Evolutionary biology, animal behavior, fourth-dimensional space, and the raison d'etre of drug metabolism and pharmacokinetics

ADME, Pharmacokinetic Scaling, Pharmacodynamic and Prediction of Human Dose and Regimen of Novel Antiviral Drugs

The search for new drugs is an extremely time-consuming and expensive endeavour. Much of that time and money go into generating predictive human pharmacokinetic profiles from preclinical efficacy and safety animal data. These pharmacokinetic profiles are used to prioritize or minimize the attrition at later stages of the drug discovery process. In the area of antiviral drug research, these pharmacokinetic profiles are equally important for the optimization, estimation of half-life, determination of effective dose, and dosing regimen, in humans. In this article we have highlighted three important aspects of these profiles. First, the impact of plasma protein binding on two primary pharmacokinetic parameters-volume of distribution and clearance. Second, interdependence of primary parameters on unbound fraction of the drug. Third, the ability to extrapolate human pharmacokinetic parameters and concentration time profiles from animal profiles.

Calculation of a First-In-Man Dose of 7-O-Succinyl Macrolactin A Based on Allometric Scaling of Data from Mice, Rats, and Dogs

7-O-Succinyl macrolactin A (SMA) exerts several pharmacological effects including anti-bacterial, anti-inflammation, and anti-cancer activities. Recently, SMA has been extensively evaluated as an anti-cancer drug. Thus, the objectives of the present study were to characterise the pharmacokinetics of SMA via both non-compartmental and compartmental analysis in mice, rats, and dogs, and to derive an appropriate first-in-man dose based on allometric scaling of the animal data. The time courses of plasma SMA concentrations after intravenous administration to rats and dogs were analysed retrospectively, as were data collected after intraperitoneal SMA injection in mice. Pharmacokinetic parameters were estimated via both noncompartmental and compartmental analysis, and were correlated with body weight and/or the potential maximum life-span. The clearance and distribution volume of SMA in humans were predicted, and a first-in-man dose proposed. A two-compartment model best described the time courses of SMA plasma concentrations after a saturation elimination process was applied to fit the dataset obtained from rats. Incorporation of the maximum potential life-span during allometric scaling was required to improve the estimation of human clearance. The SMA clearance and the distribution volume in the steady state, in a 70-kg adult male, were estimated to be 30.6 L/h and 19.5 L, respectively. To meet the area under the curve (AUC) required for anti-tumour activity, a dose of 100 mg (∼1.5 mg/kg) was finally proposed as the first dose for a 70-kg human. Although toxicological profiles derived from non-clinical studies must be considered before any final decision is made, our work will facilitate clinical studies on SMA.

Dispelling urban myths about default uncertainty factors in chemical risk assessment--sufficient protection against mixture effects?

Assessing the detrimental health effects of chemicals requires the extrapolation of experimental data in animals to human populations. This is achieved by applying a default uncertainty factor of 100 to doses not found to be associated with observable effects in laboratory animals. It is commonly assumed that the toxicokinetic and toxicodynamic sub-components of this default uncertainty factor represent worst-case scenarios and that the multiplication of those components yields conservative estimates of safe levels for humans. It is sometimes claimed that this conservatism also offers adequate protection from mixture effects. By analysing the evolution of uncertainty factors from a historical perspective, we expose that the default factor and its sub-components are intended to represent adequate rather than worst-case scenarios. The intention of using assessment factors for mixture effects was abandoned thirty years ago. It is also often ignored that the conservatism (or otherwise) of uncertainty factors can only be considered in relation to a defined level of protection. A protection equivalent to an effect magnitude of 0.001-0.0001% over background incidence is generally considered acceptable. However, it is impossible to say whether this level of protection is in fact realised with the tolerable doses that are derived by employing uncertainty factors. Accordingly, it is difficult to assess whether uncertainty factors overestimate or underestimate the sensitivity differences in human populations. It is also often not appreciated that the outcome of probabilistic approaches to the multiplication of sub-factors is dependent on the choice of probability distributions. Therefore, the idea that default uncertainty factors are overly conservative worst-case scenarios which can account both for the lack of statistical power in animal experiments and protect against potential mixture effects is ill-founded. We contend that precautionary regulation should provide an incentive to generate better data and recommend adopting a pragmatic, but scientifically better founded approach to mixture risk assessment.

Interspecies Pharmacokinetics of Xymedon

Pharmacokinetics of immunomodulator xymedon at different modes of the drug administration was studied in humans, dogs, and rats. the main parameters of xymedon pharmacokinetics varied in different animal species. The results confirmed the efficiency and correctness of using allo-metrical method for extrapolation of pharmacokinetic data for tentative evaluation of drug parameters in humans by the results of preclinical trials on animals.

Pharmacokinetics-pharmacodynamics of a sordarin derivative (GM 237354) in a murine model of lethal candidiasis

Sordarins are a new class of antifungal agents which selectively inhibit fungal protein synthesis (FPS) by impairing the function of elongation factor 2. The present study investigates possible correlations between sordarin pharmacokinetic (PK) properties and therapeutic efficacy, based on a murine model of invasive systemic candidiasis, and provides a rationale for dose selection in the first study of efficacy in humans. A significant correlation between PK parameters and the in vivo activity of GM 237354, taken as a representative FPS inhibitor, was demonstrated in a murine model of lethal systemic candidiasis. Area under the concentration-time curve (AUC) and maximum concentration of drug in serum (C(max)) over 24 h were determined after a single GM 237354 subcutaneous (s.c.) dose (50 mg/kg of body weight) in healthy animals (no significant PK changes with infection were observed for other sordarin derivatives). These results have been used to simulate PK profiles obtained after several doses and/or schedules in animal therapy. A PK-pharmacodynamic (PD) parameter such as the time that serum drug concentrations remain above the MIC (t > MIC) was also determined. Treatment efficacies were evaluated in terms of the area under the survival time curve (AUSTC), using Kaplan-Meier survival analysis and in terms of kidney fungal burden (log CFU/gram) after s.c. doses of 2.5, 5, 10, 20, and 40 mg/kg every 4, 8, or 12 h (corresponding to total daily doses of 5 to 240 mg/kg). The results show all treatments to significantly prolong survival versus that of infected and nontreated controls (P < 0.05). Relationships between simulated PK and PK-PD parameters and efficacy were explored. A good correlation independent of the dosing interval was observed with AUC (but not C(max) or t > MIC) and both AUSTC and kidney burden. Following repeated dosing every 8 h, AUC(50) (AUC at which 50% of the maximum therapeutic efficacy is obtained) was estimated as 21.7 and 37.1 microg. h/ml (total concentrations) for AUSTC and kidney burden using a sigmoid E(max) and an inhibitory sigmoid E(max) PK-PD model, respectively. For an efficacy target of 90% survival, AUC was predicted as 67 microg. h/ml. We conclude that the PK-PD approach is useful for evaluating relationships between PK parameters and efficacy in antifungal research. Moreover, the results obtained with this approach could be successfully applied to clinical studies.

Comparative pharmacokinetics and interspecies scaling of amphotericin B in several mammalian species

This study employed several interspecies scaling methods, to evaluate the applicability of extrapolating to man, pharmacokinetic information obtained from animals for amphotericin B, an anti-fungal drug. Pharmacokinetic parameters from four animal species (mouse, rat, monkey and dog) and man were obtained from the literature or from analysis of data reported in the literature. The allometric relationships (obtained from four animal species) as a function of species body weight (W; kg) for systemic clearance per maximum life span potential (CLS/MLP), steady-state volume of distribution (VSS), apparent volume of distribution (V beta) and volume of the central compartment (VC) were: 5691W1.096; 2.46W0.839; 3.08W0.948 and 1.07W0.965, respectively. The allometric relationships for half-life (h) and mean residence time (h) did not scale well with body weight. The prediction of pharmacokinetic parameters in man from the allometric equations do not always agree with those reported in the literature which are based upon a limited number of studies with few human subjects. The plasma concentration-time profiles from these animals were adjusted by normalizing the concentration with dose/W0.948, and re-plotted on different pharmacokinetic time scales. The syndesichrons plot produced an almost superimposable profile of adjusted concentrations as a function of adjusted time among the four species.

Dose-response cocaine pharmacokinetics and metabolite profile following intravenous administration and arterial sampling in unanesthetized, freely moving male rats

Despite the wealth of experimental data on cocaine abuse, there are no published dose-response pharmacokinetic studies with bolus i.v. cocaine injection in the male rat. The present study examined the pharmacokinetics of arterial plasma concentrations of cocaine and metabolite profile [benzoylecgonine (BE), ecgonine methyl ester (EME), norcocaine (NC)] following a single i.v. injection of 0.5, 1.0, or 3.0 mg/kg cocaine. Male Sprague-Dawley rats (N = 25) were anesthetized and surgically instrumented with both jugular vein (drug administration) and carotid artery (blood withdrawal) catheters and allowed to recover for at least 24 h. Arterial plasma samples (200 microliters) were obtained at eight time points (0.5, 1.5, 2.5, 10, 20, 30 min) following i.v. bolus injection (15-s injection, 15-s flush) and analyzed by single ion monitoring using GC/MS. Nonlinear regression and noncompartmental pharmacokinetic analysis were employed. Mean +/- SEM peak plasma concentrations of cocaine occurred at 30 s in a dose-response manner (370 +/- 14,755 +/- 119,2553 +/- 898 ng/ml for 0.5, 1.0, and 3.0 mg/kg groups, respectively). T1/2 alpha was < 1 min for all groups, but inversely related to dose. T1/2 beta was independent of dose 13.3 +/- 1.6, 13.0 +/- 1.5, and 12.0 +/- 2.0 min for 0.5, 1.0, and 3.0 mg/kg groups, respectively). MRT (16.0, 15.9, 14.5 min), VdSS (3.3, 3.2, and 2.8 l/kg), and ClTOT (204, 201, and 195 ml/min/kg) also provided little evidence of dose-dependent effects. Although the metabolic profile of i.v. cocaine was similarly ordered for all dose groups (BE > EME > NC), a quantitative shift in metabolite profile was evident as a function of increasing dose. This metabolic shift, perhaps attributable to saturation of plasma and liver esterases, suggests that the recently reported pharmacodynamic effects positively correlated with i.v. cocaine dose are unlikely attributable to NC, a minor but pharmacologically active metabolite. In sum, the i.v. pharmacokinetic profile in rats is distinct from that observed via the SC, IP, and PO routes of administration and offers the potential to provide a reasonable clinically relevant rodent model.

Use of quantitative modelling in methylene chloride risk assessment

The benefits of basing quantitative risk assessment on measures of 'internal dose', i.e. target organ exposures as estimated, for instance, by pharmacokinetic models, have been extensively discussed. Recasting risk assessment methods at the level of internal dose raises novel issues, however, some of which are explored by examining the 1987 revision by the US Environmental Protection Agency (EPA) of its cancer risk assessment for inhaled methylene chloride, which was based on the 1987 pharmacokinetic model results of Andersen and coworkers. The internal dose measure was the daily amount of methylene chloride metabolized by a glutathione-S-transferase pathway per 1 of target organ (liver and lung). Owing to high-dose saturation of a competing detoxification reaction, this metabolic activation is less-than-proportionally active at low exposure levels. For a given inhalation exposure, humans have relatively less metabolic activation than do mice, but this is shown to be a foreseeable consequence of their relatively lower breathing rate, a cross-species difference already accounted for in standard EPA methodology. Indeed, many species differences in the rates and tempos of physiological processes evince regular 'scaling' relationships across differently sized mammals. EPA's practice of scaling carcinogen doses by body surface area for cross-species extrapolation, often viewed as a correction for metabolic activation, is shown to be more reasonably regarded as an accommodation for the more general species variation in the pace of physiological processes underlying both pharmacokinetics and the carcinogenic response to internal doses. Under this view, the issue of cross-species dose scaling is not obviated by the use of pharmacokinetics.

Species scaling of propafenone disposition and concentration--time relationships among eight mammalian species

Usually, smaller mammals have higher clearances per unit body mass than do larger mammalian species. When clearance and other pharmacokinetic parameters are correlated with internal physiological processes, species tend to dispose of drugs at a similar pace. The first application of this concept is pharmacokinetic time, expressed with different units: Kallynochron, Apolysichron, Dienetichron, and Syndesichron. The present work describes pharmacokinetic time in these units from data obtained with propafenone in eight animal species: mouse, rat, rabbit, dog, sheep, human, cow, and horse. Additionally, volume of distribution (Vdss = 6.5 B0.94) and clearance (CL = 0.17 B0.86) were correlated to body weight (B). Different units of pharmacokinetic time were evaluated with an Akaike Information Criterion test, and the Syndesichron was the unit that provided the best superimposition for the concentration-time plot for all animal species. It can be inferred that all mammalian species eliminated half of the dose from their bodies in 4759 Syndesichrons.

Prediction of the disposition of propafenone in humans and dogs from pharmacokinetic parameters in other animal species

Most allometric studies performed until now have considered results obtained by different authors. The parameters mentioned in these studies reflect experiments made under very different conditions and have been calculated by assembling these heterogeneous data reported in the literature. In this paper, we present an allometric study of propafenone carried out in eight animal species, all treated and handled under the same conditions, and taking into account their weight to calculate different pharmacokinetic parameters. Propafenone plasma concentration-time data were analyzed by a model-independent method, and the pharmacokinetic parameters (Y) were correlated with body weight (B) using linear regression analysis by the equation Y = aBx. In addition, human and dog pharmacokinetic parameters were predicted from the results obtained in the other seven species and compared with the experimentally observed values. We demonstrated that these predictions are subject to great error when drugs with extensive metabolism, such as propafenone, are considered.

Genetic factors in neurotoxicology and neuropharmacology: a critical evaluation of the use of genetics as a research tool

Animals have evolved a detoxication system to enable them to survive in a hostile chemical environment in which foods contain many non-nutrient chemicals. Detoxication depends on enzymes which are often genetically polymorphic. As a result, inter-individual variation is common, and in humans several Mendelian loci have been identified. However, most variation in response is probably due to the action of several genes. Genetic variation in response to the neurotoxin MPTP and to chemically and physically-induced seizures is reviewed. In the former case, differences between pigmented and white mouse strains have been noted which are consistent with the hypothesis that humans are more sensitive than mice or rats because of the presence of melanin in human brains. However, variation in sensitivity probably also depends on other genes. In the case of audiogenic seizures, a single locus has been identified and mapped, but its relationship with seizures induced by other agents is not clear. Genetic variation in response to alcohol is also discussed. The failure of most toxicologists to consider genetic variation as a potentially confounding variable, and as a powerful research tool, is discussed critically in relation to non-repeatability of research on the neurotoxic effects of lead, and in relation to the genetic variation in MPTP, seizures, and alcohol response already noted. It seems clear that genetic methods provide a powerful research tool which is largely being ignored by toxicologists.

Interspecies scaling and comparisons in drug development and toxicokinetics

1. Methods of interspecies extrapolation using physiological models and allometric scaling have been reviewed with their possible application to drug development, both for candidate drug selection and the interpretation of toxicokinetic data. 2. Physiological models offer a mechanistic approach to extrapolation from one species to another, examining individual components which interrelate to produce the characteristics of the whole system. Tissues of interest are arranged in anatomical order based on blood circulation, and the disposition of a drug can be simulated with knowledge of tissue size (volume), tissue perfusion (blood flow), drug permeability, binding of the drug between the tissue and blood (partition), as well as elimination. Using this approach the behaviour of the drug under different conditions, such as dose route, disease state or animal species, can be predicted. 3. The alternative approach of allometric scaling is an empirical examination of relationships between size, time and its consequences. A regression of the logarithm of the pharmacokinetic parameter and the logarithm of the body weight of the animal species produces a linear relationship which enables the value of pharmacokinetic parameters in any animal species to be calculated from the product of an allometric coefficient and the body weight to a power function. 4. Whilst this technique gives acceptable predictions for the pharmacokinetics of those drugs eliminated renally, or which are blood flow-dependent, there is poor prediction for humans for low clearance drugs primarily eliminated by the mixed-function oxidase system. This appears to be a result of differences in maturation, and can be corrected for by including a brain weight or maximum life-span potential term into the allometric equation. 5. Of the two approaches described for extrapolation of pharmacokinetics between animal species, physiological models tend to be resource-demanding and costly, with more frequent failures, but can be invaluable for examining target organ exposure and for the targeting of drugs as in cancer chemotherapy. For routine drug development, however, allometric scaling is potentially more useful since it uses data which are routinely obtained and the calculations are relatively simple. 6. The problems of intraspecies scaling from high-dose data to low-dose predictions are discussed with respect to current models of dose levels. A new approach is proposed using a modified Hill equation based on drug exposure, which should allow for a more meaningful determination of the toxicity of a compound with different drug exposures.(ABSTRACT TRUNCATED AT 400 WORDS)

Physiological pharmacokinetic modelling

1. The different types of models are described, with emphasis on the clearance-based one-compartment model, and on full physiological models which distinguish between a number of anatomical compartments interconnected through the body fluid system. 2. The clearance-based, one-compartment model incorporates physiological concepts, such as apparent volume of distribution, systemic availability, hepatic and renal clearance. As opposed to the classical rate constant-based model, it allows a study of the influence of plasma protein binding, hepatic intrinsic clearance and blood flow. The advantages of such an approach are illustrated in two typical situations, namely renal insufficiency and saturable protein binding. 3. In full physiological models each compartment represents a particular organ or tissue, further divided into vascular, interstitial and cellular spaces. Mass balance equations are written for each of these subcompartments. Shortcomings of such comprehensive models include difficulty in collecting tissue data, especially human, and sophisticated numerical techniques needed for parameter estimation. The main advantages are specific organ metabolism and transport, and the possibility of scaling up from animal to human. 4. The pharmacokinetic parameters important for new drug registration are also listed.

New approaches to the use of pharmacokinetics in toxicology and drug development

1. The use of pharmacokinetics in toxicology, clinical pharmacology and in the individualization of dosage has been critically examined. 2. In toxicity studies, doses are given to animals with the aim of achieving substantially higher plasma levels than the therapeutic level in man. However, small animals have faster metabolic rates, shorter life spans and drug clearance is many fold faster than in man, and this difference may not be compensated for by simply mg per kg dosing. Since toxicity still occurs at these lower levels, it begs the question whether small animals require such high doses to produce toxic effects. 3. A literature survey revealed that only 5 to 31% of the papers studied attempt to relate activity with plasma levels. Examples are given of how such relationships can be used, as with D-fenfluramine, where by investigating individual responses using drug plasma levels as a probe, a greater understanding of eating disorders may be obtained. Also, with tertatolol its prolonged pharmacological activity (greater than 24 h) can be explained mathematically despite a plasma half-life of only 3 h. 4. The advantages and disadvantages of population kinetics are discussed in relation to its use in individualizing dosage, particularly in disease, its appreciation by pharmaceutical companies and regulatory authorities and the information which has been obtained so far. 5. It is of interest that one of the youngest of drug development disciplines, pharmacokinetics, is now one of the most important.

Physiologic pharmacokinetic modeling

Although physiologic modeling has not gained the widespread acceptance that was originally projected, it may serve as the basis for future PK/PD modeling approaches. In addition, with more effort applied to developing in vitro and animal-to-human predictions, physiologic modeling may assume a higher position in the pharmacokinetic modeling hierarchy.

Comparison of hepatic drug metabolizing enzyme activities in several agricultural species

1. Several pathways of drug metabolizing enzyme activity were measured in hepatic fractions of cattle, sheep, goats, chickens, turkeys, ducks, rabbits and rats. The pathways examined included the O-demethylation of p-nitrophenol, microsomal ester hydrolysis of procaine and glucuronidation of p-nitrophenol, and the cytosolic acetylation of sulfamethazine and sulfation of 2-naphthol. 2. For most enzymatic pathways measured, goats were more similar to sheep (wether) than to cattle (steers). The exception was UDP-glucuronyltransferase activity, which was significantly higher for the goat than for any other species studied. 3. Within the avian subset, the chicken and turkey were usually the most similar species. 4. The activities of arylsulfotransferase isozymes III and IV were particularly low for the duck compared to the chicken and turkey. 5. N-acetyltransferase activity was very high for rabbits and very low for sheep and goats.

Man versus beast: pharmacokinetic scaling in mammals

Land mammals range in size from the 3-g shrew to the 3000-kg elephant. Despite this 10(6) range in weight, most land mammals have similar anatomy, physiology, biochemistry, and cellular structure. This similarity has allowed interspecies scaling of physiologic properties such as heart rate, blood flow, blood volume, organ size, and longevity. The equation that is the basis for scaling physiologic properties among mammals is the power equation Y = aWb, where Y is the physiologic variable of interest, W is body weight, and log a is the y-intercept and b is the slope obtained from the plot of log Y versus log W. Animals commonly used in preclinical drug studies (i.e., mice, rats, rabbits, monkeys, and dogs) do not eliminate drugs at the same rate that humans eliminate drugs; small mammals usually eliminate drugs faster than large mammals. Since drug elimination is intimately associated with physiologic properties that are well described among species, it seems reasonable to surmise that drug elimination can be scaled among mammals. Analysis of drug pharmacokinetics in numerous species demonstrates that drug elimination among species is predictable and, in general, obeys the power equation Y = aWb. Early papers on interspecies pharmacokinetic scaling normalized the x- and y-axes to illustrate the superimpossibility of pharmacokinetic curves from different species. More recently, the x- and y-axes have been left in the common units of concentration and time, and individual pharmacokinetic variables have been adjusted to predict pharmacokinetic profiles in an untested species, usually humans.

Biological basis for extrapolation across mammalian species

The rationale for extrapolation or "scaling" across species is founded in the commonality of anatomic characteristics and the universality of physiologic functions and biochemical reactions. The development of the allometric equation, Y = aWn, relating species body size (W) with various morphological, physiological, biochemical, pharmacological, and toxicological characteristics, as the fundamental basis for extrapolation of biological data from laboratory animals to man is outlined. The familiar methods of extrapolation on the basis of "milligrams per kilogram body weight" and "body surface area" are simply examples, W1.0 and W0.67, respectively, of this equation. The experimental observations used to support these two, and other extrapolation bases, are reviewed. Criteria for the selection of an appropriate base for transfer of specific biologic data from laboratory animals to man, and the expected reliability of the extrapolation, are discussed with the enunciation of four guiding principles. The application of these principles to the extrapolation to man of dose-tumor incidence data from carcinogenicity bioassays of laboratory animals is discussed. The components are identified, and illustrative examples are given.

Scaling of antipyrine intrinsic clearance of unbound drug in 15 mammalian species

The intrinsic clearance of unbound drug (CLuint) for antipyrine in 15 mammalian species was characterized by an equation of the form, CLuint = theta 1 (body weight) theta 2 (brain weight) theta 3, where thetas are constants. Maximum lifespan potential in mammals can also be characterized by an equation of this form. It is suggested that the set of genetic mechanisms regulating longevity and other constitutional characteristics in species is also linked to rates of drug metabolism. The ability to scale interspecies data in pharmacokinetics is taken as an expression of this design principle.