Hans Steffen

Effect of Molecular Weight on the Lymphatic Absorption of Water-Soluble Compounds Following Subcutaneous Administration

The lymphatic absorption of four water-soluble compounds with different molecular weights (MW) was determined by measuring their cumulative recovery in lymph draining from the site of s.c. administration in sheep. The cumulative recoveries (% of dose, mean ± SD; N = 3) were 4.0 ± 1.5 (5-fluoro-2′-deoxyuridine, MW 246.2), 21.0 ± 7.1 (inulin, MW 5200), 38.6 ± 6.7 (cytochrome c, MW 12,300), and 59.5 ± 7.7 [human recombinant interferon (rIFN) alpha-2a, MW 19,000], respectively. Our data show that in the investigated MW range, there is a linear relationship between the molecular weight and the proportion of the dose absorbed lymphatically. An increase in molecular weight results in an increased lymphatic absorption. Molecules with MW > 16,000 are absorbed mainly by the lymphatics which drain the application site. The knowledge gained in this investigation may help to improve the mode of administration and therapeutic efficacy of endogenous proteins whose targets are lymphoid cells (e.g., interferons, interleukins). Practical implications for the clinical use of such proteins are discussed.

Active Apical Secretory Efflux of the HIV Protease Inhibitors Saquinavir and Ritonavir in Caco-2 Cell Monolayers

AbstractPurpose. To investigate in vitro the mechanisms involved in the gastrointestinal absorption of the HIV protease inhibitor, saquinavir mesylate (Invirase®), whose oral bioavailability is low, variable, and significantly increased by co-administration with ritonavir, also an HIV protease inhibitor but with higher oral bioavailability. Methods. Confluent epithelial layers of human Caco-2 cells mimicking the intestinal barrier. Results. Both saquinavir and ritonavir showed polarized transport through Caco-2 cell monolayers in the basolateral to apical direction (secretory pathway), exceeding apical to basolateral transport (absorptive pathway) by factors of 50-70 and 15-25, respectively. Active efflux was temperature dependent, saturable and inhibited by verapamil and cyclosporin A. Saquinavir and ritonavir decreased each others secretory permeability and hence elevated their net transport by the absorptive pathway. Conclusions. Saquinavir and ritonavir are both substrates for an efflux mechanism in the gut, most likely P-glycoprotein, which acts as a counter-transporter for both drugs. Together with sensitivity to gut-wall metabolism by cytochrome P-450 3A, this may partially account for the low and variable oral bioavailability of saquinavir in clinical studies and for its increased bioavailability after co-administration with ritonavir.

Recombinant Human Interferon Alpha-2a: Delivery to Lymphoid Tissue by Selected Modes of Application

The effect of different parenteral administration routes (i.d., s.c., i.v.), infusion rates, and albumin contents of the drug vehicle on the cumulative recovery of recombinant human interferon alpha-2a (rIFN alpha-2a) in lymph and on its concentration in blood and lymph was determined in sheep. Blood samples were withdrawn from a jugular vein catheter and lymph was collected from a cannulated efferent popliteal lymphatic duct. The concentration of rIFN alpha-2a in lymph and blood plasma samples was measured by an enzyme immunoassay. Following i.v. infusion of 2 × 107 U of rIFN alpha-2a, the peak concentrations measured in blood plasma and lymph, respectively, were 8250 and 14 U/ml. The concentration measured in lymph after i.d. or s.c. administration of the same dose was about 105 times higher (peak concentration, 3.1 × 106 U/ml), while blood plasma levels remained low (peak concentration, 315 U/ml). The cumulative recovery of rIFN alpha-2a in lymph following i.d. or s.c. administration was 59.2 ± 7% (mean ± SD; N = 8) and was affected neither by the infusion rate nor by the coadministration of albumin. Our data indicate that following i.d. or s.c. administration, rIFN alpha-2a (MW 19,000) is absorbed mainly by the lymphatics. This results in high levels of rIFN alpha-2a in the lymph which drains from the application site to the regional lymph nodes. The knowledge gained in this investigation may help to improve the mode of administration and therapeutic efficacy of protein drugs whose targets are lymphoid cells.

Mixed Micelles as a Proliposomal, Lymphotropic Drug Carrier

Four lipophilic, low molecular weight drugs solubilized in phosphatidylcholine–bile salt mixed micelles were injected s.c. into the hind legs of sheep and their cumulative recoveries in lymph draining from the site of application were determined. Surprisingly, the cumulative recoveries (percentage of dose) varied between less than 1 and 60%. We found that there is a correlation between the lipophilicity of the drug (log P octanol/water ∼ Rm° value) and the proportion of the dose absorbed by the lymphatic route. Drugs with Rm° values >10 are absorbed preferentially by the lymphatics (>50% of dose), whereas compounds with Rm° values <4 are hardly absorbed at all by the lymphatics (<10% of dose). By applying the prodrug principle we demonstrated that it is also possible to target drugs with Rm° values <4 to the lymphatics. Furthermore, the analysis of the collected lymph samples by gel filtration, quasi-elastic light scattering, and electron microscopy revealed that, following s.c. administration, mixed micelles are converted into homogeneous, unilamellar vesicles. In conclusion, these results suggest that mixed micelles may represent a suitable delivery system for low molecular weight drugs whose targets are lymphoid cells. In addition, for drugs where liposomal application leads to a therapeutic advantage, the thermo-dynamically stable mixed micelle could be a good alternative to the liposome. However, for both applications a high drug lipophilicity is a prerequisite.