对于 (较低) 吗啡剂量策略,非线性血脑屏障的运输是否重要?
Berfin Gülave1, Divakar Budda1, M A A Saleh1
1Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Leiden 2333 CC, the Netherlands.
概括
跨越血脑屏障 (BBB) 的非线性吗啡运输会影响大脑的暴露和波动,特别是在较低剂量时. 剂量策略显著影响大脑细胞外流体 (大脑ECF) 中的吗啡药业动力学.
科学领域:
- 药理动力学 药理动力学
- 神经科学是一个神经科学.
- 药物运输 药物运输 药物运输
背景情况:
- 吗啡通过血脑屏障 (BBB) 涉及被动扩散和活跃的运输机制.
- 这些运输过程可以导致血度和脑细胞外液 (脑ECF) 药理动力学之间的非线性关系.
- 了解这些非线性对于优化吗啡剂量策略至关重要.
研究的目的:
- 评估非线性BBB运输对吗啡及其代谢物的大脑ECF中的药理动力学的影响.
- 评估不同剂量策略 (IV,IR,ER) 如何影响吗啡的中枢神经系统暴露和度波动.
- 量化这些药理动力学特征的剂量依赖性.
主要方法:
- 一个基于生理学的药理动力学 (PBPK) 模型 (LeiCNS-PK3.0) 被扩展到包括吗啡的非线性BBB传输.
- 对各种剂量方案进行模拟,包括静脉注射 (IV),即时释放 (IR) 和延长释放 (ER) 的口服配方.
- 剂量范围从0.25-150毫克,频率从每天一次到六次. 量化了与血暴露相对的大脑ECF和峰值-低谷比率 (PTRs).
主要成果:
- 相对的吗啡暴露和PTRs表明了剂量依赖的关系.
- 最高的相对暴露 (1.4) 发生在每天一次0.25毫克的ER;最低的 (0.1) 发生在每天六次150毫克的IV.
- 在较低剂量时,PTRs较小,随着剂量增加而增加,然后在较高剂量时稳定下来,无论剂量频率如何. 吗啡与其代谢物的相对峰值度因剂量而异.
结论:
- 吗啡BBB运输的非线性显著影响大脑ECF暴露和度波动.
- 这些效应在较低剂量方案中最为明显.
- 这些发现凸显了在吗啡药理动力学中考虑非线性BBB传输对于有效的治疗策略的重要性.
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