Application of inductively coupled plasma mass spectrometry and high-performance liquid chromatography--with parallel electrospray mass spectrometry to the investigation of the disposition and metabolic fate of 2-, 3- and 4-iodobenzoic acids in the rat

ICP-MS, HPLC-ICP-MS and HPLC-ICP-MS/ESI-MS have been applied to determine the disposition and metabolic fate of 2-, 3- and 4-iodobenzoic acids following intraperitoneal administration at 50 mg kg(-1) to male bile duct cannulated rats. Quantitative excretion balance studies based on the determination of the total iodine content of urine and bile showed that all three iodobenzoic acids were rapidly excreted. Recoveries ranging from 95 to 105% of the administered doses were achieved within 24 h of administration. Metabolite profiles for urine and bile showed extensive metabolism with unchanged iodobenzoic acids forming a minor part of the total. A combination of alkaline hydrolysis and MS enabled the identification of the major metabolites of all three iodobenzoic acids as glycine and ester glucuronide conjugates with very little if any of the parent compounds excreted unchanged.

Selective binding to transthyretin and tetramer stabilization in serum from patients with familial amyloidotic polyneuropathy by an iodinated diflunisal derivative

In familial amyloidotic polyneuropathy, TTR (transthyretin) variants are deposited as amyloid fibrils. It is thought that this process involves TTR tetramer dissociation, which leads to partially unfolded monomers that aggregate and polymerize into amyloid fibrils. This process can be counteracted by stabilization of the tetramer. Several small compounds, such as diclofenac, diflunisal and flufenamic acid, have been reported to bind to TTR in vitro, in the T4 (thyroxine) binding channel that runs through the TTR tetramer, and consequently are considered to stabilize TTR. However, if these agents bind plasma proteins other than TTR, decreased drug availability will occur, compromising their use as therapeutic agents for TTR amyloidosis. In the present work, we compared the action of these compounds and of new derivatives designed to increase both selectivity of binding to TTR and inhibitory potency in relation to TTR amyloid fibril formation. We found two diflunisal derivatives that, in contrast with diclofenac, flufenamic acid and diflunisal, displaced T4 from TTR in plasma preferentially over binding to albumin and thyroxine binding globulin. The same diflunisal derivatives also had a stabilizing effect on TTR tetramers in plasma, as studied by isoelectric focusing of whole plasma under semi-denaturing conditions. In addition, by transmission electron microscopy, we demonstrated that, in contrast with other proposed TTR stabilizers (namely diclofenac, flufenamic acid and diflunisal), one of the diflunisal derivatives tested efficiently inhibited TTR aggregation. Taken together, our ex vivo and in vitro studies present evidence for the selectivity and efficiency of novel diflunisal derivates as TTR stabilizers and as inhibitors of fibril formation.

Targeting against epidermal growth factor receptors. Cellular processing of astatinated EGF after binding to cultured carcinoma cells

BACKGROUND

The alpha-emitting nuclide 211At is of great interest for radionuclide therapy when coupled to a tumor-targeting biomolecule, e.g. epidermal growth factor (EGF) the receptors of which are overexpressed in many malignancies. However, almost no information concerning the cellular processing of astatinated targeting agents is available.

MATERIALS AND METHODS

We indirectly astatinated EGF ([211At]-benzoate-EGF) and studied its cellular processing in A-431 carcinoma cells in comparison with data concerning [125I]-benzoate-EGF.

RESULTS

The biological half-life of astatine (3.5 h) was longer than the half-life of the iodine label (1.5 h). The increase of the half-life was due to longer retention of the internalised astatine radioactivity. The maximum accumulation for the astatine label occurred later (4-6h) than that for the iodine label (2-4h), indicating a slower excretion of astatine that was confirmed in experiment with 211At/1251-benzoate-EGF.

CONCLUSION

The long retention of astatine might be advantageous for radionuclide therapy.

Renal handling of iodobenzoates in rats

Renal elimination pathways of three positional isomers of iodobenzoic acid (2-iodobenzoate, 3-iodobenzoate and 4-iodobenzoate radiolabelled with 125I) were compared using the perfused rat kidney in-situ. All agents were eliminated both in a parent form (involving all renal elimination mechanisms i.e. glomerular filtration, tubular secretion, and tubular reabsorption) and also metabolized to a large extent in the kidney. After 3-iodobenzoate and 4-iodobenzoate administration, the major fractions of radioactivity found in urine were in the form of their metabolites, whereas 2-iodobenzoate was eliminated into urine mostly as the parent compound. Proportions of the individual metabolites in the urine of the perfused rat kidney were similar to those in intact rats for all agents. The results suggest that the kidney is the major organ for both the excretion and metabolism of iodobenzoates in rats. The principal renal metabolic reaction for all compounds under study was conjugation with glycine to produce the corresponding hippuric acid derivatives.

An easy colorimetric assay for screening and qualitative assessment of deiodination and dehalogenation by bacterial cultures

Halogenated organic substances are among the main environmental concerns. A number of micro-organisms are able to dehalogenate these compounds. However, the methods for the assessment of micro-organismal ability to dehalogenate are expensive and require complex instrumentation. Here, an easy colorimetric assay for the screening and assessment of the ability of bacterial cultures to deiodinate, and potentially dehalogenate, chemical substances is proposed. The method is based on the oxidation of iodide, released due to biotransformation, to iodine followed by a subsequent detection of iodine by a classical reaction with starch.

Anaerobic degradation of 3-halobenzoates by a denitrifying bacterium

A denitrifying bacterium was isolated from a river sediment after enrichment on 3-chlorobenzoate under anoxic, denitrifying conditions. The bacterium, designated strain 3CB-1, degraded 3-chlorobenzoate, 3-bromobenzoate, and 3-iodobenzoate with stoichiometric release of halide under conditions supporting anaerobic growth by denitrification. The 3-halobenzoates and 3-hydroxybenzoate were used as growth substrates with nitrate as the terminal electron acceptor. The doubling time when growing on 3-halobenzoates ranged from 18 to 25 h. On agar plates with 1 mM 3-chlorobenzoate as the sole carbon source and 30 mM nitrate as the electron acceptor, strain 3CB-1 formed small colonies (1-2 mm in diameter) in 2 to 3 weeks. Anaerobic degradation of both 3-chlorobenzoate and 3-hydroxybenzoate was dependent on nitrate as an electron acceptor and resulted in nitrate reduction corresponding to the stoichiometric values for complete oxidation of the substrate to CO2. 3-Chlorobenzoate was not degraded in the presence of oxygen. 3-Bromobenzoate and 3-iodobenzoate were also degraded under denitrifying conditions with stoichiometric release of halide, but 3-fluorobenzoate was not utilized by the bacterium. Utilization of 3-chlorobenzoate was inducible, while synthesis of enzymes for 3-hydroxybenzoate degradation was constitutively low, but inducible. Degradation was specific to the positive of the halogen substituent, and strain 3CB-1 did not utilize 2- or 4-chlorobenzoate.

In vitro studies on the cellular uptake of melanoma imaging aminoalkyl-iodobenzamide derivatives (ABA)

The cellular uptake of 11 radioiodinated aminoalkyl-iodobenzamides (ABA) was studied using cultivated murine melanoma cells (B16/C3). All derivatives showed a high uptake (up to about 80%) of radioactivity in melanotic melanoma cells; hence, accumulation of all compounds radioiodinated in the ortho position was reduced by approximately 30%. Using the compound para-[131I]iododiethyl-aminoethylbenzamide (p-131I-ABA-2-2) a close correlation of the cellular melanin content with the tracer uptake (R2 = 0.95) was verified. The presence of extracellular melanin, however, had no effect on the cellular tracer uptake. Because the accumulation was independent of the specific activity of p-131I-ABA-2-2, a significant contribution to the uptake process by binding to receptor sites could be excluded.

Oncocidin A1: a novel tubulin-binding drug with antitumor activity against human breast and ovarian carcinoma xenografts in nude mice

We identified a structural analog of thyroid hormone, methyl-3,5-diiodo-4-(4'-methoxyphenoxy) benzoate (Oncocidin A1), that inhibits human carcinoma cell proliferation and the growth of human breast (MDA MB-231) and ovarian (OVCAR-3) carcinoma xenografts in nude mice. This novel antitumor agent is orally bioavailable and well tolerated by animals. Exposure of MCF-7 and MDA MB-231 breast carcinoma cells to Oncocidin A1 in vitro caused a cell-cycle arrest in prometaphase (a G2/M arrest) and apoptosis, suggesting a cytotoxic mechanism involving mitotic spindle function. The interaction of Oncocidin A1 with microtubules was demonstrated by: 1) immunofluorescence studies of microtubule assembly in the presence of the drug in cell-free and in cellular assays; and 2) in vitro binding inhibition studies involving radiolabeled Oncocidin A1 or colchicine and tubulin monomers. Taken together, these experiments indicate that Oncocidin A1 perturbs cellular microtubule assembly, possibly by binding to the colchicine site on tubulin. Three-dimensional structural modelling of Oncocidin A1 revealed that it can adopt a twisted conformation similar to that of combretastatin A-4, which binds to the colchicine site of tubulin. The novel structural features of Oncocidin A1 could guide the design of a new class of microtubule-binding antitumor agents having substantially reduced normal tissue toxicity upon oral administration.

Enhanced binding and inertness to dehalogenation of alpha-melanotropic peptides labeled using N-succinimidyl 3-iodobenzoate

Two peptides of potential utility for targeting melanoma cells, alpha-melanocyte-stimulating hormone (alpha-MSH) and its more potent analogue [Nle4,D-Phe7]-alpha-MSH, were radioiodinated in 45-65% yield using N-succinimidyl 3-[125I]iodobenzoate (SIB). To determine whether this labeling method resulted in improved in vitro and in vivo characteristics, these peptides also were labeled with 131I by direct iodination with the iodogen method. For alpha-MSH, the rapid tissue clearance of both radionuclides in mice was consistent with rapid degradation of the peptide; however, significantly lower levels of 125I were observed in thyroid and stomach, reflecting a greater inertness to deiodination. More extensive comparisons were performed with [Nle4,D-Phe7]-alpha-MSH. The in vitro binding of [Nle4,D-Phe7,Lys11-(125I)IBA]-alpha-MSH (prepared using SIB) to the murine B-16 melanoma cell line, 34.1 +/- 4.7%, was more than twice as high as that for [Tyr2(131I),Nle4,D-Phe7]-alpha-MSH (15.0 +/- 0.1%), and its KD was more than 10-fold lower than that for conventionally labeled peptide (10 +/- 5 versus 140 +/- 14 pM). The normal tissue clearance of [Nle4,D-Phe7,Lys11-(125I)IBA]-alpha-MSH in mice was faster than that of [Tyr2(131I),-Nle4,D-Phe7]-alpha-MSH. The 19-40-fold lower activity concentrations of [Nle4,D-Phe7,Lys11-(125I)IBA]-alpha-MSH in tissues accumulating free iodide (thyroid and stomach) suggest a greater inertness of this peptide to deiodination. The primary urinary catabolite of [Nle4,D-Phe7, Lys11-(125I)IBA]-alpha-MSH was the lysine conjugate of iodobenzoic acid, whereas radioiodide was the chief catabolite generated from [Tyr2(131I),Nle4,D-Phe7]-alpha-MSH. We conclude that further evaluation of [Nle4,D-Phe7,Lys11-(125I)IBA]-alpha-MSH for targeting alpha-MSH receptors is warranted and that SIB may be a useful method for the radioiodination of peptides.

Effect of plasma binding of ortho- and para-I-benzoates on their distribution in blood and into lymph, biotransformation and excretion in rat urine

Two positional iodine derivatives of benzoic acid, i.e. ortho- (OIB) and para- (PIB), were used alone and in combination with salicylic acid (SA) to study the effects of plasma binding on their pharmacokinetics. Their lymphatic bioavailability (central lymph), their biotransformation and urinary excretion in rats were also studied. Plasma binding of the two benzoates is different, about 95% of PIB and approximately 50% of OIB are bound. The competitive inhibition effect of SA was shown by an increase in the amount of free drug in plasma in both benzoates. Lymphatic binding is lower compared to plasma binding, an effect of SA of the free faction of drug in lymph was shown only with PIB. Kinetic parameters of benzoates are influenced by plasma binding; significant differences were found mainly in total clearance and areas under concentration curves. Lymphatic bioavailability (FL) differs only slightly with different plasma binding; a significant change in FL was, however, found in PIB after SA premedication. Significantly higher urinary excretion of OIB as compared with PIB corresponds to plasma binding of drugs, SA premedication decreases total excretion of both benzoates. SA also changes the proportion of the individual fractions of metabolites of benzoates in urine.

Protein radiohalogenation: observations on the design of N-succinimidyl ester acylation agents

In previous studies we have demonstrated that antibodies radioiodinated with N-succinimidyl 3-iodobenzoate (SIB) are less susceptible to loss of radioiodine in vivo than antibodies iodinated directly by electrophilic substitution on their tyrosine residues with Iodogen. Since the Bolton-Hunter reagent, N-succinimidyl 3-(4-hydroxy-3-iodophenyl)propionate, is identical with SIB except that it contains a hydroxyl group on the aromatic ring and a two-methylene spacer, a comparison of their coupling chemistry and in vivo behavior was performed to better understand the structural requirements for a useful iodinated acylation agent. Protein concentration and pH had a significant effect on the coupling efficiency of both SIB and the Bolton-Hunter reagent; however, protein-labeling yields with SIB were generally higher by a factor of 2. Paired-label biodistribution studies in mice demonstrated that thyroid uptake (a monitor of dehalogenation) of antibody labeled by the Bolton-Hunter method was twice that of antibody labeled with SIB but only 7% of that observed for antibody labeled with Iodogen. These results suggest that even minor differences in iodination site can profoundly alter the retention of label on a protein in vivo.

[125I](+/-)FISCH: a new CNS D-1 dopamine receptor imaging ligand

Radiolabeling and in vitro and in vivo evaluation of an iodinated benzazepine: [125I] FISCH 7-Chloro-8-hydroxy-1-(4'-iodophenyl)-3-methyl-2,3,4,5- tetrahydro-1H-3-benzazepine, as a potential imaging agent for CNS D-1 dopamine receptors in animals, were investigated. After an iv injection, this benzazepine derivative showed good brain uptake in rats (2.70, 1.28, 0.48 %dose/whole brain at 2, 15 and 60 min, respectively). The striatum/cerebellum ratio was 2.50 at 60 min after the injection. The regional distribution in rat brain, as measured by ex vivo autoradiography, displayed highest uptake in the regions of the striatal complex and the substantia nigra, regions known to have a high concentration of D-1 dopamine receptors. Furthermore, this localized regional cerebral distribution was blocked by pretreatment with SCH-23390, a selective D-1 dopamine receptor antagonist. The in vitro binding affinity of this agent in rat striatum tissue preparation displayed a Kd of 1.43 +/- 0.15 nM. Competition data (in vitro) showed the following rank order of potency: SCH-23390 greater than (+/-)IBZP much greater than apomorphine greater than WB 4101 greater than ketanserin approximately spiperone. The preliminary data suggest that this analog of SCH-23390 shows similar selectivity for the CNS D-1 receptor.

Influence of the spread and period of retention of Iotrolan in the subarachnoid space on the side effects rate in myelography

Fifty patients underwent myelography with the newly developed CSF-isotonic, dimeric, non-ionic contrast medium Iotrolan. Repeat spinal and cranial computerised tomographic studies with measurement of the attenuation values were conducted to demonstrate the administered contrast medium in the spinal canal and intracranial subarachnoid space. The patients were examined neurologically, observed clinically and asked about concomitant symptoms. The period of retention and the spread of the contrast medium in the subarachnoid space was not found to have any influence on the side effects rate. In particular, no association was confirmed between intracranially demonstrable contrast medium and the occurrence of side effects.

Reductive dechlorination of 2,4-dichlorobenzoate to 4-chlorobenzoate and hydrolytic dehalogenation of 4-chloro-, 4-bromo-, and 4-iodobenzoate by Alcaligenes denitrificans NTB-1

Alcaligenes denitrificans NTB-1, previously isolated on 4-chlorobenzoate, also utilized 4-bromo-, 4-iodo-, and 2,4-dichlorobenzoate but not 4-fluorobenzoate as a sole carbon and energy source. During growth, stoichiometric amounts of halide were released. Experiments with whole cells and cell extracts revealed that 4-bromo- and 4-iodobenzoate were metabolized like 4-chlorobenzoate, involving an initial hydrolytic dehalogenation yielding 4-hydroxybenzoate, which in turn was hydroxylated to 3,4-dihydroxybenzoate. The initial step in the metabolism of 2,4-dichlorobenzoate was catalyzed by a novel type of reaction for aerobic organisms, involving inducible reductive dechlorination to 4-chlorobenzoate. Under conditions of low and controlled oxygen concentrations, A. denitrificans NTB-1 converted all 4-halobenzoates and 2,4-dichlorobenzoate almost quantitatively to 4-hydroxybenzoate.

Penetration of the brain by nonionic water soluble tri- and hexaiodinated contrast media. Experimental autoradiographic study of two contrast media: Iotrol and Iopamidol labelled with iodine 125

After suboccipital injection of Iotrol and Iopamidol labelled with iodine 125 in rabbits, we measured residual radioactivity in the whole brain and optical density on autoradiographs of brain sections obtained 2, 8 and 24 h after injection. Residual radioactivity is higher with Iotrol than with Iopamidol after 8 h and 24 h. At densitometry, while the penetration of the cortex is the same with both media at 2 h (although subcortical passage of Iotrol is greater), by 8 h the concentration of Iopamidol is twice that of Iotrol, and at 24 h it is three times as high. A similar pattern was seen in the subcortical region. These densitometric findings are in agreement with previous electrophysiological studies, in which changes were less severe and more transient with Iotrol than with Iohexol. There is nevertheless an apparent lack of agreement between the studies of radioactivity and the electrical findings. The lower neurotoxicity of Iotrol may be explained by: a longer half-life in the subarachnoid space; its larger molecules, which inhibit diffusion in the extracellular fluid, and its more hydrophilic nature, which reduces intracellular penetration.

Characterization of liposomes containing iodine-125-labeled radiographic contrast agents

Multilamellar liposomes were prepared containing either iodine-125-labeled (125I) diatrizoate or 125-I labeled iotrol in their aqueous phase. The in vitro permeabilities of liposomes containing both contrast agents were measured in the presence of saline and serum at 37 degrees C. Two different phospholipid compositions were studied: phosphatidylcholine/cholesterol/stearylamine (PC/C/S, 8: 1:1 molar ratio) and distearoylphosphatidylcholine/sphingomyelin (DSPC/SM, 5:2 mole ratio). In saline, similar permeabilities were observed for the four phospholipid-contrast agent combinations. In serum, however, leakage of 125I activity was 2 to 3 times greater from PC/C/S liposomes than from vesicles composed of DSPC/SM. When PC/C/S liposomes that contained 125I-diatrizoate were injected into rats, the clearance half-times for 125I activity from the liver, spleen, and whole body were 4.4 hours, 4.5 hours, and 2.8 hours, respectively. Liposomes composed of DSPC/SM cleared at a significantly slower rate from the liver, spleen, and whole body with half-times of 24.0 hours, 18.4 hours, and 17.2 hours observed from these tissues, respectively.

Penetration of subarachnoid contrast medium into rabbit spinal cord. Comparison between metrizamide and iohexol

The penetration into rabbit spinal cord of two nonionic contrast media, iohexol and metrizamide, and a reference tracer, technetium DTPA, were compared. The spinal subarachnoid space was perfused for 4 hours with a CSF solution to which technetium DTPA and either iohexol or metrizamide had been added. The contrast media and technetium DTPA concentrations reached a plateau level in CSF outflow within 80 minutes. The contrast media concentrations in CSF were higher than the technetium DTPA (P less than .001). In the cord tissue, technetium DTPA reached higher concentrations than the contrast media (P less than .001), and iohexol reached higher concentrations relative to technetium DTPA than metrizamide (P less than .001). The mean contrast media distribution volumes in the thoracic cord were 13% (iohexol) and 12% (metrizamide). The smaller distribution volume observed for metrizamide could be related to the larger effective size of "associated" metrizamide molecules or an interference with diffusion perhaps related to binding to glucose carriers.

Gall-bladder and colonic opacification following parenteral ioxaglate

Of 50 successive in-patients with normal blood urea levels who received ioxaglate (Hexabrix 320; May & Baker Ltd), 60% showed gall-bladder opacification 12-25 h later. None of these patients had been asked to fast after receiving the ioxaglate. This has not been reported previously with any of the presently available urographic media, either conventional or the new low-osmolality agents. This should be regarded as a normal occurrence and does not imply impairment of renal function.

Pharmacokinetics and excretion of iohexol after lumbar myelography in man

Pharmacokinetics and excretion of iohexol, a new nonionic water-soluble contrast medium, were determined after lumbar myelography. Peak plasma concentrations were obtained 2 to 6 hours after injection and ranged from 29 to 177 microgram/ml. Terminal elimination half-life was 4.0 hours, and over 90% of the dose was recovered in the urine within 24 hours. In one patient with a large lumbar cauda equina tumor, absorption and excretion were delayed; but eventually 99% was recovered indicating a large capacity for reabsorption via the lumbar subarachnoid space. One mild headache of 5 minutes' duration was reported in a 73-year-old woman. No significant changes in vital signs, neurologic examinations, or serum chemistries were observed.

Comparison of diatrizoate, iopamidol, and ioxaglate for the contrast enhancement of experimental hepatic tumors in CT

The accumulation of diatrizoate and two new low osmolality contrast agents, iopamidol and ioxaglate, was investigated in three experimental tumors (a well differentiated mammary adenocarcinoma, a poorly differentiated colon carcinoma, and a hepatoma) in the rat. All three tumors were implanted into the liver 12 to 14 days prior to intravenous injection of the contrast agents in a dose of 300 mg iodine per kg. Iodine concentrations were determined in blood, liver, and tumors at 1, 5, 10, and 30 minutes using x-ray energy spectrometry. Ratios between tumor iodine and blood iodine concentrations increased more with time with diatrizoate than either iopamidol or ioxaglate and were at 30 minutes significantly greater for diatrizoate than the other two agents. This suggests that the contrast medium efflux from the vascular compartment into the extravascular compartment of all tumors is greater for diatrizoate than either iopamidol or ioxaglate. Although it is known from clinical experience that the differential enhancement between hypodense hepatic tumors and liver parenchyma decreases rapidly with time after contrast administration, this investigation suggests that the substitution of diatrizoate by either iopamidol or ioxaglate should not affect appreciably the contrast enhancement in this condition in dynamic CT completed within the first minutes after contrast administration. In a later phase, after contrast administration, however, both iopamidol and ioxaglate should conceal hypodense hepatic tumors less than diatrizoate.

Neural tissue uptake and clearance of iohexol following lumbar myelography in rabbits

The diffusion of water-soluble contrast media (CM) into the extracellular space of the central nervous system following injection into the subarachnoid space has previously been shown. As a result of this, water-soluble CM will come in direct contact with the neurons and may interfere with their normal function. The toxic effects would thus be a result both of the molecular properties of the CM as well as the local tissue concentration. The neuronal tissue uptake and clearance of metrizamide in rabbits following lumbar myelography was described in a previous study by our group. This study indicated some retention of metrizamide in the spinal cord probably as a result of binding of the CM to the cell membrane. The mechanism for this has not yet been shown although it may relate to the binding of metrizamide via its 2-deoxy-D-glucose (2-DG) portion and the specific glucose membrane carrier. The present investigation was performed to evaluate the diffusion kinetics of a new non-ionic CM. With iohexol, which lacks a 2-DG component in its molecule a direct relationship between the neural tissue and CSF concentration was found which seems to follow a simple diffusion model. Since iohexol shows no sign of entrapment in the tissue, the contact time for neurons will be shorter than that seen with metrizamide assuming that their rate of drainage from the CSF is identical.

Absorption of iohexol from cerebrospinal fluid to blood: pharmacokinetics in humans

The absorption of iohexol from the subarachnoid space was studied in 9 patients. Serum concentrations of iohexol were measured for a minimum of 24 hours after injection. Peak serum concentrations were observed after 2.2 (1.7-2.7) hours. The half-life of the subsequent decrease in serum concentrations was 3.4 (2.2-7.9) hours. Concentrations of iohexol in cerebrospinal fluid were 0.29-4.3 mg I/ml 24 hours after injection (7 patients). Serum and cerebrospinal fluid concentrations of iohexol are comparable to those found after intrathecal injection of metrizamide.

The maximal biliary excretory rate (Tm) of ioglycamide in the rat. Effect of taurocholate

Biliary excretion of ioglycamide was studied in Wistar and Gunn rats. A hepatic transport-maximum (Tm) was observed. Higher Tm-values were found in Gunn rats, which have a greater bile flow compared to the parent Wistar rats, in spite of having a similar bile acid output. This suggests that the Tm is related to the bile acid-independent bile flow. In bile acid-depleted Wistar rats, bile acid output was 30% of control values whereas bile flow and ioglycamide-Tm had only decreased by approximately 15%. Ioglycamide excretion could not be increased by taurocholate infusion. An additional 22.0 ml of bile was excreted per mmol of biliary ioglycamide. Loads of the contrast agent markedly exceeding the Tm resulted in a decrease of its own biliary excretion and its choleretic properties. These presumed 'toxic' effects were counteracted by near-physiological amounts of taurocholate. Thus, the effect of taurocholate varies greatly depending upon the amounts of the contrast agent and the taurocholate administered.

Clinical comparison of Hexabrix, iopamidol, and Urografin-60 in whole body computed tomography

Urografin 60, iopamidol and Hexabrix were studied in patients undergoing body CT scans to examine the pharmacodynamics of these contrast agents. Immediately following rapid injection, the lower osmolality media, Hexabrix and iopamidol, gave greater aortic concentration of iodine in addition to higher concentrations in the liver and spleen. These two agents also provided significantly better renal enhancement than Urografin 60, with Hexabrix giving higher levels than iopamidol. The higher early vascular concentrations of Hexabrix and iopamidol and the relative absence of side effects due to hyperosmolality and decreased toxicity may have advantages in dynamic CT scanning.

Pharmacokinetics of iohexol, a new nonionic radiocontrast agent, in humans

Sixteen healthy men received iohexol intravenously at a concentration of 346 mg of iodine/mL. Doses of 500, 750, 1000, and 1500 mg of iodine/kg of body weight were administered to four volunteers each. Neither clearance nor percent of dose excreted in the urine showed any significant correlation with size of the dose. The overall mean (+/- SD) renal and total body clearances were 120 +/- 18.6 and 131 +/- 18.6 mL/min, respectively. The overall mean apparent volume of distribution was 165 (+/- 30.7) mL/kg. Urine contained 92.3 +/- 4.4% of the dose. Most of the drug (89.9%) was excreted within the first 12 h. An open three-compartment body model gave the best fit to the experimental data. The mean apparent first-order terminal elimination (gamma-phase) half-life was 12.6 h.

[Theory of organotropism of roentgen contrast media]

The authors summarize their own and reported data on the reasons for selective tropism for definite organs of organic iodine-containing radiographic contrast agents (RCA). Offer a theory that explains the organotropism of RCA and that is based on the physicochemical characteristics of their interrelationship with blood plasma proteins and target cells. Provide a classification of RCA the basis of which is formed by the chemical structure of the compounds in question. Review the physicochemical bases for interaction of RCA with blood serum proteins, plasma membranes and intracellular proteins of the excretory organs.

Distribution and elimination of o-125I-benzoate in rats

125I-labelled o-iodobenzoate (OIB) was prepared by means of an isotopic exchange reaction; its distribution and excretion were determined and its pharmacokinetic parameters in rats were calculated. The calculated value of the half-life of OIB elimination was 38.7 +/- 0.7 min, the distribution volume was 278.2 +/- 53.5 ml . kg-1. The rate of elimination activity in urine was in agreement with the above values. On the basis of the developed technique of separation of OIB metabolites by thin-layer chromatography, their relative proportion in rat urine was determined; within 24 h 50% of the eliminated activity was in the original form (as OIB) and the metabolites of o-iodohippurate and o-iodobenzoylglucuronide formed approximately 25% of the activity eliminated in urine each.

Contrast enhancement pharmacokinetics of six ionic and nonionic contrast media

The contrast enhancement of six contrast media (CM) was compared in 13 tissues of the rat after rapid intravenous bolus injection. The rats were sacrificed at 0 and 40 seconds and 2, 5, and 15 minutes after contrast injection. 125I labeled diatrizoate, metrizamide, ioxaglate, iohexol, iopamidol, and a nonionic dimer, iodecol, were each injected at a dose of 612 mg iodine per kg body weight, and iodine concentration (IC) and contrast enhancement were calculated from radioactivity measurements. Higher blood IC values were obtained with the nonionic CM; similar enhancement patterns were seen in the spleen, heart, lungs, and brain. Renal IC was directly related to the number of iodine atoms per ion or molecule of CM. In consequence, renal IC was inversely related to the CM osmolality, but no such correlation was seen with the blood IC. Metrizamide produced the greatest IC in the organs of the gastrointestinal tract. There was no apparent correlation of IC with molecular structure of physicochemical parameters of the CM in any of the other tissues studied.

The effect of taurocholate on canine bile flow, biliary excretion and concentration of ioglycamide

The bile acid taurocholate increases the biliary excretion of organic anions, such as sulfobromophthalein (BSP), bilirubin and iopanoic acid. In the present study has been investigated the effect of taurocholate on 1. Canine biliary excretion and concentration of the i.v. contrast medium ioglycamide and 2. Canine bile flow. The experimental model consisted of cholecystectomized, anaesthetized dogs with a fistula, through which the common bile duct could be catheterized and drained. One hour after cannulation, i.v. infusion of ioglycamide at a rate of 4 mumol/min./kg. was started. Two hours after the infusion start a control group received i.v. infusion of saline, while in another a 1.5% sodium taurocholate infusion was started with stepwise increases with 30 min. intervals from 0.4 to 0.8, 1.6 and 3.2 mumol/min./kg. Compared with control, all rates of taurocholate infusion increased bile flow and decreased biliary ioglycamide concentration. Although the bile flow with increasing taurocholate infusion rates was enhanced, the biliary ioglycamide excretion did not increase. The results indicate that ioglycamide and taurocholate are excreted into bile by separate excretion mechanisms. As taurocholate increases the biliary excretion of some other organic anions, it supports the hypothesis that organic anions are excreted into bile by more than two excretion mechanisms, taurocholate affecting only some of them.

Human pharmacokinetics of iohexol. A new nonionic contrast medium

The pharmacokinetics of iohexol, a new nonionic, water-soluble contrast medium, have been determined after intravenous injection in 20 healthy volunteers, at four different dose levels (125-500 mg I/kg). The apparent volume of distribution was 0.27 1/kg, indicating distribution in the extracellular water. The biologic half-life was 121 minutes, comparable with that of other intravascular contrast media. Iohexol was excreted completely unmetabolized in the urine, with a 100% recovery 24 hours after injection. A comparison of iohexol and chromium-51 (51Cr)-EDTA clearances indicates that iohexol is mainly excreted by glomerular filtration. The 51Cr-EDTA clearance was the same when injected separately and concomitantly with iohexol, indicating that glomerular filtration rate is not affected by iohexol. No dose dependency was observed in the investigated parameters t1/2 alpha, t1/2 beta, Vd, ClT or ClR. Iohexol pharmacokinetics are in correspondence with previously reported data on intravascular contrast media.

Plasma clearance and endocytosis of cytosolic malate dehydrogenase in the rat

1. Pig heart cytosolic malate dehydrogenase was radiolabelled with O-(4-diazo-3,5-di-[125I]iodobenzoyl)sucrose and intravenously injected into rats. Enzyme activity and radioactivity were cleared from plasma identically, with first-order kinetics, with a half-life of about 30 min. 2. The tissue distribution of radioactivity was determined at 2 h after injection. All injected radioactivity was recovered from the tissues. A high percentage of the injected dose was found in liver (37%), spleen (6%) and bone including marrow (19%). 3. Radioactivity in liver and spleen increased up to 2 h after injection and subsequently declined, with a half-life of about 20 h. 4. After differential fractionation of liver, radioactivity was largely found in the mitochondrial and lysosomal fraction. 5. Liver cells were isolated 1 h after injection of labelled enzyme. We found that Kupffer cells, endothelial cells and parenchymal cells had endocytosed the enzyme at rates corresponding to 2725, 94 and 63 ml of plasma/day per g of cell protein respectively. 6. Radioautography indicated that in spleen and bone marrow the enzyme is mainly taken up by macrophages. 7. Internalization of the enzyme by liver, spleen and bone marrow was saturable. This indicates that the enzyme is taken up in these tissues by adsorptive endocytosis. 8. The present results closely resemble those obtained previously for the mitochondrial isoenzyme of malate dehydrogenase and for lactate dehydrogenase M4. Since those enzymes are positively charged at physiological pH, whereas cytosolic malate dehydrogenase is negative, net charge cannot be the major factor determining the rate of uptake of circulating enzymes by reticuloendothelial macrophages, as has been suggested in the literature [Wachsmuth & Klingmüller (1978) J. Reticuloendothel. Soc. 24, 227-241].

Absorption after subarachnoid and subdural administration of iohexol, 51Cr-EDTA, and 125I-albumin to rabbits

The absorption of the nonionic contrast medium iohexol, the clearance tracer 51Cr-ethylenediaminetetraacetic acid, and the blood-pool marker 125I-human serum albumin was studied after subarachnoid and subdural injection in rabbits. Subdural deposition of the contrast medium and 51Cr-ethylenediaminetetraacetic acid resulted in a faster absorption rate and higher achieved blood levels than a subarachnoid injection of the two substances, where a slow absorption to lower blood concentrations was observed. No significant differences in absorption rate could be shown after subdural and subarachnoid administration of iodine-labelled albumin. The excretion of iohexol was observed for 1 week after the intrathecal injection. For both the subdural and subarachnoid depositions, about 83% of the injected iohexol was found in urine within 24 hr after injection. The total recovery of iohexol after 1 week was 96% (range, 87%-101%).

Oxygen transfer from bleomycin-metal complexes

Both Fe(III) and Cu(II) complexes of bleomycin (BLM), but not N-acetyl BLM . Fe(III), mediated the transfer of oxygen from iodosobenzene to organic substrates. In analogy with results obtained using certain cytochrome P-450 analogs, cis-stilbene was converted cleanly to the respective oxide, while no more than traces of trans-stilbene oxide were formed from trans-stilbene under identical conditions. The possible relevance of these observations to the degradation of DNA by bleomycin was also studied. In both the presence and absence of O2, BLM . Cu(II) . C6H5IO effected DNA degradation, as judged by the release of [3H]thymine from radiolabeled Escherichia coli DNA. These findings provide a valuable new assay system for the study of bleomycin analogs and suggest the possibility that bleomycin may function as an "oxygen transferase" in its degradation of DNA in situ.

The effect of theophylline on canine bile flow, biliary excretion and concentration of ioglycamide

Theophylline (TH), which has been shown in experimental dogs to increase bile-salt-independent bile flow, was studied in its effect on the biliary excretion and concentration of the intravenous contrast medium ioglycamide in cholecystectomized anesthetized dogs equipped with a Thomas cannula through which the common bile duct could be cannulated. One hour after cannulation, i.v. infusion of ioglycamide at the rate of 4 mol/min/Kg was started. Two hours later, 10 mg/kg of TH was injected intravenously and the experiment continued for a further 75 minutes. Bile was collected at 15 min. intervals throughout the whole experiment and simultaneous intravenous blood samples were taken. In this study, TH increased bile flow and decreased biliary ioglycamide concentration. Although TH increased bile flow, it had no effect on the biliary excretion of ioglycamide. It may be postulated that the organic anion ioglycamide, and possibly other organic anions, are secreted into the bile by mechanisms, unaffected by drugs which increase bile-salt-independent bile flow in a similar manner to TH.

The effect of furosemide on canine bile flow and biliary excretion of ioglycamide during cholangiography

The effect of furosemide on biliary excretion of ioglycamide and bile flow during experimental cholangiography was studied in cholecystectomized and anaesthetized dogs equipped with a Thomas cannula through which the common bile duct could be cannulated. Ioglycamide infusion was started one hour after cannulation of the common bile duct, the infusion rate being 4 micromol/min/kg. Two hours later, 2 mg/kg furosemide was injected intravenously. After furosemide administration biliary ioglycamide concentration and bile flow remained the same as before the furosemide administration. Our evidence suggests that furosemide has no effect on the biliary excretion of ioglycamide or bile flow during ioglycamide cholangiography on dogs.

Noninvasive estimation of kidney function by x-ray fluorescence analysis: biological half-time and clearance of contrast material in rabbits

A noninvasive method for glomerular filtration rate-determination, in which the use of radioactive tracers and sampling of plasma and urine can be omitted, is described. After injection of iodinated contrast material in rabbits, the iodine content of tissue, serum, and urine is measured by means of x-ray fluorescence analysis. The disappearance rates of iodine in tissue and serum are found to be the same, and a strong correlation is found between clearance values calculated from serum and tissue measurements. This indicates the possibility of evaluating kidney function by x-ray fluorescence analysis of contrast material in tissue only.

Biliary iodipamide and iodoxamate excretion as function of basal bile flow in normal, common bile duct obstructed and liver-damaged dogs

The investigation was performed in 6 cholecystectomized chronic bile fistula dogs in which, except in complete common bile duct obstruction, the bile was diverted and replaced with a constant taurocholate infusion of 0.3 mumoles per min. per kg. Iodipamide and iodoxamate were i.v. infused at a rate of 6.7 mumoles per minute per kg for 30 minutes. Different degrees of extrahepatic obstruction were simulated by producing different intrabiliary pressure conditions. Progressive hepatic parenchymal disease was induced by oral administration of dimethylnitrosamine. In both conditions basal (precontrast) bile flow, maximum biliary excretion rate and bile concentration of the contrast agents decreased with increasing hepatic dysfunction. This investigation suggests that, regardless of the underlying mechanism, the bile iodine concentration required for radiographic visualization of the biliary system is no longer attained in intravenous cholangiography when the basal bile flow decreases below 2 microliter per min per kg in the presence of a physiologic bile salt plasma pool. In hepatic dysfunction alkaline phosphatase correlated better with the maximum biliary excretion rate and concentration of the contrast agents than SGPT, SGOT, and serum bilirubin and therefore seems to be the best parameter to predict the chance of a successful intravenous cholangiography.

Gastrointestinal radiology. Pharmacokinetics of iopanoate and iodoxamate in rhesus monkeys

The pharmacokinetics, biliary excretion, plasma protein binding, enterohepatic circulation, and biotransformation of iopanoic acid and iodoxamic acid in the rhesus monkey were evaluated by a dynamic infusion method. The dynamic method has the advantage that the pharmacokinetic parameters involved in the hepatic uptake and biliary excretion can be evaluated from a single infusion experiment. The percentage of iodoxamic acid not bound to plasma protein varied from 6.1-41.2% as iodoxamic acid plasma levels were from 42 microM to 912 microM. Using the Freundlich isotherm approach, more than one class of binding site for iodoxamic acid was found. A saturable biliary excretion mechanism or hepatic uptake mechanism was determined with a Vmax of 1.03 microM/kg/min. Less than 1% of iodoxamic acid injected into the duodenum was recovered in the bile in 12 hours. Iodoxamic acid was found to exist in blood as an unchanged species. Iopanoic acid was extremely highly bound to monkey plasma protein. As blood concentration increased from 18.9 to 464 microM, the percentage unbound in plasma protein varied from 0.1-2.8%. Biliary excretion rates of iopanoic acid were fitted by a computer to the Michaelis-Menten equation against unbound plasma concentration and the average Vmax value was found to be 0.85 microM/kg/min with an average Kmax value of 0.253. Iopanoic acid was found to exist in monkey blood as unchanged species and in the bile mainly as an ester glucuronide. Coadministration experiments revealed that the interaction of iodoxamic acid and iopanoic acid in the monkey is complex. The compounds appear to compete for plasma protein binding sites as well as for binding sites on intrahepatic protein. The biliary excretion data seem to fit the ligant exclusion model, in which iopanoic acid acts as an inhibitor and competes with iodoxamic acid for binding to either of two identical sites in the liver, which, presumably, is the rate-limiting step in the liver's overall elimination of these radiographic agents.

Iotroxamide studies in man--biliary iodine levels following bolus injection and slow infusion. Comparison with ioglycamide

The concentration of iodine in the bile of patients with indwelling T-tubes has been measured following administration of the new cholangiographic agent Iotroxamide. Studies have been performed after administration of the contrast agent by both 10 min bolus injection and 1 h drip infusion techniques. Comparison has been made with the iodine concentrations obtained after administration of equimolar amounts of Ioglycamide. There was no significant difference in the biliary iodine levels obtained with the two methods of administration when Iotroxamide was the contrast agent employed. However, with Ioglycamide the slow infusion technique produced higher iodine levels than the bolus injection method (P less than 0.05). Comparison between the two agents reveals that, whichever administration technique is used, Iotroxamide provides higher iodine levels than Ioglycamide. After bolus injection the superiority for Iotroxamide is in the region of 20% and after slow infusion is of the order of 10--15%. It is concluded that Iotroxamide is likely to prove superior to Ioglycamide as a cholangiographic agent. In terms of opacification of the biliary tree there is little to choose between bolus injection and slow infusion techniques when using Iotroxamide and the relative toxicity of the two techniques should be the major factor in determining which method is employed in clinical practice.

[Chemical structure biliary excretion of iodine-containing contrast agents in hemoglobin-free perfused rat liver and in vivo (author's transl)]

Pharmacokinetical properties of eight triiodobenzene derivatives, X-ray contrast agents, were studied in the hemoglobin-free perfused rat liver with emphasis on the structural relation to biliary transport. With chemical modification of the basic structure, these agents showed different characteristics in the processes of diffusion into hepatocytes, accumulation in the cells and active transport into the bile, and were separated into four groups; [I]: Iotroxic acid (1), Iodipamic acid (2), Iodoxamic acid (3), and Ioglycamic acid (4) which showed faster rates of diffusion into hepatocytes [(1) greater than or equal to (2) greater than (3) greater (4)] and also of biliary excretion [(1) greater than (2) greater than (4) greater than (3)], [II]: Diatrizoic acid and Metrizamide showed poor diffusion and biliary excretion, [III]: Iopodic acid showed the highest permeability into and accumulation in hepatocytes with little biliary excretion, [IV]: ZK73 215 was slowly transported into the bile, yet, showed little permeation through the cell membrane. Characteristics of (1), (2) and (3) observed in the perfused liver were, in principle, confirmed in the pharmacokinetical profile observed in vivo. However, the fast diffusion of (2) into the hepatocytes appears to be hampered by high binding ability with serum proteins, whereas the relatively poor profile of the biliary excretion of (3) was improved by its low protein-binding in blood in vivo. Superiority of (1) as a cholangiographic agent was demonstrated by the fast biliary excretion in both the case of experimental systems and moderate protein-binding.

p-Cymene pathway in Pseudomonas putida: selective enrichment of defective mutants by using halogenated substrate analogs

Several classes of mutants of Pseudomonas putida (JT810) defective in the utilization of p-cymene as sole carbon source have been isolated. Selective enrichment of the mutants and for strains putatively cured of a degradative plasmid was achieved by incubation of cells in minimal growth media containing p-cymene (or p-cumate) and various halogenated analogs of the growth substrates or pathway intermediates. Analogs which led to successful enrichments included: p-chlorotoluene, p-bromotoluene, alpha-chloro-p-xylene, and p-iodobenzoate. A mutant strain, PpJT811, constitutive for the p-cymene pathway gave significantly greater enrichments of defective mutants than the wild-type parent PpJT810 after incubation with the halogenated analogs. It is suggested that the defective mutants are enriched because of the genetic alterations they possess, which confer immunity to a lethal synthesis performed by transformation of the analogs in clones possessing an intact p-cymene pathway. A nomenclature for the genetic organization of p-cymene pathway is described.

The effect of atropine on canine bile flow and biliary excretion of ioglycamate

The effect of atropine on the bile flow and biliary excretion of ioglycamate, a biliary contrast medium, was studied on four anesthetized mongrel dogs equipped with a Thomas cannula through which the common bile duct was cannulated. With an infusion rate of 2 microgram/kg/min atropine sulphate decreased bile flow significantly. At the same time, the biliary concentration of ioglycamate was significantly increased. The biliary output of ioglycamate did not change during atropine infusion. The present study suggests that in this experimental model atropine decreases the bile flow but does not affect the excretion of ioglycamate.

Kinetics of drug-drug interactions: biliary excretion of iodoxamic acid and iopanoic acid in rhesus monkeys

The dynamic method originally developed for studying the capacity-limited kinetics of the cholecystographic agents iodoxamic acid and iopanoic acid was applied to study the in vivo interactions of these two compounds following coadminstration in the monkey. Results indicate that these interactions are complex. The compounds appear to compete for plasma protein binding sites as well as for binding sites on intrahepatic proteins. The biliary excretion data apparently fit the "ligand exclusion" model in which iopanoic acid acts as an inhibitor and competes with iodoxamic acid for binding to either of two identical sites within the liver. This competition probably is the rate-limiting step in the liver's overall elimination of these radiographic contrast agents.

Biliary excretion of iodipamide and iodoxamate in dogs with hepatic dysfunction induced by oral administration of dimethylnitrosamine

Iodipamide and iodoxamate were compared in equimolar clinical dosages in five cholecystectomized chronic bile fistula dogs in which hepatic dysfunction was produced by oral administration of a total dose of 480 and 960 microliters dimethylnitrosamine (DMNA), respectively. After both DMNA dosages, the peak biliary excretion rate for iodoxamate was significantly higher than for iodipamide (p less than 0.01). The peak bile iodine concentration was not significantly different for the two agents (480 microliter DMNA: p less than 0.1; 960 microliter DMNA: p = 0.07). On the basis of this investigation, it is suggested that iodoxamate should not significantly improve the opacification of the biliary system in patients with hepatic dysfunction.

The binding of diiodosalicylate and flufenamate to the plasma antiactivator: analysis of chemical fibrinolysis

The fibrinolytic effect of diiodosalicylate was expressed as apparent units urokinase. The dissociation constant of the urokinase-inhibitor complex is increased 19 times in the presence of 10(-2) M diiodosalicylate. The binding of diiodosalicylate to the antiactivator was estimated and the increase in free urokinase in the presence of diiodosalicylate was calculated. With 10(-2) M diiodosalicylate present only 4% of the inhibitor remains free to bind urokinase. Therefore, the fibrinolytic action of diiodosalicylate can be explained on the basis of its binding to the inhibitor and the release of free urokinase.

[Comparison of the biliary excretion of the radiographic contrast media Iotroxamate and Ioglycamide in the dog]

Biliary excretion of iotroxamat (ITX) and ioglycamide (IGL) in cholecystectomized dogs fitted with a Thomas duodenal cannula is compatible with saturation kinetics exhibiting maximal excretory velocities of 2.23 +/- SD 0.18 and 1.22 +/- 0.19 mumol/min/kg, respectively. While biliary excretion of ITX obeyed classical Michaelis Menten kinetics, the data obtained with IGL suggested a more complex process. The choleretic effects of both contrast agents (23.6 +/- SD 2.29 and 25.8 +/- 2.21 microliter of excreted substance) were comparable. On the basis of these results and in view of the similar toxicity of the two contrast agents in animals, it may be expected that ITX will have advantages over IGL for intravenous cholangiography.

Pharmacokinetics of iodoxamic acid in rhesus monkey: biliary excretion, plasma protein binding, and enterophepatic circulation

The previously reported steady-state method allowed estimation of the capacity-limited pharmacokinetics of the cholangiographic agent, iodipamide. To circumvent the long time period required to establish each steady-state level, a dynamic method was applied to the study of the rate processes involved in the hepatic uptake and biliary excretion of a new cholangiographic agent, iodoxamic acid, in rhesus monkeys. The dynamic method has the advantage that the pharmacokinetic parameters involved in capacity-limited hepatic uptake or biliary excretion can be obtained from a single infusion experiment. The V max was 1.03 +/- 0.25 mumoles/kg/min (mean +/- SD); Km varied from animal to animal and ranged from 1.5 to 16.4 micrometer. Protein binding was estimated using equilibrium dialysis. The Freundlich isotherm yielded a linear plot when the natural logarithm of unbound iodoxamic acid concentration in plasma was plotted against the natural logarithm of its blood concentration. The plasma protein binding data also could be fitted to the Langmuir isotherm, presuming two independent classes of binding.

Biliary excretion of iodipamide and iodoxamate in normal and common bile duct-obstructed dogs

Iodipamide and iodoxamate were compared at equimolar clinical dosages in dogs with normal, incompletely obstructed and completely obstructed common bile ducts. Forty-eight experiments were performed under general anesthesia in six cholecystomized chronic bile fistula dogs. The peak biliary iodoxamate excretion rate, but not the peak bile iodoxamate concentration, was significantly higher with normal and incompletely obstructed common bile ducts. In complete obstruction, both a significantly higher total biliary iodoxamate excretion and concentration were obtained, but this was still insufficient for radiographic opacification by conventional technique. Lesser toxicity of iodoxamate is suggested by its significantly lower serum levels, its higher bile: urine excretion ratio and its faster compensatory urinary excretion in complete common bile duct obstruction. Iodoxamate appears on this evidence to be a better cholangiographic contrast agent than iodipamide.

Ioglycamide (Biligram) studies in man--plasma binding, renal and biliary excretion studies in jaundiced and anicteric patients

When five patients with varying degrees of hepatic impairment and a T-tube in situ were given intravenous ioglycamide at a rate of 2 mg/kg/min for two hours the mean biliary excretion in the first two hours was only 3.2% of the administered dose. In contrast, in five T-tube patients with relatively normal liver function the mean biliary excretion over the same time interval was 20.6%. The mean plasma concentration of ioglycamide achieved at the end of a two-hour intravenous infusion at 2 mg/kg/min was 1427 +/- 187 microgram/ml in six anicteric patients and 1262 +/- 82 in six jaundiced patients. Despite these very similar plasma levels the 24-hour urinary excretion of ioglycamide was 42.3 +/- 3.8% of the administered dose in the patients with jaundice compared with only 18.1 +/- 2.4% in the anicteric group. These differences probably reflect the fact that the percentage of unbound contrast agent in the plasma of the jaundiced group (11.9 +/- 1.9%) was significantly higher than that of the anicteric group (6.4 +/- 0.9%). It is suggested that bilirubin and possibly other substances in the plasma are competing with ioglycamide for binding sites on albumin. These factors need to be borne in mind when performing intravenous cholangiograms on jaundiced patients.

Effects of steroid hormones on the binding of ioglycamide (bilivistan) to human blood serum

The binding relationships between ioglycamide and steroid hormones were determined in a liquid two-phase system with labelled ioglycamide and by direct measurement of ultraviolet light absorption. It was found that an interaction between ioglycamide and steroid hormones, particularly progesterone, existed, relative to the binding to human serum protein.