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Mian P, Nolan B, van den Anker JN, van Calsteren K, Allegaert K, Lakhi N, Dallmann A. Mechanistic Coupling of a Novel in silico Cotyledon Perfusion Model and a Physiologically Based Pharmacokinetic Model to Predict Fetal Acetaminophen Pharmacokinetics at Delivery. Front Pediatr 2021; 9:733520. [PMID: 34631628 PMCID: PMC8496351 DOI: 10.3389/fped.2021.733520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/20/2021] [Indexed: 01/24/2023] Open
Abstract
Little is known about placental drug transfer and fetal pharmacokinetics despite increasing drug use in pregnant women. While physiologically based pharmacokinetic (PBPK) models can help in some cases to shed light on this knowledge gap, adequate parameterization of placental drug transfer remains challenging. A novel in silico model with seven compartments representing the ex vivo cotyledon perfusion assay was developed and used to describe placental transfer and fetal pharmacokinetics of acetaminophen. Unknown parameters were optimized using observed data. Thereafter, values of relevant model parameters were copied to a maternal-fetal PBPK model and acetaminophen pharmacokinetics were predicted at delivery after oral administration of 1,000 mg. Predictions in the umbilical vein were evaluated with data from two clinical studies. Simulations from the in silico cotyledon perfusion model indicated that acetaminophen accumulates in the trophoblasts; simulated steady state concentrations in the trophoblasts were 4.31-fold higher than those in the perfusate. The whole-body PBPK model predicted umbilical vein concentrations with a mean prediction error of 24.7%. Of the 62 concentration values reported in the clinical studies, 50 values (81%) were predicted within a 2-fold error range. In conclusion, this study presents a novel in silico cotyledon perfusion model that is structurally congruent with the placenta implemented in our maternal-fetal PBPK model. This allows transferring parameters from the former model into our PBPK model for mechanistically exploring whole-body pharmacokinetics and concentration-effect relationships in the placental tissue. Further studies should investigate acetaminophen accumulation and metabolism in the placenta as the former might potentially affect placental prostaglandin synthesis and subsequent fetal exposure.
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Affiliation(s)
- Paola Mian
- Department of Clinical Pharmacy, Medisch Spectrum Twente, Enschede, Netherlands
| | - Bridget Nolan
- Department of Obstetrics and Gynecology, Richmond University Medical Center, Staten Island, NY, United States
- Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, United States
| | - John N. van den Anker
- Division of Clinical Pharmacology, Children's National Hospital, Washington, DC, United States
- Department of Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel, Basel, Switzerland
| | - Kristel van Calsteren
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Gynecology and Obstetrics, UZ Gasthuisberg, Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- Department of Hospital Pharmacy, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
| | - Nisha Lakhi
- Department of Obstetrics and Gynecology, Richmond University Medical Center, Staten Island, NY, United States
- Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, United States
| | - André Dallmann
- Pharmacometrics/Modeling and Simulation, Research and Development, Pharmaceuticals, Bayer AG, Leverkusen, Germany
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Ramírez-Emiliano J, Fajardo-Araujo ME, Zúñiga-Trujillo I, Pérez-Vázquez V, Sandoval-Salazar C, Órnelas-Vázquez JK. Mitochondrial content, oxidative, and nitrosative stress in human full-term placentas with gestational diabetes mellitus. Reprod Biol Endocrinol 2017; 15:26. [PMID: 28376894 PMCID: PMC5381032 DOI: 10.1186/s12958-017-0244-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/24/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the mitochondrial content, and the oxidative and nitrosative stress of the placenta in women with gestational diabetes mellitus (GDM). METHODS Full-term placentas from GDM and healthy pregnancies were collected following informed consent. The lipid peroxidation (TBARS) and oxidized protein (carbonyls) levels were determined by spectrophotometry, and 3-nitrotyrosine (3-NT), subunit IV of cytochrome oxidase (COX4), adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) and actin were determined by western blot, whereas ATPase activity was performed by determining the adenosine triphosphate (ATP) consumption using a High-performance liquid chromatography (HPLC) system. RESULTS TBARS and carbonyls levels were lower in the placentas of women with GDM compared with the normal placentas (p < 0.001 and p < 0.05, respectively). Also, 3-NT/actin and AMPK/actin ratios were higher in GDM placentas than in the normal placentas (p = 0.03 and p = 0.012, respectively). Whereas COX4/actin ratio and ATPase activity were similar between GDM placentas and those controls. CONCLUSIONS These data suggest that placentas with GDM are more protected against oxidative damage, but are more susceptible to nitrosative damage as compared to normal placentas. Moreover, the increased expression levels of AMPK in GDM placentas suggest that AMPK might have a role in maintaining the mitochondrial biogenesis at normal levels. TRIAL REGISTRATION HGRL28072011 . Registered 28 July 2011.
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Affiliation(s)
- Joel Ramírez-Emiliano
- grid.412891.7Departamento de Ciencias Médicas, Universidad de Guanajuato, León, Gto. México
| | | | - Ismael Zúñiga-Trujillo
- grid.412891.7Departamento de Ciencias Médicas, Universidad de Guanajuato, León, Gto. México
| | | | - Cuauhtémoc Sandoval-Salazar
- grid.412891.7Departamento de Enfermería y Obstetricia, División de Ciencias de Salud e Ingenierías, Campus Celaya-Salvatierra, Universidad de Guanajuato, Celaya, Gto. México
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Barta E, Drugan A. A clinical study which relates to a theoretical simulation of the glucose transport in the human placenta under various diabetic conditions. J Perinat Med 2016; 44:405-10. [PMID: 26584352 DOI: 10.1515/jpm-2015-0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 10/23/2015] [Indexed: 11/15/2022]
Abstract
AIMS To characterize placental glucose delivery under normoglycemic conditions, gestational and pre-gestational diabetes and to relate the clinical data to theoretical predictions. METHODS Data from 125 pregnancies: 50 normal gestations and 75 ones with various types of diabetes were collected. In parallel, we formulated a theoretical model for the transport of glucose under various diabetic conditions. Measured glucose blood levels were fed into the theoretical model that predicts glucose supply to the fetus and the results were confronted with measured fetal weights. RESULTS Measured fetal weight and computed glucose delivery in gestational diabetic parturients resemble the situation in normal pregnancies. However, pre-gestational diabetes has a major effect as it involves heavier fetuses and enhanced computed glucose fluxes via placental membranes. CONCLUSIONS Fetal weight (increased in pre-gestational and unaltered in gestational diabetes) correlates with the predicted rate of glucose delivery through the placenta.
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Sgambati E, Marini M, Vichi D, Zappoli Thyrion GD, Parretti E, Mello G, Gheri G. Distribution of the glycoconjugate oligosaccharides in the human placenta from pregnancies complicated by altered glycemia: lectin histochemistry. Histochem Cell Biol 2007; 128:263-73. [PMID: 17653755 DOI: 10.1007/s00418-007-0312-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Accepted: 06/25/2007] [Indexed: 10/23/2022]
Abstract
The aim of this study was to investigate the distribution of the oligosaccharides of the glycoconjugates in placentas from pregnancies complicated by different degree of altered glycaemia. Placentas from women with physiological pregnancies (group 1), with pregnancies complicated by minor degree of glucose intolerance (group 2) and with pregnancies complicated by gestational diabetes mellitus (GDM) treated with insulin (group 3) were collected. Ten lectins were used (ConA, WGA, PNA, SBA, DBA, LTA, UEA I, GSL II, MAL II and SNA) in combination with chemical and enzymatic treatments. The data showed a decrease of sialic acid linked alpha(2-6) to galactose/N-acetyl-D-galactosamine and an increase of N-acetyl-D-glucosamine in the placentas of the pathological groups, in particular the group 3, comparing to the group 1. A decrease of L-fucose (LTA) and D-galactose-(beta1-3)-N-acetyl-D-galactosamine, and an increase and/or appearance of L-fucose (UEA I) and N-acetyl-D-galactosamine were observed in both the pathological groups, particularly in the group 2, with respect to the group 1. In GDM, and even in pregnancies with a simple alteration of maternal glycaemia, the changes in the distribution of oligosaccharides could be related to alteration of the structure and functionality of the placenta.
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Affiliation(s)
- Eleonora Sgambati
- Department of Anatomy, Histology and Forensic Medicine, Policlinic of Careggi, University of Florence, Viale Morgagni, 85, 50134, Florence, Italy.
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Min Y, Lowy C, Ghebremeskel K, Thomas B, Bitsanis D, Crawford MA. Fetal erythrocyte membrane lipids modification: preliminary observation of an early sign of compromised insulin sensitivity in offspring of gestational diabetic women. Diabet Med 2005; 22:914-20. [PMID: 15975108 DOI: 10.1111/j.1464-5491.2005.01556.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
AIMS Intrauterine exposure to diabetes is a significant determinant of the development of obesity and early onset of Type 2 diabetes mellitus in the offspring. Both conditions are characterized by insulin resistance and the latter is associated with reduced membrane arachidonic and docosahexaenoic acids. Hence, we investigated if the membrane arachidonic and docosahexaenoic acids are depressed in the cord blood of babies born to women with gestational diabetes. METHODS Cord (fetal) and maternal blood were obtained at delivery from control subjects (n = 33) and women with gestational diabetes (n = 40) and analysed for plasma triglycerides and cholinephosphoglycerides, and erythrocyte choline- and ethanolaminephosphoglycerides fatty acids. RESULTS Babies of gestational diabetic mothers had reduced docosahexaenoic acid in the plasma (5.9 +/- 1.4 vs. 7.1 +/- 2.0, P < 0.01) and erythrocyte (4.0 +/- 2.2 vs. 5.4 +/- 2.9, P < 0.05) cholinephosphoglycerides. Moreover, the total omega-6 and omega-3 fatty acids of the erythrocyte cholinephosphoglycerides were significantly lower (P < 0.05) in these babies. A similar trend was observed in plasma triglycerides and erythrocyte ethanolaminephosphoglycerides. The maternal plasma triglycerides and erythrocyte ethanolaminephosphoglycerides fatty acids profile were not different between the two groups. However, there was a reduction in arachidonic acid and total omega-6 fatty acids in the erythrocyte cholinephosphoglycerides of the gestational diabetic women. CONCLUSION The altered plasma and erythrocyte fatty acids in the cord blood of babies born to women with gestational diabetes suggests a perturbation in the maternal-fetal nutrient transport and/or fetal lipid metabolism.
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Affiliation(s)
- Y Min
- Institute of Brain Chemistry and Human Nutrition, London Metropolitan University, London, UK.
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Huisman MA, Egberts J. Anisotropy values for liposomes from neonatal and adult erythrocytes differ after adjustment for optical density scattering. Anal Biochem 1997; 248:301-3. [PMID: 9177759 DOI: 10.1006/abio.1997.2141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M A Huisman
- Department of Obstetrics and Gynecology, Leiden University Medical Center, The Netherlands
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Orsière TG, Chauvet MM, Dell'Amico MH, Bourdeaux MJ. Effects of benfluorex metabolites on membrane fluidity and insulin-related processes. Eur J Pharmacol 1995; 291:237-43. [PMID: 8719407 DOI: 10.1016/0922-4106(95)90063-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
As little work has dealt with the antihyperglycemic property of benfluorex at the hepatocyte level, we studied the effects of its main metabolites, S422 and S1475, on membrane fluidity and on insulin binding, internalization and action in healthy rat hepatocytes. Both metabolites were effective fluidizing agents. Neither one affected insulin binding. Only S422 favored the bound insulin-receptor internalization process. The metabolites produced no change in basal alpha-aminoisobutyric acid uptake. Only S422 promoted the insulin-stimulated alpha-aminoisobutyric acid uptake in a dose-dependent way. Therefore, our study demonstrated that: (i) the effects of S422 on insulin-related processes in isolated hepatocytes were direct, specific and not due to any membrane fluidizing mechanism; (ii) S422 improved hepatocyte response to insulin at a post-binding level. These results in vitro give an additional explanation, at the cellular level, of the benefit of benfluorex treatment for non insulin-dependent diabetes patients.
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Affiliation(s)
- T G Orsière
- Equipe Protéines Membranaires (GRIPP), URA-CNRS 1924, UFR de Pharmacie, Marseille, France
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Mazzanti L, Staffolani R, Cester N, Romanini C, Pugnaloni A, Belmonte MM, Salvolini E, Brunelli MA, Biagini G. A biochemical-morphological study on microvillus plasma membrane development. BIOCHIMICA ET BIOPHYSICA ACTA 1994; 1192:101-6. [PMID: 8204638 DOI: 10.1016/0005-2736(94)90148-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The microvillus plasma membrane of the human placental syncytiotrophoblast at term has been extensively studied, while little is known about the characteristics of its development. The aim of the present work was to compare functional and structural properties of this membrane at early and term gestational age. Ten normal term placentas (40 weeks) and ten placentas at 10 weeks of gestational age were studied. The Na+/K+-ATPase activity is significantly decreased in the syncytiotrophoblast plasma membrane obtained from term placentas as compared to the early ones, with significant variation of maximum velocity (Vmax). The microviscosity, evaluated by the P parameter of DPH and Sn parameters of 5- and 16-NS, is increased in the term placentas compared to the early placentas. This alteration is accompanied by an increased cholesterol to phospholipids ratio in term placentas, while there is a decreased unsaturated to saturated fatty acid ratio. As follows from morphological studies, an increased mean diameter in the E face was observed in the term placenta with respect to the early placenta. The distribution factor DF, which indicates the particle aggregation state, decreased in the E face in the term placenta as compared to the early one. The present biochemical morphological study shows that a deep modification of the membrane is at the basis of the syncytiotrophoblast plasma membrane development.
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Affiliation(s)
- L Mazzanti
- Institute of Biochemistry, Faculty of Medicine and Surgery, University of Ancona, Italy
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