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Drug absorption in the lungs: studies in the isolated perfused rat lung model combined with physiologically based biopharmaceutics modelling
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.ORCID iD: 0000-0002-9921-0969
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Pulmonary delivery of drugs is the preferred route of administration for treatment of local lung diseases like asthma and chronic obstructive pulmonary disease. Recently, there has also been increased interest in systemic delivery of drugs via the lungs to avoid problems with low and/or variable gastrointestinal absorption, and as a needle-free alternative for drugs that cannot be ingested. Both the pharmacological and the potentially adverse effects of inhaled drugs depend on the drug’s local and systemic concentrations, which in turn depend on the pulmonary absorption of the drug. Pulmonary drug absorption is governed by the dissolution, permeability, tissue retention, and non-absorptive clearance of the drug in the lungs. Predicting systemic and local exposure is necessary for developing an inhaled drug product, and these predictions can be based on data obtained from both in vitro and ex vivo methods, such as cell lines, solubility measurements, and the isolated perfused lung (IPL) model. Data obtained by these methods can then be used to inform physiologically based biopharmaceutics (PBB) models about drug-specific absorption parameters.

The overall aim of this thesis was to increase the mechanistic understanding of pulmonary drug absorption, with a special focus on obtaining and analyzing ex vivo absorption parameters for different inhalation drugs and formulations, and evaluating the predictive power of these parameters in simulations of pulmonary drug absorption. In the first two papers of the thesis, drugs were formulated as solutions, suspensions, and dry powders, and pulmonary absorption of these were measured using the IPL model. The data from these experiments were then analyzed to obtain absorption parameters for each drug using a PBB model. Tissue retention was shown to be an important parameter for describing drug absorption in IPL, and particle wetting was shown to greatly affect the absorption of dry powders. Permeability in IPL correlated well with intrinsic permeability measured in cell monolayers, suggesting that passive transcellular transport is the main transport mechanism in the lungs. In the second two papers, the absorption parameters obtained from IPL data were used to simulate rat and human pulmonary drug absorption. The simulations predicted systemic exposure after inhalation well for both rat and human, suggesting that ex vivo parameters can be used to predict rat in vivo and human plasma concentrations. This thesis deepens our understanding of absorption parameters involved in pulmonary drug absorption, and suggests applications for these parameters in predictions of local and systemic exposure after inhalation.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2021. , p. 56
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 292
Keywords [en]
Pulmonary drug absorption, physiologically based biopharmaceutics modeling, pulmonary drug delivery
National Category
Pharmaceutical Sciences
Research subject
Biopharmaceutics
Identifiers
URN: urn:nbn:se:uu:diva-426023ISBN: 978-91-513-1086-2 (print)OAI: oai:DiVA.org:uu-426023DiVA, id: diva2:1507087
Public defence
2021-02-05, A1:111a, BMC, Husargatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2021-01-14 Created: 2020-12-06 Last updated: 2021-01-25
List of papers
1.
The record could not be found. The reason may be that the record is no longer available or you may have typed in a wrong id in the address field.
2. Pulmonary Dissolution of Poorly Soluble Compounds Studied in an ex Vivo Rat Lung Model
Open this publication in new window or tab >>Pulmonary Dissolution of Poorly Soluble Compounds Studied in an ex Vivo Rat Lung Model
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2019 (English)In: Molecular Pharmaceutics, ISSN 1543-8384, E-ISSN 1543-8392, Vol. 16, no 7, p. 3053-3064Article in journal (Refereed) Published
Abstract [en]

Many inhaled drugs are poorly water soluble, and the dissolution rate is often the rate-limiting step in the overall absorption process. To improve understanding of pulmonary drug dissolution, four poorly soluble inhalation compounds (AZD5423 (a developmental nonsteroidal glucocorticoid), budesonide, fluticasone furoate (FF), and fluticasone propionate (FP)) were administered as suspensions or dry powders to the well-established isolated perfused 4 rat lung (IPL) model. Two particle size distributions (d50 = 1.2 mu m and d50 = 2.8 mu m) were investigated for AZD5423. The pulmonary absorption rates of the drugs from the suspensions and dry powders were compared with historical absorption data for solutions to improve understanding of the effects of dissolution on the overall pulmonary absorption process for poorly soluble inhaled drugs. A physiologically based biopharmaceutical in silico model was used to analyze the experimental IPL data and to estimate a dissolution parameter (K-ex vivo). A similar in silico approach was applied to in vitro dissolution data from the literature to obtain an in vitro dissolution parameter (Kin vitro). When FF, FP, and the larger particles of AZD5423 were administered as suspensions, drug dissolution was the rate-limiting step in the overall absorption process. However, this was not the case for budesonide, which has the highest aqueous solubility (61 mu M), and the smaller particles of AZD5423, probably because of the increased surface area available for dissolution (d50 = 1.2 mu m). The estimated dissolution parameters were ranked in accordance with the solubility of the drugs, and there was good agreement between k(ex vivo) and k(in vitro). The dry powders of all the compounds were absorbed more slowly than the suspensions, indicating that wetting is an important parameter for the dissolution of dry powders. A wetting factor was introduced to the in silico model to explain the difference in absorption profiles between the suspensions and dry powders where AZD5423 had the poorest wettability followed by FP and FF. The IPL model in combination with an in silico model is a useful tool for investigating pulmonary dissolution and improving understanding of dissolution-related parameters for poorly soluble inhaled compounds.

Keywords
inhalation, lung dissolution, isolated perfused lung model, pulmonary drug delivery, pulmonary drug absorption
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-390996 (URN)10.1021/acs.molpharmaceut.9b00289 (DOI)000474475400020 ()31136181 (PubMedID)
Funder
AstraZeneca
Available from: 2019-08-19 Created: 2019-08-19 Last updated: 2020-12-06Bibliographically approved
3. Drug Absorption Parameters Obtained Using the Isolated Perfused Rat Lung Model Are Predictive of Rat In Vivo Lung Absorption
Open this publication in new window or tab >>Drug Absorption Parameters Obtained Using the Isolated Perfused Rat Lung Model Are Predictive of Rat In Vivo Lung Absorption
2020 (English)In: AAPS Journal, E-ISSN 1550-7416, Vol. 22, no 3, article id 71Article in journal (Refereed) Published
Abstract [en]

The ex vivo isolated perfused rat lung (IPL) model has been demonstrated to be a useful tool during drug development for studying pulmonary drug absorption. This study aims to investigate the potential use of IPL data to predict rat in vivo lung absorption. Absorption parameters determined from IPL data (ex vivo input parameters) in combination with intravenously determined pharmacokinetic data were used in a biopharmaceutics model to predict experimental rat in vivo plasma concentration-time profiles and lung amount after inhalation of five different inhalation compounds. The performance of simulations using ex vivo input parameters was compared with simulations using in vitro input parameters, to determine whether and to what extent predictability could be improved by using input parameters determined from the more complex ex vivo model. Simulations using ex vivo input parameters were within twofold average difference (AAFE < 2) from experimental in vivo data for all compounds except one. Furthermore, simulations using ex vivo input parameters performed significantly better than simulations using in vitro input parameters in predicting in vivo lung absorption. It could therefore be advantageous to base predictions of drug performance on IPL data rather than on in vitro data during drug development to increase mechanistic understanding of pulmonary drug absorption and to better understand how different substance properties and formulations might affect in vivo behavior of inhalation compounds.

Place, publisher, year, edition, pages
SPRINGER, 2020
Keywords
isolated perfused lung model, lung absorption, simulation, prediction, pulmonary drug delivery
National Category
Pharmacology and Toxicology Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-412689 (URN)10.1208/s12248-020-00456-x (DOI)000531798800001 ()32394314 (PubMedID)
Note

Correction in: AAPS JOURNAL, Volume:23, Issue:1Article Number:8, DOI:10.1208/s12248-020-00545-x

Available from: 2020-06-15 Created: 2020-06-15 Last updated: 2023-08-28Bibliographically approved
4. Pulmonary drug absorption and systemic exposure in human: Predictions using physiologically based biopharmaceutics modeling
Open this publication in new window or tab >>Pulmonary drug absorption and systemic exposure in human: Predictions using physiologically based biopharmaceutics modeling
2020 (English)In: European journal of pharmaceutics and biopharmaceutics, ISSN 0939-6411, E-ISSN 1873-3441, Vol. 156, p. 191-202Article in journal (Refereed) Published
Abstract [en]

Systemic exposure of inhaled drugs is used to estimate the local lung exposure and assess systemic side effects for drugs with local pharmacological targets. Predicting systemic exposure is therefore central for successful development of drugs intended to be inhaled. Currently, these predictions are based mainly on data from in vitro experiments, but the accuracy of these predictions might be improved if they were based on data with higher physiological relevance. In this study, systemic exposure was simulated by applying biopharmaceutics input parameters from isolated perfused rat lung (IPL) data to a lung model developed in MoBi (R) as an extension to the full physiologically-based pharmacokinetic (PBPK) model in PK-Sim (R). These simulations were performed for a set of APIs with a variety of physicochemical properties and formulation types. Simulations based on rat IPL data were also compared to simulations based on in vitro data. The predictive performances of the simulations were evaluated by comparing simulated plasma concentration-time profiles to clinical observations after pulmonary administration. Simulations using IPL-based input parameters predicted systemic exposure well, with predicted AUCs within two-fold of the observed value for nine out of ten drug compounds/formulations, and predicted Cmax values within two-fold for eight out of ten drug compounds/formulations. Simulations using input parameters based on IPL data performed generally better than simulations based on in vitro input parameters. These results suggest that the developed model in combination with IPL data can be used to predict human lung absorption for compounds with different physicochemical properties and types of inhalation formulations.

Place, publisher, year, edition, pages
ELSEVIER, 2020
Keywords
Prediction of systemic exposure, Pulmonary drug absorption, Physiological based biopharmaceutics modeling, Isolated perfused lung
National Category
Pharmaceutical Sciences Pharmacology and Toxicology
Identifiers
urn:nbn:se:uu:diva-424484 (URN)10.1016/j.ejpb.2020.09.004 (DOI)000579862000017 ()32941997 (PubMedID)
Available from: 2020-11-09 Created: 2020-11-09 Last updated: 2020-12-06Bibliographically approved

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