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Biomedical subjects

A C Perkins

Publications and source records attributed to A C Perkins.

At least 91 records · Page 5Linked to original sources
PubMed1994

Scintigraphic assessment of the intragastric distribution and gastric emptying of an encapsulated drug: the effect of feeding and of a proton pump inhibitor.

BACKGROUND: Local delivery of therapeutic agents to the stomach may be a useful strategy in the treatment of Helicobacter pylori infection. We aimed to see whether the intragastric distribution and gastric retention of a therapeutic agent could be improved, either by giving omeprazole or by dosing after a meal. METHODS: Twelve healthy volunteers took part in this double-blind placebo-controlled crossover study comparing the effects of omeprazole 20 mg twice daily for 5 days with placebo, and the fasted with the fed state, on the gastric emptying and intragastric distribution of a soluble scintigrapic marker contained in a drug capsule. RESULTS: Dosing after food profoundly prolonged gastric residence of the drug label, prolonging mean time to 50% emptying (T50) from 0.5 +/- 0.1 h in the fasted state to 2.0 +/- 0.2 h when given after food. Food also improved intragastric distribution by increasing delivery to the body and fundus. Omeprazole enhanced the effect of food, prolonging T50 to 2.9 +/- 0.3 h, but had no effect in fasted subjects. CONCLUSIONS: Dosing after food markedly improves the aspects of local drug delivery to the stomach investigated in this study, and omeprazole enhances this effect. Post-prandial dosing may, therefore, be useful for improving delivery of some anti-Helicobacter agents.

Adult↗
PubMed1994

Impaired oesophageal transit of capsule versus tablet formulations in the elderly.

Drug induced oesophageal injury is an important and preventable cause of iatrogenic injury. In most cases the injury is considered to be due to mucosal contact from formulations lodged in the oesophagus. A scintigraphic study was performed comparing the oesophageal transit of enteric coated tablets with similar sized and shaped gelatin capsules, using a population of elderly healthy volunteers similar in age (50-79 years) to the population most likely to be receiving regular treatment. Twenty three volunteers injected the radiolabelled tablet or capsule with 50 ml of water while sitting on two separate occasions according to a randomisation schedule. Oesophageal transit was assessed by gamma scintigraphy. Gastric residence was also assessed in 11 of 23 subjects. While the tablet was readily cleared from the oesophagus, mean transit time 4.3 seconds (range 1.0-14.0), the capsule often showed a comparatively prolonged holdup, mean transit time 20.9 seconds (range 1.5-174.5). Ten of 11 tablets emptied from the stomach intact, while all 11 capsules broke up in the stomach. Gelatin capsules showed a clear tendency to remain within the oesophagus of healthy elderly volunteers, while similar sized enteric coated tablets did not. These studies show the importance of assessing oesophageal transit when designing the formulation of drugs with a potential for oesophageal injury.

Administration, Oral↗
PubMed1994

Scintigraphic determination of the biodistribution of an 111In-labelled poly(L-lysine) backbone branched polypeptide drug carrier in tumour-bearing mice.

A branched polypeptide drug carrier, with a poly(L-lysine) backbone, has been labelled with 111In and its biodistribution imaged in mice with transplanted B16 melanoma. Levels of tracer in tumours were not great enough for tumours to be discerned on gamma-camera images, and this was confirmed by subsequent dissection analysis. Tumour levels of 111In from labelled polymer were about 3% of the dose g-1 two days after injection. Similar levels of tracer were found in tumour tissue of mice injected with mouse immunoglobulin or serum albumin labelled with 111In by DTPA chelation, or injected with free 111In-chloride to label serum transferrin. There was rapid excretion of a sub-component of the 111In-labelled polymer visible in the images. Gel permeation chromatography suggested that the polymer was heterogeneous, some components having Stoke's radii below that allowing renal clearance. Gel permeation chromatography was used to separate labelled polymer into fractions having high, intermediate and low renal clearance. The low-excretion fraction showed a two-fold increase in tumour levels, compared with native polymer, although as this fraction showed greater survival in the blood and body as a whole, discrimination between tumour and normal tissue was not increased.

Animals↗
PubMed1994

Gamma scintigraphy in the delivery, biodistribution and targeting of therapeutic agents.

The established clinical role of radionuclide imaging includes the diagnosis and monitoring of a wide range of clinical conditions. The therapeutic use of radionuclides has centred on a relatively small number of pathological conditions, particularly within the field of oncology. More recently there has been growing interest in the use of radionuclide imaging in drug evaluation and research (RIDER). Studies have been undertaken in order to increase the understanding of the in in vivo behaviour of pharmaceutical dosage forms in addition to the in vivo behaviour of molecular and cellular anti-tumour agents. The imaging facilities required for such undertakings are available in most nuclear medicine departments, although the expertise for radiolabelling and the requirements for the production of drug conjugates and pharmaceutical formulations are limited to a small number of centres. This paper discusses the application of radionuclide imaging in drug research with particular reference to the role of gamma-scintigraphy in monitoring the biodistribution and pharmacokinetics of immune mediated drug conjugates intended for the treatment of malignant disease. Examples described include the evaluation of oral and inhaled drug delivery systems and the biodistribution and in vivo kinetics of parenteral administrations.

Animals↗
PubMed1993

Conditional immortalization of mouse myelomonocytic, megakaryocytic and mast cell progenitors by the Hox-2.4 homeobox gene.

The murine myelomonocytic cell line WEHI-3B exhibits ectopic expression of the genes encoding the homeobox protein, Hox-2.4, and the myeloid growth factor, interleukin-3 (IL-3). We showed previously that concomitant expression of IL-3 and Hox-2.4 in bone marrow cells induced the development of transplantable growth factor-independent tumours resembling the WEHI-3B tumour. We have now investigated the effect of enforced expression of Hox-2.4 alone. Bone marrow cells were infected with Hox-2.4 retrovirus and then either cultured in agar or transplanted into irradiated mice. In vitro, colonies derived from virus-infected cells readily yielded IL-3-dependent, non-tumorigenic cell lines of the myelomonocytic, megakaryocytic and mast cell lineages. Surprisingly, both the establishment and maintenance of these lines required very high concentrations of IL-3 and reduced levels promoted differentiation. Transplanted mice analysed after 3 months appeared normal but their spleen and bone marrow contained abundant provirus-bearing progenitor cells, from which IL-3-dependent long-term cell lines could readily be established in vitro. Four of 18 animals monitored for up to 12 months eventually developed clonal leukaemia, associated in three cases with IL-3 production. Thus ectopic expression of Hox-2.4 enhances self-renewal of immature myeloid progenitors and progression to a fully malignant state is favoured by somatic mutations conferring autocrine production of IL-3.

Animals↗
PubMed1993

Immunoscintigraphy of small-cell lung cancer: a study using technetium and indium labelled anti-carcinoembryonic antigen monoclonal antibody preparations.

Immunoscintigraphy with radiolabelled anti-carcinoembryonic antigen monoclonal antibody was performed on 21 patients with active small-cell lung cancer. Patients received either In-111-labelled Mab F6 F(ab')2 fragments or Tc-99m-labelled BW 431/26 intact antibody. Tumour was imaged in 13 patients (62%). Of 38 known sites of disease, 18 sites were positively detected. Serum CEA levels were known in 19 patients and were abnormally elevated in three (tumour being detected in all three patients). Eight of 15 patients with normal serum CEA had positive imaging. Using the In-111-labelled antibody seven out of ten patients (nine out of 18 sites) gave positive scans; with the Tc-99m-labelled antibody these were obtained in nine out of 18 patients (nine out of 20 sites).

Carcinoembryonic Antigen↗
PubMed1993

The value of scintigraphic studies in the assessment of patients with acute or chronic gastrointestinal haemorrhage.

The scintigrams of 76 patients with gastrointestinal bleeding referred over an 8 year period have been reviewed together with their subsequent clinical course. Twenty-five patients had either 99Tcm-sulphur colloid or 99Tcm-labelled red cell scintigraphy to localize a source of active bleeding. Fourteen patients had 99Tcm-sulphur colloid scintigraphy, of which seven were false negatives, two were false positives and two were true positives. Eleven patients had 12 99Tcm-labelled red cell scintigrams, of which three were false negatives, one was a false positive and four were true positives. Fifty patients had 99Tcm-pertechnetate scintigraphy to look for ectopic gastric mucosa in Meckel's diverticula. There were 43 true negatives, two false negatives, two true positives and three false positives in this group. Our results emphasize the need for caution in interpreting nuclear medicine studies in patients with blood loss from the gastrointestinal tract.

Acute Disease↗
PubMed1993

Immunoscintigraphy of ovarian carcinoma using a monoclonal antibody (111In-NCRC48) defining a polymorphic epithelial mucin (PEM) epitope.

An anti-polymorphic epithelial mucin (PEM) monoclonal antibody NCRC48 (IgG3) has been tested for its capacity to localize in tumours according to accepted guidelines for human administration. Following radiolabelling with 111In, 1 mg antibody was administered to 19 patients with a clinical suspicion of ovarian malignancy. Initial imaging and biodistribution studies confirm the safety of this conjugate although six out of 11 patients tested developed an antibody response to the monoclonal antibody. Immunoscintigraphy with this antibody was compared with magnetic resonance imaging and ultrasound in relation to the final tumour histology, the final accuracies being 79, 79 and 64% respectively. Positive localization of antibody was confirmed in malignant tissue with little evidence of uptake in benign tissue.

Adenocarcinoma↗
PubMed1993

Targeting of N-(2-hydroxypropyl)methacrylamide copolymer-doxorubicin conjugate to the hepatocyte galactose-receptor in mice: visualisation and quantification by gamma scintigraphy as a basis for clinical targeting studies.

N-(2-hydroxypropyl)methacrylamide (HPMA) copolymers containing doxorubicin and galactosamine have been developed to target the hepatocyte galactose receptor with the aim of organ-specific chemotherapy of primary and metastatic liver disease. Previous biodistribution studies in rats and mice have used tyrosinamide incorporated into the copolymer structure to permit labelling with 125I, enabling quantification of polymer distribution by dissection analysis. Radiolabelling of this copolymer with 131I, a radionuclide suitable for gamma scintigraphy, and the imaging analysis of its biodistribution in mice are reported. The present studies are the first to confirm the feasibility of imaging HPMA copolymer biodistribution, and such gamma scintigraphy will be of great value for clinical pharmacokinetic studies with this compound. Gamma scintigraphy is virtually the only non-invasive method of assessing hepatic uptake of this and similar materials.

Animals↗
PubMed1993

Posterior truncal vagotomy and stapling of the anterior stomach wall in 30 patients with duodenal ulcer: acid inhibition, gastric emptying, and endoscopic dye spraying. Prospects for endoscopic vagotomy.

The use of a stapling instrument (TA90) to effect a transection of the anterior gastric wall with posterior truncal vagotomy but preserving innervation to the anterior wall of the antrum for duodenal ulcer is described. The operation resulted in the endoscopic healing of all the ulcers; however, recurrent ulceration was seen in 3 of 25 patients. Basal acid output was reduced from 7.84 (SEM 1.73) to 3.49 (SEM 1.15) mmol/h (t = 2.09, df = 15.7, p = 0.05), while peak acid output was reduced from 38.67 (SEM 3.11) to 19.26 (SEM 2.3) mmol/h (t = 5.01, df = 23.9, p = 0.0000). Solid and liquid gastric emptying studies were performed, and while some delay in solid emptying was seen, only one patient complained of transient gastric stasis. Endoscopic Congo red staining was performed postoperatively and a tongue of innervated mucosa along the lesser curve was seen in each case. The procedure was easily and rapidly performed, and early clinical results are good, with 25 of 30 patients having a good (Visick I) result.

Adult↗
PubMed1992

Bisphosphonate space measurement in Paget's disease of bone treated with APD.

The bisphosphonate space (BPS) is a quantitative measurement of skeletal uptake of 99mTc-HMDP. We measured BPS in 36 patients with Paget's disease of bone, both before and 6 months after treatment with intravenous APD (disodium pamidronate) infusions. BPS fell after treatment, but proportionally less than serum alkaline phosphatase (ALP) and fasting urinary hydroxyproline/creatinine (HYPRO). There was no dose-response relationship between the dose of APD given and the percentage reduction in ALP and HYPRO at 6 months. Log dose of APD/pretreatment BPS, however, predicted the percentage reduction in ALP and HYPRO very well, and from the respective regression equations it was possible to predict the dose of APD needed to achieve normal values of ALP and HYPRO. In the 10 patients who achieved a normal ALP and 9 patients a normal HYPRO after more than 6 months treatment with APD (range 7-18 months), the predicted dose of APD agreed closely with the actual dose. In conclusion, our data support the idea that log dose APD/pretreatment BPS is a valid predictor of biochemical response in Paget's disease.

Alkaline Phosphatase↗
PubMed1992

Scintigraphic evaluation of the pharmacokinetics of a soluble polymeric drug carrier.

There is a growing interest in the use of macro-molecular carriers for therapeutic agents. If these carriers can be labelled with an appropriate gamma-emitter, their biodistribution could be followed by scintigraphy. We have imaged the biodistribution of a synthetic branched polypeptide, based on a poly-L-lysine backbone (average molecular mass 45 kDa). The polymer was conjugated to diethylene triamine penta-acetic acid and labelled by chelation with indium-111. Mice were injected i.v. with labelled material and imaged with a gamma-camera with a pin-hole collimator. Images showed the majority of tracer remaining in the blood pool, but about 35% appeared in the urinary bladder within 1.5 h. When the 111In-polymer was fractionated by gel filtration chromatography on S-300, the imaging showed that the early eluting material was retained, the intermediate showed some renal clearance, and the late was rapidly excreted. These findings show the value of gamma-scintigraphy for biodistribution studies with such polymeric drug carriers and its potential for clinical pharmacokinetic studies.

Animals↗
PubMed1992

A role for gamma scintigraphy in cancer immunology and immunotherapy.

Facilities for radiolabelling and gamma scintigraphy are largely restricted to nuclear medicine departments or specialised research institutions and are therefore not widely available to workers in cancer research. Despite this, there is growing interest in gamma scintigraphy, which can provide information relevant to the entire field of cancer immunology. This review discusses the present and future roles of gamma scintigraphy in respect of antibody-targeted, cell-mediated and cytokine therapy. The authors aim to show that gamma scintigraphy is an investigative tool of great potential.

Animals↗
PubMed1992

Monoclonal antigranulocyte antibody imaging in inflammatory bowel disease: a preliminary report.

The 99Tcm-labelled antigranulocyte antibody BW250/183 has been used in the detection of intestinal inflammation in patients with active ulcerative colitis and Crohn's disease. Planar images were obtained up to 24 h after intravenous injection of the antibody. Eight out of nine patients with ulcerative colitis and six out of seven patients with Crohn's disease gave positive images. In 11 patients distribution of the inflammation was confirmed by barium studies, colonoscopy or surgery, whilst in two the antibody scan suggested more extensive disease than barium enema. None of the patients had any adverse reactions. Imaging with BW250/183 appears to give an accurate indication of the extent of inflammation in inflammatory bowel disease.

Colitis, Ulcerative↗
PubMed1991

Detection and characterization of arterial thromboses using a platelet-specific monoclonal antibody (P256 Fab').

Arteriography does not reliably distinguish between acute and chronic arterial occlusions. Seventeen patients with acute lower limb ischaemia were investigated by arteriography and by imaging with a platelet-specific monoclonal antibody (P256 Fab'); 20 MBq 111In-labelled P256 Fab' was administered intravenously and patients were imaged at intervals of between 20 min and 24 h. Thirteen patients were subsequently treated with intra-arterial thrombolysis. In six the images showed foci of increased uptake of 111In-labelled P256 Fab' and the corresponding arterial segment was recanalized. Patency to 30 days was maintained in four cases. Seven patients had negative scans, only four of whom achieved lysis, and two of these suffered early rethrombosis. The remaining four patients were excluded from thrombolysis by the arteriographic appearances. 111In-labelled P256 Fab' imaging can identify sites of acute arterial thrombosis and may have clinical applications in the management of peripheral vascular disease. Further studies are required to test whether the technique has a role to play in patient selection for thrombolysis.

Antibodies, Monoclonal↗
PubMed1991

Effect of pretreatment with ranitidine on the pharmacokinetics and gastrointestinal transit of a sustained release theophylline preparation.

A scintigraphic and pharmacokinetic study of the behaviour of (Bronchoretard forte, CAS 58-55-9) was carried out in 8 healthy male volunteers to evaluate the sensitivity of the preparation to changes in gastric pH. Volunteers were pretreated with ranitidine (CAS 66357-35-5) (150 mg b.d.) or placebo for three days prior to and on the study day to reduce gastric acidity. The effect of the pretreatment with ranitidine on gastric pH was measured on the prestudy day and the mean pH was significantly reduced compared to the placebo (ranitidine pH 2.2 +/- 2.4; placebo pH 1.6 +/- 2.0, p less than 0.01 Wilcoxon Signed Rank test). All subjects were pretreated with theophylline for 3 days (500 mg b.d.) to achieve steady-state. On the study day the volunteers swallowed two theophylline sustained release capsules radiolabelled by inclusion of indium-111 micronised Amberlite resin and the gastrointestinal transit followed continuously for 14 h using gamma scintigraphy with a further image at 24 h. Blood samples were taken from each subject throughout the study to determine the pharmacokinetic profile of theophylline when presented in the sustained release formulation. No significant differences were found in the gastrointestinal transit of the labelled microparticulates between the data obtained from the group when treated with ranitidine or placebo. Plasma theophylline concentration profiles were identical for the two treatments. These data indicate that the theophylline sustained release formulation is not sensitive to the effects of major changes in gastric H+ concentration.

Adult↗