Effects of cysteine on the pharmacokinetics of intravenous phenytoin in rats with protein-calorie malnutrition

A sensitive LC-MS/MS method for quantification of phenytoin and its major metabolite with application to in vivo investigations of intravenous and intranasal phenytoin delivery

Phenytoin is a powerful antiseizure drug with complex pharmacokinetic properties, making it an interesting model drug to use in preclinical in vivo investigations, especially with regards to formulations aiming to improve drug delivery to the brain. Moreover, it has a major metabolite, 5‐(4‐hydroxyphenyl)‐5‐phenylhydantoin, which can be simultaneously studied to achieve a better assessment of its behaviour in the body. Here, we describe the development and validation of a sensitive LCMS/MS method for quantification of phenytoin and 5‐(4‐hydroxyphenyl)‐5‐phenylhydantoin in rat plasma and brain which can be used in such preclinical studies. Calibration curves produced covered a range of 7.81 to 250 ng/mL (plasma) and 23.4 to 750 ng/g (brain tissue) for both analytes. The method was validated for specificity, sensitivity, accuracy, and precision and found to be within the acceptable limits of ±15% over this range in both tissue types. The method when applied in two in vivo investigations: validation of a seizure model and to study the behaviour of a solution of intranasally administered phenytoin as a foundation for future studies into direct nose‐to‐brain delivery of phenytoin using specifically developed particulate systems, was highly sensitive for detecting phenytoin and 5‐(4‐hydroxyphenyl)‐5‐phenylhydantoin in rat plasma and brain.

Comparison of cubosomes and hexosomes for the delivery of phenytoin to the brain

The ability to formulate cubosomes and hexosomes with a single lipid by changing only the colloidal stabiliser presents a unique opportunity to directly compare the biological performance of these uniquely structured nanoparticles. This was explored here via the encapsulation and brain delivery of a model anti-seizure drug, phenytoin, in selachyl alcohol cubosomes and hexosomes. Nanoparticles were prepared with Pluronic® F127 or Tween 80® as the stabiliser and characterised. The internal nanostructure of nanoparticles shifted from hexosomes when using Pluronic® F127 as the stabiliser to cubosomes when using Tween 80® and was conserved following loading of phenytoin, with high encapsulation efficiencies (>97%) in both particle type. Cytotoxicity towards brain endothelial cells using the hCMEC/D3 line was comparable regardless of stabiliser type. Finally, in vivo brain delivery of phenytoin encapsulated in cubosomes and hexosomes after intravenous administration to rats was studied over a period of 60 min, showing cubosomes to be superior to hexosomes, both in terms of brain concentrations and brain to plasma ratio. While the role of stabiliser and/or internal nanostructure remains to be conclusively determined, this study is the first in vivo comparison of cubosomes and hexosomes for the delivery of a therapeutic drug molecule across the BBB and into the brain.

Pharmacokinetics of intravenous and oral DA-8159, a new erectogenic, in rats with protein-calorie malnutrition

Influence of dietary protein deficiency on the pharmacokinetics of DA-8159 and one of its metabolites, DA-8164, was investigated after intravenous and oral administration of DA-8159 at a dose of 30 mg kg−1 to male Sprague-Dawley rats allowed free access to a 23% (control) or 5% (protein-calorie malnutrition, PCM) casein diet for 4 weeks. The total area under the plasma concentration-time curve from time zero to time infinity (AUC) values of DA-8164 were significantly smaller after both intravenous (87.0 vs 162 μg min mL−1) and oral (144 vs 319 μg min mL−1) administration of DA-8159 to PCM rats. This could be due to the decrease in CYP3A1/2 (50–60%) in the rats because DA-8164 was mainly formed via CYP3A1/ 2 in rats. This could be supported by significantly slower in-vitro CLint (2.04 ± 0.646 vs 3.15 ± 0.693 μL min−1 (mg protein)−1) for the formation of DA-8164 in hepatic microsomal fraction of PCM rats. After intravenous administration of DA-8159, the AUC values of DA-8159 were not significantly different between the two groups of rats although the AUC of DA-8164 was significantly smaller in PCM rats, and this may be due to the minor metabolic pathway of DA-8164 in rats. However, after oral administration of DA-8159, the AUC of DA-8159 was significantly greater in PCM rats (194 vs 122 μg min mL−1). This was not due to enhanced absorption of DA-8159 from the gastrointestinal tract in the rats but may be due to a decreased intestinal first-pass effect of DA-8159 in the rat.

Effects of protein-calorie malnutrition on the pharmacokinetics of DA-7867, a new oxazolidinone, in rats

The pharmacokinetic parameters of DA-7867, a new oxazolidinone, were compared after intravenous and oral administration at a dose of 10mg kg−1 to control rats and rats with protein-calorie malnutrition (rats with PCM). After intravenous administration of 10mg kg−1 DA-7867 to rats, metabolism of the drug was not considerable and after 14 days approximately 85.0% of the dose was recovered as unchanged drug from urine and faeces. After intravenous administration to rats with PCM, the area under the plasma concentration-time curve from time zero to time infinity (AUC) was significantly smaller (10800 vs 6990μg min mL−1) compared with control rats. This may have been due to significantly faster total body clearance (CL, 0.930 vs 1.44mL min−1 kg−1). The faster CL in PCM rats could have been due to significantly faster non-renal clearance (0.842 vs 1.39mL min−1 kg−1 due to significantly greater gastrointestinal (including biliary) excretion; the amount of unchanged DA-7867 recovered from the entire gastrointestinal tract at 24h was significantly greater (1.19 vs 4.28% of intravenous dose)) because the renal clearance was significantly slower in PCM rats (0.0874 vs 0.0553mL min−1 kg−1). After oral administration to PCM rats, the AUC was significantly smaller compared with control rats (7900 vs 4310μgmin mL−1). This could have been due to a decrease in absorption from the gastrointestinal tract.

Gender difference in the pharmacokinetic interaction between oral warfarin and oxolamine in rats: inhibition of CYP2B1 by oxolamine in male rats

The possible reason for the significantly greater AUC of oral warfarin with oral oxolamine in male Sprague-Dawley rats was evaluated. After oral administration of warfarin at a dose of 2 mg/kg to male rats with oxolamine at doses of 10 and 50 mg/kg, the AUC values of warfarin were significantly greater than the controls (254 and 330 versus 180 microg h/ml). However, the AUC values of warfarin were not affected by oxolamine in female rats. This could be due to inhibition of CYP2B1, 2C11 and 3A2 by oxolamine in male rats, since warfarin was metabolized via CYP1A1, 2B1, 2C6, 2C11 and 3A2 in rats and CYP2B1 is male dominant, and CYP2C11 and 3A2 are male specific. Therefore, phenytoin, torasemide and clarithromycin (mainly metabolized via CYP2B1/2, 2C11 and 3A2 in rats, respectively) were administered intravenously to male rats with or without oral oxolamine. After oral oxolamine at doses of 10 and 50 mg/kg, the AUC of phenytoin was significantly greater (1280 and 1640 versus 938 microg min/ml), however, the AUC values of torasemide and clarithromycin were independent of oxolamine. The above data suggest that the significantly greater AUC of oral warfarin with oral oxolamine could be due to inhibition of CYP2B1/2 by oxolamine in male rats.

Effects of cysteine on the pharmacokinetics of oltipraz in rats with protein–calorie malnutrition

Effects of cysteine on the pharmacokinetics of oltipraz were investigated after iv (10 mg/kg) and oral (30 mg/kg) administration to male control, protein-calorie malnutrition (PCM), and PCM with oral cysteine supplementation (PCMC) rats. It was reported that oltipraz was mainly metabolized via hepatic CYP1A1/2, 2B1/2, 2C11, 3A1/2, and 2D1 in male rats. The expression and mRNA levels of CYP1A2, 2C11, and 3A1/2 were also reported to decrease in male PCM rats compared with controls. Interestingly, the decreased CYP isozymes in PCM rats returned fully or partially to controls by oral cysteine supplementation (PCMC rats). Hence, it would be expected that in PCM rats, some pharmacokinetic parameters of oltipraz are fully or partially returned to controls by cysteine. This was proven by the following parameters in PCMC rats: the AUC (328, 782, and 416 mug min/mL for control, PCM, and PCMC rats, respectively, after iv administration, and 223, 456, and 242 mug min/mL after oral administration), terminal half-life (130, 212, and 143 min), mean residence time (MRT) (149, 299, and 189 min), and in vitro CL(int) (0.181, 0.107, and 0.153 mL/min/mg protein) were fully returned to controls, and CL and CL(NR) values were partially returned to controls.

Effects of cysteine on the pharmacokinetics of intravenous torasemide in rats with protein−calorie malnutrition

Effects of cysteine on the pharmacokinetics of torasemide were investigated after intravenous administration at a dose of 2 mg/kg to control rats and rats with PCM and PCMC. Torasemide was reported to be mainly metabolized via hepatic CYP2C9 in humans, and human CYP2C9 and male rat CYP2C11 proteins have 77% homology. It has also been reported that in male rats with PCM, the CYP2C11 level decreased to approximately 20% of the control level, but the decreased CYP2C11 level in rats with PCM partially returned to the control level by oral cysteine supplementation (rats with PCMC). Hence, it could be expected that in rats with PCM, some pharmacokinetic parameters of torasemide could be significantly different compared with those in control rats and rats with PCMC; however, they could be not significantly different between control rats and rats with PCMC. This was proven by the following parameters; the AUC (1880, 4080, and 2290 microg x min/mL for control rats and rats with PCM and PCMC, respectively), terminal half-life (188, 277, and 139 min), MRT (154, 323, and 155 min), CL (1.06, 0.491, and 0.943 mL/min/kg), CL(NR) (0.992, 0.430, and 0.874 mL/min/kg), and in vitro intrinsic torasemide disappearance clearance, CL(int) (0.102, 0.0842, and 0.0997 mL/min/mg protein).

Pharmacokinetic changes in drugs during protein-calorie malnutrition: correlation between drug metabolism and hepatic microsomal cytochrome p450 isozymes

The rats with protein-calorie malnutrition (PCM, 5% casein diet for a period of 4-week) were reported to exhibit 60 and 80% suppression in the hepatic microsomal cytochrome P450 (CYP) 1A2 and CYP2C11 levels, respectively, and 40-50% decreases in CYP2E1 and CYP3A1/2 levels compared to control (23% casein diet for a period of 4-week) based on Western blot analysis. In addition, Northern blot analysis showed that CYP1A2, CYP2E1, CYP2C11, and CYP3A1/2 mRNAs decreased in the state of PCM as well. Hence, pharmacokinetic changes of the drugs in rats with PCM [especially the area under the plasma concentration-time curve from time zero to time infinity (AUC) changes of metabolite(s)] reported from literatures were tried to explain in terms of CYP isozyme changes in the rats. Otherwise, the time-averaged nonrenal clearance (CL NR) of parent drug was compared. Pharmacokinetic changes of the drugs in other types of malnutritional state, such as kwashiorkor and marasmus, in both human and animal models were also compared. The drugs reviewed are as follows: diuretics, antibiotics, anticancer agents, antiepileptics, antiarrythmics, analgesics, xanthines, antimalarials, and miscellaneous.

Effects of cysteine on the pharmacokinetics of intravenous clarithromycin in rats with protein-calorie malnutrition

Effects of cysteine on the pharmacokinetics of clarithromycin were investigated after intravenous administration of the drug at a dose of 20 mg/kg to control rats (4-week fed on 23% casein diet) and rats with PCM (protein-calorie malnutrition, 4-week fed on 5% casein diet) and PCMC (PCM treated with 250 mg/kg for oral cysteine twice daily during the fourth week). Clarithromycin has been reported to be metabolized via hepatic microsomal cytochrome P450 (CYP) 3A4 to 14-hydroxyclarithromycin (primary metabolite of clarithromycin) in human subjects. It has also been reported that in rats with PCM, CYP3A23 level decreased to 40-50% of control level, but decreased CYP3A23 level in rats with PCM completely returned to control level by oral cysteine supplementation (rats with PCMC). Human CYP3A4 and rat CYP3A23 proteins have 73% homology. In rats with PCM, the area under the plasma concentration-time curve from time zero to time infinity, AUC (567, 853 and 558 microg min/ml for control rats and rats with PCM and PCMC, respectively) and percentage of clarithromycin remaining after incubation with liver homogenate (69.6, 83.9 and 71.7%) were significantly greater than those in control rats and rats with PCMC. Moreover, in rats with PCM, the total body clearance, CL (35.3, 23.4 and 35.8 ml/min/kg), nonrenal clearance, CL(NR) (21.3, 15.2 and 24.1 ml/min/kg) and maximum velocity for the disappearance of clarithromycin after incubation with hepatic microsomal fraction, V(max) (351, 211 and 372 pmol/min/mg protein) were significantly slower than those in control rats and rats with PCMC. However, above mentioned each parameter was not significantly different between control rats and rats with PCMC. The above data suggested that metabolism of clarithromycin decreased significantly in rats with PCM as compared to control due to significantly decreased level of CYP3A23 in the rats. By cysteine supplementation (rats with PCMC), some pharmacokinetic parameters of clarithromycin (AUC, CL, CL(NR) and V(max)) were restored fully to control levels because CYP3A23 level was completely returned to control level in rats with PCMC.

Effects of cysteine on the pharmacokinetics of intravenous 2-(allylthio)pyrazine, a new chemoprotective agent, in rats with protein-calorie malnutrition

The effects of cysteine on the pharmacokinetics of 2-(allylthio)pyrazine (2-AP) were investigated after intravenous administration of the drug (50 mg/kg) to control (Sprague-Dawley) rats (4-week fed on 23% casein diet), and rats with protein-calorie malnutrition (PCM, 4-week fed on 5% casein diet) and PCMC (PCM with 250 mg/kg of oral cysteine, twice daily starting from the fourth week). In rats with PCM, the area under the plasma concentration-time curve from time zero to time infinity (AUC) of 2-AP was significantly smaller than that in control rats. However, in rats with PCMC, the AUC of 2-AP was significantly greater than that in control rats and rats with PCM. This could be due to significantly greater formation of M4 in rats with PCM and significantly smaller formation of M4 in rats with PCMC than that in control rats. In rats with PCMC, some pharmacokinetic parameters of 2-AP restored fully or more than the levels of control rats. For example, in rats with PCMC, the apparent volume of distribution at steady state of 2-AP (7290, 16,600, and 7050 ml/kg for control rats, and rats with PCM and PCMC, respectively), the percentage of dose excreted in 24-h urine as unchanged 2-AP (0.242, 0.727, and 0.130%), and 'the amount' excreted in 24-h urine as M4 (100, 228, and 51%) were comparable to those in control rats. However, the AUC (739, 434, and 1240 microg/min/ml) and total body clearance (67.7, 115, and 40.2 ml/min/kg) of 2-AP were significantly greater and slower, respectively, than those in control rats. This could be at least partly due to increase in S-methyltransferase activity (to form M4) in rats with PCM and greater restoration of its activity (decrease in its activity) in rats with PCMC.