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Development of appropriate equations for physiologically based pharmacokinetic modeling of permeability-limited and flow-limited transport.

ABSTRACT: Although the implementation of a flow-limited, well-stirred tank (WST) single-compartment tissue model in pharmacokinetics and toxicokinetics is widespread, its use is not always justified biophysically or physiologically. The WST model introduces a loss of biophysical detail, specifically the vascular space, which is present in the standard permeability-limited two-subcompartment (PLT) tissue model. To address this loss of detail when evaluating the in vivo kinetics of drugs, toxins, nutrients, and endogenous metabolites, a novel set of physiologically based pharmacokinetic tissue compartment equations is developed through application of an asymptotic approximation to a two-region vascular-extravascular system to arrive at a permeability-limited two-region asymptotically reduced (P-TAR) model and a flow-limited (F-TAR) model. Development of the TAR modeling approach illustrates the importance of relative timescales in PBPK tissue compartment model selection and the conditions under which improved biophysical realism is advantageous. In the permeability-limited regime, the TAR model formulations enable drug or toxicant concentration to be modeled in the vascular and extravascular spaces equivalent to the PLT tissue model while invoking only one state variable to represent the vascular and extravascular spaces. In the flow-limited regime, the F-TAR model is more biophysically realistic than the WST model because it maintains the anatomical distinction between the vascular and extravascular spaces, and hence offers greater pharmacological and physiological insight than the WST model, without introducing additional computational complexity.

SUBMITTER: Thompson MD

PROVIDER: S-EPMC3193163 | biostudies-other | 2011 Aug

REPOSITORIES: biostudies-other

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Development of appropriate equations for physiologically based pharmacokinetic modeling of permeability-limited and flow-limited transport.

Thompson Matthew D MD Beard Daniel A DA

Journal of pharmacokinetics and pharmacodynamics 20110517 4

Although the implementation of a flow-limited, well-stirred tank (WST) single-compartment tissue model in pharmacokinetics and toxicokinetics is widespread, its use is not always justified biophysically or physiologically. The WST model introduces a loss of biophysical detail, specifically the vascular space, which is present in the standard permeability-limited two-subcompartment (PLT) tissue model. To address this loss of detail when evaluating the in vivo kinetics of drugs, toxins, nutrients, ...[more]

PMID: 21584718

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Project description:Background and objectiveWhile one in five children in the USA are now obese, and more than three-quarters receive at least one drug during childhood, there is limited dosing guidance for this vulnerable patient population. Physiologically based pharmacokinetic modeling can bridge the gap in the understanding of how pharmacokinetics, including drug distribution and clearance, changes with obesity by incorporating known obesity-related physiological changes in children. The objective of this study was to develop a virtual population of children with obesity to enable physiologically based pharmacokinetic modeling, then use the novel virtual population in conjunction with previously developed models of clindamycin and trimethoprim/sulfamethoxazole to better understand dosing of these drugs in children with obesity.MethodsTo enable physiologically based pharmacokinetic modeling, a virtual population of children with obesity was developed using national survey, electronic health record, and clinical trial data, as well as data extracted from the literature. The virtual population accounts for key obesity-related changes in physiology relevant to pharmacokinetics, including increased body size, body composition, organ size and blood flow, plasma protein concentrations, and glomerular filtration rate. The virtual population was then used to predict the pharmacokinetics of clindamycin and trimethoprim/sulfamethoxazole in children with obesity using previously developed physiologically based pharmacokinetic models.ResultsModel simulations predicted observed concentrations well, with an overall average fold error of 1.09, 1.24, and 1.53 for clindamycin, trimethoprim, and sulfamethoxazole, respectively. Relative to children without obesity, children with obesity experienced decreased clindamycin and trimethoprim/sulfamethoxazole weight-normalized clearance and volume of distribution, and higher absolute doses under recommended pediatric weight-based dosing regimens.ConclusionsModel simulations support current recommended weight-based dosing in children with obesity for clindamycin and trimethoprim/sulfamethoxazole, as they met target exposure despite these changes in clearance and volume of distribution.

Project description:BackgroundModeling of pharmacokinetic parameters and pharmacodynamic actions requires knowledge of the arterial blood concentration. In most cases, experimental measurements are only available for a peripheral vein (usually antecubital) whose concentration may differ significantly from both arterial and central vein concentration.MethodsA physiologically based pharmacokinetic (PBPK) model for the tissues drained by the antecubital vein (referred to as "arm") is developed. It is assumed that the "arm" is composed of tissues with identical properties (partition coefficient, blood flow/gm) as the whole body tissues plus a new "tissue" representing skin arteriovenous shunts. The antecubital vein concentration depends on the following parameters: the fraction of "arm" blood flow contributed by muscle, skin, adipose, connective tissue and arteriovenous shunts, and the flow per gram of the arteriovenous shunt. The value of these parameters was investigated using simultaneous experimental measurements of arterial and antecubital concentrations for eight solutes: ethanol, thiopental, 99Tcm-diethylene triamine pentaacetate (DTPA), ketamine, D2O, acetone, methylene chloride and toluene. A new procedure is described that can be used to determine the arterial concentration for an arbitrary solute by deconvolution of the antecubital concentration. These procedures are implemented in PKQuest, a general PBPK program that is freely distributed http://www.pkquest.com.ResultsOne set of "standard arm" parameters provides an adequate description of the arterial/antecubital vein concentration for ethanol, DTPA, thiopental and ketamine. A significantly different set of "arm" parameters was required to describe the data for D2O, acetone, methylene chloride and toluene - probably because the "arm" is in a different physiological state.ConclusionsUsing the set of "standard arm" parameters, the antecubital vein concentration can be used to determine the whole body PBPK model parameters for an arbitrary solute without any additional adjustable parameters. Also, the antecubital vein concentration can be used to estimate the arterial concentration for an arbitrary input for solutes for which no arterial concentration data is available.

Dataset Information

Development of appropriate equations for physiologically based pharmacokinetic modeling of permeability-limited and flow-limited transport.

Publications

Development of appropriate equations for physiologically based pharmacokinetic modeling of permeability-limited and flow-limited transport.

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