Effect of plasma uric acid on pharmacokinetics of cyclosporine A in living-related renal transplant recipients and pharmacokinetic study in rats with experimental hyperuricaemia.

Objectives: Renal transplant recipients are thought to have an increased risk of hyperuricaemia (HU); therefore, the effects of plasma uric acid (UA) on the pharmacokinetics (PK) of cyclosporine A (CyA), an immunosuppressant, in renal transplant recipients and experimental animals were investigated....

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Publicado en:Journal of Clinical Pharmacy & Therapeutics Vol. 35; no. 3; pp. 323 - 333
Autores principales: Sugioka N, Takai M, Yoshida K, Yasuda K, Fukushima K, Kokuhu T, Okamoto M, Yoshimura N, Takada K
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2010
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2010
      vid: 35
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        105196130
        2010649940
        10.1111/j.1365-2710.2009.01105.x
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        atl: Effect of plasma uric acid on pharmacokinetics of cyclosporine A in living-related renal transplant recipients and pharmacokinetic study in rats with experimental hyperuricaemia.
      aug:
        au:
          Sugioka N
          Takai M
          Yoshida K
          Yasuda K
          Fukushima K
          Kokuhu T
          Okamoto M
          Yoshimura N
          Takada K
        affil: Department of Pharmacokinetics, Kyoto Pharmaceutical University, Yamashina-ku, Kyoto, Japan
      sug:
        subj:
          Cyclosporine Pharmacokinetics
          Kidney Transplantation
          Uric Acid Blood
          Adolescence
          Adult
          Aged
          Animal Studies
          Biological Availability
          Cyclosporine Administration and Dosage
          Descriptive Statistics
          Female
          Human
          Japan
          Male
          Middle Age
          Rats
          Retrospective Design
          Unpaired T-Tests
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objectives: Renal transplant recipients are thought to have an increased risk of hyperuricaemia (HU); therefore, the effects of plasma uric acid (UA) on the pharmacokinetics (PK) of cyclosporine A (CyA), an immunosuppressant, in renal transplant recipients and experimental animals were investigated. Methods: An open-label, non-randomized, retrospective study was performed in renal transplant recipients. Data from 76 subjects who received a renal transplantation with CyA medication were included. We compared the PK of CyA of recipients showing a high UA level with the other recipients. In addition, PK studies were performed using hyperuricaemic-model rats (HU rats) prepared by subcutaneous injection of the uricase inhibitor, potassium oxonate and intraperitoneal injection of UA. Results: The area under the blood concentration vs. time curve (AUC) up to 9 h, the blood level at 2 h after dose and peak level in high UA recipients (UA > 7·0 mg/dL) was significantly lower (about 10-16%) than that in the other recipients, although there were no differences in dose, and the trough blood level. On the contrary, there were no differences in PK parameters after intravenous administration of CyA between HU and control rats; however, AUC, peak level and bioavailability in HU rats (2·01 ± 0·56 µg h/mL, 0·47 ± 0·26 µg/mL and 0·186 ± 0·05, respectively) after oral administration were significantly lower than in the control animals (6·13 ± 0·97 µg h/mL, 0·82 ± 0·17 µg/mL and 0·458 ± 0·07 µg/mL, respectively). In addition, the absorptions of CyA and midazolam, an ideal probe for CYP3A, from the intestinal loop in HU rats were significantly less (about 50% and 37%, respectively) than in the controls. Conclusions: The absorption of CyA was affected by plasma UA in transplant recipients and experimental rats. The contribution of intestinal metabolism by CYP3A to decreasing CyA absorption in HU rats was significant. These results suggest that transplant recipients with high UA may have poor absorption of CyA.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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