Pharmacokinetic and pharmacodynamic characterization of inhaled β2 - agonists using the isolated human lung perfusion model ; Pharmakokinetische und pharmakodynamische Charakterisierung inhalativer β2 - Agonisten anhand des isolierten humanen Lungenperfusionsmodells

The inhaled pharmacotherapy is fundamental in the management of obstructive lung diseases such as asthma bronchiale or chronic obstructive pulmonary disease. In this context short- and long-acting β2-agonists play a prominent role as relieve and control medication. Regarding the risk-benefit profile of an inhaled drug, the pattern of pulmonary deposition and the rate and extent of absorption into systemic circulation are essential parameters. New developments of drugs are characterized by high lung retention and improved efficacy. The aim of the present thesis was the parallel evaluation the pharmacokinetic (PK) and -dynamic (PD) properties of inhaled β2-agonists employing an isolated human lung perfusion model (IPL). The short-acting β2-agonist salbutamol and the newly developed ultra long-acting β2-agonist GW597901 were chosen for the analysis of pulmonary drug absorption and bronchodilation. In a pharmacokinetic enabling study an established human IPL setting was modified to monitor the pharmacokinetics of the β2-agonists by measuring the concentrations in perfusion fluid, lung tissue and BAL samples obtained during and after the experiments. The IPL model revealed differences in the pulmonary absorption behaviour of GW597901 and salbutamol. The lipophilic compound GW597901 was distributed to a lower extent into the perfusion fluid compared to the more hydrophilic compound salbutamol. The analyzed time profiles of nebulized salbutamol in the perfusate were consistent to with a clinical study if considering experimental conditions as the actual deposited doses and the differing volume of distribution. Thus, the suitability of the IPL model for the PK analysis of inhaled β2-agonists was confirmed. In a PK/PD study the human ex vivo model was employed for the first time for the evaluation of the clinical relevant bronchodilating effect induced by inhaled β2-agonists in addition to the analysis of their pharmacokinetics. Thereby the focus was to determine the onset and extent of bronchodilation. A new method was ...