Perivascular Tissue Pharmacokinetics of Dipyridamole

Correlation of tissue drug concentrations with in vivo magnetic resonance images of polymer drug depot around arteriovenous graft

Sustained delivery of anti-proliferative drugs to the perivascular area using an injectable polymeric platform is a strategy to inhibit vascular hyperplasia and stenosis. In this study, the concentrations of sirolimus in vascular tissues were evaluated after delivery using an injectable platform made of poly(lactic-co-glycolic acid)-polyethylene glycol-poly(lactic-co-glycolic acid) (PLGA-PEG-PLGA). In order to optimize the drug release profile, the effect of two solvents or solid loading of the sirolimus into the polymer gel was first examined in vitro. The early release was slower with loading of dry drug into the polymer, compared to drug dissolution in solvents. Dry sirolimus was therefore used to load the polymer and applied to the perivascular surface of the graft-venous anastomosis at the time of surgical placement of a carotid-jugular synthetic hemodialysis graft in a porcine model. This was replenished by ultrasound-guided injection of additional drug-laden polymer at one, two and three weeks post-operatively. Magnetic resonance imaging (MRI) using pulse sequences specifically designed for optimal detection of the polymeric gel showed that the polymer injected post-operatively remained at the juxta-anastomotic perivascular site at two weeks. Sirolimus was extracted from various segments of the juxta-anastomotic tissues and the drug concentrations were determined using HPLC MS/MS. Tissue sirolimus concentrations at one and two weeks were highest near the venous anastomosis, which were approximately 100- to 500-fold greater than the concentrations necessary to inhibit vascular smooth muscle cell proliferation in vitro. Drug concentrations remained above the inhibitory concentrations for at least six weeks post-operatively. Thus, serial injections of sustained-delivery polymer gel loaded with sirolimus can provide high localized concentrations at target vascular tissues and thus may be useful for the prevention and treatment of vascular proliferative disorders such as hemodialysis graft stenosis. In addition, MRI is useful for the monitoring of the location of the drug depot.

Bipartite expressions for diffusional mass transport in biomembranes

Analytical expressions for solute diffusion through a membrane barrier for different initial and boundary conditions are available in the literature. The three commonest initial and boundary conditions are for a membrane without solute respectively immersed in a solution of constant concentration, immersed in such a solution for one side but with the other side isolated, and immersed in such a solution for one side and with the other side kept at zero concentration. The physical quantities for the first two initial and boundary conditions are concentration and average concentration (the total solute entering the membrane) with amperometric current (flux) and solute that permeates through the membrane (charge passed) for the third initial and boundary condition. Expressions for these methods in the literature are inconvenient for practical applications because of the infinite mathematical series required. An investigation of convergence of these expressions was therefore carried out. Simple but accurate bipartite expressions for these methods were constructed and provided theoretical support for studies on mass transport characterization of biomembranes. As a specific application, these expressions enabled a direct fit of the simulated observables to experimental values to obtain diffusion coefficients. For these initial and boundary conditions and corresponding physical quantities, simple one point methods for diffusion coefficient estimation are also suggested. These latter diffusion coefficients can be initial values for numerical fit methods.