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1.
Drug Metab Dispos ; 48(12): 1264-1270, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33037044

RESUMEN

Organic anion-transporting polypeptide (OATP) 1B1/3-mediated drug-drug interaction (DDI) potential is evaluated in vivo with rosuvastatin (RST) as a probe substrate in clinical studies. We calibrated our assay with RST and estradiol 17-ß-D-glucuronide (E217ßG)/cholecystokinin-8 (CCK8) as in vitro probes for qualitative and quantitative prediction of OATP1B-mediated DDI potential for RST. In vitro OATP1B1/1B3 inhibition using E217ßG and CCK8 yielded higher area under the curve (AUC) ratio (AUCR) values numerically with the static model, but all probes performed similarly from a qualitative cutoff-based prediction, as described in regulatory guidances. However, the magnitudes of DDI were not captured satisfactorily. Considering that clearance of RST is also mediated by gut breast cancer resistance protein (BCRP), inhibition of BCRP was also incorporated in the DDI prediction if the gut inhibitor concentrations were 10 × IC50 for BCRP inhibition. This combined static model closely predicted the magnitude of RST DDI with root-mean-square error values of 0.767-0.812 and 1.24-1.31 with and without BCRP inhibition, respectively, for in vitro-in vivo correlation of DDI. Physiologically based pharmacokinetic (PBPK) modeling was also used to simulate DDI between RST and rifampicin, asunaprevir, and velpatasvir. Predicted AUCR for rifampicin and asunaprevir was within 1.5-fold of that observed, whereas that for velpatasvir showed a 2-fold underprediction. Overall, the combined static model incorporating both OATP1B and BCRP inhibition provides a quick and simple mathematical approach to quantitatively predict the magnitude of transporter-mediated DDI for RST for routine application. PBPK complements the static model and provides a framework for studying molecules when a dynamic model is needed. SIGNIFICANCE STATEMENT: Using 22 drugs, we show that a static model for organic anion-transporting polypeptide (OATP) 1B1/1B3 inhibition can qualitatively predict potential for drug-drug interaction (DDI) using a cutoff-based approach, as in regulatory guidances. However, consideration of both OATP1B1/3 and gut breast cancer resistance protein inhibition provided a better prediction of the magnitude of the transporter-mediated DDI of these inhibitors with rosuvastatin. Based on these results, we have proposed an empirical mechanistic-static approach for a more reliable prediction of transporter-mediated DDI liability with rosuvastatin that drug development teams can leverage.


Asunto(s)
Transportador 1 de Anión Orgánico Específico del Hígado/metabolismo , Modelos Biológicos , Rosuvastatina Cálcica/farmacocinética , Miembro 1B3 de la Familia de los Transportadores de Solutos de Aniones Orgánicos/metabolismo , Transportador de Casetes de Unión a ATP, Subfamilia G, Miembro 2/antagonistas & inhibidores , Transportador de Casetes de Unión a ATP, Subfamilia G, Miembro 2/metabolismo , Área Bajo la Curva , Colecistoquinina/farmacocinética , Evaluación Preclínica de Medicamentos , Interacciones Farmacológicas , Estradiol/análogos & derivados , Estradiol/farmacocinética , Células HEK293 , Humanos , Transportador 1 de Anión Orgánico Específico del Hígado/antagonistas & inhibidores , Proteínas de Neoplasias/antagonistas & inhibidores , Proteínas de Neoplasias/metabolismo , Fragmentos de Péptidos/farmacocinética , Miembro 1B3 de la Familia de los Transportadores de Solutos de Aniones Orgánicos/antagonistas & inhibidores
2.
Theranostics ; 10(7): 3138-3150, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32194859

RESUMEN

Multiple sclerosis (MS) is a demyelinating inflammatory disease of the central nervous system (CNS), which is a chronic progressive disease and is caused by uncontrolled activation of myelin antigen specific T cells. It has high unmet medical needs due to the difficulty of efficient drug delivery into the CNS to control tissue inflammation. In this study, we demonstrate that a fusion protein of NOD-like receptor family member X1 (NLRX1) and blood brain barrier (BBB)-permeable peptide, dNP2 ameliorates experimental autoimmune encephalomyelitis (EAE). Methods: We purified recombinant LRR or NBD regions of NLRX1 protein conjugated with dNP2. To examine intracellular delivery efficiency of the recombinant protein, we incubated the proteins with Jurkat T cells or murine splenic T cells and their delivery efficiency was analyzed by flow cytometry. To investigate the therapeutic efficacy in an EAE model, we injected the recombinant protein into mice with 3 different treatment schemes e.g., prevention, semi-therapeutic, and therapeutic. To analyze their functional roles in T cells, we treated MACS-sorted naïve CD4 T cells with the proteins during their activation and differentiation into Th1, Th17, and Treg cells. Results: dNP2-LRR protein treatment showed significantly higher delivery efficiency than TAT-LRR or LRR alone in Jurkat T cells and mouse splenic T cells. In all three treatment schemes of EAE experiments, dNP2-LRR administration showed ameliorated tissue inflammation and disease severity with reduced number of infiltrating T cells producing inflammatory cytokines such as IFNγ. In addition, dNP2-LRR inhibited T cell activation, cytokine production, and Th1 differentiation. Conclusion: These results suggest that dNP2-LRR is a novel agent, which regulates effector T cell functions and could be a promising molecule for the treatment of CNS autoimmune diseases such as multiple sclerosis.


Asunto(s)
Péptidos de Penetración Celular/administración & dosificación , Portadores de Fármacos/administración & dosificación , Encefalomielitis Autoinmune Experimental/tratamiento farmacológico , Proteínas Mitocondriales/química , Linfocitos T/efectos de los fármacos , Secuencia de Aminoácidos , Animales , Barrera Hematoencefálica , Péptidos de Penetración Celular/farmacocinética , Portadores de Fármacos/farmacocinética , Evaluación Preclínica de Medicamentos , Encefalomielitis Autoinmune Experimental/inmunología , Femenino , Humanos , Células Jurkat , Activación de Linfocitos/efectos de los fármacos , Linfocinas/biosíntesis , Ratones , Ratones Endogámicos C57BL , Fragmentos de Péptidos/administración & dosificación , Fragmentos de Péptidos/farmacocinética , Fragmentos de Péptidos/farmacología , Fragmentos de Péptidos/uso terapéutico , Dominios Proteicos , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/uso terapéutico , Organismos Libres de Patógenos Específicos , Médula Espinal/metabolismo , Médula Espinal/patología , Linfocitos T/inmunología , Linfocitos T/metabolismo
3.
Clin Cancer Res ; 26(6): 1318-1326, 2020 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-31843751

RESUMEN

PURPOSE: Tumor periphery and lymph nodes of tumor-induced lymphangiogenesis often abundantly express VEGFR-3. In our previous study, we identified a 5-amino acid peptide named TMVP1, which binds specifically to VEGFR-3. The objective of this study was to develop a novel 68Ga-labeled TMVP1 for VEGFR-3 PET imaging and to investigate its safety, biodistribution, and tumor-localizing efficacy in xenograft tumor models and a small cohort of patients with recurrent ovarian and cervical cancer. EXPERIMENTAL DESIGN: The DOTA-conjugated TMVP1 peptide was labeled with radionuclide 68Ga. SPR and saturation binding assays were used for the receptor-binding studies. Gynecologic xenograft tumors were employed for small-animal PET imaging and biodistribution of 68Ga-DOTA-TMVP1 in vivo. In the clinical study, 5 healthy volunteers and 8 patients with gynecologic cancer underwent whole-body PET/CT after being injected with 68Ga-DOTA-TMVP1. RESULTS: DOTA-TMVP1 was successfully labeled with 68Ga. LECs showed higher binding capacity with 68Ga-DOTA-TMVP1 than LEC(shVEGFR-3) and human umbilical vein endothelial cells. In mice with subcutaneous C33-A and SKOV-3 xenografts, the tracer was rapidly eliminated through the kidney to the bladder, and the small-animal PET/CT helped to clearly visualize the tumors. In patients with recurrent ovarian cancer and cervical cancer, tracer accumulation well above the background level was demonstrated in most identified sites of disease; especially with recurrent endodermal sinus tumors, the diagnostic value of 68Ga-DOTA-TMVP1 was comparable with that of 18F-FDG PET/CT. CONCLUSIONS: 68Ga-DOTA-TMVP1 is a potential PET tracer for imaging VEGFR-3 with favorable pharmacokinetics.


Asunto(s)
Fluorodesoxiglucosa F18/farmacocinética , Compuestos Heterocíclicos con 1 Anillo/farmacocinética , Neoplasias Ováricas/patología , Fragmentos de Péptidos/farmacocinética , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Neoplasias del Cuello Uterino/patología , Receptor 3 de Factores de Crecimiento Endotelial Vascular/metabolismo , Animales , Línea Celular Tumoral , Evaluación Preclínica de Medicamentos , Femenino , Fluorodesoxiglucosa F18/química , Compuestos Heterocíclicos con 1 Anillo/química , Humanos , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Ováricas/metabolismo , Fragmentos de Péptidos/química , Radiofármacos/química , Radiofármacos/farmacocinética , Distribución Tisular , Neoplasias del Cuello Uterino/diagnóstico por imagen , Neoplasias del Cuello Uterino/metabolismo , Ensayos Antitumor por Modelo de Xenoinjerto
4.
Mol Pharm ; 15(3): 1169-1179, 2018 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-29436835

RESUMEN

Peptides often suffer from short in vivo half-lives due to proteolysis and renal clearance that limit their therapeutic potential in many indications, necessitating pharmacokinetic (PK) enhancement. d-Peptides, composed of mirror-image d-amino acids, overcome proteolytic degradation but are still vulnerable to renal filtration due to their small size. If renal filtration could be slowed, d-peptides would be promising therapeutic agents for infrequent dosing, such as in extended-release depots. Here, we tether a diverse set of PK-enhancing cargoes to our potent, protease-resistant d-peptide HIV entry inhibitor, PIE12-trimer. This inhibitor panel provides an opportunity to evaluate the PK impact of the cargoes independently of proteolysis. While all the PK-enhancing strategies (PEGylation, acylation, alkylation, and cholesterol conjugation) improved in vivo half-life, cholesterol conjugation of PIE12-trimer dramatically improves both antiviral potency and half-life in rats, making it our lead anti-HIV drug candidate. We designed its chemical synthesis for large-scale production (CPT31) and demonstrated that the PK profile in cynomolgous monkeys supports future development of monthly or less frequent depot dosing in humans. CPT31 could address an urgent need in both HIV prevention and treatment.


Asunto(s)
Inhibidores de Fusión de VIH/farmacocinética , Infecciones por VIH/tratamiento farmacológico , VIH-1/efectos de los fármacos , Fragmentos de Péptidos/farmacocinética , Animales , Colesterol/química , Preparaciones de Acción Retardada , Portadores de Fármacos/química , Diseño de Fármacos , Evaluación Preclínica de Medicamentos , Inhibidores de Fusión de VIH/administración & dosificación , Inhibidores de Fusión de VIH/síntesis química , Infecciones por VIH/prevención & control , Infecciones por VIH/virología , VIH-1/fisiología , Semivida , Macaca fascicularis , Masculino , Modelos Animales , Fragmentos de Péptidos/administración & dosificación , Fragmentos de Péptidos/síntesis química , Ratas , Ratas Sprague-Dawley , Estereoisomerismo
5.
Brain Res ; 1664: 1-8, 2017 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-28347670

RESUMEN

This study describes the localization of [D-Leu-4]-OB3 and MA-[D-Leu-4]-OB3, synthetic peptide leptin mimetics, in the hypothalamus of Swiss Webster and C57BL/6J wild-type mice, leptin-deficient ob/ob mice, and leptin-resistant diet-induced obese (DIO) mice. The mice were given [D-Leu-4]-OB3 or MA-[D-Leu-4]-OB3 in 0.3% dodecyl maltoside by oral gavage. Once peak serum concentrations were reached, the mice received a lethal dose of pentobarbital and were subjected to intracardiac perfusion fixation. The brains were excised, post-fixed in paraformaldehyde, and cryo-protected in sucrose. Free-floating frozen coronal sections were cut at 25-µm and processed for imaging by immunofluorescence microscopy. In all four strains of mice, dense staining was concentrated in the area of the median eminence, at the base and/or along the inner wall of the third ventricle, and in the brain parenchyma at the level of the arcuate nucleus. These results indicate that [D-Leu-4]-OB3 and MA-[D-Leu-4]-OB3 cross the blood-brain barrier and concentrate in an area of the hypothalamus known to regulate energy balance and glucose homeostasis. Most noteworthy is the localization of [D-Leu-4]-OB3 immunoreactivity within the hypothalamus of DIO mice via a conduit that is closed to leptin in this rodent model, and in most cases of human obesity. Together with our previous studies describing the effects of [D-Leu-4]-OB3 and MA-[D-Leu-4]-OB3 on energy balance, glucose regulation, and signal transduction pathway activation, these findings are consistent with a central mechanism of action for these synthetic peptide leptin mimetics, and suggest their potential usefulness in the management of leptin-resistant obesity and type 2 diabetes in humans.


Asunto(s)
Hipotálamo/química , Leptina/administración & dosificación , Leptina/farmacocinética , Fragmentos de Péptidos/administración & dosificación , Fragmentos de Péptidos/farmacocinética , Administración Oral , Animales , Anticuerpos/administración & dosificación , Barrera Hematoencefálica/metabolismo , Técnica del Anticuerpo Fluorescente , Hipotálamo/inmunología , Leptina/inmunología , Masculino , Ratones Endogámicos C57BL , Fragmentos de Péptidos/inmunología
6.
Peptides ; 75: 109-17, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26643957

RESUMEN

Obesity is an escalating epidemic, but an effective non-invasive therapy is still scarce. For obesity treatment, anorexigenic neuropeptides are promising tools, but their delivery from the periphery to the brain is complicated by their peptide character. In order to overcome this unfavorable fact, we have applied the lipidization of neuropeptide prolactin-releasing peptide (PrRP), whose strong anorexigenic effect was demonstrated. A palmitoylated analog of human PrRP (h palm-PrRP31) was injected in free-fed Wistar rats by three routes: subcutaneous (s.c.), intraperitoneal (i.p) (both 5 mg/kg) and intravenous (i.v.) (from 0.01 to 0.5 mg/kg). We found a circulating compound in the blood after all three applications with the highest concentration after i.v. administration. This corresponds to the effect on food intake, which was also strongest after i.v. injection. Moreover, this is in agreement with the fact that the expression of c-Fos in specific brain regions involved in food intake regulation was also highest after intravenous application. Pharmacokinetic data are further supported by results obtained from dynamic light scattering and CD spectroscopy. Human palm-PrRP31 analog showed a strong tendency to micellize, and formation of aggregates suggested lower availability after i.p. or s.c. application. We have demonstrated that palm-PrRP influenced food intake even in free fed rats. Not surprisingly, the maximal effect was achieved after the intravenous application even though two orders of magnitude lower dose was used compared to both two other applications. We believe that palm-PrRP could have a potential as an antiobesity drug when its s.c. application would be improved.


Asunto(s)
Fármacos Antiobesidad/administración & dosificación , Ingestión de Energía/efectos de los fármacos , Fragmentos de Péptidos/administración & dosificación , Hormona Liberadora de Prolactina/análogos & derivados , Animales , Fármacos Antiobesidad/metabolismo , Fármacos Antiobesidad/farmacocinética , Encéfalo/metabolismo , Células CHO , Cricetinae , Cricetulus , Evaluación Preclínica de Medicamentos , Humanos , Neuronas/efectos de los fármacos , Neuronas/metabolismo , Obesidad/tratamiento farmacológico , Fragmentos de Péptidos/metabolismo , Fragmentos de Péptidos/farmacocinética , Hormona Liberadora de Prolactina/administración & dosificación , Hormona Liberadora de Prolactina/metabolismo , Hormona Liberadora de Prolactina/farmacocinética , Unión Proteica , Proteínas Proto-Oncogénicas c-fos/metabolismo , Ratas , Receptores Acoplados a Proteínas G/metabolismo
7.
Adv Clin Exp Med ; 24(4): 579-84, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26469101

RESUMEN

BACKGROUND: It was previously found that synthetic, insect-derived octapeptide leucopyrokinin (LPK) applied directly into the lateral brain ventricle induced a significant antinociceptive effect in rats. Its synthetic truncated analog heptapeptide [2-8]-leucopyrokinin displayed a stronger antinociceptive effect in comparison to native LPK. Moreover it was previously found a high accumulation of these both 125I-labeled peptides in adrenals, as well as in hypothalamus and in hippocampus of rats brain. OBJECTIVES: The aim of the present study was to assess the distribution of 125I-labeled [2-8]-leucopyrokinin in rats' internal organs an in several parts of the brain after peripheral - intraperitoneal (i.p.) administration. MATERIAL AND METHODS: The study was performed on male Wistar rats. A synthetic [2-8]-leucopyrokinin ([2-8]-LPK) was iodinated with Na125I. On the day of experiment a solution of 125I-[2-8]-LPK was i.p. injected and the next after 1 and 24 h animals were sacrificed by decapitation. Radioactivity levels in samples of parts of the brain and of internal organs were determined by counter Gamma Auto Count. RESULTS: A uniform, low accumulation 125I-[2-8]-LPK was found in evaluated samples of the brain and in internal organs. CONCLUSIONS: The results of the present study indicate a weak penetration into the brain and internal organs of intraperitoneally applied 125I-[2-8]-LPK in rats and correspond with previously determined weak biological effects of i.p. injected LPK and [2-8]-LPK.


Asunto(s)
Analgésicos/administración & dosificación , Analgésicos/farmacocinética , Neuropéptidos/administración & dosificación , Neuropéptidos/farmacocinética , Oligopéptidos/administración & dosificación , Oligopéptidos/farmacocinética , Fragmentos de Péptidos/administración & dosificación , Fragmentos de Péptidos/farmacocinética , Ácido Pirrolidona Carboxílico/análogos & derivados , Glándulas Suprarrenales/metabolismo , Animales , Hipocampo/metabolismo , Hipotálamo/metabolismo , Inyecciones Intraperitoneales , Masculino , Permeabilidad , Ácido Pirrolidona Carboxílico/administración & dosificación , Ácido Pirrolidona Carboxílico/farmacocinética , Ratas Wistar , Distribución Tisular
8.
Gut ; 64(2): 222-32, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24811998

RESUMEN

OBJECTIVE: Antimicrobial peptides (AMP) provide protection from infection by pathogenic microorganisms and restrict bacterial growth at epithelial surfaces to maintain mucosal homeostasis. In addition, they exert a significant anti-inflammatory activity. Here we analysed the anatomical distribution and biological activity of an orally administered AMP in the context of bacterial infection and host-microbial homeostasis. DESIGN: The anatomical distribution as well as antibacterial and anti-inflammatory activity of the endogenous AMP cryptdin 2 and the synthetic peptide Pep19-2.5 at the enteric mucosal surface were analysed by immunostaining, functional viability and stimulation assays, an oral Salmonella enterica subsp. enterica sv. Typhimurium (S. Typhimurium) model and comparative microbiota analysis. RESULTS: Endogenous cryptdin 2 was found attached to bacteria of the enteric microbiota within the intestinal mucus layer. Similarly, the synthetic peptide Pep19-2.5 attached rapidly to bacterial cells, exhibited a marked affinity for the intestinal mucus layer in vivo, altered the structural organisation of endotoxin in a mucus matrix and demonstrated potent anti-inflammatory and antibacterial activity. Oral Pep19-2.5 administration induced significant changes in the composition of the enteric microbiota as determined by high-throughput 16S rDNA sequencing. This may have contributed to the only transient improvement of the clinical symptoms after oral infection with S. Typhimurium. CONCLUSIONS: Our findings demonstrate the anti-inflammatory activity and mucus affinity of the synthetic AMP Pep19-2.5 and characterise the influence on microbiota composition and enteropathogen infection after oral administration.


Asunto(s)
Antibacterianos/farmacocinética , Antiinflamatorios/farmacocinética , Mucosa Intestinal/metabolismo , Fragmentos de Péptidos/farmacocinética , Administración Oral , Animales , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Antiinflamatorios/administración & dosificación , Células Cultivadas , Defensinas , Evaluación Preclínica de Medicamentos/métodos , Femenino , Interacciones Huésped-Patógeno/fisiología , Humanos , Mucosa Intestinal/microbiología , Ratones Endogámicos C57BL , Microbiota/efectos de los fármacos , Moco/metabolismo , Moco/microbiología , Fragmentos de Péptidos/administración & dosificación , Fragmentos de Péptidos/uso terapéutico , Proteínas/metabolismo , Infecciones por Salmonella/tratamiento farmacológico , Infecciones por Salmonella/metabolismo , Infecciones por Salmonella/microbiología , Salmonella typhimurium/efectos de los fármacos , Salmonella typhimurium/metabolismo , Salmonella typhimurium/fisiología
9.
Int J Nanomedicine ; 9: 4819-28, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25378923

RESUMEN

PURPOSE: As a potential protein therapeutic for type 2 diabetes mellitus (T2DM), BAY 55-9837 is limited by poor stability and a very short half-life in vivo. The purpose of this study was to construct a novel nanostructured biomaterial by conjugating BAY 55-9837 to chitosan-decorated selenium nanoparticles (CS-SeNPs) to prolong the in vivo half-life of BAY 55-9837 by reducing its renal clearance rate. MATERIALS AND METHODS: BAY 55-9837-loaded CS-SeNPs (BAY-CS-SeNPs) were prepared, and their surface morphology, particle size, zeta potential, and structure were characterized. The stability, protein-loading rate, and in vitro release of BAY 55-9837 from CS-SeNPs were also quantified. Additionally, a sensitive high-performance liquid chromatography (HPLC) assay was developed for the quantification of BAY 55-9837 in mouse plasma. Thereafter, mice were injected via the tail vein with either BAY 55-9837 or BAY-CS-SeNPs, and the plasma concentration of BAY 55-9837 was determined via our validated HPLC method at different time intervals postinjection. Relevant in vivo pharmacokinetic parameters (half-life, area under the curve from time 0 to last sampling point, observed clearance) were then calculated and analyzed. RESULTS: BAY-CS-SeNPs were successfully synthesized, with diameters of approximately 200 nm. BAY-CS-SeNPs displayed good stability with a high protein-loading rate, and the release process of BAY 55-9837 from the CS-SeNPs lasted for over 70 hours, with the cumulative release reaching 78.9%. Moreover, the conjugation of CS-SeNPs to BAY 55-9837 significantly reduced its renal clearance to a rate of 1.56 mL/h and extended its half-life to 20.81 hours. CONCLUSION: In summary, our work provides a simple method for reducing the renal clearance rate and extending the half-life of BAY 55-9837 in vivo by utilizing CS-SeNPs as nanocarriers.


Asunto(s)
Quitosano/química , Portadores de Fármacos/farmacocinética , Nanopartículas/química , Fragmentos de Péptidos/farmacocinética , Selenio/química , Animales , Diabetes Mellitus Tipo 2 , Portadores de Fármacos/química , Estabilidad de Medicamentos , Semivida , Ratones , Tamaño de la Partícula , Fragmentos de Péptidos/química , Péptido Intestinal Vasoactivo/química , Péptido Intestinal Vasoactivo/farmacocinética
10.
Peptides ; 51: 65-73, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24262271

RESUMEN

Low angiotensin-(1-7) (Ang-(1-7)) concentration is observed in some cardiovascular diseases and exercise training seems to restore its concentration in the heart. Recently, a novel formulation of an orally active Ang-(1-7) included in hydroxy-propyl-beta-cyclodextrin (HPB-CD) was developed and chronically administered in experimental models of cardiovascular diseases. The present study examined whether chronic administration of HPB-CD/Ang-(1-7) produces beneficial cardiovascular effects in spontaneously hypertensive rats (SHR), as well as to compare the results obtained with those produced by exercise training. Male SHR (15-week old) were divided in control (tap water) or treated with HPB-CD/Ang-(1-7) (corresponding to 30µgkg(-1)day(-1) of Ang-(1-7)) by gavage, concomitantly or not to exercise training (treadmill, 10 weeks). After chronic treatment, hemodynamic, morphometric and molecular analysis in the heart were performed. Chronic HPB-CD/Ang-(1-7) decreased arterial blood pressure (BP) and heart rate in SHR. The inclusion compound significantly improved left ventricular (LV) end-diastolic pressure, restored the maximum and minimum derivatives (dP/dT) and decreased cardiac hypertrophy index in SHR. Chronic treatment improved autonomic control by attenuating sympathetic modulation on heart and vessels and the SAP variability, as well as increasing parasympathetic modulation and HR variability. Overall results were similar to those obtained with exercise training. These results show that chronic treatment with the HPB-CD/Ang-(1-7) inclusion compound produced beneficial effects in SHR resembling the ones produced by exercise training. This observation reinforces the potential cardiovascular therapeutic effect of this novel peptide formulation.


Asunto(s)
Angiotensina I/administración & dosificación , Antihipertensivos/administración & dosificación , Excipientes/administración & dosificación , Hipertensión/terapia , Fragmentos de Péptidos/administración & dosificación , beta-Ciclodextrinas/administración & dosificación , 2-Hidroxipropil-beta-Ciclodextrina , Administración Oral , Angiotensina I/farmacocinética , Animales , Antihipertensivos/farmacocinética , Presión Sanguínea , Terapia Combinada , Evaluación Preclínica de Medicamentos , Terapia por Ejercicio , Frecuencia Cardíaca , Hipertensión/fisiopatología , Masculino , Miocardio/metabolismo , Miocardio/patología , Fragmentos de Péptidos/farmacocinética , Condicionamiento Físico Animal , Ratas , Ratas Endogámicas SHR , Presión Ventricular
11.
Biotechnol Prog ; 29(3): 681-7, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23606619

RESUMEN

Chlorella pyrenoidosa is a unicellular green algae and has been a popular foodstuff worldwide. However, no reports on the antitumor peptides from such a microalgae are available in the literature. In this study, using low-temperature high-pressure extraction, enzymatic hydrolysis, ion exchange, and gel filtration chromatography, we separated a polypeptide that exhibited inhibitory activity on human liver cancer HepG2 cells, and named the polypeptide CPAP (C. pyrenoidosa antitumor polypeptide). Furthermore, the micro- and nanoencapsulation of CPAP were investigated by using two methods: complex coacervation and ionotropic gelation. The in vitro release tests revealed that CPAP was well preserved against gastric enzymatic degradation after micro/nanoencapsulation and the slowly controlled release in the intestine could be potentially achieved. These results suggest that CPAP may be a useful ingredient in food, nutraceutical, and pharmaceutical applications.


Asunto(s)
Antineoplásicos/química , Antineoplásicos/farmacología , Chlorella/química , Péptidos/química , Péptidos/farmacología , Proteínas de Plantas/química , Proteínas de Plantas/farmacología , Antineoplásicos/aislamiento & purificación , Antineoplásicos/farmacocinética , Cromatografía en Gel , Endopeptidasas , Células Hep G2 , Humanos , Nanocápsulas/química , Tamaño de la Partícula , Fragmentos de Péptidos/química , Fragmentos de Péptidos/aislamiento & purificación , Fragmentos de Péptidos/farmacocinética , Fragmentos de Péptidos/farmacología , Péptidos/aislamiento & purificación , Péptidos/farmacocinética , Extractos Vegetales/química , Proteínas de Plantas/aislamiento & purificación , Proteínas de Plantas/farmacocinética
12.
Biomed Chromatogr ; 26(8): 1024-32, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22623136

RESUMEN

For the development of human antibody Fc (fraction crystallizable) region-containing therapeutic protein candidates, which can be either monoclonal antibodies (mAbs) or pharmacologically active proteins/peptides fused to the Fc region of human Immunoglobulin G (IgG), reliable quantification of these proteins in animal pharmacokinetic study plasma samples is critical. LC-MS/MS has emerged as a promising assay platform for this purpose. LC-MS/MS assays used for bioanalysis of human antibody Fc region-containing therapeutic protein candidates frequently rely upon quantification of a 'signature' surrogate peptide whose sequence is unique to the protein analyte of interest. One drawback of the signature peptide approach is that a new LC-MS/MS assay must be developed for each new human Fc region-containing therapeutic protein. To address this issue, we propose an alternative 'universal surrogate peptide' approach for the quantification of human antibody Fc region-containing therapeutic protein candidates in plasma samples from all nonclinical species. A single surrogate tryptic peptide was identified in the Fc region of most human antibody Fc-containing therapeutic protein candidates. An LC-MS-MS method based upon this peptide was shown to be capable of supporting bioanalysis of a diversity of human Fc region-containing therapeutic protein candidates in plasma samples of all commonly used animal species.


Asunto(s)
Anticuerpos Monoclonales/química , Descubrimiento de Drogas/métodos , Evaluación Preclínica de Medicamentos/métodos , Fragmentos Fc de Inmunoglobulinas/química , Fragmentos de Péptidos/química , Secuencia de Aminoácidos , Animales , Anticuerpos Monoclonales/sangre , Anticuerpos Monoclonales/metabolismo , Anticuerpos Monoclonales/farmacocinética , Asparagina/química , Asparagina/metabolismo , Ácido Aspártico/química , Ácido Aspártico/metabolismo , Cromatografía Liquida/métodos , Simulación por Computador , Perros , Cobayas , Humanos , Hidrólisis , Fragmentos Fc de Inmunoglobulinas/sangre , Fragmentos Fc de Inmunoglobulinas/metabolismo , Macaca fascicularis , Macaca mulatta , Ratones , Datos de Secuencia Molecular , Fragmentos de Péptidos/sangre , Fragmentos de Péptidos/metabolismo , Fragmentos de Péptidos/farmacocinética , Conejos , Ratas , Espectrometría de Masas en Tándem/métodos , Tripsina/química
13.
Ann Rheum Dis ; 71(1): 143-9, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21998117

RESUMEN

OBJECTIVE: To facilitate the targeting to inflammation sites of small anti-inflammatory peptides, with short half-lives, by fusion with the latency-associated peptide (LAP) of transforming growth factor ß1 through a cleavable matrix metalloproteinase (MMP) linker. This design improves efficacy, overcoming the limitations to their clinical use. METHODS: We generated latent forms of vasoactive intestinal peptide (VIP), α-melanocyte-stimulating hormone (MSH) and γ(3)MSH by fusion to LAP through an MMP cleavage site using recombinant DNA technology. The biological activities of these latent therapeutics were studied in vivo using monosodium urate (MSU)-induced peritonitis and collagen-induced arthritis (CIA) models. We assessed gene therapy and purified protein therapy. RESULTS: The recruitment of the polymorphonuclear cells induced by MSU injection into mouse peritoneal cavity was reduced by 35% with γ(3)MSH (1 nmol), whereas administration of a much lower dose of purified latent LAP-MMP-γ(3)MSH (0.03 nmol) attenuated leucocyte influx by 50%. Intramuscular gene delivery of plasmids coding LAP-MMP-VIP and LAP-MMP-αMSH at disease onset reduced the development of CIA compared with LAP-MMP, which does not contain any therapeutic moiety. Histological analysis confirmed a significantly lower degree of inflammation, bone and cartilage erosion in groups treated with LAP-MMP-VIP or LAP-MMP-αMSH. Antibody titres to collagen type II and inflammatory cytokine production were also reduced in these two groups. CONCLUSION: Incorporation of small anti-inflammatory peptides within the LAP shell and delivered as recombinant protein or through gene therapy can control inflammatory and arthritic disease. This platform delivery can be developed to control human arthritides and other autoimmune diseases.


Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Artritis Experimental/terapia , Hormonas Estimuladoras de los Melanocitos/uso terapéutico , Fragmentos de Péptidos/uso terapéutico , Peritonitis/terapia , Proteínas Recombinantes de Fusión/uso terapéutico , Factor de Crecimiento Transformador beta/uso terapéutico , Péptido Intestinal Vasoactivo/uso terapéutico , Animales , Antiinflamatorios no Esteroideos/farmacocinética , Artritis Experimental/tratamiento farmacológico , Artritis Experimental/metabolismo , Artritis Experimental/patología , Citocinas/sangre , Sistemas de Liberación de Medicamentos , Diseño de Fármacos , Evaluación Preclínica de Medicamentos/métodos , Terapia Genética/métodos , Semivida , Masculino , Hormonas Estimuladoras de los Melanocitos/genética , Hormonas Estimuladoras de los Melanocitos/farmacocinética , Ratones , Ratones Endogámicos DBA , Fragmentos de Péptidos/genética , Fragmentos de Péptidos/farmacocinética , Peritonitis/tratamiento farmacológico , Peritonitis/metabolismo , Proteínas Recombinantes de Fusión/farmacocinética , Distribución Tisular , Resultado del Tratamiento , Péptido Intestinal Vasoactivo/genética , Péptido Intestinal Vasoactivo/farmacocinética
14.
Cancer Chemother Pharmacol ; 68(2): 513-24, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21085965

RESUMEN

PURPOSE: Characterize the preclinical pharmacokinetics, metabolic profile, multi-species toxicology, and antitumor efficacy of azurin-p28 (NSC 745104), an amphipathic, 28 amino acid fragment (aa 50-77) of the copper containing redox protein azurin that preferentially enters cancer cells and is currently under development for treatment of p53-positive solid tumors. METHODS: An LC/MS/MS assay was developed, validated, and applied to liver microsomes, serum, and tumor cells to assess cellular uptake and metabolic stability. Pharmacokinetics was established after administration of a single intravenous dose of p28 in preclinical species undergoing chronic toxicity testing. Antitumor efficacy was assessed on human tumor xenografts. A human therapeutic dose was predicted based on efficacy and pharmacokinetic parameters. RESULTS: p28 is stable, showed tumor penetration consistent with selective entry into tumor cells and significantly inhibited p53-positive tumor growth. Renal clearance, volume of distribution, and metabolic profile of p28 was relatively similar among species. p28 was non-immunogenic and non-toxic in mice and non-human primates (NHP). The no observed adverse effect level (NOAEL) was 120 mg/kg iv in female mice. A NOAEL was not established for male mice due to decreased heart and thymus weights that was reversible and did not result in limiting toxicity. In contrast, the NOAEL for p28 in NHP was defined as the highest dose (120 mg/kg/dose; 1,440 mg/m(2)/dose) studied. The maximum-tolerated dose (MTD) for subchronic administration of p28 to mice is >240 mg/kg/dose (720 mg/m(2)/dose), while the MTD for subchronic administration of p28 to Cynomolgous sp. is >120 mg/kg (1,440 mg/m(2)/dose). The efficacious (murine) dose of p28 was 10 mg/kg ip per day. CONCLUSIONS: p28 does not exhibit preclinical immunogenicity or toxicity, has a similar metabolic profile among species, and is therapeutic in xenograft models.


Asunto(s)
Antineoplásicos/efectos adversos , Antineoplásicos/farmacocinética , Azurina/efectos adversos , Azurina/farmacocinética , Neoplasias/tratamiento farmacológico , Fragmentos de Péptidos/farmacocinética , Proteína p53 Supresora de Tumor/antagonistas & inhibidores , Animales , Antineoplásicos/metabolismo , Antineoplásicos/uso terapéutico , Azurina/metabolismo , Azurina/uso terapéutico , Biotransformación , Línea Celular Tumoral , Evaluación Preclínica de Medicamentos , Femenino , Humanos , Macaca fascicularis , Masculino , Ratones , Ratones Desnudos , Nivel sin Efectos Adversos Observados , Fragmentos de Péptidos/efectos adversos , Fragmentos de Péptidos/metabolismo , Fragmentos de Péptidos/uso terapéutico , Organismos Libres de Patógenos Específicos , Carga Tumoral/efectos de los fármacos , Proteína p53 Supresora de Tumor/metabolismo , Ubiquitinación/efectos de los fármacos , Ensayos Antitumor por Modelo de Xenoinjerto
15.
Exp Clin Endocrinol Diabetes ; 118(1): 31-7, 2010 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19472101

RESUMEN

Obesity in human was found mainly due to the poor transportation of leptin through brain-blood barrier (BBB), called as leptin resistance. To produce a leptin capable of penetrating BBB, we have added Tat-PTD(9) to the C terminal of leptin to construct a fusion protein. The fusion Tat-leptin and native leptin genes were synthesized by single-step insertion of a polymerase chain reaction and expressed in Escherichia coli BL21 (Rosseta). The expressing products were purified and renatured by Ni-NTA affinity chromatography, and identified by the molecular size in SDS-PAGE gel and by its immunoreactivity to specific antibody with Western-blotting assay. To bio-functionally evaluate the fusion protein, Balb/c mice fed with high-fat diet (HFD) were given Tat-leptin, leptin or saline for 19 days. The immunohistochemical staining showed the increases in positive stains for the leptin in the region of hypothalamus of the HFD mice with either Tat-leptin or leptin as compared to saline group, but the staining intensity and frequency in the group with Tat-leptin were stronger and higher than those in the group with leptin. Furthermore, the most efficiency in preventing the body-weight gain caused by HFD was found in Tat-leptin group among these three groups. These results suggest that Tat-modified leptin may become a great potential candidate for the prevention or therapy of obese patients.


Asunto(s)
Fármacos Antiobesidad/farmacología , Fármacos Antiobesidad/farmacocinética , Hipotálamo/metabolismo , Leptina/análogos & derivados , Fragmentos de Péptidos/farmacocinética , Productos del Gen tat del Virus de la Inmunodeficiencia Humana/farmacología , Productos del Gen tat del Virus de la Inmunodeficiencia Humana/farmacocinética , Animales , Fármacos Antiobesidad/administración & dosificación , Fármacos Antiobesidad/aislamiento & purificación , Barrera Hematoencefálica , Grasas de la Dieta/administración & dosificación , Sistemas de Liberación de Medicamentos/métodos , Genes tat , Hipotálamo/efectos de los fármacos , Hipotálamo/patología , Inmunohistoquímica , Leptina/biosíntesis , Leptina/genética , Leptina/aislamiento & purificación , Leptina/farmacocinética , Leptina/farmacología , Masculino , Ratones , Ratones Endogámicos BALB C , Obesidad/tratamiento farmacológico , Obesidad/metabolismo , Obesidad/patología , Fragmentos de Péptidos/genética , Fragmentos de Péptidos/farmacología , Reacción en Cadena de la Polimerasa , Distribución Aleatoria , Proteínas Recombinantes de Fusión/biosíntesis , Proteínas Recombinantes de Fusión/aislamiento & purificación , Proteínas Recombinantes de Fusión/farmacocinética , Proteínas Recombinantes de Fusión/farmacología , Factores de Tiempo , Distribución Tisular , Aumento de Peso/efectos de los fármacos , Productos del Gen tat del Virus de la Inmunodeficiencia Humana/biosíntesis , Productos del Gen tat del Virus de la Inmunodeficiencia Humana/genética , Productos del Gen tat del Virus de la Inmunodeficiencia Humana/aislamiento & purificación
16.
J Control Release ; 135(1): 2-10, 2009 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-19095020

RESUMEN

The therapeutic index of current anti-cancer chemotherapeutics can be improved by two major mechanisms: 1) developing drugs which are specifically toxic to the cancer cells and 2) developing methods to deliver drugs to the tumor site. In an attempt to combine these approaches, we developed a thermally responsive polypeptide inhibitor of c-Myc. This polypeptide is based on the thermally responsive Elastin-like polypeptide (ELP). When injected systemically, ELP-fused drugs will aggregate and accumulate at the tumor site where local hyperthermia is applied. ELP was fused to a peptide which blocks c-Myc/Max dimerization (H1), thereby inhibiting transcription activation by c-Myc (ELP-H1). In this study, the cellular uptake, intracellular distribution, and potency of the Pen, Tat and Bac cell penetrating peptides fused to ELP-H1 were evaluated. While Pen-ELP-H1 and Tat-ELP-H1 were localized in the cytoplasm, Bac-ELP-H1 localized to the nucleus in a subset of the cells and was the most potent inhibitor of MCF-7 cell proliferation. This data demonstrates that ELP can be targeted to the desired cellular compartment simply by choice of the CPP used, resulting in a more potent nuclear targeted c-Myc inhibitory polypeptide which may be beneficial in cancer therapy.


Asunto(s)
Antineoplásicos/administración & dosificación , Portadores de Fármacos/química , Fragmentos de Péptidos/química , Péptidos/química , Proteínas Proto-Oncogénicas c-myc/antagonistas & inhibidores , Proteínas Recombinantes de Fusión/química , Antineoplásicos/farmacocinética , Antineoplásicos/farmacología , Línea Celular Tumoral , Núcleo Celular/efectos de los fármacos , Núcleo Celular/metabolismo , Proliferación Celular/efectos de los fármacos , Citoplasma/efectos de los fármacos , Citoplasma/metabolismo , Relación Dosis-Respuesta a Droga , Portadores de Fármacos/síntesis química , Portadores de Fármacos/farmacocinética , Femenino , Humanos , Hipertermia Inducida , Microscopía Fluorescente , Neoplasias/tratamiento farmacológico , Neoplasias/metabolismo , Fragmentos de Péptidos/síntesis química , Fragmentos de Péptidos/farmacocinética , Péptidos/síntesis química , Péptidos/farmacocinética , Transición de Fase , Proteínas Recombinantes de Fusión/síntesis química , Proteínas Recombinantes de Fusión/farmacocinética , Temperatura , Factores de Tiempo
17.
Eur J Nucl Med Mol Imaging ; 35(6): 1056-64, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18228018

RESUMEN

PURPOSE: The uptake of (99m)Tc-UBI (29-41) was evaluated at sites of bacterial infections in rabbits before and after treatment with ciprofloxacin. METHODS: Staphylococcus aureus susceptible to ciprofloxacin was used to induce a focal infection in each rabbit of group 1 (G1), group 2 (G2), and group 3 (G3) with 2 x 10(4), 2 x 10(6), and 2 x 10(8) colony forming units (CFU), respectively. After 24 h, images of infected thighs (target: T) and contralateral thighs (nontarget: NT) were acquired. Animals then received ciprofloxacin intramuscularly for 5 days followed by imaging on the third and fifth days. The control group 4 (G4) was imaged at days 1, 3, and 5 under the same acquisition parameters. Group 5 (G5) was employed to study biodistribution of the peptide. RESULTS: Increases in (T/NT) ratios in G1, G2, and G3 were observed from 5 min onwards with maximum values at 60 min. G3 revealed the highest accumulation of the peptide. Growth of the same strain of S. aureus on blood agar medium was visualized after fine needle aspiration. After ciprofloxacin treatment, the images for G1-G3 resulted in significantly decreased (P < 0.05) T/NT values on the third and fifth days that correlated with reduction in number of viable bacteria. No significant difference (P < 0.05) in left to right thigh ratios in the control group (G4) was observed. Biodistribution of the peptide showed rapid removal of tracer from circulation through the kidneys. CONCLUSIONS: ( 99m ) Tc-UBI (29-41) accumulation directly correlates with the number of viable bacteria. This infection localization agent can be utilized for monitoring efficacy and duration of antibiotic treatment.


Asunto(s)
Ciprofloxacina/uso terapéutico , Miositis/diagnóstico por imagen , Miositis/metabolismo , Compuestos de Organotecnecio/farmacocinética , Fragmentos de Péptidos/farmacocinética , Infecciones Estafilocócicas/diagnóstico por imagen , Infecciones Estafilocócicas/metabolismo , Animales , Antiinfecciosos/uso terapéutico , Tasa de Depuración Metabólica , Miositis/tratamiento farmacológico , Especificidad de Órganos , Conejos , Cintigrafía , Radiofármacos/farmacocinética , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/metabolismo , Muslo/diagnóstico por imagen , Distribución Tisular , Resultado del Tratamiento
18.
Circulation ; 116(5): 552-60, 2007 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-17664384

Asunto(s)
Anticoagulantes/uso terapéutico , Trombofilia/tratamiento farmacológico , Trombosis/prevención & control , Angina Inestable/tratamiento farmacológico , Anticoagulantes/efectos adversos , Anticoagulantes/clasificación , Anticoagulantes/farmacocinética , Azetidinas/efectos adversos , Azetidinas/farmacocinética , Azetidinas/uso terapéutico , Bencimidazoles/efectos adversos , Bencimidazoles/uso terapéutico , Bencilaminas/efectos adversos , Bencilaminas/farmacocinética , Bencilaminas/uso terapéutico , Isquemia Encefálica/tratamiento farmacológico , Ensayos Clínicos como Asunto , Cumarinas/uso terapéutico , Dabigatrán , Inhibidores del Factor Xa , Fibrinolíticos/efectos adversos , Fibrinolíticos/clasificación , Fibrinolíticos/farmacocinética , Fibrinolíticos/uso terapéutico , Fondaparinux , Predicción , Hemorragia/inducido químicamente , Heparina/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Hirudinas/farmacocinética , Humanos , Morfolinas/farmacocinética , Morfolinas/uso terapéutico , Infarto del Miocardio/tratamiento farmacológico , Fragmentos de Péptidos/farmacocinética , Fragmentos de Péptidos/uso terapéutico , Polisacáridos/farmacología , Polisacáridos/uso terapéutico , Protrombina/antagonistas & inhibidores , Pirazoles/uso terapéutico , Piridinas/efectos adversos , Piridinas/uso terapéutico , Piridonas/uso terapéutico , Proteínas Recombinantes/farmacocinética , Proteínas Recombinantes/uso terapéutico , Rivaroxabán , Tiofenos/farmacocinética , Tiofenos/uso terapéutico , Trombina/antagonistas & inhibidores , Trombosis/tratamiento farmacológico , Warfarina/uso terapéutico
19.
Expert Opin Pharmacother ; 3(6): 777-88, 2002 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12036417

RESUMEN

Heparin is a commonly used anticoagulant in patients with coronary artery disease but its use does not always result in low rates of ischaemic and bleeding events, so the search for new anticoagulants continues. Thrombin plays a key role in both thrombosis and haemostasis and direct thrombin inhibitors modelled on the hirudin molecule found in the saliva of the medicinal leech, Hirudo medicinalis, have recently been developed. To date, the only direct thrombin inhibitor shown to reduce both the ischaemic and the bleeding complications associated with percutaneous coronary intervention (PCI) is bivalirudin, which is approved for this indication in the US and New Zealand. This agent is currently being studied in patients undergoing PCI with or without glycoprotein IIb/IIIa inhibitors and stenting. Bivalirudin has been shown to significantly reduce the risk of reinfarction in patients with acute myocardial infarction (MI) treated with streptokinase, but its use for this indication is not approved in the US. It may also prove to be beneficial in patients with acute MI treated with other fibrinolytic regimens or with primary or facilitated PCI. Bivalirudin is suitable for use as an alternative to heparin in the majority of patients undergoing PCI and in patients receiving streptokinase for acute MI.


Asunto(s)
Angioplastia Coronaria con Balón/métodos , Anticoagulantes/uso terapéutico , Enfermedad Coronaria/tratamiento farmacológico , Hirudinas/análogos & derivados , Infarto del Miocardio/tratamiento farmacológico , Fragmentos de Péptidos/uso terapéutico , Proteínas Recombinantes/uso terapéutico , Enfermedad Aguda , Angina de Pecho/tratamiento farmacológico , Anticoagulantes/farmacocinética , Anticoagulantes/farmacología , Ensayos Clínicos como Asunto , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Trombosis Coronaria/prevención & control , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Interacciones Farmacológicas , Hirudinas/farmacocinética , Hirudinas/farmacología , Humanos , Fragmentos de Péptidos/farmacocinética , Fragmentos de Péptidos/farmacología , Proteínas Recombinantes/farmacocinética , Proteínas Recombinantes/farmacología
20.
Clin Ther ; 24(1): 38-58, 2002 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11833835

RESUMEN

BACKGROUND: Studies of the anticoagulant effects of hirudin, which is derived from the saliva of the leech Hirudo medicinalis, led to the development of compounds that can directly inhibit thrombin activity without the need for additional cofactors. One of these is the direct thrombin inhibitor bivalirudin, which has recently been approved by the US Food and Drug Administration for use as an anticoagulant in patients with unstable angina undergoing percutaneous transluminal coronary angioplasty. OBJECTIVE: This is a review of the pharmacologic properties, efficacy, tolerability, and potential cost-effectiveness of bivalirudin in the treatment of ischemic coronary syndromes. METHODS: Articles were identified by searches of MEDLINE (1966-September 2001), International Pharmaceutical Abstracts (1970-September 2001), and the Iowa Drug Information Service (1966-September 2001) using the terms bivalirudin and Hirulog. The reference lists of retrieved articles were also reviewed for relevant articles. RESULTS: Bivalirudin is a synthetic polypeptide that directly inhibits thrombin by binding simultaneously to its active catalytic site and its substrate recognition site. After intravenous administration, peak plasma concentrations occur in 2 minutes. In patients given a 1.0-mg/kg bolus followed by a 2.5-mg/kg per hour infusion, a median activated clotting time of 346 seconds is achieved with little interpatient or intrapatient variability. Clearance of bivalirudin occurs through a combination of renal elimination and proteolytic cleavage, and doses may need to be decreased in the presence of renal dysfunction. In patients undergoing percutaneous coronary interventions, bivalirudin has been associated with equivalent efficacy but lower bleeding rates (P < 0.001) than unfractionated heparin (UFH). Data from the Hirulog Early Reperfusion/Occlusion-2 study suggest no reduction in mortality with bivalirudin compared with heparin when either is added to aspirin and streptokinase in patients with acute myocardial infarction, despite a lower reinfarction rate (P < 0.001). Experience with bivalirudin in patients with unstable angina and heparin-induced thrombocytopenia (HIT), as well as in patients receiving glycoprotein IIb/IIIla inhibitors, is limited. The differences in bleeding rates between bivalirudin and heparin in published clinical trials probably reflect differences in levels of anticoagulation achieved in comparator groups. CONCLUSIONS: Given its high cost, bivalirudin should be reserved for use as an alternative to UFH, primarily in patients with HIT, until clinical trials have more clearly demonstrated its benefits in terms of efficacy or safety.


Asunto(s)
Anticoagulantes/uso terapéutico , Antitrombinas/uso terapéutico , Terapia con Hirudina , Hirudinas/análogos & derivados , Fragmentos de Péptidos/uso terapéutico , Proteínas Recombinantes/uso terapéutico , Trombosis/prevención & control , Angina Inestable/tratamiento farmacológico , Angioplastia Coronaria con Balón , Anticoagulantes/efectos adversos , Anticoagulantes/economía , Anticoagulantes/farmacocinética , Anticoagulantes/farmacología , Antitrombinas/efectos adversos , Antitrombinas/farmacocinética , Antitrombinas/farmacología , Ensayos Clínicos como Asunto , Hirudinas/efectos adversos , Hirudinas/economía , Hirudinas/farmacocinética , Hirudinas/farmacología , Humanos , Infarto del Miocardio/tratamiento farmacológico , Fragmentos de Péptidos/efectos adversos , Fragmentos de Péptidos/economía , Fragmentos de Péptidos/farmacocinética , Fragmentos de Péptidos/farmacología , Proteínas Recombinantes/efectos adversos , Proteínas Recombinantes/economía , Proteínas Recombinantes/farmacocinética , Proteínas Recombinantes/farmacología , Trombocitopenia/tratamiento farmacológico , Trombosis/sangre , Trombosis/economía
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