ABSTRACT:The purpose of this investigation was to examine the effects of surgery and anesthesia on in vivo CYP3A activity and portal venous blood flow. Midazolam, a CYP3A probe for both rats and humans, was administered orally (2.7 mg), intravenously (0.57 mg), or via the portal vein (0.57 mg) to rats 4 h after anesthesia with ketamine/ xylazine and surgery for placement of indwelling vascular and duodenal catheters´and 3 days after surgery (chronic). The systemic clearance of midazolam was 51 ؎ 4 ml/min/kg in the chronic animals, and this was significantly decreased (29 ؎ 1 ml/min/kg, P ‫؍‬ 0.024) in acute rats studied 4 to 6 h after anesthesia and surgery. The hepatic availability (F H ), directly determined from the aortic and hepatic venous concentration gradient, was significantly higher in the acute animals (0.57 ؎ 0.05) compared with the chronic animals (0.33 ؎ 0.07, P ‫؍‬ 0.001). Hepatic availability was determined using a classical approach in which F H was calculated from the area under the plasma concentration versus time curve ratio after portal venous or intravenous administration. F H was higher in the acute rats (0.48) compared with the chronic animals (0.27 ؎ 0.03). Portal venous blood flow was significantly lower in the acute animals (5.0 ؎ 0.4 ml/min/100 g body weight) compared with the chronic animals (9.1 ؎ 0.9 ml/min/100 g body weight, P ‫؍‬ 0.015). The effect of surgery and anesthesia was confirmed using the indicator dye dilution method after infusion of [ 14 C]polyethylene glycol 4000 into the superior mesenteric artery. Our data suggest that anesthesia and surgery decreases both hepatic CYP3A activity and hepatic blood flow in rats. Studies performed in rats within 3 days of surgery and anesthesia are conducted under nonphysiologic conditions and therefore provide inaccurate assessment of drug disposition, in particular, clearance and bioavailability.During drug development, in vivo drug absorption and hepatic first-pass metabolism studies commonly are performed in rats, dogs, and primates after surgical manipulation to implant vascular and gastrointestinal catheters. The absorption and bioavailability of orally administered drugs is dependent on intestinal and liver function, including metabolism. The ability to quantify the extent and variability of first-pass metabolism and the inhibition of metabolism in vivo are important for the development of oral dosage forms. To separately determine the effects of the liver on hepatic first-pass metabolism from the contribution by the gut, the area under the plasma concentration versus time curve (AUC) following drug administration via the portal vein is compared with the AUC obtained after oral and intravenous drug administration. These experiments are typically conducted using rodents and are often conducted shortly after the animal has regained its righting reflex. Consciousness and mobility, not gastrointestinal or liver function, are therefore frequently used as parameters of surgical recovery. Although studies have clearly demonstrated tha...

The mechanism of liver injury in endotoxemia is unclear. Previous studies have shown that splenectomy protects the liver from endotoxin-induced injury. The purpose of this study was to determine the relationship of TNFalpha and IFNgamma release and endotoxin-induced liver injury in splenectomized and nonsplenectomized rats. Splenectomized and nonsplenectomized (Sham) rats with chronic catheters in the aorta and inferior vena cava (IVC) were parenterally infused with 10 to 5000 microg/kg endotoxin. TNFalpha, IFNgamma, and alanine aminotransferase (ALT), a marker of hepatocellular damage, were measured in aortic blood. Compared to sham controls, splenectomized animals demonstrated significantly reduced endotoxin-induced ALT concentrations at endotoxin doses >10 microg/kg. Peak endotoxin-induced TNFalpha concentrations were not significantly different between the splenectomized and sham groups. In contrast, peak endotoxin-induced IFNgamma concentrations were significantly decreased in the splenectomized group. These data suggest a relationship between endotoxin-induced IFNgamma and liver injury. We speculate that the spleen contributes to the endotoxin-induced liver injury by modulating release of IFNgamma.

ABSTRACT:Itraconazole ( During drug discovery and preclinical drug development, in vivo drug disposition and bioavailability studies are often conducted in rats, dogs, primates, and other species. It is increasingly recognized that the fraction of an orally administered drug that reaches the systemic circulation is controlled by both intestinal and hepatic metabolism. However, the contribution of the intestinal epithelia to the overall "first-pass effect" of drugs is difficult to quantify because the small intestine and liver are connected in series. Correct assessment of the separate roles of hepatic and intestinal drug metabolizing capacity in determining drug bioavailability and the extent of first-pass metabolism led us to develop (Uhing and Kimura, 1995a,b;Beno et al., 2001) and validate (Esguerra et al., 2000;Shaw et al., 2002;Uhing et al., 2004) a 5-catheter rat model for pharmacokinetic and drug-drug interaction studies in rats. Drug disposition studies can be conducted in awake, free-moving animals that have fully recovered from surgery and anesthesia and have regained their preoperative weight. Simultaneous sampling allows us to quantify the precise time course of changes in such pharmacokinetic parameters as clearance and hepatic extraction ratio.Itraconazole (ITZ), an orally active triazole antifungal agent, exhibits dose-dependent first-pass metabolism and nonlinear pharmacokinetics in both humans and rats (Hardin et al., 1988;Heykants et al., 1989;Yoo et al., 2000;Shin et al., 2004). Hydroxyitraconazole (OH-ITZ) is a major metabolite that is formed by CYP3A and has antifungal activity similar to ITZ (Heykants et al., 1989;Poirier and Cheymol, 1998). Both ITZ and OH-ITZ are potent inhibitors of CYP3A, and OH-ITZ often displays higher plasma concentrations after ITZ administration (Heykants et al., 1989;Poirier and Cheymol, 1998). Calculation of oral bioavailability compares the time-averaged AUC following oral administration to the time-averaged AUC after intravenous drug administration. Measurement of dose dependence and time-dependence in bioavailability and first-pass metabolism of itraconazole may be unreliable when based upon time-average values for AUC. Using our novel 5-catheter chronic rat model (Fig. 1), we administered ITZ intraduodenally and obtained blood samples simultaneously from aorta, portal vein, and hepatic vein. In particular, this recently validated model (Beno et al., 2001;Uhing et al., 2004) obviated the need to administer ITZ by both the intravenous and

Most models of liver dysfunction in sepsis use endotoxin (lipopolysaccharide; LPS) to induce a pathophysiological response. In our study published in this issue (Beno DWA, Uhing MR, Goto M, Chen Y, Jiyamapa-Serna VA, and Kimura RE. Am J Physiol Gastrointest Liver Physiol 280: G858-G865, 2001), the adverse effect of LPS on hepatic function in vivo was only significant at relatively high LPS doses despite high tumor necrosis factor-alpha concentrations. However, many patients with sepsis are exposed to multiple bacterial toxins that may augment the immune response, resulting in increased hepatic dysfunction. We have developed a model of polymicrobial sepsis by parentally administering a combination of staphylococcal enterotoxin B (SEB) and LPS. Using this model, we demonstrate that SEB (50 microg/kg) potentiates the effect of LPS-induced hepatic dysfunction as measured by decreased rates of biliary indocyanine green clearance and bile flow. These increases were most pronounced with doses of 10 and 100 microg/kg LPS, doses that by themselves do not induce hepatic dysfunction. This may explain the seemingly increased incidence and severity of liver dysfunction in sepsis, and it suggests that the exclusive use of LPS for replicating septic shock may not be relevant for studies of hepatic dysfunction.