The PK-Eye: A Novel In Vitro Ocular Flow Model for Use in Preclinical Drug Development.

A 2-compartment in vitro eye flow model has been developed to estimate ocular drug clearance by the anterior aqueous outflow pathway. The model is designed to accelerate the development of longer-acting ophthalmic therapeutics. Dye studies show aqueous flow is necessary for a molecule injected into the vitreous cavity to clear from the model. The clearance times of proteins can be estimated by collecting the aqueous outflow, which was first conducted with bevacizumab using phosphate-buffered saline in the vitreous cavity. A simulated vitreous solution was then used and ranibizumab (0.5 mg) displayed a clearance time of 8.1 ± 3.1 days, which is comparable to that observed in humans. The model can estimate drug release from implants or the dissolution of suspensions as a first step in their clearance mechanism, which will be the rate-limiting step for the overall resident time of a candidate dosage form in the vitreous. A suspension of triamcinolone acetonide (Kenalog®) (4.0 mg) displayed clearance times spanning 26-28 days. These results indicate that the model can be used to determine in vitro-in vivo correlations in preclinical studies to develop long-lasting therapeutics to treat blinding diseases at the back of the eye.

[1]  Hyuncheol Kim,et al.  Intraocular pharmacokinetics of ranibizumab in vitrectomized versus nonvitrectomized eyes. , 2014, Investigative Ophthalmology and Visual Science.

[2]  Osamu Sawada,et al.  Pharmacokinetics of bevacizumab and its effect on vascular endothelial growth factor after intravitreal injection of bevacizumab in macaque eyes. , 2010, Investigative ophthalmology & visual science.

[3]  R. Banerjee,et al.  Artificial vitreous replacements. , 2003, Bio-medical materials and engineering.

[4]  P. Worth Longest,et al.  Comparing MDI and DPI Aerosol Deposition Using In Vitro Experiments and a New Stochastic Individual Path (SIP) Model of the Conducting Airways , 2012, Pharmaceutical Research.

[5]  J. Schouten,et al.  The cost-utility of aflibercept for the treatment of age-related macular degeneration compared to bevacizumab and ranibizumab and the influence of model parameters , 2014, Graefe's Archive for Clinical and Experimental Ophthalmology.

[6]  J. Kornfield,et al.  Rheological properties of the vitreous and the role of hyaluronic acid. , 2008, Journal of biomechanics.

[7]  M. Stewart Pharmacokinetics, pharmacodynamics and pre-clinical characteristics of ophthalmic drugs that bind VEGF , 2014, Expert review of clinical pharmacology.

[8]  Wei Wang,et al.  Immunogenicity of protein aggregates--concerns and realities. , 2012, International journal of pharmaceutics.

[9]  L. Rangell,et al.  PHARMACOKINETICS AND RETINAL DISTRIBUTION OF RANIBIZUMAB, A HUMANIZED ANTIBODY FRAGMENT DIRECTED AGAINST VEGF-A, FOLLOWING INTRAVITREAL ADMINISTRATION IN RABBITS , 2007, Retina.

[10]  B. Short Safety Evaluation of Ocular Drug Delivery Formulations: Techniques and Practical Considerations , 2008, Toxicologic pathology.

[11]  M. Knopp,et al.  ANATOMIC AND PHARMACOKINETIC PROPERTIES OF INTRAVITREAL BEVACIZUMAB AND RANIBIZUMAB AFTER VITRECTOMY AND LENSECTOMY , 2013, Retina.

[12]  Amin Rostami-Hodjegan,et al.  Simulation and prediction of in vivo drug metabolism in human populations from in vitro data , 2007, Nature Reviews Drug Discovery.

[13]  Jennifer J. Kang-Mieler,et al.  Advances in ocular drug delivery: emphasis on the posterior segment , 2014, Expert opinion on drug delivery.

[14]  Jing Xu,et al.  Permeability and Diffusion in Vitreous Humor: Implications for Drug Delivery , 2004, Pharmaceutical Research.

[15]  N. Fotaki Flow-through cell apparatus (USP apparatus 4):Operation and features , 2011 .

[16]  Osamu Sawada,et al.  Effect of vitrectomy on aqueous VEGF concentration and pharmacokinetics of bevacizumab in macaque monkeys. , 2012, Investigative ophthalmology & visual science.

[17]  W. Jiskoot,et al.  Immunogenicity of Therapeutic Proteins: The Use of Animal Models , 2011, Pharmaceutical Research.

[18]  H. Kristensen,et al.  Influence of Antidrug Antibodies on Plectasin Efficacy and Pharmacokinetics , 2009, Antimicrobial Agents and Chemotherapy.

[19]  J. Pulido,et al.  Pharmacokinetics of intravitreal ranibizumab (Lucentis). , 2007, Ophthalmology.

[20]  P. Heiduschka,et al.  Penetration of bevacizumab through the retina after intravitreal injection in the monkey. , 2007, Investigative ophthalmology & visual science.

[21]  D. C. Browne,et al.  Low-Level Drug Release-Rate Testing of Ocular Implants Using USP Apparatus 4 Dissolution and HPLC End Analysis , 2010 .

[22]  Gopi Shankar,et al.  Scientific and regulatory considerations on the immunogenicity of biologics. , 2006, Trends in biotechnology.

[23]  Samirkumar R Patel,et al.  Treatment of acute posterior uveitis in a porcine model by injection of triamcinolone acetonide into the suprachoroidal space using microneedles. , 2013, Investigative ophthalmology & visual science.

[24]  D. Maurice,et al.  Review: practical issues in intravitreal drug delivery. , 2001, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[25]  C. Cebulla,et al.  Intravitreal Devices for the Treatment of Vitreous Inflammation , 2012, Mediators of inflammation.

[26]  Malcolm Rowland,et al.  Human clearance prediction: shifting the paradigm , 2009, Expert opinion on drug metabolism & toxicology.

[27]  S. Tamilvanan,et al.  Clinical concerns of immunogenicity produced at cellular levels by biopharmaceuticals following their parenteral administration into human body , 2010, Journal of drug targeting.

[28]  Clive G. Wilson,et al.  Ophthalmic drug delivery systems for the treatment of retinal diseases: basic research to clinical applications. , 2010, Investigative ophthalmology & visual science.

[29]  R. Cuthbertson,et al.  Intraocular pharmacokinetics and safety of a humanized monoclonal antibody in rabbits after intravitreal administration of a solution or a PLGA microsphere formulation. , 1999, Toxicological sciences : an official journal of the Society of Toxicology.

[30]  J. Robinson,et al.  Ocular pharmacokinetics/pharmacodynamics , 1997 .

[31]  Yahya E Choonara,et al.  A review of implantable intravitreal drug delivery technologies for the treatment of posterior segment eye diseases. , 2010, Journal of Pharmacy and Science.

[32]  F. Macri,et al.  The rate of aqueous humor formation in buphthalmic rabbit eyes. , 1967, Investigative ophthalmology.

[33]  Y. Tabata,et al.  Ocular drug delivery for bioactive proteins , 2011 .

[34]  T. Krohne,et al.  Pharmakokinetik intravitreal applizierter VEGF-Inhibitoren , 2014, Der Ophthalmologe.

[35]  S. Bartels Aqueous humor flow measured with fluorophotometry in timolol-treated primates. , 1988, Investigative ophthalmology & visual science.

[36]  Uday B. Kompella,et al.  Prediction of Vitreal Half-Life Based on Drug Physicochemical Properties: Quantitative Structure–Pharmacokinetic Relationships (QSPKR) , 2009, Pharmaceutical Research.

[37]  S. Yeh,et al.  Sustained-Release Corticosteroid Options , 2014, Journal of ophthalmology.

[38]  S. Hayreh Posterior drainage of the intraocular fluid from the vitreous , 1966 .

[39]  A. Goepferich,et al.  Controlled release of therapeutic antibody formats. , 2014, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[40]  K. Tojo,et al.  In vivo/in vitro correlation of intravitreal delivery of drugs with the help of computer simulation. , 1994, Biological & pharmaceutical bulletin.

[41]  D. Sène,et al.  Biotherapies in inflammatory ocular disorders: Interferons, immunoglobulins, monoclonal antibodies. , 2013, Autoimmunity reviews.

[42]  M. Maia,et al.  Cytokines in neovascular age-related macular degeneration: fundamentals of targeted combination therapy , 2011, British Journal of Ophthalmology.

[43]  K. Tojo,et al.  Pharmacokinetic model for in vivo/in vitro correlation of intravitreal drug delivery. , 2001, Advanced drug delivery reviews.

[44]  G. Moss,et al.  An investigation into solvent‐membrane interactions when assessing drug release from organic vehicles using regenerated cellulose membranes , 2008, The Journal of pharmacy and pharmacology.

[45]  M. Robinson,et al.  Biodegradable Implants for Sustained Drug Release in the Eye , 2010, Pharmaceutical Research.

[46]  M. Hutmacher,et al.  Population Pharmacokinetics of Pegaptanib in Patients With Neovascular, Age‐Related Macular Degeneration , 2012, Journal of clinical pharmacology.

[47]  Michael H. Miller,et al.  Intraocular concentration and pharmacokinetics of triamcinolone acetonide after a single intravitreal injection. , 2003, Ophthalmology.

[48]  A. Urtti,et al.  Permeability of retinal pigment epithelium: effects of permeant molecular weight and lipophilicity. , 2005, Investigative ophthalmology & visual science.

[49]  A. Mitra,et al.  Posterior segment ocular pharmacokinetics using microdialysis in a conscious rabbit model. , 2003, Investigative ophthalmology & visual science.

[50]  J. H. Park,et al.  Pharmacokinetics of intravitreally injected bevacizumab in vitrectomized eyes. , 2013, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[51]  C. Quale,et al.  Minimizing Variability of Cascade Impaction Measurements in Inhalers and Nebulizers , 2008, AAPS PharmSciTech.

[52]  M. Maia,et al.  Therapeutic monoclonal antibodies in ophthalmology , 2009, Progress in Retinal and Eye Research.

[53]  A. Loewenstein,et al.  Pharmacokinetics of bevacizumab after topical and intravitreal administration in human eyes , 2013, Graefe's Archive for Clinical and Experimental Ophthalmology.

[54]  Giovanni Vozzi,et al.  New eye phantom for ophthalmic surgery , 2014, Journal of biomedical optics.

[55]  M. P. Kummer,et al.  Artificial Vitreous Humor for In Vitro Experiments , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[56]  PenedonesAna,et al.  Safety monitoring of ophthalmic biologics: a systematic review of pre- and postmarketing safety data. , 2014 .

[57]  Y. Vugmeyster,et al.  Pharmacokinetics and toxicology of therapeutic proteins: Advances and challenges. , 2012, World journal of biological chemistry.

[58]  I. Fatt Flow and diffusion in the vitreous body of the eye. , 1975, Bulletin of mathematical biology.

[59]  Marc B. Brown,et al.  An investigation into the influence of binary drug solutions upon diffusion and partition processes in model membranes , 2008, The Journal of pharmacy and pharmacology.

[60]  S. Mohammadein,et al.  Concentration distribution around a growing gas bubble in tissue. , 2010, Mathematical biosciences.

[61]  M. Abdekhodaie,et al.  Retina-Choroid-Sclera Permeability for Ophthalmic Drugs in the Vitreous to Blood Direction: Quantitative Assessment , 2012, Pharmaceutical Research.

[62]  Remigius U Agu,et al.  In vitro and in vivo testing methods for respiratory drug delivery , 2011, Expert opinion on drug delivery.

[63]  R. Gurny,et al.  Intraocular implants for extended drug delivery: therapeutic applications. , 2006, Advanced drug delivery reviews.

[64]  T. Yilmaz,et al.  Pharmacokinetics of triamcinolone acetonide for the treatment of macular edema , 2011, Expert opinion on drug metabolism & toxicology.

[65]  P. Missel Hydraulic Flow and Vascular Clearance Influences on Intravitreal Drug Delivery , 2002, Pharmaceutical Research.

[66]  Mark R Prausnitz,et al.  Ocular delivery of macromolecules. , 2014, Journal of controlled release : official journal of the Controlled Release Society.

[67]  Clive G. Wilson,et al.  Intravitreal therapy for neovascular age-related macular degeneration and inter-individual variations in vitreous pharmacokinetics , 2010, Progress in Retinal and Eye Research.

[68]  C. Meyer,et al.  Intraocular pharmacokinetics of bevacizumab following a single intravitreal injection in humans , 2012 .

[69]  A. Urtti,et al.  Prediction of the Vitreal Half-Life of Small Molecular Drug-Like Compounds , 2012, Pharmaceutical Research.

[70]  N. Eter,et al.  Intraocular pharmacokinetics of bevacizumab after a single intravitreal injection in humans. , 2008, American journal of ophthalmology.

[71]  Sachin S Thakur,et al.  Intravitreal drug delivery in retinal disease: are we out of our depth? , 2014, Expert opinion on drug delivery.

[72]  J. Wolter PORES IN THE INTERNAL LIMITING MEMBRANE OF THE HUMAN RETINA , 1964, Acta ophthalmologica.

[73]  C. R. Ethier,et al.  Ocular biomechanics and biotransport. , 2004, Annual review of biomedical engineering.

[74]  C. Ross Ethier,et al.  Fluid Mechanics of the Eye , 2012 .

[75]  W. L. Fowlks Meridional flow from the corona ciliaris through the pararetinal zone of the rabbit vitreous. , 1963, Investigative ophthalmology.

[76]  Jesper Østergaard,et al.  Role of in vitro release models in formulation development and quality control of parenteral depots , 2009, Expert opinion on drug delivery.

[77]  D. Smerdon Anatomy of the eye and orbit , 2000 .

[78]  L. Bartalena,et al.  Vitreous Substitutes: The Present and the Future , 2014, BioMed research international.

[79]  S. Kaushal,et al.  Vitreous substitutes: a comprehensive review. , 2011, Survey of ophthalmology.

[80]  J. Cunha-Vaz The blood-ocular barriers: past, present, and future , 2007, Documenta Ophthalmologica.

[81]  Jay C. Sy,et al.  Single compartment drug delivery. , 2014, Journal of controlled release : official journal of the Controlled Release Society.

[82]  L. Block,et al.  Solubility and dissolution of triamcinolone acetonide. , 1973, Journal of pharmaceutical sciences.

[83]  A. Erginay,et al.  Pharmacokinetic-pharmacodynamic modeling of the effect of triamcinolone acetonide on central macular thickness in patients with diabetic macular edema. , 2004, Investigative ophthalmology & visual science.

[84]  R. Repetto,et al.  Mathematical model of flow in the vitreous humor induced by saccadic eye rotations: effect of geometry , 2010, Biomechanics and modeling in mechanobiology.

[85]  N. V. Chong,et al.  Pharmacokinetic evaluation of pegaptanib octasodium for the treatment of diabetic edema , 2014, Expert opinion on drug metabolism & toxicology.

[86]  P. Kuebler,et al.  Pharmacokinetics of ranibizumab in patients with neovascular age-related macular degeneration: a population approach. , 2013, Investigative ophthalmology & visual science.

[87]  R. Kuijpers,et al.  The neonatal Fc receptor is expressed by human retinal pigment epithelial cells and is downregulated by tumour necrosis factor-alpha , 2011, British Journal of Ophthalmology.

[88]  B. Kuppermann,et al.  ASSESSMENT OF THE DIFFERENCES IN PHARMACOKINETICS AND PHARMACODYNAMICS BETWEEN FOUR DISTINCT FORMULATIONS OF TRIAMCINOLONE ACETONIDE , 2013, Retina.

[89]  I. Perlman,et al.  ELECTROPHYSIOLOGIC AND RETINAL PENETRATION STUDIES FOLLOWING INTRAVITREAL INJECTION OF BEVACIZUMAB (AVASTIN) , 2006, Retina.

[90]  Stephan Reichl,et al.  Toward the practical implementation of eye-related bioavailability prediction models. , 2014, Drug discovery today.

[91]  Hannah M Jones,et al.  Simulation of Human Intravenous and Oral Pharmacokinetics of 21 Diverse Compounds Using Physiologically Based Pharmacokinetic Modelling , 2011, Clinical pharmacokinetics.

[92]  Clive G. Wilson,et al.  The vitreous humor as a barrier to nanoparticle distribution. , 2013, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[93]  K. Schaal,et al.  The premacular bursa's shape revealed in vivo by swept-source optical coherence tomography. , 2014, Ophthalmology.

[94]  Shiow-Fern Ng,et al.  The relevance of polymeric synthetic membranes in topical formulation assessment and drug diffusion study , 2012, Archives of pharmacal research.

[95]  M. Almukainzi,et al.  Simulated Biological Fluids with Possible Application in Dissolution Testing , 2011 .

[96]  A. Loewenstein,et al.  Drug Delivery to the Posterior Segment of the Eye , 2011, European journal of ophthalmology.

[97]  Yu-Ling Cheng,et al.  Computational modeling of drug distribution in the posterior segment of the eye: effects of device variables and positions. , 2014, Mathematical biosciences.

[98]  Yonghong Sun,et al.  Expression and distribution of immunoglobulin G and its receptors in an immune privileged site: the eye , 2011, Cellular and Molecular Life Sciences.

[99]  W. Wilson,et al.  The pharmacokinetics of rituximab following an intravitreal injection. , 2006, Experimental eye research.

[100]  Paul J. Missel,et al.  Simulating Intravitreal Injections in Anatomically Accurate Models for Rabbit, Monkey, and Human Eyes , 2012, Pharmaceutical Research.

[101]  R. Brubaker The flow of aqueous humor in the human eye. , 1982, Transactions of the American Ophthalmological Society.

[102]  Jing Xu,et al.  Computer Simulation of Convective and Diffusive Transport of Controlled-Release Drugs in the Vitreous Humor , 2004, Pharmaceutical Research.

[103]  P. Brigidi,et al.  The Three Genetics (Nuclear DNA, Mitochondrial DNA, and Gut Microbiome) of Longevity in Humans Considered as Metaorganisms , 2014, BioMed research international.

[104]  Victor H. Barocas,et al.  Computer Modeling of Drug Delivery to the Posterior Eye: Effect of Active Transport and Loss to Choroidal Blood Flow , 2008, Pharmaceutical Research.

[105]  W. Weitschies,et al.  Simulation of drug distribution in the vitreous body after local drug application into intact vitreous body and in progress of posterior vitreous detachment. , 2014, Journal of pharmaceutical sciences.

[106]  Yang Chen,et al.  Formulation and in vitro/in vivo correlation of a drug-in-adhesive transdermal patch containing azasetron. , 2012, Journal of pharmaceutical sciences.

[107]  Michail E. Kavousanakis,et al.  Computational modeling of drug delivery to the posterior eye , 2014 .

[108]  M. Mohamed,et al.  Anti‐vascular endothelial growth factor therapies in ophthalmology: current use, controversies and the future , 2014, British journal of clinical pharmacology.

[109]  Rodolfo Repetto,et al.  Experimental investigation of vitreous humour motion within a human eye model , 2005, Physics in medicine and biology.

[110]  Usha Chakravarthy,et al.  Ranibizumab versus bevacizumab to treat neovascular age-related macular degeneration: one-year findings from the IVAN randomized trial. , 2012, Ophthalmology.

[111]  Kakuji Tojo,et al.  A pharmacokinetic model for ocular drug delivery. , 2004, Chemical & pharmaceutical bulletin.

[112]  D. Fei,et al.  Preclinical pharmacokinetics of Ranibizumab (rhuFabV2) after a single intravitreal administration. , 2005, Investigative ophthalmology & visual science.

[113]  P. Beer,et al.  VITREOUS LEVELS OF UNBOUND BEVACIZUMAB AND UNBOUND VASCULAR ENDOTHELIAL GROWTH FACTOR IN TWO PATIENTS , 2006, Retina.

[114]  Rupak K Banerjee,et al.  Evaluation of coupled convective-diffusive transport of drugs administered by intravitreal injection and controlled release implant. , 2005, Journal of controlled release : official journal of the Controlled Release Society.

[115]  Arto Urtti,et al.  Challenges and obstacles of ocular pharmacokinetics and drug delivery. , 2006, Advanced drug delivery reviews.

[116]  R. Banerjee,et al.  Effect of retinal permeability, diffusivity, and aqueous humor hydrodynamics on pharmacokinetics of drugs in the eye. , 2008, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[117]  S. Acharya,et al.  Computational modeling of intravitreal drug delivery in the vitreous chamber with different vitreous substitutes , 2008 .

[118]  W Weitschies,et al.  Simulation of the Conjunctival and Choroidal Blood Flow Using a New Multi-Layer Diffusion Cell , 2013, Biomedizinische Technik. Biomedical engineering.

[119]  M. Yablonski,et al.  Aqueous humor dynamics in the aging human eye. , 1999, American journal of ophthalmology.

[120]  P. Szurman,et al.  Vitreous levels of bevacizumab and vascular endothelial growth factor-A in patients with choroidal neovascularization. , 2008, Ophthalmology.

[121]  G. Peyman,et al.  Triamcinolone acetonide in ocular therapeutics. , 2007, Survey of ophthalmology.

[122]  L. Aiello,et al.  RISKS OF INTRAVITREOUS INJECTION: A COMPREHENSIVE REVIEW , 2004, Retina.

[123]  Heather J. Ruskin,et al.  Probabilistic methods for drug dissolution. Part 2. Modelling a soluble binary drug delivery system dissolving in vitro , 2006, Simul. Model. Pract. Theory.

[124]  L. Kowalczuk,et al.  Protein delivery for retinal diseases: From basic considerations to clinical applications , 2010, Progress in Retinal and Eye Research.

[125]  P. Bishop Structural macromolecules and supramolecular organisation of the vitreous gel , 2000, Progress in Retinal and Eye Research.

[126]  C. Meyer,et al.  INTRAOCULAR PHARMACOKINETICS AFTER A SINGLE INTRAVITREAL INJECTION OF 1.5 mg VERSUS 3.0 mg OF BEVACIZUMAB IN HUMANS , 2011, Retina.

[127]  D. D’Amico,et al.  Evaluation of the retinal toxicity and pharmacokinetics of dexamethasone after intravitreal injection. , 1992, Archives of ophthalmology.