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Methodological Approaches to Evaluate Fetal Drug Exposure
Naïm Bouazza1,2,3, Frantz Foissac1,2,3, Déborah Hirt1,2,3,4
1Universite Paris Descartes, EA7323, Sorbonne Paris Cite, France.
Predicting fetal drug exposure is crucial for maternal-fetal health. Physiologically based pharmacokinetic (PBPK) models show promise for in-silico prediction, but further research on placental development is needed.
Area of Science:
- Pharmacology
- Toxicology
- Maternal-Fetal Medicine
Background:
- Drug use during pregnancy poses risks to both mother and fetus.
- Xenobiotics crossing the placenta can lead to developmental abnormalities and deficiencies.
- Pregnant women and fetuses are an understudied population regarding drug efficacy and safety.
Purpose of the Study:
- To review methodologies for predicting fetal drug exposure.
- To highlight the need for reliable in-utero drug exposure prediction.
Main Methods:
- Analysis of neonatal cord blood and maternal drug concentrations.
- Population pharmacokinetic modeling to quantify drug exchange.
- Ex-vivo human placental cotyledon perfusion studies.
- Physiologically based pharmacokinetic (PBPK) modeling.
Main Results:
- Cord blood concentration is a key measure of transplacental drug transfer.
- PBPK models demonstrate encouraging results for predicting fetal drug exposure.
- Ex-vivo perfusion is a reference method but has limitations for in-vivo extrapolation.
Conclusions:
- PBPK models are a promising in-silico tool for predicting fetal drug exposure.
- Current PBPK models primarily represent late pregnancy.
- Further understanding of placental permeability and transporter development is essential.
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