Evidence map›Paper›PMID 33067715›Full record

ArticlePharmaceutical research2020

Pharmacokinetics and Biodistribution of Tacrolimus after Topical Administration: Implications for Vascularized Composite Allotransplantation.

Firuz G Feturi, Jonas T Schnider, Paolo M Fanzio, Vasil E Erbas, Sinan Oksuz, Huseyin Sahin, Liwei Dong, Jignesh M Unadkat, Alexander M Spiess, Jan A Plock and 3 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Pharmaceutical research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 4 countries.

Firuz G FeturiDepartment of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Room 4103, PTC 700 Technology Drive, Pittsburgh, Pennsylvania, 15219, USA.
Jonas T SchniderDepartment of Plastic and Reconstructive Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Paolo M FanzioDepartment of Plastic and Reconstructive Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Vasil E ErbasDepartment of Plastic, Reconstructive and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
Sinan OksuzDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medicalpark Gaziantep Hospital, Gaziantep, Turkey.
Huseyin SahinPrivate Cagsu Hospital, Duzce, Turkey.
Liwei DongPlastic and Aesthetic Surgery Department, XiJing Hospital, Xi'an, Shaanxi, China.
Jignesh M UnadkatDepartment of Plastic and Reconstructive Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Alexander M SpiessDepartment of Plastic and Reconstructive Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jan A PlockDivision of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Mario G SolariDepartment of Plastic and Reconstructive Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Vijay S GorantlaDepartments of Surgery, Ophthalmology and Bioengineering, Wake Forest Baptist Medical Center, Wake Forest Institute for Regenerative Medicine, Richard H. Dean Biomedical Building, Suite 333, 391 Technology Way, Winston-Salem, North Carolina, 27101, USA. vgorant@wakehealth.edu.
Raman VenkataramananDepartment of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Room 4103, PTC 700 Technology Drive, Pittsburgh, Pennsylvania, 15219, USA. rv@pitt.edu.
University of Pittsburgh · USForest Institute · USMedical Park Gaziantep Hospital · TRTurkish Armed Forces · TRUniversity Hospital of Zurich · CHXijing Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe high doses of oral tacrolimus (TAC) (1,2) necessary to prevent acute rejection (AR) after vascularized composite allotransplantation (VCA) are associated with systemic adverse effects. The skin is the most antigenic tissue in VCA and the primary target of AR. However, the short-term use of topical TAC (Protopic®), as an off-label adjunct to oral TAC, to treat AR episodes pro re nata (PRN), has yielded inconsistent results. There is lack of data on the pharmacokinetics and tissue distribution of topical TAC in VCA, that hampers our understanding of the reasons for unreliable efficacy. Toward this goal, we evaluated the ability of topical TAC to achieve high local tissue concentrations at the site of application with low systemic concentrations. MATERIALS AND

methodsWe assessed the pharmacokinetics and tissue distribution of topical TAC (Protopic®, 0.03%) after single or repeated topical application in comparison to those after systemic delivery in rats. Animals received a single topical application of TAC ointment (Group 1) or an intravenous (IV) injection of TAC (Group 2) at a dose of 0.5 mg/kg. In another experiment, animals received daily topical application of TAC ointment (Group 3), or daily intraperitoneal (IP) injection of TAC (Group 4) at a dose of 0.5 mg/kg for 7 days. TAC concentrations in blood and tissues were analyzed by Liquid Chromatography-Mass Spectrometry (LC/MS-MS).

resultsFollowing single topical administration, TAC was absorbed slowly with a Tmax of 4 h and an absolute bioavailability of 11%. The concentrations of TAC in skin and muscle were several folds higher than whole blood concentrations. Systemic levels remained subtherapeutic (< 3 ng/ml) with repeated once daily applications.

conclusionTopical application of TAC ointment (Protopic®, 0.03%) at a dose of 0.5 mg/kg/day provided high concentrations in the local tissues with low systemic exposure. Repeated topical administration of TAC is well tolerated with no local or systemic adverse effects. This study confirms the feasibility of topical application of TAC for site specific graft immunosuppression and enables future applications in VCA.

Indexed as

Vascularized Composite AllotransplantationAdministration, TopicalAnimalsCalcineurin InhibitorsComposite Tissue AllograftsGraft RejectionGraft SurvivalImmunosuppressive AgentsInjections, IntravenousMaleMuscle, SkeletalProof of Concept StudyRats, Inbred LewSkinTacrolimusTissue DistributionCalcineurin InhibitorsImmunosuppressive AgentsTacrolimuspharmacokineticstacrolimustissue distributiontopical deliveryvascularized composite allotransplantation

Identifiers

PMID33067715
OpenAlexW3093046878

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.