to study the distribution and protein binding of tacrolimus in human blood

INTRODUCTION: Tacrolimus is a macrolide immunosuppressant that has a narrow therapeutic index, displays considerable variability in response, and has the potential for serious drug interactions. Therapeutic drug monitoring and dose individualisation for tacrolimus is complicated but essential. Few studies have investigated the blood distribution and protein binding of tacrolimus and the results of these studies are conflicting. The aim of the present study is to establish and validate methods to investigate the distribution of tacrolimus in human blood. To conduct these studies at clinically relevant concentrations the use of 3H-dihydro-tacrolimus instead of tacrolimus was investigated. METHODS: The use of radiolabelled tacrolimus was validated by conducting studies with a mixture of both labelled and unlabelled drug where tacrolimus was analysed by LC-MS/MS. The in vitro distribution of tacrolimus and 3H-dihydro-tacrolimus was investigated in blood collected from healthy subjects using Ficoll-Paque reagent and density gradient ultracentrifugation, respectively. The unbound fraction of tacrolimus in plasma was studied using equilibrium dialysis conducted at 37 degrees C. RESULTS: In blood, tacrolimus was found to be mainly associated with erythrocytes (85.3+/-1.5%), followed by diluted plasma proteins (14.3+/-1.5%) and lymphocytes (0.46+/-0.10%). In plasma, tacrolimus was found to mainly be associated with the soluble protein fraction (61.2+/-2.5%), high-density lipoproteins (HDL, 28.1+/-5.4%), low-density lipoproteins (LDL, 7.8+/-1.6%), and very low-density lipoproteins (VLDL, 1.4+/-0.3%). The unbound fraction of tacrolimus was found to be only 1.2+/-0.12%. Statistical comparison indicated that there was no significant difference in the blood distribution and plasma protein binding of 3H-dihydro-tacrolimus when compared with tacrolimus. DISCUSSION: These results have important implications for therapeutic drug monitoring of tacrolimus and subsequent studies of tacrolimus distribution in transplant recipients.     

In vitro blood distribution and plasma protein binding of the tyrosine kinase inhibitor imatinib and its active metabolite, CGP74588, in rat, mouse, dog, monkey, healthy humans and patients with acute lymphatic leukaemia

AIMS: To determine blood binding parameters of imatinib and its metabolite CGP74588 in humans and non-human species. METHODS: The blood distribution and protein binding of imatinib and CGP74588 were determined in vitro using (14)C labelled compounds. RESULTS: The mean fraction of imatinib in plasma (f(p)) was 45% in dog, 50% in mouse, 65% in rat, 70% in healthy humans and up to 92% in acute lymphatic leukaemia (AML) patients. Similarly, f(p) for CGP74588 was low in dog and monkey (30%), higher in rat, mouse and humans (70%) and highest in some AML patients (90%). The unbound fraction of imatinib and CGP74588 in plasma was lower in rat, mouse, healthy humans and AML patients (2.3-6.5% at concentrations < or = 5000 ng ml(-1)) compared to monkey and dog (7.6-19%). Both compounds displayed high binding to human alpha(1)-acid glycoprotein. AML patients had a reduced haematocrit and showed greatest variability in their blood binding parameters. CONCLUSION: Imatinib and CGP74588 displayed very similar blood binding parameters within all species/groups investigated. The five species clustered into two distinct groups with rat, mouse and humans being clearly different from dog and monkey. For both compounds, higher protein binding was associated with a decreased partitioning into blood cells.     

The Stereoselective Distribution of Halofantrine Enantiomers Within Human,Dog, and Rat Plasma Lipoproteins

Purpose. To study the in vitro distribution of the enantiomers of theantimalarial drug halofantrine in human, dog and rat plasmalipoprotein-fractions.Methods. Plasma was spiked with racemic halofantrine (1000 ng/ml)and incubated for 1 h at 37°C. The fractions (high and low densitylipoproteins, triglyceride-rich lipoproteins and lipoprotein deficientplasma) were separated using density gradient ultracentrifugation.Fractions were assayed for halofantrine enantiomer using stereospecifichigh performance liquid chromatography.Results. The (–) enantiomer of halofantrine displayed higher affinityfor the lipoprotein-deficient fraction than the (+) enantiomer in allthree species. The (+) enantiomer was predominately located in thelipoprotein rich fractions of dog and human plasma (the (+):(–) ratioranging from 1.2–9.6). In contrast, the (+):(–) ratio was consistently<1 in lipoprotein-deficient fractions. Dog displayed a large magnitudeof stereoselectivity in halofantrine distribution to the plasma fractionstested. There were substantial interspecies differences in the pattern ofdistribution of halofantrine enantiomers within the different fractions. Asignificant positive relationship was observed between halofantrineuptake into lipoprotein-rich fractions and the percent of apolar corelipid in those fractions. There was also a strong negative correlationbetween total protein concentration and the enantiomeric ratio in thelipoprotein-deficient plasma fraction.Conclusion. Distribution of halofantrine enantiomer to plasma lipoprotein-fractions is stereoselective and species specific. This differentialbinding of halofantrine enantiomers to lipoproteins may need to beconsidered in viewing pharmacokinetic and pharmacodynamic datainvolving the drug.     

Assay of antipyrine and its primary metabolites in plasma, saliva and urine by high-performance liquid chromatography and some preliminary results in man.

A reversed phase system for the HPLC separation of antipyrine and its primary metabolites is described. Based on this system an assay procedure for antipyrine in plasma and saliva was developed with a lowest measurable concentration of 25 ng/ml and precision of +/- 3.6 and +/- 4.5%, respectively. Furthermore, assays for the parent compound, 3-hydroxymethyl-antipyrine, norantipyrine and 4-hydroxy-antipyrine in urine were developed. The lowest measurable concentration for these compounds is about 100 ng/ml except for 3-hydroxymethyl-antipyrine with a lowest measurable concentration of about 200 ng/ml. The precision was established at +/- 3.6 and +/- 5.0% for 3-hydroxymethyl-antipyrine, and antipyrine, respectively, and +/- 7.0 and +/- 3.6% for norantipyrine and 4-hydroxy-antipyrine, respectively. The method was applied to studies on antipyrine metabolism in humans. Following administration of a single dose of 500 mg antipyrine to 5 healthy volunteers, 3.3 +/- 1.2% of the dose was recovered from 48-hour hydrolyzed urine as unchanged drug, 39.7+/- 8.7% as 3-hydroxymethyl-antipyrine, 14.5 +/- 6.8% as norantipyrine and 28.5 +/- 2.2% as 4-hydroxy-antipyrine.     

Stability, human blood distribution and rat tissue localization of promazine and desmonomethylpromazine

The stability in human blood and urine, partitioning into red blood cells and plasma protein binding of promazine and desmonomethylpromazine were investigated. Tissue localization was investigated in rats. Promazine and desmonomethylpromazine were stable in human plasma and urine for at least 64 days at -20 degrees. The percentage of promazine not bound to protein in plasma was 10.4 +/- 2.43 as estimated by equilibrium dialysis with correction for volume shift, and 11.6 +/- 0.43 per cent as estimated by ultracentrifugation. Data for the mean plasma/red blood cell concentration ratio and the red blood cell/plasma distribution coefficient for promazine were 1.19 +/- 0.13 and 8.21 +/- 0.40, respectively. There was no evidence of time-dependence in plasma/red blood cell partitioning. Ten rat organs and tissues were examined. The concentrations of promazine and desmonemethylpromazine were highest in lung. For promazine, the rank order of tissue localization was lung greater than liver greater than kidney greater than intestine greater than brain greater than spleen greater than red blood cell greater than voluntary muscle greater than plasma greater than stomach greater than heart. For desmonomethylpromazine, the order was reversed in the cases of spleen and brain and interchanged in the cases of stomach and muscle. The brain/plasma concentration ratios for promazine and desmonomethylpromazine in rat were 4.69 and 3.87, respectively.     

灯盏花素及其β-环糊精包合物在大鼠体内的药代动力学

目的建立测定大鼠血浆中灯盏乙素浓度的反相高效液相色谱法，研究灯盏花素及其β-环糊精包合物(灯盏花素-β-CD)大鼠灌胃后体内药代动力学行为。方法以甲醇-水-醋酸盐缓冲液为流动相，Shim-pack C₁₈为固定相；12只大鼠随机均分为2组，分别灌胃灯盏花素及其包合物后，检测血浆药物浓度。药时数据采用3P97药代计算程序处理。结果线性范围10-400 ng·mL^-1，方法回收率95.32%-98.81%；灯盏花素和包合物的C_max分别为(154±18) ng·mL^-1和(328±31) ng·mL^-1；AUC_0-12h分别为(710±126) ng·h·mL^-1和(1 093±200)ng·h·mL^-1，经t检验两者有极显著性差异(P<0.01)。结论该法准确、灵敏，适用于灯盏乙素血浆浓度的测定；制备的灯盏花素包合物与灯盏花素相比吸收显著增加。