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>PHARMACOKINETICS OF A RECOMBINANT AMINO TERMINAL FRAGMENT OF BACTERICIDALsol;PERMEABILITY INCREASING PROTEIN lpar;rBPI21rpar; AFTER LIVER SURGERY IN RATS AND HUMANS
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PHARMACOKINETICS OF A RECOMBINANT AMINO TERMINAL FRAGMENT OF BACTERICIDALsol;PERMEABILITY INCREASING PROTEIN lpar;rBPI21rpar; AFTER LIVER SURGERY IN RATS AND HUMANS
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机译：PHARMACOKINETICS OF A RECOMBINANT AMINO TERMINAL FRAGMENT OF BACTERICIDALsol;PERMEABILITY INCREASING PROTEIN lpar;rBPI21rpar; AFTER LIVER SURGERY IN RATS AND HUMANS
ABSTRACTMajor liver resections are associated with considerable morbidity and mortality. Gut-derived bacteria and bacterial endotoxin (LPS) are considered to play a central role in the pathophysiology of these complications. Like human BPI, rBPl21binds to LPS from Gram-negative bacteria. By binding and clearing of LPS, rBPI21can inhibit a number of endotoxin-induced humoral and cellular responses. Because of this capacity, rBPI21could partially compensate for the loss of hepatic mononuclear phagocytic system function after liver resection. However, the liver is also thought to be an important organ for the clearance of BPI, and reduction of liver mass could result in a decreased clearance and exceedingly high plasma levels of rBPI21. In this study we therefore investigated the pharmacokinetics of rBPI21in rats and in patients undergoing a major liver resection. Rats were administered an intravenous (i.v.) bolus of rBPI21after undergoing a 60% or 80% hepatectomy (with sham-operated controls). Patients undergoing a hemihepatectomy and healthy volunteers received rBPI21or placebo by continuous i.v. infusion for 48 h. Plasma concentrations were measured by sandwich ELISA. In rats, 60% hepatectomy did not consistently change the clearance of rBPI21, whereas 80% hepatectomy decreased the clearance of rBPI21severalfold. In hemihepatectomized patients, the clearance of rBPI21after major hepatectomy was also slower, when compared with healthy volunteers, but this difference had disappeared within 24 h. Our data indicate that the administration of rBPI21in patients undergoing liver resection is well tolerated and does not result in exceedingly high plasma levels. Additional studies on the efficacy of rBPI21in the prevention of complications after hepatectomy are needed.
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