Aj. Schwab et Ks. Pang, The multiple indicator-dilution method for the study of enzyme heterogeneity in liver: Theoretical basis, DRUG META D, 27(6), 1999, pp. 746-755
The theoretical basis of the use of the multiple indicator dilution techniq
ue to account for the heterogeneous distribution (or zonation) of enzymes i
n the liver was explored. The microcirculation was assumed to consist of id
entical capillaries perfused in parallel, with enzymatic activities for dru
g metabolism being distributed uniformly over the upstream half (periportal
or pp) or the downstream half (perivenous or pv) of the flow path, whereas
all other transport/removal processes were assumed to be homogeneously dis
tributed. Outflow dilution profiles for parent drug and metabolite were est
imated by inversion of Laplace transforms or by a finite difference method.
The areas under the curves for parent and metabolite, the mean transit tim
es of parent (MTT) and metabolite (MTTM) mean time from injection of parent
to exit of metabolite from organ, and their relative dispersions (CV2 or C
VM2) were estimated from analytical expressions. When the influx-efflux rat
io (or cellular-sinusoidal distribution ratio) for metabolite was equal to
or smaller than that of the parent, the MTT, ranking was: pp < homogeneous
< pv. The ranking was reversed when the influx-efflux ratio for metabolite
greatly exceeded that for the parent. The presence of elimination pathways
for the metabolite reduced its kMTT(M) and CVM2, more for pp than for homog
eneous and pv cases. The theory can be applied to determine enzyme zonation
in multiple indicator dilution studies with use of the area under the curv
e for the metabolite and MTT, during prograde (from portal vein to hepatic
vein) and retrograde (from hepatic vein to portal vein) perfusion.