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Zhu Y, Pan X, Jia Y, Yang X, Song X, Ding J, Zhong W, Feng J, Zhu L. Exploring Route-Specific Pharmacokinetics of PFAS in Mice by Coupling in Vivo Tests and Physiologically Based Toxicokinetic Models. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127012. [PMID: 38088889 PMCID: PMC10718298 DOI: 10.1289/ehp11969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/08/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Oral ingestion, inhalation, and skin contact are important exposure routes for humans to uptake per- and polyfluoroalkyl substances (PFAS). However, nasal and dermal exposure to PFAS remains unclear, and accurately predicting internal body burden of PFAS in humans via multiple exposure pathways is urgently required. OBJECTIVES We aimed to develop multiple physiologically based toxicokinetic (PBTK) models to unveil the route-specific pharmacokinetics and bioavailability of PFAS via respective oral, nasal, and dermal exposure pathways using a mouse model and sought to predict the internal concentrations in various tissues through multiple exposure routes and extrapolate it to humans. METHODS Mice were administered the mixed solution of perfluorohexane sulfonate, perfluorooctane sulfonate, and perfluorooctanoic acid through oral, nasal, and dermal exposure separately or jointly. The time-dependent concentrations of PFAS in plasma and tissues were determined to calibrate and validate the individual and combined PBTK models, which were applied in single- and repeated-dose scenarios. RESULTS The developed route-specific PBTK models successfully simulated the tissue concentrations of PFAS in mice following single or joint exposure routes as well as long-term repeated dose scenarios. The time to peak concentration of PFAS in plasma via dermal exposure was much longer (34.1-83.0 h) than that via nasal exposure (0.960 h). The bioavailability of PFAS via oral exposure was the highest (73.2%-98.0%), followed by nasal (33.9%-66.8%) and dermal exposure (4.59%-7.80%). This model was extrapolated to predict internal levels in human under real environment. DISCUSSION Based on these data, we predict the following: PFAS were absorbed quickly via nasal exposure, whereas a distinct hysteresis effect was observed for dermal exposure. Almost all the PFAS to which mice were exposed via gastrointestinal route were absorbed into plasma, which exhibited the highest bioavailability. Exhalation clearance greatly depressed the bioavailability of PFAS via nasal exposure, whereas the lowest bioavailability in dermal exposure was because of the interception of PFAS within the skin layers. https://doi.org/10.1289/EHP11969.
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Affiliation(s)
- Yumin Zhu
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
| | - Xiaoyu Pan
- Beijing Sankuai Online Technology Co., Ltd., Beijing, P. R. China
| | - Yibo Jia
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
| | - Xin Yang
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
| | - Xiaohua Song
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
| | - Jiaqi Ding
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
| | - Wenjue Zhong
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
| | - Jianfeng Feng
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
| | - Lingyan Zhu
- Key Laboratory of Pollution Processes and Environmental Criteria, Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin, P. R. China
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Hu M, Zhang Z, Zhang Y, Zhan M, Qu W, He G, Zhou Y. Development of human dermal PBPK models for the bisphenols BPA, BPS, BPF, and BPAF with parallel-layered skin compartment: Basing on dermal administration studies in humans. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 868:161639. [PMID: 36649768 DOI: 10.1016/j.scitotenv.2023.161639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/19/2022] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Risk assessment of human exposure to bisphenols (BPs) including bisphenol A, S, F and AF (BPA, BPS, BPF and BPAF) have suggested that except for ingestion, health risk resulting from dermal contact is not negligible. However, the absorption kinetics of BPA substitutes in humans following dermal exposure have been poorly studied. This study aimed to address the knowledge gap in physiologically based pharmacokinetic (PBPK) modeling of BPA and its high-concerned substitutes (BPS, BPF and BPAF) following dermal administration. Parallel-layered skin compartmental model for dermal absorption of BPs was for the first time proposed and human dermal administration studies were conducted to determine dermal bio-accessibility of BPS from thermal paper (TP) (n = 4), BPF (n = 4) and BPAF (n = 5) from personal care products (PCPs). Further, pharmacokinetics of BPS and its metabolites following human handling TP were investigated and the dermal PBPK models for BPA and BPS were validated using the available human biomonitoring data. Overall, 28.03 % ± 13.76 % of BPS in TP was transferred to fingers followed by absorption of 96.17 % ± 2.78 % of that. The dermal bio-accessibilities of BPs in PCPs were 31.65 % ± 2.90 % for BPF and 12.49 % ± 1.66 % for BPAF. Monte Carlo analysis indicated that 90 % of the predicted variability fell within one order of magnitude, which suggested that the developed PBPK models had medium uncertainty. Global sensitivity analysis revealed that the model uncertainty is mainly attributed to the variabilities of dermal absorption parameters. Compared with the previous models for BPs, the developed dermal PBPK models were capable of more accurate predictions of the internal dose metric in target organs following human dermal exposure to BPs via TP and PCPs routes. These results suggested that the developed human dermal PBPK models would provide an alternative tool for assessing the risk of human exposure to BPs through dermal absorption.
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Affiliation(s)
- Man Hu
- School of Public Health/Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China; School of Public Health, Fudan University, Shanghai 200032, China; Pudong New Area Centers for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China
| | - Zhichun Zhang
- School of Public Health/Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China; School of Public Health, Fudan University, Shanghai 200032, China; Pudong New Area Centers for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China
| | - Yining Zhang
- School of Public Health/Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China; School of Public Health, Fudan University, Shanghai 200032, China; Pudong New Area Centers for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China
| | - Ming Zhan
- Pudong New Area Centers for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China
| | - Weidong Qu
- School of Public Health/Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China; School of Public Health, Fudan University, Shanghai 200032, China
| | - Gengsheng He
- School of Public Health/Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China; School of Public Health, Fudan University, Shanghai 200032, China
| | - Ying Zhou
- School of Public Health/Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China; School of Public Health, Fudan University, Shanghai 200032, China; Pudong New Area Centers for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai 200136, China.
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Elmokadem A, Zhang Y, Knab T, Jordie E, Gillespie WR. Bayesian PBPK modeling using R/Stan/Torsten and Julia/SciML/Turing.Jl. CPT Pharmacometrics Syst Pharmacol 2023; 12:300-310. [PMID: 36661183 PMCID: PMC10014045 DOI: 10.1002/psp4.12926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Physiologically-based pharmacokinetic (PBPK) models are mechanistic models that are built based on an investigator's prior knowledge of the in vivo system of interest. Bayesian inference incorporates an investigator's prior knowledge of parameters while using the data to update this knowledge. As such, Bayesian tools are well-suited to infer PBPK model parameters using the strong prior knowledge available while quantifying the uncertainty on these parameters. This tutorial demonstrates a full population Bayesian PBPK analysis framework using R/Stan/Torsten and Julia/SciML/Turing.jl.
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Affiliation(s)
| | - Yi Zhang
- Sage Therapeutics, Inc., Cambridge, Massachusetts, USA
| | - Timothy Knab
- Metrum Research Group, Tariffville, Connecticut, USA
| | - Eric Jordie
- Metrum Research Group, Tariffville, Connecticut, USA
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Hu M, Zhang Y, Zhan M, He G, Qu W, Zhou Y. Physiologically-based toxicokinetic modeling of human dermal exposure to diethyl phthalate: Application to health risk assessment. CHEMOSPHERE 2022; 307:135931. [PMID: 35940406 DOI: 10.1016/j.chemosphere.2022.135931] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/22/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
Diethyl phthalate (DEP) has been most frequently detected in personal care products (PCPs) as a solvent followed by indoor air as one of the semi-volatile organic compounds (SVOCs). Human exposure to DEP predominantly occurs via dermal uptake. However, the available physiologically based toxicokinetics (PBTK) models are developed in rats for risk assessment of DEP exposure resulting from the oral than dermal pathway. To address this issue, DEP in simulated PCPs was dermally administrated to five adult volunteers at real population levels. Following the construction of a dermal absorption model for DEP, the dermal PBTK modeling of DEP involving PCPs and air-to-skin exposure routes in humans was developed for the first time. The data of monoethyl phthalate (MEP) in serum or urine obtained from published human studies and this study were applied to calibrate and validate the developed dermal PBTK model. Monte Carlo simulation was used to evaluate model uncertainty. The dermal absorption fraction of DEP was obtained to be 56.2% for PCPs exposure and 100% for air-to-skin exposure, respectively. Approximate 24.9% of DEP in exposed skin became absorbed into systemic circulation. Model predictions were generally within 2-fold of the observed MEP levels in human serum or urine. Uncertainty analysis showed 90% of the predicted variability (P95/P5) fell within less than one order of magnitude. Assuming human intake of 5 mg/kg bw per day, the predicted serum area under the curve at steady state of DEP from the dermal route was 1.7 (PCPs) and 2.4 (air) times of those from the peroral route, respectively. It suggested that dermal exposure to DEP would pose greater risk to human health compared with oral exposure. The application of the developed dermal PBTK model provides a valuable insight into health risk assessment of DEP in humans.
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Affiliation(s)
- Man Hu
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' Republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China; Pudong New Area for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Yining Zhang
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' Republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China; Pudong New Area for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Ming Zhan
- Pudong New Area for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Gengsheng He
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' Republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China
| | - Weidong Qu
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' Republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ying Zhou
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' Republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China; Pudong New Area for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China.
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Zhang Z, Hu M, Xuan D, Wu L, Zhang Y, He G, Zhou Y. Physiologically based pharmacokinetic (PBPK) modeling of BDE-209 following oral exposure in Chinese population. Food Chem Toxicol 2022; 169:113416. [PMID: 36096292 DOI: 10.1016/j.fct.2022.113416] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/15/2022] [Accepted: 09/03/2022] [Indexed: 11/27/2022]
Abstract
The wide usage of decabromodiphenyl ether (BDE-209) as additive brominated flame retardant has caused its widespread occurrence in the environment and high exposure risk in humans. Estimating its internal exposure dose and reconstruction of external exposure dose using physiologically based pharmacokinetic (PBPK) modelling approach is a key step in the risk assessment of BDE-209. However, the PBPK model for BDE-209 is currently unavailable. This study has established two oral permeability-limited PBPK models of BDE-209 without enterohepatic recirculation (EHR) (model 1) and with EHR (model 2) for Chinese population. Using the in vitro experiments, the average binding of BDE-209 to human plasma protein (99.64% ± 2.97%) was obtained. Moreover, blood sample analysis and systematic literature review were performed to obtain internal and external exposure data of BDE-209 used for model calibration and validation. The predictions of both models were within 2-fold of the observed, and a longer half-life of serum BDE-209 was observed in model 2 than model 1. Based on the models, a human biomonitoring guidance value (HBM-GV) of 93.61 μg/g lw was derived for BDE-209, and there is no health risk found for Chinese population currently. This study provides new quantitative assessment tools for health risk assessment of BDE-209.
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Affiliation(s)
- Zhichun Zhang
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China; Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Man Hu
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China; Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Dongliang Xuan
- Jiading District Center for Disease Control and Prevention, Shanghai, 201899, China
| | - Linying Wu
- Jiading District Center for Disease Control and Prevention, Shanghai, 201899, China
| | - Yanfei Zhang
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China; Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China
| | - Gengsheng He
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ying Zhou
- Centers for Water and Health, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the Peoples' republic of China, Fudan University, Shanghai, 200032, China; School of Public Health, Fudan University, Shanghai, 200032, China; Pudong New Area Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, 200136, China.
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Yost EE, Galizia A, Kapraun DF, Persad AS, Vulimiri SV, Angrish M, Lee JS, Druwe IL. Health Effects of Naphthalene Exposure: A Systematic Evidence Map and Analysis of Potential Considerations for Dose-Response Evaluation. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:76002. [PMID: 34251878 PMCID: PMC8274693 DOI: 10.1289/ehp7381] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Naphthalene is a polycyclic aromatic hydrocarbon that has been associated with health effects, including cancer. As the state of the science on naphthalene toxicity continues to evolve, updated toxicity reference value(s) may be required to support human health risk assessment. OBJECTIVES We present a systematic evidence map of studies that could be used to derive toxicity reference value(s) for naphthalene. METHODS Human and animal health effect studies and physiologically based pharmacokinetic (PBPK) models were identified from a literature search based on populations, exposures, comparators, and outcomes (PECO) criteria. Human and animal studies meeting PECO criteria were refined to a smaller subset considered most informative for deriving chronic reference value(s), which are preferred for assessing risk to the general public. This subset was evaluated for risk of bias and sensitivity, and the suitability of each study for dose-response analysis was qualitatively assessed. Lowest observed adverse effect levels (LOAELs) were extracted and summarized. Other potentially relevant studies (e.g., mechanistic and toxicokinetic studies) were tracked as supplemental information but not evaluated further. Existing reference values for naphthalene are also summarized. RESULTS We identified 26 epidemiology studies and 16 animal studies that were considered most informative for further analysis. Eleven PBPK models were identified. The available epidemiology studies generally had significant risk of bias and/or sensitivity concerns and were mostly found to have low suitability for dose-response analysis due to the nature of the exposure measurements. The animal studies had fewer risk of bias and sensitivity concerns and were mostly found to be suitable for dose-response analysis. CONCLUSION Although both epidemiological and animal studies of naphthalene provide weight of evidence for hazard identification, the available animal studies appear more suitable for reference value derivation. PBPK models and mechanistic and toxicokinetic data can be applied to extrapolate these animal data to humans, considering mode of action and interspecies metabolic differences. https://doi.org/10.1289/EHP7381.
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Affiliation(s)
- Erin E. Yost
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Audrey Galizia
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Dustin F. Kapraun
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Amanda S. Persad
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Suryanarayana V. Vulimiri
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Michelle Angrish
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Janice S. Lee
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Ingrid L. Druwe
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
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Karanikas N, Foster C, Beltran Hernandez A, Harvey A, Targal O, Horswill N. Conventional and Alternative Aviation Fuels: Occupational Exposure and Health Effects. ACS CHEMICAL HEALTH & SAFETY 2021. [DOI: 10.1021/acs.chas.0c00120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Nektarios Karanikas
- School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia
| | - Cherry Foster
- School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia
| | - Adolfo Beltran Hernandez
- School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia
| | - Alice Harvey
- School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia
| | - Ozan Targal
- School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia
| | - Nathan Horswill
- School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia
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Chaphekar N, Dodeja P, Shaik IH, Caritis S, Venkataramanan R. Maternal-Fetal Pharmacology of Drugs: A Review of Current Status of the Application of Physiologically Based Pharmacokinetic Models. Front Pediatr 2021; 9:733823. [PMID: 34805038 PMCID: PMC8596611 DOI: 10.3389/fped.2021.733823] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/16/2021] [Indexed: 12/31/2022] Open
Abstract
Pregnancy and the postpartum period are associated with several physiological changes that can alter the pharmacokinetics (PK) and pharmacodynamics (PD) of drugs. For certain drugs, dosing changes may be required during pregnancy and postpartum to achieve drug exposures comparable to what is observed in non-pregnant subjects. There is very limited data on fetal exposure of drugs during pregnancy, and neonatal exposure through transfer of drugs via human milk during breastfeeding. Very few systematic clinical pharmacology studies have been conducted in pregnant and postpartum women due to ethical issues, concern for the fetus safety as well as potential legal ramifications. Over the past several years, there has been an increase in the application of modeling and simulation approaches such as population PK (PopPK) and physiologically based PK (PBPK) modeling to provide guidance on drug dosing in those special patient populations. Population PK models rely on measured PK data, whereas physiologically based PK models incorporate physiological, preclinical, and clinical data into the model to predict drug exposure during pregnancy. These modeling strategies offer a promising approach to identify the drugs with PK changes during pregnancy to guide dose optimization in pregnancy, when there is lack of clinical data. PBPK modeling is also utilized to predict the fetal exposure of drugs and drug transfer via human milk following maternal exposure. This review focuses on the current status of the application of PBPK modeling to predict maternal and fetal exposure of drugs and thereby guide drug therapy during pregnancy.
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Affiliation(s)
- Nupur Chaphekar
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Prerna Dodeja
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Imam H Shaik
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Steve Caritis
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Women's Hospital of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Raman Venkataramanan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Women's Hospital of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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