Antibiotic treatment failure might be due to bacterial resistance or suboptimal exposure at target site and there is a lack of knowledge on the interaction between antimicrobial pharmacodynamics (PD) and the immune response to bacterial infections. Therefore, it is crucial to develop tools to increase the understanding of drug disposition to better evaluate antibiotic candidates in drug development and to elucidate the role of the immune system in bacterial infections. Colistin is used as salvage therapy against multidrug resistant Gram-negative infections. In this work, a whole-body physiologically based pharmacokinetic model (WBPBPK) was developed to characterize the pharmacokinetics (PK) of colistin and its prodrug colistin methanesulfonate (CMS) in animal and human. The scalability of the model from animal to human was assessed with satisfactory predictive performance for CMS and demonstrating the need for a mechanistic understanding of colistin elimination. The WBPBPK model was applied to investigate the impact of pathophysiological changes commonly observed in critically ill patients on tissue distribution of colistin and to evaluate different dosing strategies. Model predicted concentrations in tissue were used in combination with a semi-mechanistic PKPD model to predict bacterial killing in tissue for two strains of Pseudomonas aeruginosa. Finally, a toxicokinetic (TK) model was constructed to describe the time course of E. coli endotoxin concentrations in plasma and the effect on pro-inflammatory cytokine release. The model adequately described the concentration-time profiles of endotoxin and its stimulation of IL-6 and TNF-α production using an indirect response model combined with a transit compartment chain with a tolerance component to endotoxemia. The WBPBPK model developed in this work increased the knowledge on colistin tissue exposure under various conditions and could be used in drug development process to assess antibiotic efficacy or to test new drug combinations. The model describing endotoxin TK and its effect on cytokines is a new tool to be further applied in longitudinal studies to explore the immune response cascade induced by bacterial infections. The methodology applied in this thesis contributes to the development of an integrated modeling framework including physiology, drug distribution, bacterial growth and killing as well as the immune response to infection.

The medical use of marijuana is increasing, yet little is known about the exposure-response relationships resulting in its psychoactive effects. Δ9-tetrahydrocannabinol (THC) and its active metabolite (11-hydroxy-THC; THC-OH) are the principal psychoactive components in marijuana. It is well known that the plasma concentrations of the psychoactive components of marijuana do not directly relate to the observed psychoactive effects. The presence of a counter-clockwise hysteresis in the plasma concentrations-effect plot demonstrates a temporal delay between the plasma concentrations and observed effect following the intravenous administration of THC. The overarching objective of this research was to better understand the relationship between the plasma and brain concentrations of the psychoactive components (THC and THC-OH) and the observable psychoactive effects after intravenous administration of THC, utilizing model-based approaches. Specifically, the pharmacokinetics were explored using population pharmacokinetic (Pop PK) and physiologically-based pharmacokinetic (PBPK) modeling whereas the pharmacodynamics (PD) of the psychoactive effect (“highness”) were explored using effect-compartment modeling and linking the PD to the PBPK-derived concentrations predicted in the brain and an assumed effect-site. A “hypothetical” effect compartment model was developed to characterize the observed delay in peak “highness” ratings. A direct relationship was established between the reported psychoactive effects (“highness” or intoxication) and the predicted effect-site concentrations of both components (THC and THC-OH) using this effect-compartment modeling approach. The faster plasma to effect compartment equilibration for THC-OH indicated a more rapid equilibration of the active metabolite between plasma and the effect-site (biophase) than for the parent THC. In addition, a PBPK modeling approach was pursued to predict and relate the brain concentrations of THC and THC-OH to the psychoactive effect. The relationship between the effect and the predicted unbound brain concentration of THC indicated an indirect relationship, suggesting a temporal delay between brain concentrations of THC and observed effect. However, a direct relationship was observed between the observed effect and the unbound brain THC-OH concentrations. In addition, the unbound concentrations of THC-OH in the brain were predicted to be higher than the corresponding THC concentrations. These findings highlight the importance for the inclusion of THC-OH, in addition to THC, when relating the observed effect to the concentrations of the psychoactive components of marijuana. These models contribute to the understanding of the PK-PD relationships associated with marijuana use and are important steps in the prediction of the pharmacodynamic effects related to the psychoactive components in marijuana and establish an approach for investigating other THC-related effects.

Drei Verteilungskoeffizienten, die für physiologie-basierte Pharmakokinetik (PBPK)-Modelle relevant sind, wurden mit verschiedenen Ansätzen modelliert. Für den Blut/Luft-Verteilungskoeffizienten wurde ein auf linearen Solvatations-Energie-Beziehungen (LSER) beruhendes Literaturmodell angewendet und diskutiert. Mit einer schematischen Aufteilung des Blutkompartiments in Wasser und einen organischen Teil wurde der Blut/Luft-Verteilungskoeffizient mit einer linearen Regression von anderen Verteilungskoeffizienten vorhergesagt. Zusätzlich wurde ein Fragmentmodell entwickelt. Der Fett/Luft-Verteilungskoeffizient wurde mit dem LSER-Ansatz und mit anderen Verteilungskoeffizienten modelliert. Der Koeffizient Fett/Blut wurde aus den ersten beiden errechnet. Da der inverse dimensionslose Henry-Koeffizient Wasser/Luft-Verteilungskoeffizient bei der Blut/Luft-Modellierung zum Einsatz kommt und dieser aus dem Dampfdruck und der Wasserlöslichkeit gewonnen werden kann, wurde der Dampfdruck ebenfalls modelliert.

L’hexabromocyclododécane (HBCD) a été utilisé comme additif dans des polystyrènes (PS). En 2013, l’HBCD a été inclus à la Convention de Stockholm comme Polluant Organique Persistant. Les denrées alimentaires d’origine animale (DAOA) constituent la source principale d’exposition de la population générale à ce polluant. Le niveau moyen d’exposition du consommateur ne représente pas un risque majeur pour la sécurité sanitaire des aliments (EFSA, 2011). Malgré des concentrations moyennes généralement proches d’un ng g-1 lipides dans les DAOA, des concentrations maximales supérieures à 2000 ng g-1 lipides dans certains échantillons d’œuf ont été rapportées. Plusieurs sources potentielles d’exposition orale des volailles existent. Les poules pondeuses pourraient être exposées majoritairement à l’isomère α-HBCD. Au vu de l’absence d’informations dans la littérature sur le devenir de l’α-HBCD chez la poule pondeuse, une expérimentation in vivo a été réalisée et a permis d’estimer la plupart des paramètres cinétiques du devenir de l’α-HBCD ingéré chez la poule pondeuse. Un modèle pharmacocinétique basé sur la physiologie (PBPK) de transfert de l’α-HBCD chez la poule pondeuse a été développé, calibré par des données de la littérature, soumis à analyse de sensibilité et plusieurs paramètres ont été ajustés sur des résultats in vivo. Une validation du modèle a été testée. Ce modèle a permis de déterminer l’influence des caractéristiques physiologiques de la poule pondeuse sur le devenir de l’α-HBCD en cas d’exposition à la molécule. Parmi les caractéristiques d’intérêt, le poids vif (PV) est celle qui influence le plus la concentration d’α-HBCD dans les tissus et les œufs. Un PV bas et des performances de ponte réduites prédisposent à une concentration plus élevée dans ces matrices. La mue produit une augmentation de la charge corporelle de la molécule. Ce modèle peut être extrapolé à d’autres animaux et molécules lipophiles après modification de certains paramètres / Hexabromocyclododecane (HBCD) has been used as an additive in polystyrene (PS). In 2013, HBCD was included in the Stockholm Convention as a Persistent Organic Pollutant. The foodstuffs of animal origin are the main source of exposure of the general population to this pollutant. The mean exposure level of the consumers to HBCD doesn’t represent a major risk to the food safety (EFSA, 2011). In spite of mean concentrations generally close to 1 ng g-1 lipids in the foodstuffs of animal origin, maximal concentrations higher than 2000 ng g-1 lipids have been reported in some egg samples. There are several potential sources of oral exposure of the hens to this pollutant. The hens could be exposed mainly to the α-HBCD isomer. Since the bibliographic synthesis highlights the absence of information about the α-HBCD kinetics in the laying hen, an in vivo experience has been realized and has allowed the estimation of the majority of the α-HBCD kinetic parameters in the laying hen. A physiologically based pharmacokinetic (PBPK) model has been developed, calibrated by literature data, submit to a sensitivity analysis and some parameters have been adjusted on the basis of experimental data. A validation of the model has been attempted. This model has allowed to determine the influence of the main physiological characteristics of the laying hen exposed to the molecule on the α-HBCD accumulation in tissues and transfer to eggs. Among the physiological characteristics of concern, the body weight (BW) is the main feature influencing the α-HBCD kinetics. If the hen is exposed to the α-HBCD, a low BW and low laying performances predispose the hen to have higher concentrations of the molecule in all the matrices. The molting stage raises the body charge of the molecule. This model can be extrapolated to other animals and lipophilic molecules after modification of some parameters

La colistine est un vieil antibiotique, utilisé à la fois en médecine humaine et vétérinaire. Cependant, l'arsenal antibiotique étant de plus en plus limité, la colistine apparait comme un des derniers remparts dans la lutte contre les bactéries multi-résistantes chez l'Homme. Afin de préserver l'efficacité de la colistine, deux problématiques ont été abordées dans cette thèse : (i) les risques de sélection de résistance à la colistine en lien avec la découverte fin 2015 d'un gène porté par un plasmide (mcr-1). Ainsi, l'impact de l'usage de colistine par voie orale en production porcine a été évalué in vivo et une absence de sélection a été observée dans nos conditions expérimentales. De façon similaire, l'usage (minoritaire) de colistine en médecine humaine comme prophylaxie de décontamination digestive sélective (SDD) a été étudié chez des rats hébergeant un microbiote intestinal humain. Les résultats préliminaires ne montrent pas non plus d'effet de sélection. (ii) le développement d'un modèle pharmacocinétique basé sur la physiologie (PBPK) chez le porc pour l'usage par voie systémique de la colistine et de sa prodrogue, le colistine méthanesulfonate (CMS). Ce modèle a permis d'explorer la distribution tissulaire du CMS et de la colistine, notamment au niveau rénal où la toxicité est la plus fréquente. Comme application de ce modèle, l'estimation des temps d'attente avant abattage lors d'usage de CMS chez le porc a été effectué. Enfin, la capacité des modèles PBPK à réaliser des extrapolations intra et inter-espèces a été utilisé pour adapter ce modèle chez l'adulte et l'enfant, afin de pouvoir prédire les concentrations plasmatiques de colistine lors d'un traitement. / Colistin is an old antibiotic used in human and veterinary medicine. However, as less and less antibiotics are discovered, colistin is considered as a last-line antibiotic to fight against multi-drug resistant bacteria in human. In order to preserve the efficacy of colistin, two issues were investigated in this thesis:(i) Risks of selection of bacteria resistant to colistin, in conjunction with the discovery by the end of 2015 of a plasmid-mediated resistance gene (mcr-1). Thus, the impact of oral use of colistin in pigs was assessed in vivo and no selection was observed in our experimental conditions. Similarly, the use of colistin in human medicine for selective digestive decontamination was studied thanks to human flora‐associated rats. Preliminary results were also neither in favour of a selective effect of colistin.(ii) development of a physiologically-based pharmacokinetic model (PBPK) in pigs for the systemic use of colistin and its prodrug, the colistimethate sodium (CMS). This model provided a further insight into CMS and colistin tissue distribution, especially in kidneys where toxic effects are frequent. As a model application, the withdrawal period after use of CMS in pigs was estimated. Then, we used the ability of PBPK models to carry out intra and inter-species extrapolations in order to adapt this model in adults and children and eventually predict the plasmatic concentrations of colistin during a treatment with CMS.

Drei Verteilungskoeffizienten, die für physiologie-basierte Pharmakokinetik (PBPK)-Modelle relevant sind, wurden mit verschiedenen Ansätzen modelliert. Für den Blut/Luft-Verteilungskoeffizienten wurde ein auf linearen Solvatations-Energie-Beziehungen (LSER) beruhendes Literaturmodell angewendet und diskutiert. Mit einer schematischen Aufteilung des Blutkompartiments in Wasser und einen organischen Teil wurde der Blut/Luft-Verteilungskoeffizient mit einer linearen Regression von anderen Verteilungskoeffizienten vorhergesagt. Zusätzlich wurde ein Fragmentmodell entwickelt. Der Fett/Luft-Verteilungskoeffizient wurde mit dem LSER-Ansatz und mit anderen Verteilungskoeffizienten modelliert. Der Koeffizient Fett/Blut wurde aus den ersten beiden errechnet. Da der inverse dimensionslose Henry-Koeffizient Wasser/Luft-Verteilungskoeffizient bei der Blut/Luft-Modellierung zum Einsatz kommt und dieser aus dem Dampfdruck und der Wasserlöslichkeit gewonnen werden kann, wurde der Dampfdruck ebenfalls modelliert.

L’amélioration du développement du médicament est un véritable défi et ceci encore plus dans le domaine de l’oncologie dans lequel le besoin d’avoir de nouvelles alternatives thérapeutiques est primordial. De plus, on note que le taux d’approbation des nouveaux anticancéreux après leur entrée en phase 1 fait partie des plus bas taux de toutes les aires thérapeutiques. De ce fait, ce processus doit être amélioré et l’utilisation de nouvelles approches faisant le lien entre développement préclinique et clinique par anticipation des propriétés pharmacocinétiques et d’efficacité pourrait être une perspective intéressante.L’objectif de ce travail est l’élaboration de stratégies basées sur la modélisation mathématique de données précliniques in vivo et in vitro afin d’anticiper le comportement chez l’homme d’un nouvel inhibiteur de bcl-2 développé par les Laboratoires Servier pour soutenir le développement clinique. Ce projet a été mené suivant différentes étapes :Premièrement, un modèle semi-mécanistique décrivant le mode d’action de la molécule a été établi chez la souris.Une stratégie d’extrapolation inter-espèces des caractéristiques PK utilisant la modélisation PBPK a été effectuée afin d’anticiper les profils temps-concentration chez l’homme.Des stratégies d’extrapolation de la partie PD basées sur différentes hypothèses ont été proposées pour prédire une efficacité chez l’homme et des doses à tester lors de l’étude clinique.Les prédictions obtenues ont ainsi été comparées aux résultats cliniques issus de la première étude réalisée chez l’homme confirmant le caractère utile de telles approches et la supériorité des stratégies bâties à l’aide de concepts semi-mécanistiques par rapport aux approches plus empiriques.Ce projet souligne donc le grand intérêt d’élaborer des approches translationnelles inter-espèces durant le développement du médicament et pourrait favoriser leur utilisation afin d’accélérer le développement de nouvelles entités, diminuant ainsi les risques d’échecs ainsi que les coûts financiers / Improvement of drug development is a very challenging question and even more in the field of oncology wherein the need for new medicines is crucial. In addition, the rate of approval for anticancer drugs after entry in phase I clinical trial was reported as one of the lowest of all therapeutic areas. Thereby, this process has to be improved, and the use of new approaches fulfilling the gap between preclinical and clinical settings by anticipating human pharmacokinetics and efficacy could be an interesting solution.The work is focused on the building of strategies based on mathematical modeling of in vivo and in vitro preclinical data to anticipate the behavior of a new bcl-2 inhibitor developed by Servier laboratories in human to support clinical development. This project was elaborated following different steps:Firstly, a semi-mechanistic relationship was established in mice to describe the mechanism of action of the compound.PK extrapolation strategy using PBPK modeling was performed to anticipate human concentration-time profiles.PD extrapolation strategies based on different assumptions were proposed to predict human efficacy and doses to be tested in clinical trial.Predictions obtained were consequently compared to clinical results from a First in Human study confirming the usefulness of such approaches and the superiority of mechanism-based strategies compared to more empirical approaches.Therefore, this project highlights the large interest of elaborating interspecies translational approaches during drug development and could promote their use to accelerate new entities development, decreasing the risks of failure and financial costs.

Nuclear receptors play significant roles in the regulation of transporters and enzymes to balance the level of endogenous molecules and to protect the body from foreign molecules. The vitamin D receptor (VDR) and its natural ligand, 1alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3], was shown to upregulate rat ileal apical sodium dependent bile acid transporter (Asbt) to increase the reclamation of bile acids, ligands of the farnesoid X receptor (FXR). FXR is considered to be an important, negative regulator of the cholesterol metabolizing enzyme, Cyp7a1, which metabolizes cholesterol to bile acids in the liver. In rats, decreased Cyp7a1 and increased P-glycoprotein/multidrug resistance protein 1 (P-gp/Mdr1) expressions pursuant to 1,25(OH)2D3 treatment was viewed as FXR effects in which hepatic VDR protein is poorly expressed. In contrast, changes in rat intestinal and renal transporters such as multidrug resistance associated proteins (Mrp2, Mrp3, and Mrp4), Asbt, and P-gp after administration of 1,25(OH)2D3 were attributed directly as VDR effects due to higher VDR levels expressed in these tissues. Higher VDR expressions were found among mouse hepatocytes compared to those in rats. Hence, fxr(-/-) and fxr(+/+) mouse models were used to discriminate between VDR vs. FXR effects in murine livers. Hepatic Cyp7a1 in mice was found to be upregulated with 1,25(OH)2D3 treatment, via the derepression of the short heterodimer partner (SHP). Putative VDREs, identified in mouse and human SHP promoters, were responsible for the inhibitory effect on SHP. The increase in hepatic Cyp7a1 expression and decreased plasma and liver cholesterol were observed in mice prefed with a Western diet. A strong correlation was found between tissue Cyp7a1 and P-gp changes and 1,25(OH)2D3 plasma and tissue concentrations, confirming that VDR plays an important role in the disposition of xenobiotics and cholesterol metabolism. Moreover, renal and brain Mdr1a/P-gp were found to be directly upregulated by the VDR in mice, and concomitantly, increased renal and brain secretion of digoxin, a P-gp substrate, in vivo. The important observations: the cholesterol lowering and increased brain P-gp efflux activity properties suggest that VDR is a therapeutic target for treatment of hypercholesterolemia and Alzheimer’s diseases, since beta amyloid, precursors of plague, are P-gp substrates.

Nuclear receptors play significant roles in the regulation of transporters and enzymes to balance the level of endogenous molecules and to protect the body from foreign molecules. The vitamin D receptor (VDR) and its natural ligand, 1alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3], was shown to upregulate rat ileal apical sodium dependent bile acid transporter (Asbt) to increase the reclamation of bile acids, ligands of the farnesoid X receptor (FXR). FXR is considered to be an important, negative regulator of the cholesterol metabolizing enzyme, Cyp7a1, which metabolizes cholesterol to bile acids in the liver. In rats, decreased Cyp7a1 and increased P-glycoprotein/multidrug resistance protein 1 (P-gp/Mdr1) expressions pursuant to 1,25(OH)2D3 treatment was viewed as FXR effects in which hepatic VDR protein is poorly expressed. In contrast, changes in rat intestinal and renal transporters such as multidrug resistance associated proteins (Mrp2, Mrp3, and Mrp4), Asbt, and P-gp after administration of 1,25(OH)2D3 were attributed directly as VDR effects due to higher VDR levels expressed in these tissues. Higher VDR expressions were found among mouse hepatocytes compared to those in rats. Hence, fxr(-/-) and fxr(+/+) mouse models were used to discriminate between VDR vs. FXR effects in murine livers. Hepatic Cyp7a1 in mice was found to be upregulated with 1,25(OH)2D3 treatment, via the derepression of the short heterodimer partner (SHP). Putative VDREs, identified in mouse and human SHP promoters, were responsible for the inhibitory effect on SHP. The increase in hepatic Cyp7a1 expression and decreased plasma and liver cholesterol were observed in mice prefed with a Western diet. A strong correlation was found between tissue Cyp7a1 and P-gp changes and 1,25(OH)2D3 plasma and tissue concentrations, confirming that VDR plays an important role in the disposition of xenobiotics and cholesterol metabolism. Moreover, renal and brain Mdr1a/P-gp were found to be directly upregulated by the VDR in mice, and concomitantly, increased renal and brain secretion of digoxin, a P-gp substrate, in vivo. The important observations: the cholesterol lowering and increased brain P-gp efflux activity properties suggest that VDR is a therapeutic target for treatment of hypercholesterolemia and Alzheimer’s diseases, since beta amyloid, precursors of plague, are P-gp substrates.