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Biomedical subjects

W J Jusko

Publications and source records attributed to W J Jusko.

At least 91 records · Page 5Linked to original sources

Differential dynamics of receptor down-regulation and tyrosine aminotransferase induction following glucocorticoid treatment.

Autoregulation of glucocorticoid receptor (GR) concentration in vivo may be an important determinant of steroid sensitivity. The dynamics of GR regulation were assessed and compared to regulation of tyrosine aminotransferase (TAT) expression in liver tissue taken from rats treated with a single 50 mg/kg i.v. dose of methylprednisolone. Plasma methylprednisolone concentrations were determined by HPLC analysis. Receptor and TAT message levels were determined by quantitative Northern hybridization. Methylprednisolone plasma kinetics showed a half-life of 0.6 h. Receptor occupancy occurred rapidly and cytosolic GR reappeared over 2-12 h. TAT activity rose between 2 and 6 h and then dissipated. Reduction in receptor mRNA levels occurred very rapidly, being detectable by 30 min following steroid administration. A down-regulated steady-state in GR message expression was reached by 2 h post-injection, and was maintained throughout the 18 h examined in this study. Comparison of methylprednisolone kinetics demonstrated that down-regulation was maintained long after drug was eliminated. In contrast, TAT message induction occurred with a sharp peak; maximal induction occurred between 5-6 h and return to baseline at approx. 8-10 h post-induction. This study shows that unlike TAT induction, GR message repression in vivo does not require continual presence of hormone.

Adrenalectomy↗

Physicochemical, pharmacokinetic and pharmacodynamic evaluation of liposomal tacrolimus (FK 506) in rats.

PURPOSE: Tacrolimus (FK 506) is a new potent immunosuppressant. Because of poor water solubility, the conventional intravenous dosage forms of FK 506 (C-FK 506) contain surfactants such as HCO-60 which may cause adverse effects. We sought a liposomal formulation of FK 506 (L-FK 506) containing endogenous phospholipids to target drug to the spleen, a major organ controlling the immune system. METHODS: L-FK 506, consisting of 0.1 micron diameter vesicles of phosphatidylcholine and phosphatidylglycerol (molar ratio 9:1) and 7.5 mole% drug, was evaluated for in vitro stability. The intravenous disposition profile, spleen distribution, and immunosuppression of L-FK 506 was compared with that of C-FK 506 in the rat after single doses of 0.3 mg/kg. RESULTS: The L-FK 506 showed good in vitro stability. L-FK 506 exhibited an increased volume of distribution at steady-state (Vss) (from 3.41 to 14.71 L/kg) and increased mean residence time (MRT) (from 2.83 to 16.07 hr). FK 506 concentrations in spleen were increased by 40% at 10 hr after administration of the liposomal formulation. The pharmacodynamics of L-FK 506, evaluated by the extent of inhibition of splenocyte proliferation, was comparable to that of C-FK 506. CONCLUSIONS: Liposomal FK 506 may be an improved dosage form for parenteral use.

Animals↗

Effect of corticosteroid binding globulin on the pharmacokinetics of prednisolone in rats.

PURPOSE: The effect of exogenous corticosteroid binding globulin (CBG) on the pharmacokinetics of intravenous prednisolone was determined in rats to test the "free hormone hypothesis." METHODS: A dose of CBG to yield 95% binding with 1000 ng/ml of prednisolone in vitro in rat plasma or saline was administered before dosing 2 mg/kg of prednisolone hemisuccinate or methylprednisolone intravenously. Drug concentrations in plasma samples were assayed by HPLC. RESULTS: Single administration of CBG decreased apparent prednisolone clearance by 56% (155 to 66 ml/min/kg) and reduced apparent VSS by 35% (4.1 to 2.7 L/kg) (p < 0.001). Methylprednisolone pharmacokinetics, studied as a negative control because the drug does not bind to CBG, did not change. CONCLUSIONS: The corticosteroid bound to CBG does not appear to be available for removal by clearance organs.

Animals↗

Analysis of tacrolimus (FK 506) in relation to therapeutic drug monitoring.

Tacrolimus (FK506) is a macrolide lactone which is used as an immunosuppressant agent for organ transplantation. Patient monitoring during clinical trials initially involved use of extraction/enzyme immunoassays (ELISA) for plasma and whole blood concentrations of FK506. Therapeutic concentrations of FK506 are approximately 0.4-1.2 ng/ml in plasma and 5-20 ng/ml in whole blood. Blood:plasma ratios are variable among patients and range from 11 to 114. A validation and quality assurance program was established to standardize procedures and assure concordance of ELISA analytic results from clinical sites participating in liver/kidney trials. HPLC/ELISA methods have been used for assessing assay specificity. Comparison of the ELISA method with a HPLC-MS procedure (TexMS) shows good correlation, but indicates metabolite inclusion in the ELISA. This method may be of value in conditions of altered FK-506 metabolism. Commercialization of the immunoassay has been made by Incstar with the ELISA and Abbott Laboratories with an IMx procedure; the two methods are generally comparable. Additional methods offering clinical promise are radioreceptor and pentamer complex ELISA assays. There are diverse methods offering sensitive quantitation but with varying specificity for tacrolimus in patient plasma and whole blood.

Animals↗

Combined inhibition effects of tacrolimus and methylprednisolone on in vitro human lymphocyte proliferation.

Tacrolimus (FK 506) has synergistic immunosuppressive effects in combination with corticosteroids. A steroid dose-lowering effect can be explained partly by the inhibition by FK 506 of cytochrome P-450 IIIA, which metabolizes corticosteroids. We investigated the influence of combinations of FK 506 and methylprednisolone (MPL) on the suppression of in vitro human lymphocyte proliferation. To quantify the type of drug interaction (synergistic, additive, and antagonistic), three methods (Drewinko's statistical analysis, median-effect principle, and normal distribution model) were used. The interaction appeared synergistic in most combination ratios, but the extent of synergism varied depending on the quantitative method. There may be optimal combination ratios of FK 506 and MPL which achieve more effective immunosuppressive effects.

Cells, Cultured↗

An improved pharmacodynamic model for formation of methemoglobin by antimalarial drugs.

The widely used 8-aminoquinoline antimalarial group of compounds and the derivatives such as WR242511 that are being developed for possible prophylactic anticyanide applications have complex interactions with erythrocytes. Methemoglobin (MetHb) levels following the use of this drug predicted by earlier authors grossly deviated from the observed steady state levels under multiple-dose conditions. We propose a pharmacokinetic-pharmacodynamic model to characterize literature data for blood levels of MetHb generated after administration of WR242511. The model is based on an indirect mechanism involving WR242511 putative metabolite concentration, Cm on the formation of MetHb (rate constant, kr) and on depletion of reducing equivalents leading to accumulation of MetHb. Eventual depletion of MetHb is modeled as related to the disposition of both the drug metabolite and MetHb. The rate of change of MetHb concentration in the blood under the influence of a dose of WR242511 in dogs was governed by this relationship: d[MetHb]/d(t) = kr.Cm.[Hb]-kh.[MetHb], where kr is 2.9 x 10(-5) ml.ng-1.hr-1 and kh is 0.0418 hr-1. This model was validated with multiple-dose data. The model is simple and compatible with the physiological behavior of MetHb in vivo under single-dose and multiple-dose conditions of WR242511 administration.

Absorption↗

Methylprednisolone pharmacokinetics and pharmacodynamics in chronic renal failure.

Methylprednisolone (MP) pharmacokinetics and its directly suppressive effects on cortisol secretion and cell trafficking were compared in 6 chronic renal failure (CRF) subjects and 6 healthy controls. After IV administration of MP 0.6 mg/kg as Solu-Medrol, the pharmacokinetics of methylprednisolone were similar. The clearance was about 280 ml/hr/kg, volume of distribution was 1.1 l/kg, t1/2 was 2.7 hr, and fraction unbound was 0.2. Physiologic pharmacodynamics models were applied for the suppression of cortisol secretion and recirculation of basophils, T-helper cells, and T-suppressor cells. The net response (area under the curve) and inhibitory concentrations (IC50) of methylprednisolone for each pharmacodynamic parameter were similar in both groups. As the pharmacokinetics of other corticosteroids are altered in CRF, the lack of pharmacokinetic/dynamic changes of methylprednisolone may offer a therapeutic advantage for CRF patients.

Adult↗

Fifteen years of operation of a high-performance liquid chromatographic assay for prednisolone, cortisol and prednisone in plasma.

A high-performance liquid chromatographic (HPLC) assay first described in 1979 has been modified and revalidated for the simultaneous determination of prednisone, cortisol and prednisolone in human plasma using betamethasone as an internal standard. Revisions include: mobile phase composition; use of a precolumn, automated injector, integrator, and computer software; improved sensitivity and quantitation; thorough investigation of stability, variation, and specimen type; and inclusion of suggested quality control criteria. Plasma-based drug standards are extracted with methylene chloride and washed with sodium hydroxide followed by a water wash. After evaporation of solvent and reconstitution with mobile phase, the extracts are then injected onto a silica gel column (Zorbax SIL) for chromatography with UV absorbance at 254 nm. Calculated limits of quantitation are 10 ng/ml and limits of detection are less than 5 ng/ml. Intra- and inter-day coefficients of variation for quality control samples for all three corticosteroids are less than 11.2%. Recovery and stability data are also provided. Several drugs that may be coadministered do not interfere with the analysis.

Chromatography, High Pressure Liquid↗

Bioavailability and reversible metabolism of prednisone and prednisolone in man.

The pharmacokinetics of prednisone and prednisolone was examined in 12 healthy male subjects to assess the bioavailability and the parameters of reversible metabolism between the two steroids. After an oral prednisone dose of 0.8 mg kg-1 and an intravenous prednisolone dose of 0.66 mg kg-1, the bioavailability was found to be about 62%. The fraction of the dose recovered in the urine as the hydroxylated metabolites of prednisone and prednisolone was lower after the oral prednisone dose, suggesting that poor absorption of prednisone was the main cause of the low bioavailability. There was a high degree of interconversion between prednisone and prednisolone with 76% of the dose being recycled. The formation clearance of prednisolone from prednisone is much greater than the formation clearance of prednisone from prednisolone or the irreversible elimination clearances of the two steroids. The possible dose dependences of bioavailability and interconversion may be important factors in prednisolone therapy.

Administration, Oral↗

An algorithm and computer program for calculating the mean transit time and distribution rate parameters of generated metabolites undergoing linear tissue distribution and linear or non-linear central elimination.

A method is described for calculating the mean transit time and distribution rate parameters of a generated primary metabolite undergoing linear distribution and linear or non-linear central elimination, and of catenary metabolites with any precursor order. It is also applicable to a drug and its interconversion metabolite and does not require separate administration of the metabolite. The method allows steady-state volume of distribution and distribution clearance of a metabolite to be calculated, provided that the central volume of distribution of the metabolite is known. An algorithm and computer program to implement the proposed method are presented. The calculations require the plasma concentration versus time curves of the metabolite and its precursor. The method is applied to both published and simulated data.

Algorithms↗

Effects of indomethacin on the pharmacokinetics and pharmacodynamics of prednisolone in rats.

The effect of indomethacin on the disposition of prednisolone and the induction of tyrosine aminotransferase (TAT) was examined in male Sprague-Dawley rats. Rats were pretreated with either indomethacin (5 mg/kg, intraperitoneally) or phosphate buffered saline (control) twice daily for 6 days followed by a single dose of prednisolone. Blood samples were collected after prednisolone administration. In separate animals, hepatic TAT activity (pharmacologic effect) was measured 4 h after the prednisolone dose. In addition, the effect of indomethacin on the in vitro protein binding of prednisolone was examined in pooled rat and human plasma. The clearance and apparent volume of distribution of prednisolone in the control and indomethacin-treated animals were similar, averaging 4.71 versus 4.05 L/h/kg and 1.37 versus 1.33 L/kg, respectively. The elimination half-life was 0.48 h in both groups. Indomethacin also did not affect the protein binding of prednisolone in rat or human plasma. However, indomethacin pretreatment increased the hepatic TAT activity induced by prednisolone. These studies indicate that indomethacin may affect the pharmacological effects of prednisolone without influencing its pharmacokinetics.

Animals↗

Pharmacodynamic model for joint exogenous and endogenous corticosteroid suppression of lymphocyte trafficking.

The circadian pattern of the immune system correlates with that of circulating T-helper cells and inversely with cortisol concentrations. Corticosteroids, both endogenous and exogenous, cause lymphocyte dimunition in blood by retention of cells in the lymphatic circulation. A physiologic pharmacodynamic model was developed to describe changes in circulating lymphocytes as a function of both endogenous cortisol and methylprednisolone concentrations. The model was applied to T-helper and T-suppressor cell data collected from six asthmatic men during baseline, after single-dose, and after 6 days of 20 mg daily methylprednisolone. The model described all phases of the study well. Baseline circadian rhythm of lymphocytes was related to cortisol concentrations. Multiple-dosing of methylprednisolone caused apparent tolerance and decreased the sensitivity of lymphocytes to corticosteroids by 116% and markedly reduced endogenous cortisol concentrations. A 60% increase in circulating T-helper cells was observed which could be accounted for by dual changes in receptor sensitivity and endogenous cortisol.

Adrenal Cortex Hormones↗