title: Vaginal deployment and tenofovir delivery by microbicide gels.
abstract: Gels are one of the soft material platforms being evaluated to deliver topically acting anti-HIV drugs (microbicides) to the vaginal environment. For each drug, its loaded concentration, gel properties and applied volume, and frequency of dosing can be designed to optimize PK and, thence, PD. These factors also impact user sensory perceptions and acceptability. Deterministic compartmental modeling of vaginal deployment and drug delivery achieved by test gels can help delineate how multiple parameters characterizing drug, vehicle, vaginal environment, and dosing govern details of PK and PD and also gel leakage from the canal. Such microbicide delivery is a transport process combining convection, e.g., from gel spreading along the vaginal canal, with drug diffusion in multiple compartments, including gel, mucosal epithelium, and stroma. The present work builds upon prior models of gel coating flows and drug diffusion (without convection) in the vaginal environment. It combines and extends these initial approaches in several key ways, including: (1) linking convective drug transport due to gel spreading with drug diffusion and (2) accounting for natural variations in dimensions of the canal and the site of gel placement therein. Results are obtained for a leading microbicide drug, tenofovir, delivered by three prototype microbicide gels, with a range of rheological properties. The model includes phosphorylation of tenofovir to tenofovir diphosphate (which manifests reverse transcriptase activity in host cells), the stromal concentration distributions of which are related to reference prophylactic values against HIV. This yields a computed summary measure related to gel protection ("percent protected"). Analyses illustrate tradeoffs amongst gel properties, drug loading, volume and site of placement, and vaginal dimensions, in the time and space history of gel distribution and tenofovir transport to sites of its anti-HIV action and concentrations and potential prophylactic actions of tenofovir diphosphate therein.
authors: Department of Biomedical Engineering, Duke University, Room 136 Hudson Hall, Box 90281, Durham, NC, 27708, USA, yajing.gao@duke.edu.
authors: Y
authors: Y
authors: Gao
authors: A
authors: A
authors: Yuan
authors: O
authors: O
authors: Chuchuen
authors: A
authors: A
authors: Ham
authors: K H
authors: KH
authors: Yang
authors: D F
authors: DF
authors: Katz
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000032:analysis / Q000737:chemistry / Q000493:pharmacokinetics; D000465:Algorithms; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000032:analysis / Q000737:chemistry / Q000493:pharmacokinetics; D001711:Biotransformation; D019295:Computational Biology; D018481:Convection; D004058:Diffusion; D004339:Drug Compounding; D005260:Female; D005782:Gels; D006801:Humans; D008954:Models, Biological; D009092:Mucous Membrane / Q000254:growth & development / Q000378:metabolism*; D063065:Organophosphonates / Q000008:administration & dosage* / Q000032:analysis / Q000737:chemistry / Q000493:pharmacokinetics; D014677:Pharmaceutical Vehicles / Q000737:chemistry*; D010766:Phosphorylation; D000068698:Tenofovir; D014018:Tissue Distribution; D014621:Vagina / Q000254:growth & development / Q000378:metabolism*; D066228:Vaginal Absorption; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage / Q000032:analysis / Q000737:chemistry / Q000493:pharmacokinetics; D014783:Viscosity
chemical_list: D019380:Anti-HIV Agents; D005782:Gels; D063065:Organophosphonates; D014677:Pharmaceutical Vehicles; D014622:Vaginal Creams, Foams, and Jellies; D000068698:Tenofovir; D000225:Adenine