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在子,老鼠和人类中开发一个基于生理学的尼托福兰的药动力学模型
Raju Prasad Sharma1, Elsje J Burgers1, Joost B Beltman1
1Division of Drug Discovery and Safety, Leiden Academic Centre for Drug Research, Leiden University, Einsteinweg 55, 2333 CC Leiden, The Netherlands.
尼托福兰 (NFT) 可以引起肝脏毒性,特别是在功能受损的患者中. 一个新的生理学基础的药理动力学 (PBPK) 模型预测这些人更高的NFT肝脏暴露,增加DILI风险.
科学领域:
- 药理动力学 药理动力学
- 药物引起的肝损伤 (DILI)
- 脏生理学 脏生理学
背景情况:
- 尼托福兰 (NFT) 是尿路感染的重要抗生素.
- NFT与药物诱导性肝损伤 (DILI) 有关,但机制尚不清楚.
- 了解NFT处置对于预测DILI风险至关重要.
研究的目的:
- 为跨物种 (子,老鼠,人类) 的NFT开发一个基于生理学的药理动力学 (PBPK) 模型.
- 使用PBPK模型来预测NFT诱导的肝毒性.
- 研究功能对NFT药理动力学和DILI风险的影响.
主要方法:
- 使用子和老鼠现有的动力数据构建PBPK模型.
- 整合肠肝循环 (EHR) 进入PBPK模型使用大鼠数据.
- 将PBPK模型推断为人类生理学,并与人类运动数据验证.
主要成果:
- 活跃的管状分泌和中的再吸收显著影响NFT脏清除和尿动力学.
- 人类PBPK模型准确地预测了NFT动力学,胆道分泌量最小.
- 模拟表明,中度至重度功能障碍 (减少GFR) 患者的NFT肝脏暴露率高出2-3倍.
结论:
- 由于药物暴露增加,功能衰竭可能会增加NFT诱导的肝损伤 (DILI) 的风险.
- 降低功能可能导致治疗NFT度低于最佳水平,并增加抗菌素耐药性.
- 开发的PBPK模型可以根据患者的年龄和GFR等特征预测个体NFT动力学,帮助个性化DILI风险评估.
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