1
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Giacoppo D, Saucedo J, Scheller B. Coronary Drug-Coated Balloons for De Novo and In-Stent Restenosis Indications. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2023; 2:100625. [PMID: 39130710 PMCID: PMC11308150 DOI: 10.1016/j.jscai.2023.100625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 08/13/2024]
Abstract
Drug-coated balloons are approved outside the United States, not only for the treatment of peripheral arteries but also for coronary arteries. This review describes the technological basics, the scenarios of clinical application, and the current available data from clinical trials for the different coronary indications.
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Affiliation(s)
- Daniele Giacoppo
- Cardiology Department, Alto Vicentino Hospital, Santorso, Italy
- Cardiovascular Research Institute, Mater Private Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland
- ISAResearch Center, Deutsches Herzzentrum München, Technisches Universität München, Munich, Germany
| | - Jorge Saucedo
- Cardiology Department, Froedtert Hospital, Medical College of Wisconsin, Milwaukee, Illinois
| | - Bruno Scheller
- Clinical and Experimental Interventional Cardiology, University of Saarland, Homburg/Saar, Germany
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2
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Shazly T, Torres WM, Secemsky EA, Chitalia VC, Jaffer FA, Kolachalama VB. Understudied factors in drug-coated balloon design and evaluation: A biophysical perspective. Bioeng Transl Med 2023; 8:e10370. [PMID: 36684110 PMCID: PMC9842065 DOI: 10.1002/btm2.10370] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/28/2022] [Accepted: 06/12/2022] [Indexed: 01/25/2023] Open
Abstract
Drug-coated balloon (DCB) percutaneous interventional therapy allows for durable reopening of the narrowed lumen via physical tissue expansion and local anti-restenosis drug delivery, providing an alternative to traditional uncoated balloons or a permanent indwelling implant such as a conventional metallic drug-eluting stent. While DCB-based treatment of peripheral arterial disease (PAD) has been incorporated into clinical guidelines, DCB use has been recently curtailed due to reports that showed evidence of increased mortality risk in patients treated with paclitaxel (PTX)-coated balloons. Given the United States Food and Drug Administration's 2019 consequent warning regarding PTX-eluting DCBs and the subsequent marked reduction in clinical DCB use, there is now a critical need to better understand the compositional and mechanical factors underlying DCB efficacy and safety. Most work to date on DCB refinement has focused on designing both the enabling balloon catheter and alternate coatings composed of various drugs and excipients, followed by device evaluation in preclinical and clinical studies. We contend that improvement in DCB performance will require a better understanding of the biophysical factors operative during and following balloon deployment, and moreover that the elaboration and demonstrated control of these factors are needed to address current concerns with DCB use. This article provides a perspective on the biophysical interactions that govern DCB performance and offers new design strategies for the development of next-generation DCB devices.
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Affiliation(s)
- Tarek Shazly
- College of Engineering & Computing University of South Carolina Columbia South Carolina USA
| | - William M Torres
- College of Engineering & Computing University of South Carolina Columbia South Carolina USA
- Exponent Inc. Philadelphia Pennsylvania USA
| | - Eric A Secemsky
- Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center Boston Massachusetts USA
| | - Vipul C Chitalia
- Department of Medicine, Boston University School of Medicine Boston Veterans Affairs Healthcare System Boston Massachusetts USA
| | - Farouc A Jaffer
- Cardiovascular Research Center and Cardiology Division Massachusetts General Hospital Boston Massachusetts USA
| | - Vijaya B Kolachalama
- Department of Medicine, Boston University School of Medicine; Department of Computer Science and Faculty of Computing & Data Sciences Boston University Boston Massachusetts USA
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3
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Abbasnezhad N, Zirak N, Champmartin S, Shirinbayan M, Bakir F. An Overview of In Vitro Drug Release Methods for Drug-Eluting Stents. Polymers (Basel) 2022; 14:2751. [PMID: 35808798 PMCID: PMC9269075 DOI: 10.3390/polym14132751] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 01/08/2023] Open
Abstract
The drug release profile of drug-eluting stents (DESs) is affected by a number of factors, including the formulation, design, and physicochemical properties of the utilized material. DES has been around for twenty years and despite its widespread clinical use, and efficacy in lowering the rate of target lesion restenosis, it still requires additional development to reduce side effects and provide long-term clinical stability. Unfortunately, for analyzing these implants, there is still no globally accepted in vitro test method. This is owing to the stent's complexity as well as the dynamic arterial compartments of the blood and vascular wall. The former is the source of numerous biological, chemical, and physical mechanisms that are more commonly observed in tissue, lumen, and DES. As a result, universalizing bio-relevant apparatus, suitable for liberation testing of such complex implants is difficult. This article aims to provide a comprehensive review of the methods used for in vitro release testing of DESs. Aspects related to the correlation of the release profiles in the cases of in vitro and in vivo are also addressed.
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Affiliation(s)
- Navideh Abbasnezhad
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
- Arts et Métiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013 Paris, France;
| | - Nader Zirak
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
- Arts et Métiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013 Paris, France;
| | - Stéphane Champmartin
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
| | - Mohammadali Shirinbayan
- Arts et Métiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013 Paris, France;
| | - Farid Bakir
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
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4
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Raza F, Zafar H, Khan MW, Ullah A, Khan AU, Baseer A, Fareed R, Sohail M. Recent advances in the targeted delivery of paclitaxel nanomedicine for cancer therapy. MATERIALS ADVANCES 2022; 3:2268-2290. [DOI: 10.1039/d1ma00961c] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cancer cases have reached an all-time high in the current era.
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Affiliation(s)
- Faisal Raza
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, P. R. China
| | - Hajra Zafar
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, P. R. China
| | | | - Aftab Ullah
- Department of Pharmacy, Shantou University Medical College, Shantou, 515041, P. R. China
| | | | - Abdul Baseer
- Department of Pharmacy, Abasyn University, Peshawar, Pakistan
| | - Rameesha Fareed
- Riphah Institute of Pharmaceutical Sciences, Riphah International University Islamabad, Pakistan
| | - Muhammad Sohail
- School of Pharmacy, Yantai University, Shandong, 264005, China
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5
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Nazarkina ZK, Chelobanov BP, Kuznetsov KA, Shutov AV, Romanova IV, Karpenko AA, Laktionov PP. Influence of Elongation of Paclitaxel-Eluting Electrospun-Produced Stent Coating on Paclitaxel Release and Transport through the Arterial Wall after Stenting. Polymers (Basel) 2021; 13:1165. [PMID: 33916436 PMCID: PMC8038586 DOI: 10.3390/polym13071165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 12/30/2022] Open
Abstract
It was previously shown that polycaprolactone (PCL)-based electrospun-produced paclitaxel (PTX)-enriched matrices exhibit long-term drug release kinetics and can be used as coatings for drug-eluting stents (DES). The installation of vascular stents involves a twofold increase in stent diameter and, therefore, an elongation of the matrices covering the stents, as well as the arterial wall in a stented area. We studied the influence of matrix elongation on its structure and PTX release using three different electrospun-produced matrices. The data obtained demonstrate that matrix elongation during stent installation does not lead to fiber breaks and does not interfere with the kinetics of PTX release. To study PTX diffusion through the expanded artery wall, stents coated with 5%PCL/10%HSA/3%DMSO/PTX and containing tritium-labeled PTX were installed into the freshly obtained iliac artery of a rabbit. The PTX passing through the artery wall was quantified using a scintillator β-counter. The artery retained the PTX and decreased its release from the coating. The retention of PTX by the arterial wall was more efficient when incubated in blood plasma in comparison with PBS. The retention/accumulation of PTX by the arterial wall provides a prolonged drug release and allows for the reduction in the dose of the drugs in electrospun-produced stent coatings.
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Affiliation(s)
- Zhanna K. Nazarkina
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, 630090 Novosibirsk, Russia; (B.P.C.); (K.A.K.); (I.V.R.); (P.P.L.)
| | - Boris P. Chelobanov
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, 630090 Novosibirsk, Russia; (B.P.C.); (K.A.K.); (I.V.R.); (P.P.L.)
| | - Konstantin A. Kuznetsov
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, 630090 Novosibirsk, Russia; (B.P.C.); (K.A.K.); (I.V.R.); (P.P.L.)
| | - Alexey V. Shutov
- Lavrentyev Institute of Hydrodynamics, Siberian Branch, Russian Academy of Sciences, 630090 Novosibirsk, Russia;
| | - Irina V. Romanova
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, 630090 Novosibirsk, Russia; (B.P.C.); (K.A.K.); (I.V.R.); (P.P.L.)
| | - Andrey A. Karpenko
- Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 630055 Novosibirsk, Russia;
| | - Pavel P. Laktionov
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, 630090 Novosibirsk, Russia; (B.P.C.); (K.A.K.); (I.V.R.); (P.P.L.)
- Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 630055 Novosibirsk, Russia;
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6
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Taking paclitaxel coated balloons to a higher level: Predicting coating dissolution kinetics, tissue retention and dosing dynamics. J Control Release 2019; 310:94-102. [PMID: 31430500 DOI: 10.1016/j.jconrel.2019.08.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/16/2019] [Indexed: 11/20/2022]
Abstract
Paclitaxel coated balloons (PCBs) are a promising non-implantable alternative to drug-eluting stents, whereby drug is delivered to the arterial wall in solid form as a semi-continuous solid coating or as micro drug depots. To date, it has been impossible to predict or even infer local tissue dosing levels and persistence, making it difficult to compare in vivo performance of different devices in healthy animals or to extrapolate such data to diseased human arteries. Here we derive and analyze a coupled reaction diffusion model that accounts for coating dissolution and tissue distribution, and predicts the concentration of dissolved drug in the tissue during and post dissolution. Time scale analysis and numerical simulations based on estimated diffusion coefficients in healthy animal and diseased human arteries both imply that dissolution of crystalline paclitaxel coating is mass transfer coefficient-limited, and can therefore be solved for independently of the tissue transport equations. Specifically, coating retention is predicted to follow piecewise linear kinetics, reflecting the differential and faster dissolution of lumenal versus tissue-embedded coating owing to a disparity in convective forces. This prediction is consistent with published data on a range of PCBs and allowed for the estimation of the associated dissolution rate-constants and the maximal soluble drug concentration in the tissue during coating dissolution. Maximal soluble drug concentration in the tissue scales as the product of the solubility and ratio of the dissolution and diffusion rate-constants. Thus, coatings characterized by micromolar solubilities give rise to nanomolar soluble concentrations in healthy animal arteries and ~0.1 micromolar in calcified atherosclerotic arteries owing to slower tissue diffusion. During dissolution, retention in porcine iliofemoral arteries is predicted to be dominated by solid coating, whereas post dissolution it is dominated by receptor-bound drug (3.7 ng receptors/g tissue). Paclitaxel coating dissolution and dosing kinetics can now be modeled based upon accepted principles of surface dissolution and tissue transport to provide insights into the dependence of clinical efficacy on device properties and the interplay of lesion complexity and procedural parameters.
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7
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Homma R, Shinozuka M, Shimazaki N, Ogawa E, Arai T. Heat Enhances <i>Ex Vivo</i> Paclitaxel Delivery to Porcine Carotid Artery Wall. ADVANCED BIOMEDICAL ENGINEERING 2019. [DOI: 10.14326/abe.8.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Rie Homma
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
| | - Machiko Shinozuka
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
| | | | - Emiyu Ogawa
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
| | - Tsunenori Arai
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University
- Department of Applied Physics and Physico-Informatics, Faculty of Science and Technology, Keio University
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8
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Flow-Mediated Drug Transport from Drug-Eluting Stents is Negligible: Numerical and In-vitro Investigations. Ann Biomed Eng 2018; 47:878-890. [PMID: 30552528 DOI: 10.1007/s10439-018-02176-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 11/27/2018] [Indexed: 12/21/2022]
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9
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Vauquelin G. Link between a high k on for drug binding and a fast clinical action: to be or not to be? MEDCHEMCOMM 2018; 9:1426-1438. [PMID: 30288218 PMCID: PMC6151451 DOI: 10.1039/c8md00296g] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/15/2018] [Indexed: 01/21/2023]
Abstract
Review articles on binding kinetics essentially focus on drugs that dissociate slowly from their target since this is required for the successful treatment of many pathophysiological conditions. Recently, the therapeutic benefit of a high k on (i.e. the second order association rate constant) has also been linked to fast association and to a fast clinical action. Other studies, however, called this assertion into question since additional factors, like the dosing paradigm and the binding mechanism, are important as well. The still ongoing reticence about integrating binding kinetics in lead optimization programs motivated us to critically review the link between the drug's kinetic rate constants and their in vitro and in vivo target occupancy profile, with special focus on k on. The presented simulations tally with a positive link between a drug's effective/observed association rate (which is quite easy to determine in vitro) and the swiftness of its clinical action. On the other hand, the simulations show that the k on-concept should not be confounded with the effective association process since increasing this parameter only enhances the drug's in vitro and in vivo association under certain conditions: the binding mechanism should be suitable, rebinding (and thus the factors within the target's micro-environment that favour this mechanism) should not be too prominent and the dosage should not be kept in par with the drug's affinity. Otherwise, increasing k on could be ineffective or even be counter-productive.
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Affiliation(s)
- Georges Vauquelin
- Department of Molecular and Biochemical Pharmacology , Vrije Universiteit Brussel , Pleinlaan 2 , B-1050 Brussels , Belgium .
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10
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Plch J, Venclikova K, Janouskova O, Hrabeta J, Eckschlager T, Kopeckova K, Hampejsova Z, Bosakova Z, Sirc J, Hobzova R. Paclitaxel-Loaded Polylactide/Polyethylene Glycol Fibers with Long-Term Antitumor Activity as a Potential Drug Carrier for Local Chemotherapy. Macromol Biosci 2018; 18:e1800011. [DOI: 10.1002/mabi.201800011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/01/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Johana Plch
- Department of Pediatric Hematology and Oncology; 2nd Medical Faculty; Charles University and Motol University Hospital; V uvalu 84 150 06 Prague 5 Czech Republic
| | - Kristyna Venclikova
- Institute of Macromolecular Chemistry; Academy of Sciences; Heyrovsky Sq. 2 162 06 Prague 6 Czech Republic
| | - Olga Janouskova
- Institute of Macromolecular Chemistry; Academy of Sciences; Heyrovsky Sq. 2 162 06 Prague 6 Czech Republic
| | - Jan Hrabeta
- Department of Pediatric Hematology and Oncology; 2nd Medical Faculty; Charles University and Motol University Hospital; V uvalu 84 150 06 Prague 5 Czech Republic
| | - Tomas Eckschlager
- Department of Pediatric Hematology and Oncology; 2nd Medical Faculty; Charles University and Motol University Hospital; V uvalu 84 150 06 Prague 5 Czech Republic
| | - Katerina Kopeckova
- Department of Oncology; 2nd Medical Faculty; Charles University and Motol University Hospital; V uvalu 84 150 06 Prague 5 Czech Republic
| | - Zuzana Hampejsova
- Department of Analytical Chemistry; Faculty of Science; Charles University; Hlavova 8 128 43 Prague 2 Czech Republic
| | - Zuzana Bosakova
- Department of Analytical Chemistry; Faculty of Science; Charles University; Hlavova 8 128 43 Prague 2 Czech Republic
| | - Jakub Sirc
- Institute of Macromolecular Chemistry; Academy of Sciences; Heyrovsky Sq. 2 162 06 Prague 6 Czech Republic
| | - Radka Hobzova
- Institute of Macromolecular Chemistry; Academy of Sciences; Heyrovsky Sq. 2 162 06 Prague 6 Czech Republic
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11
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Tzafriri AR, Garcia-Polite F, Zani B, Stanley J, Muraj B, Knutson J, Kohler R, Markham P, Nikanorov A, Edelman ER. Calcified plaque modification alters local drug delivery in the treatment of peripheral atherosclerosis. J Control Release 2017; 264:203-210. [PMID: 28867375 DOI: 10.1016/j.jconrel.2017.08.037] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/07/2017] [Accepted: 08/29/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Calcific atherosclerosis is a major challenge to intraluminal drug delivery in peripheral artery disease (PAD). OBJECTIVES We evaluated the effects of orbital atherectomy on intraluminal paclitaxel delivery to human peripheral arteries with substantial calcified plaque. METHODS Diagnostic angiography and 3-D rotational imaging of five fresh human lower limbs revealed calcification in all main arteries. The proximal or distal segment of each artery was treated using an orbital atherectomy system (OAS) under simulated blood flow and fluoroscopy. Explanted arterial segments underwent either histomorphometric assessment of effect or tracking of 14C-labeled or fluorescent-labeled paclitaxel. Radiolabeled drug quantified bulk delivery and fluorescent label established penetration of drug over finer spatial domain in serial microscopic sections. Results were interpreted using a mathematical model of binding-diffusion mediated arterial drug distribution. RESULTS Lesion composition affected paclitaxel absorption and distribution in cadaveric human peripheral arteries. Pretreatment imaging calcium scores in control femoropopliteal arterial segments correlated with a log-linear decline in the bulk absorption rate-constant of 14C-labeled, declining 5.5-fold per calcified quadrant (p=0.05, n=7). Compared to controls, OAS-treated femoropopliteal segments exhibited 180μm thinner intima (p<0.001), 45% less plaque calcification, and 2 log orders higher paclitaxel bulk absorption rate-constants. Correspondingly, fluorescent paclitaxel penetrated deeper in OAS-treated femoropopliteal segments compared to controls, due to a 70% increase in diffusivity (p<0.001). CONCLUSIONS These data illustrate that calcified plaque limited intravascular drug delivery, and controlled OAS treatment of calcific plaques resulted in greater drug permeability and improved adjunct drug delivery to diseased arteries.
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Affiliation(s)
- Abraham R Tzafriri
- CBSET Inc., 500 Shire Way, Lexington, MA, USA; IMES, MIT, 77 Massachusetts Avenue, Cambridge, MA, USA.
| | - Fernando Garcia-Polite
- CBSET Inc., 500 Shire Way, Lexington, MA, USA; IMES, MIT, 77 Massachusetts Avenue, Cambridge, MA, USA
| | - Brett Zani
- CBSET Inc., 500 Shire Way, Lexington, MA, USA
| | | | - Benny Muraj
- CBSET Inc., 500 Shire Way, Lexington, MA, USA
| | - Jennifer Knutson
- CBSET Inc., 500 Shire Way, Lexington, MA, USA; Cardiovascular Systems, Inc., 1225 Old Hwy 8NW, Saint Paul, MN, USA
| | - Robert Kohler
- Cardiovascular Systems, Inc., 1225 Old Hwy 8NW, Saint Paul, MN, USA
| | | | | | - Elazer R Edelman
- IMES, MIT, 77 Massachusetts Avenue, Cambridge, MA, USA; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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12
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Alfonso F, Scheller B. State of the art: balloon catheter technologies – drug-coated balloon. EUROINTERVENTION 2017; 13:680-695. [DOI: 10.4244/eij-d-17-00494] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Louage B, De Wever O, Hennink WE, De Geest BG. Developments and future clinical outlook of taxane nanomedicines. J Control Release 2017; 253:137-152. [DOI: 10.1016/j.jconrel.2017.03.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/14/2017] [Accepted: 03/16/2017] [Indexed: 02/09/2023]
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14
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Vauquelin G. Cell membranes… and how long drugs may exert beneficial pharmacological activity in vivo. Br J Clin Pharmacol 2016; 82:673-82. [PMID: 27135195 PMCID: PMC5338106 DOI: 10.1111/bcp.12996] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/28/2016] [Accepted: 04/28/2016] [Indexed: 12/14/2022] Open
Abstract
The time course of the beneficial pharmacological effect of a drug has long been considered to depend merely on the temporal fluctuation of its free concentration. Only in the last decade has it become widely accepted that target-binding kinetics can also affect in vivo pharmacological activity. Although current reviews still essentially focus on genuine dissociation rates, evidence is accumulating that additional micro-pharmacokinetic (PK) and -pharmacodynamic (PD) mechanisms, in which the cell membrane plays a central role, may also increase the residence time of a drug on its target. The present review provides a compilation of otherwise widely dispersed information on this topic. The cell membrane can intervene in drug binding via the following three major mechanisms: (i) by acting as a sink/repository for the drug; (ii) by modulating the conformation of the drug and even by participating in the binding process; and (iii) by facilitating the approach (and rebinding) of the drug to the target. To highlight these mechanisms, we focus on drugs that are currently used in clinical therapy, such as the antihypertensive angiotensin II type 1 receptor antagonist candesartan, the atypical antipsychotic agent clozapine and the bronchodilator salmeterol. Although the role of cell membranes in PK-PD modelling is gaining increasing interest, many issues remain unresolved. It is likely that novel biophysical and computational approaches will provide improved insights in the near future.
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Affiliation(s)
- Georges Vauquelin
- Department Molecular and Biochemical PharmacologyVrije Universiteit BrusselBrusselsBelgium
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15
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Computational Model of Drug-Coated Balloon Delivery in a Patient-Specific Arterial Vessel with Heterogeneous Tissue Composition. Cardiovasc Eng Technol 2016; 7:406-419. [PMID: 27443840 DOI: 10.1007/s13239-016-0273-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 07/06/2016] [Indexed: 01/23/2023]
Abstract
Balloon angioplasty followed by local delivery of antiproliferative drugs to target tissue is increasingly being considered for the treatment of obstructive arterial disease, and yet there is much to appreciate regarding pharmacokinetics in arteries of non-uniform disease. We developed a computational model capable of simulating drug-coated balloon delivery to arteries of heterogeneous tissue composition comprising healthy tissue, as well as regions of fibrous, fibro-fatty, calcified and necrotic core lesions. Image processing using an unsupervised clustering technique was used to reconstruct an arterial geometry from a single, patient-specific color image obtained from intravascular ultrasound-derived virtual histology. Transport of free drug was modeled using a time-dependent reaction-diffusion model and the bound, immobilized drug using the time-dependent reaction equation. The governing equations representing the transport of free as well as bound drug along with a set of initial settings and boundary conditions were solved numerically using an explicit finite difference scheme that satisfied the Courant-Friedrichs-Lewy stability criterion. Our results support previous findings related to the transport and binding of drug in arteries where tissue retention is strongly dependent on local pharmacologic properties. Additionally, modeling results indicate that non-uniform disease composition leads to heterogeneous arterial drug distribution patterns, although further validation using animal studies is required to fully appreciate pharmacokinetics in disease-laden arteries.
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16
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Brahmbhatt A, Misra S. Techniques in Vascular and Interventional Radiology Drug Delivery Technologies in the Superficial Femoral Artery. Tech Vasc Interv Radiol 2016; 19:145-52. [PMID: 27423996 DOI: 10.1053/j.tvir.2016.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Peripheral arterial disease (PAD) affects over 8 million people in the United States alone. Although great strides have been made in reducing the burden of cardiovascular disease the prevalence of PAD is expected to rise with the age of global population. PAD characterized by narrowing of arterial blood can be asymptomatic or cause limb threatening claudication. It has been classically treated with bypass, but these techniques have been supplanted by endovascular therapy. Plain old balloon angioplasty has been successful in helping revascularize lesions, but its effect has not been durable because of restenosis. This prompted the creation of several technologies aimed at reducing restenosis. These advances slowly improved outcomes and the durability of endovascular management. Among the main tools used in current endovascular practice are drug-delivery devices aimed at inhibiting the inflammatory and proliferative pathways that lead to restenosis. This article examines the current drug-delivery technologies used in the superficial femoral artery.
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Affiliation(s)
- Akshaar Brahmbhatt
- Vascular and Interventional Radiology Translational Laboratory, Department of Radiology Mayo Clinic, Rochester, MN; Department of Radiology, Mayo Clinic, Rochester, MN; Rutgers-New Jersey Medical School, Newark, NJ
| | - Sanjay Misra
- Vascular and Interventional Radiology Translational Laboratory, Department of Radiology Mayo Clinic, Rochester, MN; Department of Radiology, Mayo Clinic, Rochester, MN.
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Efficacy and Safety of Paclitaxel-Coated Balloon for the Treatment of In-Stent Restenosis in High-Risk Patients. Am J Cardiol 2015; 116:1690-4. [PMID: 26428021 DOI: 10.1016/j.amjcard.2015.08.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/29/2015] [Accepted: 08/29/2015] [Indexed: 11/21/2022]
Abstract
In-stent restenosis (ISR) is a major cause of failure of percutaneous coronary intervention. The efficacy and safety of drug-coated balloon (DCB) in patients with high-risk clinical features are largely unknown. We enrolled 82 consecutive patients at high risk of bleeding with angiographically significant (diameter stenosis ≥ 50%) ISR of bare metal stent (BMS) or drug-eluting stent (DES), treated with paclitaxel-coated balloon. All patients presented at least one of the following criteria: high bleeding risk, neoplasm, chronic inflammatory disease, and need for noncardiac surgery. Dual antiplatelet therapy was indicated for 4 weeks after the procedure. At angiographic follow-up, overall late lumen loss was 0.24 ± 0.32 mm, with no significant difference between BMS-ISR and DES-ISR (0.25 ± 0.35 vs 0.22 ± 0.30 mm, p = 0.714). The Kaplan-Meier estimate for major adverse clinical events-free survival at 3 years was 81.4% (82.3% in BMS-ISR vs 79.4% in DES-ISR, log-rank p = 0.866). No stent thrombosis has been recorded. In conclusion, the use of paclitaxel-coated balloon seems to be associated with favorable outcomes after percutaneous coronary intervention for BMS-ISR or DES-ISR in patients with high-risk clinical features and could be considered as a reasonable option in the presence of systemic co-morbidities and contraindications to long-term dual antiplatelet therapy.
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18
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Experimental and computational study of mechanical and transport properties of a polymer coating for drug-eluting stents. Ther Deliv 2015; 6:1255-68. [DOI: 10.4155/tde.15.74] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background: Experimental and computational characterizations in the preclinical development of biomedical devices are complementary and can significantly help in a thorough analysis of the performances before clinical evaluation. Methodology: Here mechanical and drug delivery properties of a polymer platform, ad hoc prepared to obtain coatings for drug-eluting stents, is reported; polymer formulation and starting drug loading were varied to study the behavior of the platform; a finite element model was constructed starting from experimental data. Results: Different platform formulations affected mechanical and drug transport properties; these properties can be fine tuned by varying the starting platform formulation. Finite element analysis allowed visualizing drug distribution maps over time in biological tissues for different commercial stents and polymer platform formulations.
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19
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Vijayaratnam PRS, O’Brien CC, Reizes JA, Barber TJ, Edelman ER. The Impact of Blood Rheology on Drug Transport in Stented Arteries: Steady Simulations. PLoS One 2015; 10:e0128178. [PMID: 26066041 PMCID: PMC4466567 DOI: 10.1371/journal.pone.0128178] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 04/24/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND METHODS It is important to ensure that blood flow is modelled accurately in numerical studies of arteries featuring drug-eluting stents due to the significant proportion of drug transport from the stent into the arterial wall which is flow-mediated. Modelling blood is complicated, however, by variations in blood rheological behaviour between individuals, blood's complex near-wall behaviour, and the large number of rheological models which have been proposed. In this study, a series of steady-state computational fluid dynamics analyses were performed in which the traditional Newtonian model was compared against a range of non-Newtonian models. The impact of these rheological models was elucidated through comparisons of haemodynamic flow details and drug transport behaviour at various blood flow rates. RESULTS Recirculation lengths were found to reduce by as much as 24% with the inclusion of a non-Newtonian rheological model. Another model possessing the viscosity and density of blood plasma was also implemented to account for near-wall red blood cell losses and yielded recirculation length increases of up to 59%. However, the deviation from the average drug concentration in the tissue obtained with the Newtonian model was observed to be less than 5% in all cases except one. Despite the small sensitivity to the effects of viscosity variations, the spatial distribution of drug matter in the tissue was found to be significantly affected by rheological model selection. CONCLUSIONS/SIGNIFICANCE These results may be used to guide blood rheological model selection in future numerical studies. The clinical significance of these results is that they convey that the magnitude of drug uptake in stent-based drug delivery is relatively insensitive to individual variations in blood rheology. Furthermore, the finding that flow separation regions formed downstream of the stent struts diminish drug uptake may be of interest to device designers.
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Affiliation(s)
- Pujith R. S. Vijayaratnam
- School of Mechanical and Manufacturing Engineering, the University of New South Wales, Sydney, New South Wales, Australia
| | - Caroline C. O’Brien
- Harvard-MIT Biomedical Engineering Center, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - John A. Reizes
- School of Mechanical and Manufacturing Engineering, the University of New South Wales, Sydney, New South Wales, Australia
| | - Tracie J. Barber
- School of Mechanical and Manufacturing Engineering, the University of New South Wales, Sydney, New South Wales, Australia
| | - Elazer R. Edelman
- Harvard-MIT Biomedical Engineering Center, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
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20
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Liourdi D, Kallidonis P, Kyriazis I, Tsamandas A, Karnabatidis D, Kitrou P, Spyroulias GA, Kostopoulou ON, Marousis K, Kalpaxis DL, Goumenos DS, Liatsikos E. Evaluation of the Distribution of Paclitaxel by Immunohistochemistry and Nuclear Magnetic Resonance Spectroscopy After the Application of a Drug-Eluting Balloon in the Porcine Ureter. J Endourol 2015; 29:580-9. [DOI: 10.1089/end.2014.0683] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Despoina Liourdi
- Department of Internal Medicine, General Hospital of Aeghio, Aeghio, Greece
| | | | - Iason Kyriazis
- Department of Urology, University of Patras, Patras, Greece
| | | | | | | | | | | | - Kostas Marousis
- Department of Biochemistry, University of Patras, Patras, Greece
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21
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Kolandaivelu K, O'Brien CC, Shazly T, Edelman ER, Kolachalama VB. Enhancing physiologic simulations using supervised learning on coarse mesh solutions. J R Soc Interface 2015; 12:20141073. [PMID: 25652458 PMCID: PMC4345474 DOI: 10.1098/rsif.2014.1073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/15/2015] [Indexed: 11/29/2022] Open
Abstract
Computational modelling of physical and biochemical processes has emerged as a means of evaluating medical devices, offering new insights that explain current performance, inform future designs and even enable personalized use. Yet resource limitations force one to compromise with reduced order computational models and idealized assumptions that yield either qualitative descriptions or approximate, quantitative solutions to problems of interest. Considering endovascular drug delivery as an exemplary scenario, we used a supervised machine learning framework to process data generated from low fidelity coarse meshes and predict high fidelity solutions on refined mesh configurations. We considered two models simulating drug delivery to the arterial wall: (i) two-dimensional drug-coated balloons and (ii) three-dimensional drug-eluting stents. Simulations were performed on computational mesh configurations of increasing density. Supervised learners based on Gaussian process modelling were constructed from combinations of coarse mesh setting solutions of drug concentrations and nearest neighbourhood distance information as inputs, and higher fidelity mesh solutions as outputs. These learners were then used as computationally inexpensive surrogates to extend predictions using low fidelity information to higher levels of mesh refinement. The cross-validated, supervised learner-based predictions improved fidelity as compared with computational simulations performed at coarse level meshes--a result consistent across all outputs and computational models considered. Supervised learning on coarse mesh solutions can augment traditional physics-based modelling of complex physiologic phenomena. By obtaining efficient solutions at a fraction of the computational cost, this framework has the potential to transform how modelling approaches can be applied in the evaluation of medical technologies and their real-time administration in an increasingly personalized fashion.
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Affiliation(s)
- Kumaran Kolandaivelu
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Caroline C O'Brien
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Tarek Shazly
- College of Engineering and Computing, University of South Carolina, Columbia, SC 29208, USA
| | - Elazer R Edelman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Vijaya B Kolachalama
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA Charles Stark Draper Laboratory, 555 Technology Square, Cambridge, MA 02139, USA
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22
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Ng VG, Mena C, Pietras C, Lansky AJ. Local delivery of paclitaxel in the treatment of peripheral arterial disease. Eur J Clin Invest 2015; 45:333-45. [PMID: 25615282 DOI: 10.1111/eci.12407] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/19/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite advancements from balloon angioplasty to drug-eluting stents, primary patency rates after endovascular revascularization of peripheral artery disease have remained inferior compared to surgery. Endovascular revascularization has been limited by restenosis and mechanical stent failure. Thus, there is increased research into other nonstent-based local drug delivery modalities, which can provide an active drug to inhibit restenosis focally and avoid the risk of systemic adverse effects. METHODS This review will summarize the unique properties of paclitaxel and studies on paclitaxel local delivery for the treatment of peripheral artery disease. A MEDLINE search for relevant peer-reviewed scientific literature published in English was conducted. Search terms included but were not limited to paclitaxel pharmacodynamics, paclitaxel local drug delivery, and drug eluting balloons, with a focus on the use of paclitaxel in the context of coronary and peripheral vascular disease. RESULTS The primary search produced 182 results of which 51 papers were relevant. Of the 51 relevant papers, 27 were original research papers and 24 were either review papers, commentary or opinion papers. CONCLUSIONS Paclitaxel has several chemical properties, which make it ideal for local drug delivery including its hydrophobicity, ability to concentrate into the arterial intima layer and prolonged effect on cells even after brief exposure periods. Local delivery of paclitaxel via injection catheters, balloon catheters and coated balloons has shown encouraging results in terms of efficacy and safety in small-scale animal and clinical studies. Additional preclinical and clinical studies are needed to determine the long-term efficacy and safety of these treatments in humans.
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Affiliation(s)
- Vivian G Ng
- Yale Cardiovascular Research Group, Yale University Medical Center, New Haven, CT, USA
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23
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Abouelmagd SA, Sun B, Chang AC, Ku YJ, Yeo Y. Release kinetics study of poorly water-soluble drugs from nanoparticles: are we doing it right? Mol Pharm 2015; 12:997-1003. [PMID: 25658769 DOI: 10.1021/mp500817h] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In vitro drug release kinetics studies are routinely performed to examine the ability of new drug formulations to modulate drug release. The underlying assumption is that the studies are performed in a sufficiently dilute solution, where the drug release is not limited by the solubility and the difference in release kinetics profile reflects the performance of a drug carrier in vivo. This condition is, however, difficult to meet with poorly water-soluble drug formulations, as it requires a very large volume of release medium relative to the formulation mass, which makes it challenging to measure the drug concentration accurately. These difficulties are aggravated with nanoparticle (NP) formulations, which are hard to separate from the release medium and thus require a dialysis bag or repeated high-speed centrifugation for sampling. Perhaps for these reasons, drug release kinetics studies of NPs of poorly water-soluble drugs are often performed in suboptimal conditions in which the NPs are not sufficiently diluted. However, such a practice can potentially underestimate drug release from NPs, leading to an inaccurate prediction that the NPs will attenuate the drug activity in vivo. Here we perform release kinetics studies of two different NP formulations of paclitaxel, a representative poorly water-soluble drug, according to common practices in the literature. We find that the drug release from NPs can be substantially underestimated depending on the choice of the release medium, NP/medium ratio, and handling of release samples. We discuss potential consequences of underestimating drug release, ending with suggestions for future studies with NP formulations of poorly water-soluble drugs.
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Affiliation(s)
- Sara A Abouelmagd
- Department of Industrial and Physical Pharmacy and ‡Weldon School of Biomedical Engineering, Purdue University , West Lafayette, Indiana 47907, United States
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24
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Au JLS, Guo P, Gao Y, Lu Z, Wientjes MG, Tsai M, Wientjes MG. Multiscale tumor spatiokinetic model for intraperitoneal therapy. AAPS JOURNAL 2014; 16:424-39. [PMID: 24570339 DOI: 10.1208/s12248-014-9574-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 01/22/2014] [Indexed: 11/30/2022]
Abstract
This study established a multiscale computational model for intraperitoneal (IP) chemotherapy, to depict the time-dependent and spatial-dependent drug concentrations in peritoneal tumors as functions of drug properties (size, binding, diffusivity, permeability), transport mechanisms (diffusion, convection), spatial-dependent tumor heterogeneities (vessel density, cell density, pressure gradient), and physiological properties (peritoneal pressure, peritoneal fluid volume). Equations linked drug transport and clearance on three scales (tumor, IP cavity, whole organism). Paclitaxel was the test compound. The required model parameters (tumor diffusivity, tumor hydraulic conductivity, vessel permeability and surface area, microvascular hydrostatic pressure, drug association with cells) were obtained from literature reports, calculation, and/or experimental measurements. Drug concentration-time profiles in peritoneal fluid and plasma were the boundary conditions for tumor domain and blood vessels, respectively. The finite element method was used to numerically solve the nonlinear partial differential equations for fluid and solute transport. The resulting multiscale model accounted for intratumoral spatial heterogeneity, depicted diffusive and convective drug transport in tumor interstitium and across blood vessels, and provided drug flux and concentration as a function of time and spatial position in the tumor. Comparison of model-predicted tumor spatiokinetics with experimental results (autoradiographic data of 3H-paclitaxel in IP ovarian tumors in mice, 6 h posttreatment) showed good agreement (1% deviation for area under curve and 23% deviations for individual data points, which were several-fold lower compared to the experimental intertumor variations). The computational multiscale model provides a tool to quantify the effects of drug-, tumor-, and host-dependent variables on the concentrations and residence time of IP therapeutics in tumors.
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Affiliation(s)
- Jessie L-S Au
- College of Pharmacy, The Ohio State University, Columbus, Ohio, 43210, USA,
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25
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Numerical modelling of the physical factors that affect mass transport in the vasculature at early time periods. Med Eng Phys 2014; 36:308-17. [PMID: 24462324 DOI: 10.1016/j.medengphy.2013.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 10/11/2013] [Accepted: 11/20/2013] [Indexed: 11/21/2022]
Abstract
Coronary artery disease results in blockages or narrowing of the artery lumen. Drug eluting stents were developed to replace bare metal stents in an effort to combat re-blocking of the lumen. A key element in determining the therapeutic success of a drug eluting stent is an in-depth understanding of the physical factors that affect mass transport of the drug into the arterial wall, over early time periods. The numerical models developed within this study focus on assessing the influence of a host of physical factors that either facilitate or impede therapeutic drug delivery into the arterial wall from the unit cell of an idealised stent. This study demonstrates that model reduction strategies to 2D and 1D can still adequately represent a 3D curved arterial wall and strut polymer coating, respectively, using an idealistic stent geometry. It was shown that the level of strut compression can have a significant impact on therapeutic drug delivery in the arterial wall.
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26
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Bozsak F, Chomaz JM, Barakat AI. Modeling the transport of drugs eluted from stents: physical phenomena driving drug distribution in the arterial wall. Biomech Model Mechanobiol 2014; 13:327-47. [DOI: 10.1007/s10237-013-0546-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 12/12/2013] [Indexed: 01/09/2023]
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27
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Denny WJ, Walsh MT. Numerical modelling of mass transport in an arterial wall with anisotropic transport properties. J Biomech 2014; 47:168-77. [DOI: 10.1016/j.jbiomech.2013.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 08/28/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
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28
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O'Connell BM, Cunnane EM, Denny WJ, Carroll GT, Walsh MT. Improving smooth muscle cell exposure to drugs from drug-eluting stents at early time points: a variable compression approach. Biomech Model Mechanobiol 2013; 13:771-81. [PMID: 24101254 DOI: 10.1007/s10237-013-0533-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 09/22/2013] [Indexed: 11/29/2022]
Abstract
The emergence of drug-eluting stents (DES) as a viable replacement for bare metal stenting has led to a significant decrease in the incidence of clinical restenosis. This is due to the transport of anti-restenotic drugs from within the polymer coating of a DES into the artery wall which arrests the cell cycle before restenosis can occur. The efficacy of DES is still under close scrutiny in the medical field as many issues regarding the effectiveness of DES drug transport in vivo still exist. One such issue, that has received less attention, is the limiting effect that stent strut compression has on the transport of drug species in the artery wall. Once the artery wall is compressed, the stents ability to transfer drug species into the arterial wall can be reduced. This leads to a reduction in the spatial therapeutic transfer of drug species to binding sites within the arterial wall. This paper investigates the concept of idealised variable compression as a means of demonstrating how such a stent design approach could improve the spatial delivery of drug species in the arterial wall. The study focused on assessing how the trends in concentration levels changed as a result of artery wall compression. Five idealised stent designs were created with a combination of thick struts that provide the necessary compression to restore luminal patency and thin uncompressive struts that improve the transport of drugs therein. By conducting numerical simulations of diffusive mass transport, this study found that the use of uncompressive struts results in a more uniform spatial distribution of drug species in the arterial wall.
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Affiliation(s)
- Barry M O'Connell
- Centre for Applied Biomedical Engineering (CABER), Department of Mechanical, Aeronautical and Biomedical Engineering and The Materials and Surface Science Institute, University of Limerick, Limerick, Ireland
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29
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Abraham J, Stark J, Gorman J, Sparrow E, Kohler R. A Model of Drug Deposition Within Artery Walls. J Med Device 2013. [DOI: 10.1115/1.4024321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | - John Gorman
- University of St. Thomas,
School of Engineering
| | - Ephraim Sparrow
- University of Minnesota, Department of Mechanical Engineering
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30
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Keyes JT, Simon BR, Vande Geest JP. A finite element study on variations in mass transport in stented porcine coronary arteries based on location in the coronary arterial tree. J Biomech Eng 2013; 135:61008-11. [PMID: 23699720 DOI: 10.1115/1.4024137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/04/2013] [Indexed: 11/08/2022]
Abstract
Drug-eluting stents have a significant clinical advantage in late-stage restenosis due to the antiproliferative drug release. Understanding how drug transport occurs between coronary arterial locations can better help guide localized drug treatment options. Finite element models with properties from specific porcine coronary artery sections (left anterior descending (LAD), right (RCA); proximal, middle, distal regions) were created for stent deployment and drug delivery simulations. Stress, strain, pore fluid velocity, and drug concentrations were exported at different time points of simulation (0-180 days). Tests indicated that the highest stresses occurred in LAD sections. Higher-than-resting homeostatic levels of stress and strain existed at upwards of 3.0 mm away from the stented region, whereas concentration of species only reached 2.7 mm away from the stented region. Region-specific concentration showed 2.2 times higher concentrations in RCA artery sections at times corresponding to vascular remodeling (peak in the middle segment) compared to all other segments. These results suggest that wall transport can occur differently based on coronary artery location. Awareness of peak growth stimulators and where drug accumulation occurs in the vasculature can better help guide local drug delivery therapies.
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Affiliation(s)
- Joseph T Keyes
- Graduate Interdisciplinary Program in Biomedical Engineering, The University of Arizona,Tucson, AZ 85721, USA.
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31
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O'Brien CC, Kolachalama VB, Barber TJ, Simmons A, Edelman ER. Impact of flow pulsatility on arterial drug distribution in stent-based therapy. J Control Release 2013; 168:115-24. [PMID: 23541929 DOI: 10.1016/j.jconrel.2013.03.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/19/2013] [Indexed: 11/30/2022]
Abstract
Drug-eluting stents reside in a dynamic fluid environment where the extent to which drugs are distributed within the arterial wall is critically modulated by the blood flowing through the arterial lumen. Yet several factors associated with the pulsatile nature of blood flow and their impact on arterial drug deposition have not been fully investigated. We employed an integrated framework comprising bench-top and computational models to explore the factors governing the time-varying fluid dynamic environment within the vasculature and their effects on arterial drug distribution patterns. A custom-designed bench-top framework comprising a model of a single drug-eluting stent strut and a poly-vinyl alcohol-based hydrogel as a model tissue bed simulated fluid flow and drug transport under fully apposed strut settings. Bench-top experiments revealed a relative independence between drug distribution and the factors governing pulsatile flow and these findings were validated with the in silico model. Interestingly, computational models simulating suboptimal deployment settings revealed a complex interplay between arterial drug distribution, Womersley number and the extent of malapposition. In particular, for a stent strut offset from the wall, total drug deposition was sensitive to changes in the pulsatile flow environment, with this dependence increasing with greater wall displacement. Our results indicate that factors governing pulsatile luminal flow on arterial drug deposition should be carefully considered in conjunction with device deployment settings for better utilization of drug-eluting stent therapy.
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Affiliation(s)
- Caroline C O'Brien
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
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32
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Location-dependent coronary artery diffusive and convective mass transport properties of a lipophilic drug surrogate measured using nonlinear microscopy. Pharm Res 2012; 30:1147-60. [PMID: 23224981 DOI: 10.1007/s11095-012-0950-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Arterial wall mass transport properties dictate local distribution of biomolecules or locally delivered dugs. Knowing how these properties vary between coronary artery locations could provide insight into how therapy efficacy is altered between arterial locations. METHODS We introduced an indocarbocyanine drug surrogate to the lumens of left anterior descending and right coronary (LADC; RC) arteries from pigs with or without a pressure gradient. Interstitial fluorescent intensity was measured on live samples with multiphoton microscopy. We also measured binding to porcine coronary SMCs in monoculture. RESULTS Diffusive transport constants peaked in the middle sections of the LADC and RC arteries by 2.09 and 2.04 times, respectively, compared to the proximal and distal segments. There was no statistical difference between the average diffusivity value between LADC and RC arteries. The convection coefficients had an upward trend down each artery, with the RC being higher than the LADC by 3.89 times. CONCLUSIONS This study demonstrates that the convective and diffusive transport of lipophilic molecules changes between the LADC and the RC arteries as well as along their length. These results may have important implications in optimizing drug delivery for the treatment of coronary artery disease.
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33
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Analysis of drug distribution from a simulated drug-eluting stent strut using an in vitro framework. Ann Biomed Eng 2012; 40:2687-96. [PMID: 22648579 DOI: 10.1007/s10439-012-0604-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 05/22/2012] [Indexed: 10/28/2022]
Abstract
The mechanisms of delivery of anti-proliferative drug from a drug-eluting stent are defined by transport forces in the coating, the lumen, and the arterial wall. Dynamic asymmetries in the localized flow about stent struts have previously been shown to contribute to significant heterogeneity in the spatial distribution of drug in in silico three-compartmental models of stent based drug delivery. A novel bench-top experiment has been created to confirm this phenomena. The experiment simulates drug release from a single stent strut, and then allows visualization of drug uptake into both lumen and tissue domains using optical techniques. Results confirm the existence of inhomogeneous and asymmetric arterial drug distributions, with this distribution shown to be sensitive to the flow field surrounding the strut.
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34
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Tzafriri AR, Groothuis A, Price GS, Edelman ER. Stent elution rate determines drug deposition and receptor-mediated effects. J Control Release 2012; 161:918-26. [PMID: 22642931 DOI: 10.1016/j.jconrel.2012.05.039] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 05/16/2012] [Accepted: 05/19/2012] [Indexed: 10/28/2022]
Abstract
Drug eluting stent designs abound and yet the dependence of efficacy on drug dose and elution duration remains unclear. We examined these issues within a mathematical framework of arterial drug distribution and receptor binding following stent elution. Model predictions that tissue content linearly tracks stent elution rate were validated in porcine coronary artery sirolimus-eluting stents implants. Arterial content varied for stent types, progressively declining from its Day 1 peak and tracking with rate-limiting drug elution--near zero-order release was three-fold more efficient at depositing drug in the stented lesion than near first-order release. In vivo data were consistent with an overabundance of non-specific sirolimus-binding sites relative to the specific receptors and to the delivered dose. The implication is that the persistence time of receptor saturation and effect is more sensitive to duration of elution than to eluted amount. Consequently, the eluted amount should be sufficiently high to saturate receptors at the target lesion, but dose escalation alone is an inefficient strategy for prolonging the duration of sirolimus deposition. Moreover, receptor saturating drug doses are predicted to be most efficacious when eluted from stents in a constant zero order fashion as this maximizes the duration of elution and receptor saturation.
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35
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Zhu X, Pack DW, Braatz RD. Modelling intravascular delivery from drug-eluting stents with biodurable coating: investigation of anisotropic vascular drug diffusivity and arterial drug distribution. Comput Methods Biomech Biomed Engin 2012; 17:187-98. [PMID: 22512464 DOI: 10.1080/10255842.2012.672815] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In-stent restenosis occurs in coronary arteries after implantation of drug-eluting stents with non-uniform restenosis thickness distribution in the artery cross section. Knowledge of the spatio-temporal drug uptake in the arterial wall is useful for investigating restenosis growth but may often be very expensive/difficult to acquire experimentally. In this study, local delivery of a hydrophobic drug from a drug-eluting stent implanted in a coronary artery is mathematically modelled to investigate the drug release and spatio-temporal drug distribution in the arterial wall. The model integrates drug diffusion in the coating and drug diffusion with reversible binding in the arterial wall. The model is solved by the finite volume method for both high and low drug loadings relative to its solubility in the stent coating with varied isotropic-anisotropic vascular drug diffusivities. Drug release profiles in the coating are observed to depend not only on the coating drug diffusivity but also on the properties of the surrounding arterial wall. Time dependencies of the spatially averaged free- and bound-drug levels in the arterial wall on the coating and vascular drug diffusivities are discussed. Anisotropic vascular drug diffusivities result in slightly different average drug levels in the arterial wall but with very different spatial distributions. Higher circumferential vascular diffusivity results in more uniform drug loading in the upper layers and is potentially beneficial in reducing in-stent restenosis. An analytical expression is derived which can be used to determine regions in the arterial with higher free-drug concentration than bound-drug concentration.
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Affiliation(s)
- Xiaoxiang Zhu
- a Department of Chemical Engineering , Massachusetts Institute of Technology , Cambridge , MA 02139 , USA
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Baek N, Lee J, Park K. Aqueous N,N-diethylnicotinamide (DENA) solution as a medium for accelerated release study of paclitaxel. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 15:527-42. [PMID: 15212332 DOI: 10.1163/156856204323005343] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
N,N-Diethylnicotinamide (DENA) was identified as an excellent hydrotropic agent for paclitaxel (PTX) in our previous studies. The aqueous solubility of PTX was increased by several orders of magnitude in the presence of DENA. Because of such a high hydrotropic property, DENA was used as a release medium providing a sink condition for the release of PTX from poly(lactic-co-glycolic acid) (PLGA) matrices. The release profiles of PTX from PLGA matrices into DENA, serum and phosphate-buffered saline (PBS) were compared. The stability of PTX in DENA and the degradation of PLGA molecules in DENA were examined. The degradation rate constant of PTX in 2 M DENA was similar to those in other aqueous solutions. The use of 2 M DENA as a release medium allowed differentiation of the release profiles of PTX from PLGA matrices made of different PLGA compositions. The PTX release from PLGA matrices was much faster in DENA solution than in serum or PBS, and the concentration of DENA affected the PTX release rate. The presence of DENA in the release medium increased the hydrolysis rate of PLGA polymers. The faster release of PTX from PLGA matrices in DENA solution may be due to the high PTX solubility and faster degradation of PLGA polymers in the presence of DENA. Our study suggests that the aqueous DENA solution can be used for the accelerated release study of PTX from PLGA matrices.
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Affiliation(s)
- Namjin Baek
- Department of Pharmaceutics and Biomedical Engineering, Purdue University School of Pharmacy, Room G22, 575 Stadium Mall Drive, West Lafayette, IN 47907-2051, USA
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Long-Term Follow-Up After Treatment of Coronary In-Stent Restenosis With a Paclitaxel-Coated Balloon Catheter. JACC Cardiovasc Interv 2012; 5:323-30. [DOI: 10.1016/j.jcin.2012.01.008] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 01/18/2012] [Indexed: 11/22/2022]
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Kleinedler JJ, Pjescic I, Bullock KK, Khaliq A, Foley JD, Dugas TR. Arterial pharmacokinetics of red wine polyphenols: implications for novel endovascular therapies targeting restenosis. J Pharm Sci 2012; 101:1917-31. [PMID: 22359273 DOI: 10.1002/jps.23074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 12/20/2011] [Accepted: 01/18/2012] [Indexed: 11/12/2022]
Abstract
Drug-eluting stents (DESs) are endovascular devices that provide controlled release of compounds to interfere with restenosis, an adverse outcome of angioplasty characterized by thickening of the arterial wall. Accumulating evidence suggests that arterial pharmacokinetics determine the biological effect and potential toxicity of stent-based therapeutics. The aim of this study was to examine how drug polarity, drug load, and protein binding influence release from a polymer film and distribution within arterial tissue. The transport and safety profile of resveratrol (RESV) and quercetin (QUER), two red wine polyphenols known to interfere with events in the pathogenesis of restenosis, were compared with paclitaxel (Taxol), a lipophilic drug used in DES. In bovine arteries, RESV showed considerable protein binding and arterial kinetics that were found to mimick Taxol. In contrast, the less lipophilic QUER showed limited tissue distribution. Measured diffusivity of RESV and QUER was coupled with a novel computational method for assessment of biphasic drug release kinetics and arterial drug retention profiles. Modeling revealed that drugs associated with high- and low-protein-binding affinity result in markedly distinct arterial drug profiles. These data underscore the importance of arterial partitioning and propagation of drug within arterial tissue in the rational design of DES coatings.
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Affiliation(s)
- James J Kleinedler
- Department of Pharmacology, Toxicology, and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71103, USA
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Vauquelin G. Determination of drug–receptor residence times by radioligand binding and functional assays: experimental strategies and physiological relevance. MEDCHEMCOMM 2012. [DOI: 10.1039/c2md20015e] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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40
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Katori N, Sai K, Saito Y, Fukushima-Uesaka H, Kurose K, Yomota C, Kawanishi T, Nishimaki-Mogami T, Naito M, Sawada JI, Kunitoh H, Nokihara H, Sekine I, Ohe Y, Yoshida T, Matsumura Y, Saijo N, Yamamoto N, Okuda H, Tamura T. Genetic variations of orosomucoid genes associated with serum alpha-1-acid glycoprotein level and the pharmacokinetics of paclitaxel in Japanese cancer patients. J Pharm Sci 2011; 100:4546-59. [PMID: 21638284 DOI: 10.1002/jps.22648] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 05/02/2011] [Accepted: 05/11/2011] [Indexed: 11/08/2022]
Abstract
Alpha-1-acid glycoprotein (AGP) encoded by orosomucoid genes (ORM1 and ORM2) is an acute-phase response protein and functions as a drug-binding protein that affects pharmacokinetics (PK)/pharmacodynamics of binding drugs. To explore the effects of genetic variations of ORMs and a role of AGP on paclitaxel (PTX) therapy, we analyzed the duplication and genetic variations/haplotypes of ORMs in 165 Japanese cancer patients and then investigated their associations with serum AGP levels and the PK parameters of PTX. No effects of ORM duplications on serum AGP levels at baseline or PK of PTX were observed, but close associations of ORM1 -559T > A with the increases of AGP levels and area under the curve (AUC) of PTX metabolites were detected. In addition, a significant correlation between the serum AGP level and the AUCs of PTX metabolites was observed, suggesting that AGP may function as a carrier of PTX from the blood into the liver via putative receptors. This study provided useful information on the possible clinical importance of ORM genetic polymorphisms and a novel role of AGP in PTX therapy.
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Affiliation(s)
- Noriko Katori
- National Institute of Health Sciences, Tokyo 158-8501, Japan.
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Steele TWJ, Huang CL, Kumar S, Widjaja E, Chiang Boey FY, Loo JSC, Venkatraman SS. High-throughput screening of PLGA thin films utilizing hydrophobic fluorescent dyes for hydrophobic drug compounds. J Pharm Sci 2011; 100:4317-29. [PMID: 21607953 DOI: 10.1002/jps.22625] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 04/02/2011] [Accepted: 04/26/2011] [Indexed: 01/06/2023]
Abstract
Hydrophobic, antirestenotic drugs such as paclitaxel (PCTX) and rapamycin are often incorporated into thin film coatings for local delivery using implantable medical devices and polymers such as drug-eluting stents and balloons. Selecting the optimum coating formulation through screening the release profile of these drugs in thin films is time consuming and labor intensive. We describe here a high-throughput assay utilizing three model hydrophobic fluorescent compounds: fluorescein diacetate (FDAc), coumarin-6, and rhodamine 6G that were incorporated into poly(d,l-lactide-co-glycolide) (PLGA) and PLGA-polyethylene glycol films. Raman microscopy determined the hydrophobic fluorescent dye distribution within the PLGA thin films in comparison with that of PCTX. Their subsequent release was screened in a high-throughput assay and directly compared with HPLC quantification of PCTX release. It was observed that PCTX controlled-release kinetics could be mimicked by a hydrophobic dye that had similar octanol-water partition coefficient values and homogeneous dissolution in a PLGA matrix as the drug. In particular, FDAc was found to be the optimal hydrophobic dye at modeling the burst release as well as the total amount of PCTX released over a period of 30 days.
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Affiliation(s)
- Terry W J Steele
- Materials and Science Engineering, Division of Materials Technology, Nanyang Technological University, Singapore 639798
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Steele TWJ, Huang CL, Widjaja E, Boey FYC, Loo JSC, Venkatraman SS. The effect of polyethylene glycol structure on paclitaxel drug release and mechanical properties of PLGA thin films. Acta Biomater 2011; 7:1973-83. [PMID: 21300188 DOI: 10.1016/j.actbio.2011.02.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 12/21/2010] [Accepted: 02/02/2011] [Indexed: 01/28/2023]
Abstract
Thin films of poly(lactic acid-co-glycolic acid) (PLGA) incorporating paclitaxel typically have slow release rates of paclitaxel of the order of 1 μg day(-1) cm(-2). For implementation as medical devices a range of zero order release rates (i.e. 1-15 μg day(-1) cm(-2)) is desirable for different tissues and pathologies. Eight and 35 kDa molecular weight polyethylene glycol (PEG) was incorporated at 15%, 25% and 50% weight ratios into PLGA containing 10 wt.% paclitaxel. The mechanical properties were assessed for potential use as medical implants and the rates of release of paclitaxel were quantified as per cent release and the more clinically useful rate of release in μg day(-1) cm(-2). Paclitaxel quantitation was correlated with the release of PEG from PLGA, to further understand its role in paclitaxel/PLGA release modulation. PEG release was found to correlate with paclitaxel release and the level of crystallinity of the PEG in the PLGA film, as measured by Raman spectrometry. This supports the concept of using a phase separating, partitioning compound to increase the release rates of hydrophobic drugs such as paclitaxel from PLGA films, where paclitaxel is normally homogeneously distributed/dissolved. Two formulations are promising for medical device thin films, when optimized for tensile strength, elongation, and drug release. For slow rates of paclitaxel release an average of 3.8 μg day(-1) cm(-2) using 15% 35k PEG for >30 days was achieved, while a high rate of drug release of 12 μg day(-1) cm(-2) was maintained using 25% 8 kDa PEG for up to 12 days.
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Affiliation(s)
- Terry W J Steele
- Nanyang Technological University, Materials and Science Engineering, Division of Materials Technology, Singapore, Singapore
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O'Brien CC, Finch CH, Martens P, Barber TJ, Simmons A. Development of an in vitro method for modeling drug release and subsequent tissue drug uptake and deposition in a pulsatile flow network. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2011; 2011:3262-3265. [PMID: 22255035 DOI: 10.1109/iembs.2011.6090886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A novel benchtop model of drug elution and arterial drug deposition following stent implantation has been developed. The model contains a single drug loaded strut and a compartment simulating the vessel wall, housed in a flow chamber under a pulsatile flow regime. Each component has programmable transport properties that can be implemented into a computational model of drug elution. An initial experiment determining the effects of luminal flow on drug deposition patterns was performed. The results show that spatial distribution of drug correlates with areas of low and recirculating flow surrounding the strut. This spatial distribution of drug was shown to be dependent on both transient release behavior and the local flow field surrounding the strut. Furthermore, these results showed that the novel method could be used to study the effects of luminal flow in the presence of single or multiple struts. The method could also be used to explore more complex drug release strategies.
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Affiliation(s)
- Caroline C O'Brien
- Graduate School of Biomedical Engineering, The University of New South Wales, Sydney, UNSW, Australia 2052 .
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Vauquelin G, Charlton SJ. Long-lasting target binding and rebinding as mechanisms to prolong in vivo drug action. Br J Pharmacol 2010; 161:488-508. [PMID: 20880390 PMCID: PMC2990149 DOI: 10.1111/j.1476-5381.2010.00936.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 05/17/2010] [Accepted: 06/10/2010] [Indexed: 11/28/2022] Open
Abstract
An increasing number of examples in the literature suggest that the in vivo duration of drug action not only depends on macroscopic pharmacokinetic properties like plasma half-life and the time needed to equilibrate between the plasma and the effect compartments, but is also influenced by long-lasting target binding and rebinding. The present review combines information from different research areas and simulations to explore the nature of these mechanisms and the conditions in which they are most prevalent. Simulations reveal that these latter phenomena become especially influential when there is no longer sufficient free drug around to maintain high levels of receptor occupancy. There is not always a direct link between slow dissociation and long-lasting in vivo target protection, as the rate of free drug elimination from the effect compartment is also a key influencing factor. Local phenomena that hinder the diffusion of free drug molecules away from their target may allow them to consecutively bind to the same target and/or targets nearby (denoted as 'rebinding') even when their concentration in the bulk phase has already dropped to insignificant levels. The micro-anatomic properties of many effect compartments are likely to intensify this phenomenon. By mimicking the complexity of tissues, intact cells offer the opportunity to investigate both mechanisms under the same, physiologically relevant conditions.
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Affiliation(s)
- Georges Vauquelin
- Department of Molecular and Biochemical Pharmacology, Vrije Universiteit Brussel, Brussels, Belgium.
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Vauquelin G. Rebinding: or why drugs may act longer in vivo than expected from their in vitro target residence time. Expert Opin Drug Discov 2010; 5:927-41. [PMID: 22823988 DOI: 10.1517/17460441.2010.512037] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
IMPORTANCE OF THE FIELD It is well established that the in vivo duration of drug action not only depends on macroscopic pharmacokinetic properties like its plasma half-life, but also on the residence time of the drug-target complexes. However, drug 'rebinding' (i.e., the consecutive binding of dissociated drug molecules to the original target and/or targets nearby) can be influential in vivo as well. AREAS COVERED IN THIS REVIEW Information about rebinding is available since the 1980s but it is dispersed in the life sciences literature. This review compiles this information. In this respect, neurochemists and biopohysicians advance the same equations to describe drug rebinding. WHAT THE READER WILL GAIN The rebinding mechanism is explained according to the prevailing viewpoint in different life science disciplines. There is a general consensus that high target densities, high association rates and local phenomena that hinder the diffusion of free drug molecules away from their target all promote rebinding. TAKE HOME MESSAGE Simulations presented here for the first time suggest that rebinding may increase the duration and even the constancy of the drug's clinical action. Intact cell radioligand dissociation and related ex vivo experiments offer useful indications about a drug's aptitude to experience target rebinding.
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Affiliation(s)
- Georges Vauquelin
- Free University Brussels (VUB), Department of Molecular and Biochemical Pharmacology, Building E.5.10, Pleinlaan 2, B-1050 Brussels, Belgium +32 2 6291955 ; +32 2 6291358 ;
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Affiliation(s)
- William A. Gray
- From the Department of Medicine, Columbia University Medical Center (W.A.G., J.F.G.) and Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, New York, NY
| | - Juan F. Granada
- From the Department of Medicine, Columbia University Medical Center (W.A.G., J.F.G.) and Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, New York, NY
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Raval A, Parikh J, Engineer C. Mechanism of controlled release kinetics from medical devices. BRAZILIAN JOURNAL OF CHEMICAL ENGINEERING 2010. [DOI: 10.1590/s0104-66322010000200001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- A. Raval
- Sardar Vallabhbhai National Institute of Technology, India
| | - J. Parikh
- Sardar Vallabhbhai National Institute of Technology, India
| | - C. Engineer
- Sahajanand Medical Technologies Pvt. Ltd., India
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49
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Drug release from coronary eluting stents: A multidomain approach. J Biomech 2010; 43:1580-9. [DOI: 10.1016/j.jbiomech.2010.01.033] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 11/17/2009] [Accepted: 01/03/2010] [Indexed: 11/23/2022]
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50
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Empirical models for dosage optimization of four β-lactams in critically ill septic patients based on therapeutic drug monitoring of amikacin. Clin Biochem 2010; 43:589-98. [DOI: 10.1016/j.clinbiochem.2009.12.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 11/27/2009] [Accepted: 12/08/2009] [Indexed: 12/31/2022]
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