Isotope-labelled urea to test colon drug delivery devices in vivo: principles, calculations and interpretations

Abstract

This paper describes various methodological aspects that were encountered during the development of a system to monitor the in vivo behaviour of a newly developed colon delivery device that enables oral drug treatment of inflammatory bowel diseases. [13C]urea was chosen as the marker substance. Release of [13C]urea in the ileocolonic region is proven by the exhalation of 13CO2 in breath due to bacterial fermentation of [13C]urea. The 13CO2 exhalation kinetics allows the calculation of a lag time as marker for delay of release, a pulse time as marker for the speed of drug release and the fraction of the dose that is fermented. To determine the total bioavailability, also the fraction of the dose absorbed from the intestine must be quantified. Initially, this was done by calculating the time-dependent [13C]urea appearance in the body urea pool via measurement of 13C abundance and concentration of plasma urea. Thereafter, a new methodology was successfully developed to obtain the bioavailability data by measurement of the urinary excretion rate of [13C]urea. These techniques required two experimental days, one to test the coated device, another to test the uncoated device to obtain reference values for the situation that 100 % of [13C]urea is absorbed. This is hampered by large day-to-day variations in urea metabolism. Finally, a completely non-invasive, one-day test was worked out based on a dual isotope approach applying a simultaneous administration of [13C]urea in a coated device and [15N2]urea in an uncoated device. All aspects of isotope-related analytical methodologies and required calculation and correction systems are described.