title: Compartmentalized intrapulmonary pharmacokinetics of amphotericin B and its lipid formulations.
abstract: We investigated the compartmentalized intrapulmonary pharmacokinetics of amphotericin B and its lipid formulations in healthy rabbits. Cohorts of three to seven noninfected, catheterized rabbits received 1 mg of amphotericin B deoxycholate (DAMB) per kg of body weight or 5 mg of either amphotericin B colloidal dispersion (ABCD), amphotericin B lipid complex (ABLC), or liposomal amphotericin B (LAMB) per kg once daily for a total of 8 days. Following sparse serial plasma sampling, rabbits were sacrificed 24 h after the last dose, and epithelial lining fluid (ELF), pulmonary alveolar macrophages (PAM), and lung tissue were obtained. Pharmacokinetic parameters in plasma were derived by model-independent techniques, and concentrations in ELF and PAM were calculated based on the urea dilution method and macrophage cell volume, respectively. Mean amphotericin B concentrations +/- standard deviations (SD) in lung tissue and PAM were highest in ABLC-treated animals, exceeding concurrent plasma levels by 70- and 375-fold, respectively (in lung tissue, 16.24 +/- 1.62 versus 2.71 +/- 1.22, 6.29 +/- 1.17, and 6.32 +/- 0.57 microg/g for DAMB-, ABCD-, and LAMB-treated animals, respectively [P = 0.0029]; in PAM, 89.1 +/- 37.0 versus 8.92 +/- 2.89, 5.43 +/- 1.75, and 7.52 +/- 2.50 mug/ml for DAMB-, ABCD-, and LAMB-treated animals, respectively [P = 0.0246]). By comparison, drug concentrations in ELF were much lower than those achieved in lung tissue and PAM. Among the different cohorts, the highest ELF concentrations were found in LAMB-treated animals (2.28 +/- 1.43 versus 0.44 +/- 0.13, 0.68 +/- 0.27, and 0.90 +/- 0.28 microg/ml in DAMB-, ABCD-, and ABLC-treated animals, respectively [P = 0.0070]). In conclusion, amphotericin B and its lipid formulations displayed strikingly different patterns of disposition in lungs 24 h after dosing. Whereas the disposition of ABCD was overall not fundamentally different from that of DAMB, ABLC showed prominent accumulation in lung tissue and PAM, while LAMB achieved the highest concentrations in ELF.
authors.affiliation: Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD 20892, USA.
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Groll
authors.forename: Caron A
authors.initials: CA
authors.lastname: Lyman
authors.forename: Vidmantas
authors.initials: V
authors.lastname: Petraitis
authors.forename: Ruta
authors.initials: R
authors.lastname: Petraitiene
authors.forename: Derek
authors.initials: D
authors.lastname: Armstrong
authors.forename: Diana
authors.initials: D
authors.lastname: Mickiene
authors.forename: Raul M
authors.initials: RM
authors.lastname: Alfaro
authors.forename: Robert L
authors.initials: RL
authors.lastname: Schaufele
authors.forename: Tin
authors.initials: T
authors.lastname: Sein
authors.forename: John
authors.initials: J
authors.lastname: Bacher
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000737:chemistry* / Q000493:pharmacokinetics*; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000737:chemistry* / Q000493:pharmacokinetics*; D003840:Deoxycholic Acid / Q000008:administration & dosage / Q000493:pharmacokinetics; D004338:Drug Combinations; D005260:Female; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008081:Liposomes / Q000008:administration & dosage / Q000493:pharmacokinetics; D008168:Lung / Q000166:cytology / Q000378:metabolism*; D016676:Macrophages, Alveolar / Q000378:metabolism; D010713:Phosphatidylcholines / Q000008:administration & dosage / Q000493:pharmacokinetics; D010715:Phosphatidylglycerols / Q000008:administration & dosage / Q000493:pharmacokinetics; D011817:Rabbits; D014018:Tissue Distribution
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D008081:Liposomes; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination