title: Peripheral deposition of alpha1-protease inhibitor using commercial inhalation devices.
abstract: Patients with hereditary alpha1-proteinase inhibitor (alpha1-PI) deficiency are at risk of developing lung emphysema. To prevent the development of this disease, alpha1-PI replacement therapy via inhalation may be a more convenient and effective therapy than the intravenous administration of the drug. In order to optimise this treatment approach, lung deposition of inhaled radiolabelled alpha1-PI (Prolastin) was studied using four different commercial inhalation devices (PARI-LC Star, HaloLite, and AKITA system in combination with LC Star and Sidestream) in six patients with alpha1-PI deficiency and mild-to-severe chronic obstructive pulmonary disease. The time required to deposit 50 mg of the Prolastin (5% solution) in the lung periphery was used as a measure for the efficiency of delivery. The time was calculated from measurements of total and peripheral lung deposition of the radiolabelled alpha1-PI. This time was shortest for the AKITA system (18-24 min) and significantly higher for the PARI-LC Star (44 min) and the HaloLite (100 min). The higher efficiency of drug delivery using the AKITA system is due to the fact that this device controls breathing patterns, which are optimised for each patient individually.
authors.affiliation: Clinical Research Group Aerosols in Medicine of the GSF-Institute for Inhalation Biology and the Asklepios Clinic for Respiratory Medicine, Gauting, Germany. brand@inamed.de
authors.forename: P
authors.initials: P
authors.lastname: Brand
authors.forename: H
authors.initials: H
authors.lastname: Beckmann
authors.forename: M
authors.initials: M
authors.lastname: Maas Enriquez
authors.forename: T
authors.initials: T
authors.lastname: Meyer
authors.forename: B
authors.initials: B
authors.lastname: Müllinger
authors.forename: K
authors.initials: K
authors.lastname: Sommerer
authors.forename: N
authors.initials: N
authors.lastname: Weber
authors.forename: T
authors.initials: T
authors.lastname: Weuthen
authors.forename: G
authors.initials: G
authors.lastname: Scheuch
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000209:etiology; D012129:Respiratory Function Tests; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D000515:alpha 1-Antitrypsin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications / Q000188:drug therapy*
chemical_list: D015842:Serine Proteinase Inhibitors; D000515:alpha 1-Antitrypsin