Biomedical subjects

W J Jusko

Publications and source records attributed to W J Jusko.

At least 55 records · Page 3Linked to original sources

PubMed1998

Pharmacokinetic and pharmacoimmunodynamic interactions between prednisolone and sirolimus in rabbits.

PURPOSE: To assess pharmacokinetic and pharmacoimmunodynamic interactions between prednisolone (Pred, I1 mg/kg) and sirolimus (Sir, 0.25 mg/kg) in rabbits. METHODS: After intravenous administration, plasma concentrations of Pred and corticosterone, and Sir blood concentrations were followed for 24 hours along with blood granulocyte and T-helper cell counts. Ex vivo and in vitro whole blood lymphocyte proliferation marked lymphocyte reactivity. RESULTS: Pred terminal half-life and clearance were 1.1 hr and 0.72 l/hr/kg with no difference after Sir. Sir values were 13 hr and 0.16 l/hr/kg and Pred produced no changes. Corticosterone production (0-12hr) was suppressed by 55% after Pred alone or combined, while Sir did not cause adrenal suppression. Blood T-helper cells and granulocytes displayed circadian rhythms after placebo. Over 12 hr, T-helper cell counts were decreased by Pred (40%) and Sir (19%) while granulocyte numbers increased by 56% and 23%. After coadministration, cell numbers were similar to Pred alone. Pred and Sir decreased lymphocyte reactivity by 41% and 56% over 24 hr and their combination reached 85% inhibition with additive interaction. In vitro studies showed antagonistic or synergistic interactions depending on drug concentration ratios. CONCLUSIONS: At therapeutic concentrations, Sir and Pred do not significantly interact pharmacokinetically and have additive pharmacoimmunodynamics. Thus, the therapeutic application of this combination is promising.

Animals↗

PubMed1998

Estimation of oral bioavailability of a long half-life drug in healthy subjects.

PURPOSE: To estimate and compare the oral bioavailability of a drug (BMS-187745) administered as single doses of oral solution of either the parent drug or its prodrug (BMS-188494). METHODS: A single-dose, two-period, three-treatment, control-balanced, residual-effect, incomplete block crossover study was completed in 16 healthy male subjects. All subjects received a 10 mg IV infusion of BMS-187745, and a single oral dose of either BMS-187745 (PO1) or BMS-188494 (PO2). A model is proposed to calculate the oral bioavailability of BMS-187745 which has a long half-life; incomplete data points were available to characterize its elimination phase. The plasma concentration-time data obtained following IV infusion of parent drug, and after administration of either PO1 or PO2 treatment were fitted simultaneously with systemic pharmacokinetic parameters shared by both the oral and IV routes of administration. RESULTS: The best simultaneous fittings of the plasma concentration-time data were obtained by using a biexponential pharmacokinetic model with a first-order absorption rate constant. The mean bioavailability (F) values of BMS- 187745 estimated by the proposed model were 26.5% and 2.6% when given as oral solution of its prodrug and as the parent drug. The coefficient of variation (CV) of these F values are reasonable, ranging from 38-40%. In contrast, F calculated by the model-independent AUC method exhibited high CV, ranging from 111-120%. CONCLUSIONS: The oral bioavailability values estimated by the proposed model were more reasonable compared to those calculated by the model-independent AUC method. The proposed approach may be useful for estimating bioavailability of long half-life drugs when incomplete data points are available to characterize their elimination phase.

Administration, Oral↗

PubMed1998

Note: caution in use of empirical equations for pharmacodynamic indirect response models.

An empirical equation was recently proposed and used to characterize inhibitory drug effects on production of an endogenous substance. The limitations of this empirical equation are described utilizing mathematical equations and simulations based on the exact differential equation for Indirect Response Model I. The latter is preferable for fitting data using indirect response models.

Data Interpretation, Statistical↗

PubMed1998

Dose-dependence and repeated-dose studies for receptor/gene-mediated pharmacodynamics of methylprednisolone on glucocorticoid receptor down-regulation and tyrosine aminotransferase induction in rat liver.

Dose-dependent and repeated-dose effects of methylprednisolone (MPL) on down-regulation of glucocorticoid receptor messenger RNA (GR mRNA) and GR density, as well as tyrosine aminotransferase (TAT) mRNA and TAT induction by receptor/gene-mediated mechanisms in rat liver were examined. A previously developed pharmacokinetic/pharmacodynamic (PK/PD) model was used to design these studies which sought to challenge the model. Three groups of male adrenalectomized Wistar rats received MPL by i.v. injection: low-dose (10 mg/kg at Time 0), high-dose (50 mg/kg at Time 0), and dual-dose (50 mg/kg at Time 0 and 24 hr). Plasma concentrations of MPL, and hepatic content of free GR, GR mRNA, TAT mRNA, and TAT activity were determined. The P-Pharm program was applied for population analysis of MPL PK revealing low interindividual variation in CL and Vc values (3-14%). Two indirect response models were applied to test two competing hypotheses for GR mRNA dynamics. Indirect Pharmacodynamic Response Model I (Model A) where the complex in the nucleus decreases the transcription rate of GR mRNA better described GR mRNA/GR down-regulation. Levels of TAT mRNA began to increase at 1-2 hr, reached a maximum at 5-6 hr, and declined to the baseline at 12-14 hr after MPL dosing. The induction of TAT activity followed a similar pattern with a delay of about 1-2 hr. The low-dose group had 50-60% of the TAT mRNA and TAT induction compared to the high-dose group. Since the GR density returned to about 70% of the baseline level before the second 50 mg/kg dose at 24 hr, tolerance was found for TAT mRNA/TAT induction where only 50-60% of the initial responses were produced. Our fourth-generation model describes the dose dependence and tolerance effects of TAT mRNA/TAT induction by MPL involving multiple-step signal transduction controlled by the steroid regimen, free GR density, and GR occupancy. This model may provide the foundation for studying other induced proteins or enzymes mediated by the similar receptor/nuclear events.

Animals↗

PubMed1998

Characterization of pharmacodynamic recession slopes for direct and indirect response models.

Direct pharmacologic effects are known to recede over time with largely linear slopes (Levy's k.m product, J. Pharm. Sci. 53:342, 1964) and indirect responses have similar behavior. Pharmacodynamic slope properties were examined mathematically for the Hill function with monoexponential drug disposition and simulations were carried out for other pharmacokinetic functions. Both types of pharmacodynamic profiles exhibit a single terminal inflection point (fp) when drug concentrations exceed the EC50 (that concentration causing one-half maximum effect, Emax). For direct effects it was found that Cfp (the drug concentration at fp) = EC50, the determinants of inflection time were identified, and Slopefp = -lambda z gamma Emax/4 where lambda z is the terminal disposition slope and gamma is the Hill coefficient. These characteristics were explored for the four basic indirect response models which also exhibit recession profiles with slight sigmoidity and a single terminal inflection point at higher doses. The drug concentration at inflection Cfp is < or = IC50 or SC50 (drug concentrations causing half-maximal inhibition or stimulation), while the inflection response (Rfp) attains constant values at larger doses. Indirect Response Models I, III, and IV have nearly linear return slopes for a wide range of doses which are governed by the disposition slope lambda z of the drug, loss constant kout of the response, maximum inhibition (Imax) or stimulation (Smax) factors, and a unique fractional constant (0 < G < or = 1). Model II exhibits more complex behavior with recession slopes which are less likely to be parallel for various doses. Most indirect responses are expected to show nearly linear recession slopes which are parallel for moderate to large doses and mainly governed by an identical combination of pharmacokinetic (lambda z), system (kout), and dynamic capacity factors (Imax or Smax).

Models, Biological↗

PubMed1998

Mathematical formalism and characteristics of four basic models of indirect pharmacodynamic responses for drug infusions.

Indirect response models require differential equations to describe the nonlinear inhibition or stimulation of the production or loss (kout) of the response variable. Partially integrated solutions for these models developed previously for i.v. bolus or biphasic pharmacokinetics were extended to consider drug infusions for limited or extended durations. Qualitative examination was made of the role of infusion rate and duration, type and rate of drug disposition, Imax or Smax capacity factors, IC50 or SC50 sensitivity factors, and Kout values. Properties of the response curves characterized include curve shapes, maximum or minimum response, onset rate, steady-state, and return to baseline. Some comparisons were made with behavior of i.v. bolus doses. These relationships provide both a formal and practical basis for better understanding of the time-course of basic indirect response models.

Models, Biological↗

PubMed1998

Fourth-generation model for corticosteroid pharmacodynamics: a model for methylprednisolone effects on receptor/gene-mediated glucocorticoid receptor down-regulation and tyrosine aminotransferase induction in rat liver.

A fourth-generation pharmacokinetic/pharmacodynamic (PK/PD) model for receptor/genemediated effects of corticosteroids was developed. Male adrenalectomized Wistar rats received a 50 mg/kg i.v. bolus dose of methylprednisolone (MPL). Plasma concentrations of MPL, hepatic glucocorticoid receptor (GR) messenger RNA (mRNA) and GR density, tyrosine amino-transferase (TAT) mRNA, and TAT activity in liver were determined at various time points up to 72 hr after MPL dosing. Down-regulation of GR mRNA and GR density were observed: GR mRNA level declined to 45-50% of the baseline in 8-10 hr, and slowly returned to predose level in about 3 days; GR density fell to 0 soon after dosing and returned to the baseline in two phases. The first phase, occurring in the first 10 hr, entailed recovery from 0 to 30%. The second phase was parallel to the GR mRNA recovery phase. Two indirect response models were applied for GR mRNA dynamics regulated by activated steroid-receptor complex. A full PK/PD model for GR mRNA/GR down-regulation was proposed, including GR recycling theory. TAT mRNA began to increase at about 1.5 hr, reached the maximum at about 5.5 hr, and declined to the baseline at about 14 hr after MPL dosing. TAT induction followed a similar pattern with a delay of about 1-2 hr. A transcription compartment was applied as one of the cascade events leading to TAT mRNA and TAT induction. Pharmacodynamic parameters were obtained by fitting seven differential equations piecewise using the maximum likelihood method in the ADAPT II program. This model can describe GR down-regulation and the precursor/product relationship between TAT mRNA and TAT in receptor/gene-mediated corticosteroid effects.

Animals↗

PubMed1998

Pharmacokinetic-pharmacodynamic modeling of tolmetin antinociceptive effect in the rat using an indirect response model: a population approach.

The relationship between the pharmacokinetics and the antinociceptive effect of tolmetin was characterized by an indirect model using a population approach. Animals received an intra-articular injection of uric acid in the right hindlimb to induce its dysfunction. Once dysfunction was complete, rats received an oral tolmetin dose of 1, 3.2, 10, 31.6, 56.2 or 100 mg/kg and antinociceptive effect and blood tolmetin concentration were simultaneously evaluated. Tolmetin produced a dose-dependent recovery of functionality, which was not directly related to blood concentration. An inhibitory indirect response model was used based on these response patterns and the fact that tolmetin reduced nociception by inhibiting prostaglandin synthesis. Pharmacokinetic (PK) and pharmacodynamic (PD) data were simultaneously fitted using nonlinear mixed effects modeling (NONMEM) to the one-compartment model and indirect response model. The individual time courses of the response were described using Bayesian analysis with population parameters as a priori estimates. There was good agreement between the predicted and observed data. Population analysis yielded a maximal inhibition of the nociceptive response of 76% and an IC50 of 9.22 micrograms/ml. This IC50 is similar to that for tolmetin-induced prostaglandin synthesis inhibition in vitro (3.0 micrograms/ml). The present results demonstrate that mechanism-based PK-PD analysis using a population approach is useful for quantitating individual responses as well as reflecting the actual mechanism of action of a given drug in vivo.

Animals↗

PubMed1998

Characteristics of indirect pharmacodynamic models and applications to clinical drug responses.

This review describes four basic physiologic indirect pharmacodynamic response (IDR) models which have been proposed to characterize the pharmacodynamics of drugs that act by indirect mechanisms such as inhibition or stimulation of the production or dissipation of factors controlling the measured effect. The principles underlying IDR models and their response patterns are described. The applicability of these basic IDR models to characterize pharmacodynamic responses of diverse drugs such as inhibition of gastric acid secretion by nizatidine and stimulation of MX protein synthesis by interferon alpha-2a is demonstrated. A list of other uses of these models is provided. These models can be readily extended to accommodate additional complexities such as nonstationary or circadian baselines, equilibration delay, depletion or accumulation of a precursor pool, sigmoidicity, or other mechanisms. Indirect response models which have a logical mechanistic basis account for time-delays in many responses and are widely applicable in clinical pharmacology.

Humans↗

PubMed1998

Pharmacokinetic and pharmacodynamic characteristics and safety of inhaled albuterol enantiomers in healthy volunteers.

The pharmacokinetics and pharmacodynamics of inhaled albuterol given as single or multiple doses of racemate (RS-) or single enantiomers (R-, S-) were determined. In an open-label, three-way crossover, parallel-dose study, 1.25 and 5 mg of (R)- and (S)-albuterol and 2.5 and 10 mg of (RS)-albuterol were given via nebulization to 15 healthy volunteers. The pharmacokinetic parameters of each enantiomer were determined by noncompartmental and model-fitting analyses. Both (R)- and (S)-albuterol showed rapid absorption and biexponential decline, with half-lives (t1/2) averaging 4 and 6 hours, respectively. There were no differences in pharmacokinetics of (R)-albuterol when administered as (R)- or (RS)-albuterol at the 5-mg dose with equivalent relative bioavailability as seen from maximum concentration (Cmax) and area under the concentration-time curve (AUC). The same was true for (S)-albuterol at the 1.25-mg and 5-mg doses. The data from 5-mg doses were considered to be more reliable due to assay sensitivity limitations, and indicated equivalent absorption and disposition of the individual enantiomers. There was no evidence of in vivo racemization, and (R)-albuterol did not interconvert to (S)-albuterol. Plasma potassium, plasma glucose, heart rate, and QTc interval were used in linear and Emax models to assess responses relating to (R)-albuterol concentrations. The Emax for potassium change was 1.32 meq/L, with an EC50 of 0.59 and 0.94 ng/mL after administration of (R)- and (RS)-albuterol, respectively. The slopes and intercepts for glucose and heart rate changes were similar after administration of (R)- and (RS)-albuterol. No concentration-effect relationships were evident for QTc interval or for (S)-albuterol. The extrapulmonary responses of (R)-albuterol and adverse effects were similar for single R-enantiomer or the racemic mixture.

Administration, Inhalation↗

PubMed1998

Clinical pharmacokinetics and pharmacodynamics of a new squalene synthase inhibitor, BMS-188494, in healthy volunteers.

A double-blind, placebo-controlled, parallel-group, ascending, multiple-dose study was completed in 45 healthy male volunteers to assess the maximum tolerated dose, pharmacokinetics, and pharmacodynamics of BMS-187745, a squalene synthase inhibitor, administered as multiple oral doses of its prodrug BMS-188494. Participants received a daily oral dose of 10 mg for 2 weeks, or a daily oral dose of 25, 50, 100, or 200 mg for 4 weeks. The absorption rate constant (ka) and bioavailability (F) values were estimated by fitting the plasma BMS-187745 concentration-time data to a biexponential function with a first-order ka. Values for F were similar for all five dose levels, and thus were independent of dose. The ka values also were similar for all dose groups except the 50-mg group, for which ka values were somewhat higher. The change in urinary excretion rate of farnesyl pyrophosphate metabolite (dioic acid) was determined to be a pharmacodynamic measure. There was no significant change in dioic acid excretion at doses of less than 100 mg given for 4 weeks. An indirect pharmacodynamic response model with threshold concentration (CT) and based on inhibition of squalene synthase was proposed to describe the effect versus time data. The pharmacodynamic data from all dose levels were fitted simultaneously to the proposed model and the fitted parameters estimated as CT = 3.9 micrograms/mL, kout = 0.47 hr-1, IC50 = 4.1 micrograms/mL, and Imax = 1.0. The proposed indirect response model requiring a threshold concentration provides a useful means of quantitating responses for a new type of therapeutic agent.

Adult↗

PubMed1998

Species differences in sirolimus stability in humans, rabbits, and rats.

Species differences in the in vitro stability of sirolimus was assessed in plasma and whole blood in relation to red blood cell distribution. Fresh blood and plasma samples obtained from humans, rabbits, and rats were aliquoted and spiked with sirolimus. After incubation from 0 to 144 hr in a shaking water bath maintained at 37 degrees C, sirolimus concentrations were quantified by a specific high-liquid performance chromatographic method. Sirolimus was unstable in both plasma and whole blood. Sirolimus degradation half-life in whole blood was 135 hr (vs. 7.2 hr in plasma) in humans, 62 hr (vs. 3.1 hr) in rabbits, and 15 hr (vs. 2.2 hr) in rats. Sirolimus stability is greater in whole blood compared with plasma in proportion to the whole blood/plasma ratio and hematocrit. In vivo instability may account for up to 36% of sirolimus clearance in humans and 13% in rabbits, and this is an important factor in the pharmacokinetics of this drug.

Animals↗

PubMed1998

Species- and gender-related differences in cyclosporine/prednisolone/sirolimus interactions in whole blood lymphocyte proliferation assays.

Cyclosporin A (CyA), prednisolone (Pred) and sirolimus (Sir) inhibit lymphocyte proliferation at the cytokine transcription (CyA and Pred) or signal transduction (Sir) levels. Their double and triple interactions were studied on lectin-induced proliferation of whole blood lymphocytes (WBLP) from male and female humans, rabbits and rats. Isobols along with the Universal Response Surface Approach were used to describe and quantify the nature and intensity of drug interactions by determining alpha values. CyA was always less potent than Pred and Sir while these two compounds were relatively equipotent. Species-related differences were observed with single drugs. Rabbit WBLP were resistant to Pred action (Imax = 67%) and rats were more sensitive to Pred (IC50 = 9.1 nM in females) and Sir (2.8 nM) actions than humans (32 and 55 nM). Gender differences were observed but were not consistent across species. All double-drug combinations were synergistic, and combinations containing Pred were 10 to 100 times more synergistic in rabbits (alpha Pred/Sir = 213 and alpha CyA/Pred = 147 in males) than in rats (12 and 2.1) or humans (3.7 and 5.7) in relation to the lower efficacy of Pred. Double-combination alpha values were able to describe CyA/Pred/Sir triple combination effects. These studies indicate that CyA, Pred and Sir act and synergistically interact in vitro in species- and gender-dependent fashions. Adrenalectomized rats better resemble humans in these responses. WBLP are useful in various species in determining immunosuppressive drug action and interactions.

Adult↗

PubMed1998

Pharmacokinetics/dynamics of 5c8, a monoclonal antibody to CD154 (CD40 ligand) suppression of an immune response in monkeys.

The pharmacokinetics and pharmacodynamics (PK/PD) of chimeric (Ch5c8) and humanized (Hu5c8) 5c8, a monoclonal antibody that binds CD154 (CD40 ligand), thus blocking the interaction between CD40 and CD154, were investigated in cynomolgus monkeys. Single-dose groups (n = 3 animals per dose) received saline, 0.2, 1, 5 or 20 mg/kg i.v. doses of Hu5c8. The repeat-dose groups (n = 4 animals) received 0 or 5 mg/kg i.v. doses of Ch5c8 or Hu5c8 on days 1, 2, 3, 5, 7 and 9. The single-dose PK parameters showed dose proportionality, with a terminal half-life of 300 h, a volume of distribution at steady state of 73 ml/kg and clearance of 0.2 ml.h-1.kg-1. The repeat-dose regimen produced a longer terminal half-life (500 h) and lower clearance (0.13 ml.h-1.kg-1) than in the single-dose groups. The antibody titer to tetanus toxoid (ATT) challenge served as the immunodynamic marker. The primary ATT response consisted of a latent phase of approximately 10 days, during which the immune system was processing antigen but not yet producing antibody, a rise to an antibody maximum titer at approximately 18 days and a decline toward baseline by approximately 40 days in controls. The 5c8 produced a log(dose)-proportional reduction in the area under the curve of ATT. An indirect PK/PD model based on the kinetics of tetanus toxoid exposure and inhibition of ATT production in relation to 5c8 concentrations was developed. A median inhibitory concentration of 0.84 microg/ml and a efficacy of 0.84 reflected marked inhibition of ATT response by 5c8. The model provides quantitation of reduced ATT responses after 5c8 and was applicable to primary and secondary immune responses and to both single-dose and multiple-dose treatments. The monoclonal antibody 5c8 blocks the CD40 and CD154 interaction, producing consistent and substantive reduction in antibody formation after administration of tetanus toxoid, which can be characterized with PK/PD modeling. It is anticipated that 5c8 may have utility in the treatment of antibody-mediated autoimmune disease.

Animals↗

PubMed1997

Lipophilic benzamide and anilide derivatives as high-performance liquid chromatography internal standards: application to sirolimus (rapamycin) determination.

Finding a suitable internal standard in reversed-phase high-performance liquid chromatography is often difficult. A general approach for selecting and synthesizing the proper internal standard is presented and applied to a validated method for quantitation of sirolimus in several biological matrices. A series of fifteen N-alkylbenzamides, N-alkyltoluamides and N-alkanoylanilines with a log P range of 3.51 to 6.68 were synthesized as internal standards; N-undecyl-o-toluamide was evaluated most extensively. Sirolimus quantitation involves a simple sample clean-up procedure followed by isocratic chromatography on a heated C18 analytical column with an 70% methanol-water mobile phase and ultraviolet detection at 278 nm. This method was linear from 2.5 to 200 ng with a limit of quantitation of 2.5 ng using a 1-ml blood sample. Sirolimus recovery was above 72.1%. The intra-day and inter-day coefficients of variation were less than 11.7%. Several drugs and sirolimus metabolites do not interfere with the analysis. This method was used to measure sirolimus in blood from rats, rabbits and humans.

Administration, Oral↗

PubMed1997

Corticosteroid effects in skeletal muscle: gene induction/receptor autoregulation.

Common side effects of corticosteroid therapy include muscle weakness and atrophy, which are in part mediated by the induction of the enzyme glutamine synthetase. In addition, corticosteroids autoregulate their own receptor, thereby modulating tissue sensitivity to the hormone. The data in this report demonstrate that these gene-mediated effects are evident in muscle after short-term administration. Determination of molecular response dynamics could be useful in the design of future treatment regimens.

Animals↗

PubMed1997

A computer program using disposition decomposition analysis in pharmacodynamics.

A personal computer based program (DDAPD1) was developed for calculating or determining the apparent distribution function of a drug to a possibly heterogeneous biophase, the mean transit time of a drug at the biophase, the ratio of distribution clearance to biophase volume of distribution, the drug concentration-time function at the biophase (Cb(t)), and a function which reflects the relationship between the pharmacodynamic response and Cb(t) of the drug. This program uses an approach based on disposition decomposition analysis and the hysteresis minimization principle. The application of the program is demonstrated using published data for heptabarbital.

Barbiturates↗

PubMed1997

Nonlinear perpendicular least-squares regression in pharmacodynamics.

Currently available software for nonlinear regression does not account for errors in both the independent and the dependent variables. In pharmacodynamics, measurement errors are involved in the drug concentrations as well as in the effects. Instead of minimizing the sum of squared vertical errors (OLS), a Fortran program was written to find the closest distance from a measured data point to the tangent line of an estimated nonlinear curve and to minimize the sum of squared perpendicular distances (PLS). A Monte Carlo simulation was conducted with the sigmoidal Emax model to compare the OLS and PLS methods. The area between the true pharmacodynamic relationship and the fitted curve was compared as a measure of goodness of fit. The PLS demonstrated an improvement over the OLS by 20.8% with small differences in the parameter estimates when the random noise level had a standard deviation of five for both concentration and effect. Consideration of errors in both concentrations and effects with the PLS could lead to a more rational estimation of pharmacodynamic parameters.

Algorithms↗