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Biomedical subjects

Suzanne Weck

Publications and source records attributed to Suzanne Weck.

4 recordsLinked to original sources

Alteplase as a catheter locking solution: in vitro evaluation of biochemical stability and antimicrobial properties.

PURPOSE: To reduce potential complications of fibrin deposition to catheter surfaces, there is increasing empiric use of alteplase as a catheter lock solution. The purpose is to evaluate the properties of alteplase when reconstituted in sterile water (SW) or bacteriostatic water (BW) for prolonged periods. MATERIALS AND METHODS: Alteplase in glass vials was reconstituted (1 mg/mL) with SW or BW (0.9% benzyl alcohol) in duplicates and stored at 37 degrees C. Biochemical assays were performed at days 0 and 7 and included optical clarity, protein concentration, percent protein monomer, and in vitro clot lysis activity. Microbiologic assays were performed on days 7 through 28 with use of a standardized antimicrobial effectiveness test (pass/fail) and pour-plate methods incubated at 22.5 degrees C (fungus, 3-7 days) or 32.5 degrees C (bacteria, 3-5 days). Organisms tested included Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans, and Aspergillus niger. RESULTS: Biochemical assay results were as follows: on day 0, all samples were clear/colorless; protein concentrations were 1.10 mg/mL +/- 0 in SW and 1.11 mg/mL +/- 0 in BW; percent protein monomer was 8.2% +/- 0.07 in SW and 98.6% +/- 0.07 in BW; and in vitro clot lysis activity (in percent of relative activity) was 100% in all samples. On day 7, all samples were clear/colorless, protein concentrations were 1.11 mg/mL +/- 0.07 in SW and 1.11 mg/mL +/- 0.07 in BW; percent protein monomer was 97.4% +/- 0.21 in SW and 96.1% +/- 0.21 in BW; and in vitro clot lysis activity (relative activity compared with day 0) was 91% +/- 2.8 in SW and 90% +/- 2.8 in BW. Microbiologic assays (US Pharmacopeia [USP] antimicrobial effectiveness test) yielded a failing result for alteplase reconstituted in SW and a passing result for alteplase reconstituted in BW. CONCLUSIONS: Alteplase reconstituted with SW or BW remains relatively stable with retained bioactivity when stored at 37 degrees C for as long as 7 days. Despite the biochemical similarities of the two solutions, only alteplase in BW met USP criteria as an effective antimicrobial solution. Further clinical evaluation is warranted.

Biological Assay↗

Characterization of alteplase (tPA) following delivery through the AngioJet rheolytic catheter.

PURPOSE: To analyze alteplase solutions following delivery through the AngioJet Xpeedior rheolytic thrombectomy device to characterize the viability of proteins exposed to high shear stress. METHODS: Alteplase solutions were prepared by reconstitution in sterile water to obtain a targeted concentration of 1.0 mg/mL. A baseline control sample was obtained. The AngioJet system was modified by occluding the return line to allow collection of the dispersed fluid volume. Alteplase solutions (n=5) were delivered through the 6-F, 120-cm Xpeedior catheter and collected. All samples were assayed and compared to baseline using qualitative visual inspection, ultraviolet spectrophotometry, size exclusion chromatography, and in vitro clot lysis assays. RESULTS: Analysis of the test solutions demonstrated a mean protein recovery of 98.0%+/-3.5% of targeted concentration; the collected protein was fully active, as determined by clot lysis assays (specific activity > or =100%). All samples were clear and colorless. No significant fragmentation or aggregation of protein was observed. CONCLUSIONS: Alteplase solutions, when delivered through the AngioJet Xpeedior rheolytic thrombectomy device, remain stable and biologically active in vitro. Further clinical investigation is warranted using this method as a novel approach for pharmacomechanical thrombolysis.

Catheterization↗

Alteplase: stability and bioactivity after dilution in normal saline solution.

PURPOSE: To characterize the biochemical stability and bioactivity of reconstituted alteplase when diluted to a concentration of 0.01 mg/mL in normal saline solution and stored at ambient temperature for as long as 24 hours in commercial saline solution bags. MATERIALS AND METHODS: Two commercially available formulations of lyophilized alteplase (2-mg and 50-mg vials, respectively) were reconstituted with sterile water to a final concentration of 1 mg/mL. For each vial configuration, 5 mg of alteplase (5 mL) was added to a commercial 500-mL bag of normal saline solution to achieve a 0.01-mg/mL targeted concentration. Solutions were assayed for optical clarity, pH, protein concentration, and in-vitro clot lysis activity. Assays of the solutions were performed at time points of 0 (control), 4, 8, and 24 hours at ambient room temperature and compared to controls. RESULTS: On visual inspection, aliquots of the diluted protein solutions in clear glass vials remained clear/colorless after 24 hours. Bioactivity (clot lysis assay) over the course of 24 hours at ambient temperature remained essentially unchanged relative to control (2-mg vial: mean of 98.3%, range of 93.7%-103.3%; 50-mg vial: mean of 103.1%, range of 100.6%-108.3%). The mean protein recovery rates (relative to targeted concentration) over a 24-hour period were 43% (range, 39%-46%) and 42% (range, 40%-45%) for the 2-mg and 50-mg vial configurations, respectively. CONCLUSIONS: Alteplase diluted in normal saline solution at a concentration of 0.01 mg/mL is biochemically stable and active at ambient temperature for as long as 24 hours as assessed by in vitro clot lysis assays. Alteplase appears to have a bimodal solubility profile in normal saline solution and further studies are required to determine the activity and solubility of alteplase concentrations lower than 0.01 mg/mL.

Biological Assay↗

Tenecteplase: stability and bioactivity of thawed or diluted solutions used in peripheral thrombolysis.

PURPOSE: Tenecteplase (TNK; TNKase) is a third-generation plasminogen activator approved for acute myocardial infarction with an enhanced safety profile compared to alteplase. The stability and bioactivity of reconstituted frozen/thawed and diluted tenecteplase solutions used in noncoronary peripheral thrombolysis was determined. MATERIALS AND METHODS: Lyophilized TNK was freshly reconstituted in sterile water (5 mg/mL) and used as control. In freeze/thaw studies, reconstituted TNK aliquots were stored frozen for 4 weeks at -20 degrees C, thawed at ambient temperature, and assayed with and without an additional freeze/thaw cycle. Additional freshly reconstituted TNK aliquots were assayed after six freeze/thaw cycles when frozen at two separate temperatures (-20 degrees and -70 degrees C) and thawed at 2-8 degrees C or ambient temperature. In dilution studies, reconstituted TNK was diluted in 500-mL commercially available normal saline solution bags to concentrations of 0.01, 0.02, and 0.05 mg/mL. Samples were assayed after 0, 8, and 24 hours at ambient temperature. Optical clarity, pH, protein concentration, particle counts, and in-vitro clot-lysis assays were performed. Protein monomer (%), single-chain protein (%), and particle counts were performed in freeze/thaw studies. RESULTS: Frozen/thawed TNK aliquots met all specifications as freshly reconstituted product. For dilution studies (0.01, 0.02, and 0.05 mg/mL), the recovered protein retained 83%-100% bioactivity after 24 hours. The recovered protein rates over the course of 24 hours (relative to target concentration) were 70%-75%, 80%-85%, and 94%-95% at 0.01, 0.02, and 0.05 mg/mL, respectively. Assayed solutions were clear/colorless at all concentrations and time points. CONCLUSION: TNK is fully active after reconstitution and freezing/thawing. TNK dilutions used in clinical practice (0.01-0.05 mg/mL) demonstrated retention of biologic activity at 24 hours without precipitates.

Biological Assay↗