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Jeong H, Armstrong AT, Isoherranen N, Czuba L, Yang A, Zumpf K, Ciolino J, Torres E, Stika CS, Wisner KL. Temporal changes in the systemic concentrations of retinoids in pregnant and postpartum women. PLoS One 2023; 18:e0280424. [PMID: 36795769 PMCID: PMC9934425 DOI: 10.1371/journal.pone.0280424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/02/2023] [Indexed: 02/17/2023] Open
Abstract
Retinoids and vitamin A are essential for multiple biological functions, including vision and immune responses, as well as the development of an embryo during pregnancy. Despite its importance, alterations in retinoid homeostasis during normal human pregnancy are incompletely understood. We aimed to characterize the temporal changes in the systemic retinoid concentrations across pregnancy and postpartum period. Monthly blood samples were collected from twenty healthy pregnant women, and plasma concentrations of retinol, all-trans-retinoic acid (atRA), 13-cis-retinoic acid (13cisRA), and 4-oxo-retinoic acids were measured using liquid chromatography-tandem mass spectrometry. Significant decreases in 13cisRA concentrations over the pregnancy were observed, with rebound increases in retinol and 13cisRA levels after delivery. Of note, atRA concentrations exhibited a unique temporal pattern with levels peaking at mid-pregnancy. While the 4-oxo-atRA concentration was below the limit of quantification, 4-oxo-13cisRA was readily detectable, and its temporal change mimicked that of 13cisRA. The time profiles of atRA and 13cisRA remained similar after correction by albumin levels for plasma volume expansion adjustment. Together, the comprehensive profiling of systemic retinoid concentrations over the course of pregnancy provides insights into pregnancy-mediated changes in retinoid disposition to maintain its homeostasis.
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Affiliation(s)
- Hyunyoung Jeong
- Department of Industrial and Physical Pharmacy and Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, IN, United States of America
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, IN, United States of America
| | - Abigail T. Armstrong
- Department of Industrial and Physical Pharmacy and Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, IN, United States of America
| | - Nina Isoherranen
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA, United States of America
| | - Lindsay Czuba
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA, United States of America
| | - Amy Yang
- Department of Preventive Medicine (Biostatistics), Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Katelynn Zumpf
- Department of Preventive Medicine (Biostatistics), Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Jody Ciolino
- Department of Preventive Medicine (Biostatistics), Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Elizabeth Torres
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Catherine S. Stika
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Katherine L. Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
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Shum S, Yadav A, Fay E, Moreni S, Mao J, Czuba L, Wang C, Isoherranen N, Hebert MF. Infant dextromethorphan and dextrorphan exposure via breast milk from mothers who are CYP2D6 extensive metabolizers. J Clin Pharmacol 2021; 62:747-755. [PMID: 34889461 DOI: 10.1002/jcph.2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/03/2021] [Indexed: 11/11/2022]
Abstract
The risk of infant exposure to dextromethorphan (DM) and its active metabolite, dextrorphan (DX), through breast milk has not been evaluated. In this study, bound and unbound DM and DX concentrations in breast milk and plasma at 2 h post-dose were measured in 20 lactating women (n = 20) following a single 30 mg oral dose of DM. The DM and DX concentrations in breast milk were positively correlated with their respective plasma concentrations. The breast milk-to-plasma (M/P) ratios of 1.0 and 1.6 and the unbound M/P ratios of 1.1 and 2.0 for DM and DX, respectively, suggested that DM and DX are extensively distributed into breast milk. The infant exposure following a single dose of 30 mg DM was estimated using the breast milk concentrations to be 0.33 ± 0.32 μg/kg/day and 1.8 ± 1.0 μg/kg/day for DM and DX, respectively. The steady-state infant exposure was estimated using the M/P ratios and previously reported AUC of DM and DX following repeated dosing of DM 60 mg orally twice daily to be 0.64 ± 0.22 μg/kg/day and 1.23 ± 0.38 μg/kg/day, respectively. Based on these estimated infant doses, the relative infant doses (RIDs) were estimated to be <1%, suggesting the infant is only exposed to a minor fraction of adult dose through breast milk; however, one nursing infant developed an erythematous rash during this study which warrants additional research to fully elucidate the risks of infant exposure to DM and DX through breast milk. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sara Shum
- University of Washington, Department of Pharmaceutics, Seattle, WA, USA
| | - Aprajita Yadav
- University of Washington, Department of Pharmaceutics, Seattle, WA, USA
| | - Emily Fay
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA
| | - Sue Moreni
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA
| | - Jennie Mao
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA
| | - Lindsay Czuba
- University of Washington, Department of Pharmaceutics, Seattle, WA, USA
| | - Celine Wang
- University of Washington, Department of Pharmacy, Seattle, WA, USA
| | - Nina Isoherranen
- University of Washington, Department of Pharmaceutics, Seattle, WA, USA
| | - Mary F Hebert
- University of Washington, Department of Obstetrics and Gynecology, Seattle, WA, USA.,University of Washington, Department of Pharmacy, Seattle, WA, USA
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Zhong G, Snyder J, Hogarth C, LaFrance J, Huang W, Topping T, Palau L, Ghiaur G, Duncan K, Vaishnava S, Czuba L, Isoherranen N. Postnatal loss of Cyp26a1 and Cyp26b1 in mice causes impaired retinoid homeostasis in multiple organs. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.07035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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