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Browsing by master's degree program "Utbildningsprogrammet för provisorsexamen"

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  • Jalonen, Daniel (2023)
    Orexin receptors have gained more attention due to increased knowledge of their physiological significance. The successful development of orexin receptor antagonists treating insomnia has enlarged the scope of research leading to an interest in developing small molecule agonists that have drug-like properties and induce activation in the orexinergic system. Transforming this idea into reality has remained an unaccomplished challenge. In this work, molecular mechanism of activation in orexin receptor type 2 is studied by conducting molecular dynamics simulations after capturing coordinates of active and inactive state crystal structures. The crystal structure coordinates define the starting pose for the protein and the ligand in the simulations. Preliminary steps prior to simulation include building the surrounding system and model building in which homology modeling is employed to reconstruct missing loops. A 100-nanosecond simulation is executed for both models. Active and inactive state models display stable binding event characteristics when examining the coordinate changes of every atom during the simulation. No major conformational changes are observed. The most congruent feature relative to the literature is the difference in the interactive role of residue Q3x32 between the simulations. The agonist forms two consistent hydrogen bonds with the upward-shifted Q3x32 while an inactive downward-facing version is observed in the antagonist model. Some residues present unexpected features omitting comparative functions of literature, which along with general inconsistency of protein-ligand contacts undermine the reliability of models heavily. The simulations conducted need to be extended to produce a hypothesis for the activation mechanism because of the defects around simulation protocols and the low quantity of simulation runs.
  • Salminen, Emma (2024)
    Finland is one of the first countries in the world to introduce automatic substitution of biological medicines in community pharmacies. The automatic substitution for biological medicines will be introduced in stages in years 2024–2026. The successful and safe transition requires guidelines for implementing new operating practices and dispensing practices, including possible continuing education to community pharmacists to ensure their sufficient competence e.g. in advising patient how to use their administration devices. Therefore, the change process requires competence development and management. The purpose of competence management is to create, maintain and develop an organization. Competence management is part of strategic personnel management, which ensures that the organization has the core competence and other necessary competence to implement its mission. The aim of this master's thesis was to study the competence management while preparing for the automatic substitution of biologics in community pharmacies in Finland. The research focused on the competence management practices and competence development needs within the framework of 1) personnel management and competence development and 2) automatic substitution of biologics. The research was carried out as a qualitative focus group discussions (FGDs) (n = 6, altogether of 23 participants) in January 2023. Voluntary participant participated in the group discussions from community pharmacies of different sizes and from different parts of Finland. Of the participants there were pharmacy owners with M.Sc. (Pharm) degree (n = 5/23, 22 %), pharmacists with M.Sc. (Pharm) degree (n = 10/23, 43 %) and pharmacists with B.Sc. (Pharm) degree (n = 8/23, 35 %). Qualitative content analysis was carried out inductively, i.e. data oriented. In addition to the themes emerging from the research material, the main themes of the discussion body partially guided the analysis. SRQR checklist was used to support detailed reporting to evaluate the reliability of the study. The data analysis identified 1) factors related to the current practices and needs of competence management and needs for competence development, 2) methods applicable for competence development of pharmaceutical personnel, and 3) functions related to the delivery of the biological medicine, such as medication counselling, support for the patient's self-care and a possible substitution of biologics, as well as the functions and tools that support these. The results of this study indicated that competence management practices vary between community pharmacies, and the competence management actions were not always systematically planned. Community pharmacies did not yet have operating models or practices for implementing automatic substitution of biologics, although they perceived that automatic substitution practices for inhalable medicinal products could perform as a model for the substitution of biologics. Despite some perceived uncertainties concerning implementation of automatic substitution of biologics, community pharmacists and pharmacy owners had mainly positive attitude towards the coming changes.
  • Kunnola, Eva (2023)
    Osastofarmasian ja kliinisen farmasian palvelut Suomen sairaala-apteekeissa ja lääkekeskuksissa ovat jo 2000-luvun alusta lähtien kehittyneet suuntaan, johon Maailman terveysjärjestön (WHO) lääkitysturvallisuusohjelma Medication Without Harm ohjaa. Suomen viranomaiset ovat viime vuosina linjanneet farmasistien roolista moniammatillisessa lääkehoidon toteutuksessa useissa ohjeistuksissa. Vuosina 2017–2022 kotimaisessa ja kansainvälisessä tutkimuksessa osastofarmasian ja kliinisen farmasian hyötyjä sekä niiden yhteyttä lääkitysturvallisuuteen on tutkittu aktiivisesti. Osastofarmasian ja kliinisen farmasian palveluiden tilanteen ja niiden avulla saavutettujen hyötyjen ensimmäinen kansallinen kyselytutkimus sairaala-apteekeille ja lääkekeskuksille tehtiin Suomessa vuonna 2011, ja se toistettiin samalla menetelmällä vuonna 2016. Tämän tutkimuksen tavoitteena oli tehdä vastaava valtakunnallinen seuranta-tutkimus osastofarmasian ja kliinisen farmasian palvelujen tilanteesta Suomessa vuonna 2022. Tämä tutkimus toteutettiin samalla e-lomakepohjalla kuin aikaisemmat tutkimukset, muokaten kysymyksiä ajantasaisemmaksi. Kysely lähetettiin sairaala-apteekkeihin, julkisiin ja yksityisiin lääkekeskuksiin sekä joukolle vastaanottajia kuntayhtymissä, hyvinvointialueilla ja yrityksissä, joissa mahdollisesti tuotettiin osastofarmasian ja kliinisen farmasian palveluita. Kyselyn vastausprosentti (62 %) sekä osa tuloksista raportoitiin edeltävään tutkimukseen vertailemisen vuoksi vain sairaala-apteekkien ja itsenäisten julkisten lääkekeskusten osalta (n=29). Muut vastaajat (n=16) analysoitiin omana ryhmänään, mutta uusien kysymysten osalta raportoitiin yleisimmin kaikkien vastaajien (n=45) vastaukset yhdessä. Osastofarmasian ja kliinisen farmasian palveluita tuotti 82 % (n=37/45) kaikista vastaajista. Palveluiden avulla saavutettuja hyötyjä oli tutkinut 24 % (n=9/37) kaikista vastaajista, jotka tuottivat palveluja. Kyselyn tulosten perusteella osastofarmasian ja kliinisen farmasian henkilökunta oli vastaajaorganisaatioissa kasvanut vuosina 2017–2022, ja palveluita tarjottiin yhä laajemmin erilaisissa hoitoympäristöissä. Erityisesti palvelut olivat yleistyneet potilaita vastaanottavissa yksiköissä, kuten ensiavussa ja päivystyksessä, terveyskeskusten vastaanotoilla sekä poliklinikoilla, joissa työ painottuu lääkityksen ajantasaistamiseen. Työtehtävät olivat monipuolisia, ja kliinisten asiantuntijatehtävien osuus oli edelleen kasvanut. Järjestelmälähtöinen lääkitysturvallisuuden edistäminen sekä lääkehoitoprosessin kokonaisvaltainen kehittäminen näkyivät tehtävien jakaumassa. Eniten olivat yleistyneet eri tasoiset lääkityksen arvioinnit sekä lääkitysturvallisuusauditoinnit, kun vuonna 2016 eniten oli yleistynyt lääkitystiedon ajan-tasaistaminen. Tässä kyselyssä farmasian ammattilaisten osallistuminen potilaan kotiutusvaiheeseen oli vähentynyt. Lisäksi osastofarmaseuttien logististen tehtävien selvää vähenemistä ei vielä nähty huolimatta automaation, älylääkekaappien ja osastolääketyöntekijöiden yleistymisestä. Palveluiden avulla saavutetuista hyödyistä lääkehoidon arviointien lisääntymistä oli tutkittu eniten, ja lääkehoidon arviointiin liittyvät koulutukset olivat myös eniten suoritettuja täydennyskoulutuksia. Kliinisen farmasian palveluiden kohdentamista niistä eniten hyötyville potilaille tulisi edelleen kehittää, ja täydennyskoulutukseen käytettävää aikaa tulisi organisaatioissa lisätä. Osastofarmasian ja kliinisen farmasian palvelut ovat laajentuneet kotimaisten ja kansainvälisten suositusten mukaisesti ja keskittyvät yhä enemmän lääkitysturvallisuuden edistämiseen. Palvelut painottuvat tällä hetkellä erityisesti potilaita vastaanottaviin yksiköihin. Jatkossa kliinisen farmasian palveluita tulee kohdentaa enemmän myös potilaan kotiutusvaiheeseen, koska kansainvälisten tutkimusten mukaan se voisi olla erityisen kustannusvaikuttavaa.
  • Tuomisto, Justiina (2023)
    Children´s medication treatment has many special features that predispose to medication errors, such as dosing of medications according to weight or age and the off-label use of medications. In the medical treatment of children high-alert medicinal substances are used and the incorrect use of which can cause harm to the patient. The aim of this study was to identify medication errors in pediatric patients of parenteral nutrition products (PN) and concentrated electrolytes, which belong to high-alert medicinal substances in different stages of medication management and use process and also to identify the contributing factors behind the errors in order to promote medication safety. The data for the retrospective registry study were made up of HaiPro accident reports (n=528) related to PN, lipids, concentrated electrolytes, solutions affecting electrolyte balance and dialysis fluids made in the period 2018-2020 at the Children`s and Adolescent`s hospital in Helsinki from which the reports related to high-alert medications were identified (n=317). ISMP´s (Institute for Safe Medication Practices) and JCI´s (Joint Comission International) lists of high-alert medications was used to limit the data. The final research material was further limited to reports (n=254) in which the medicinal substance appeared more than ten times in the entire material. The data were analyzed quantitatively to describe the frequencies (n) and percentages (%) of PN and concentrated electrolytes, and qualitativevely to identify the stages of the medication management and use process, types of medication errors and contributing factors. High-alert medications accounted for more than half (n=317/528, 60,0 %) of the entire material of this study. Medication errors (n=378) were identified most during the administration and preparation phase of the medication. In the administration phase, 56,8 % (n=117/206) of errors were identified with PN and the most common error was disturbances in the infusion tubing, wrong infusion rate or wrong dose. With concentrated electrolytes, errors in the administration phase were identified in 50,0 % (n=86/172) of all errors and the most common error was wrong product the patient received, wrong infusion rate and medicine not being administered. In the medication preparation phase, errors were identified in 20,9% (n=43/206) of PN and 30,2% (n=52/172) of concentrated electrolytes. The most common error in the preparation phase was incorrect preparation of medicine with both groups of medicinal substances. Factors related to workload and resources and human factors related to the employee, were most identified as contributing factors (n=753) in both medication groups. Targeting preventive protections, especially in the administration and preparation phases of the medicine is desirable both with PN and concentrated electrolytes. It is also important to plan safeguards comprehensively for the entire mediacation management and use process taking into account the key contributing factors that predispose to medication errors.
  • Juvankoski, Jonna (2023)
    The medication process in palliative care is prone to medication errors and their significant consequences.The complex nature of palliative care medication includes frequent use of parenteral drugs and drug mixtures. Many of the medications used parenterally are considered high-alert medications which carry a significant risk of harm if used in error. By investing in medication safety initiatives, quality of palliative care can be improved, and costs reduced. The aim of this study was to identify the most common compositions of parenteral morphine and oxycodone mixtures administered in patient units providing special level (level B) palliative and hospice care in Helsinki. Identifying the most common compositions enables further researchon standardizing mixtures and centralizing compounding to improve medication safety. This study was conducted as a retrospective medical record review. The data was extracted from the electronic client and patient record system Apotti and consisted of medication administration records of 120 patients receiving special level B palliative and hospice care in Helsinki At-home Hospital and two patient wards in Suursuo Hospital. The data was analyzed with descriptive statistics using Microsoft Excel program. Patient characteristics, including age and ICD-10 diagnosis groups were analyzed. The most common drug combinations used in the mixtures and the combinations with the most variation were identified. Four drug combinations with the most unique compositions were selected for further analysis in which drug concentrations and daily drug doses were analyzed based on continuous infusion rates. 182 drug mixtures including morphine and 147 including oxycodone were identified. A diluent (NaCl 0.9%) was used in 225 mixtures and most often (178/225) the mixtures were diluted into volume of 20 ml. The most frequently used drug combination was comprised of morphine, midazolam, and haloperidol (26.4%), followed by the combination of oxycodone, midazolam, and haloperidol (21.8%). These combinations were also among the four combinations with the most unique compositions with the combination of oxycodone and midazolam and the combination of morphine, midazolam, haloperidol and glycopyrronium. In the four drug combinations with the most unique compositions, the variation was often relatively minor, and the largest variations were observed in opioid components: especially morphine was used in a wide variety of concentrations (2.00–17.91 mg/ml) and daily doses (15–260 mg). Most of the mixtures selected for further review (89/96) were compounded to provide a continuous infusion over a period of four days. In the studied units, mixtures with comparable compositions and features were frequently utilized, suggesting that standardization may be a feasible way to improve medication safety and quality of care in palliative care. As most of the mixtures were administered via PCA, standardization could be particularly advantageous. While it may be possible to standardize and centrally compound mixtures used in this study, more research is needed in several aspects, including physiochemical properties of the mixtures, meeting the clinical requirements in the units, and understanding the underlying factors behind medicine prescribing.
  • Loppi, Tiia (2024)
    Ischemic heart disease, which often progresses to heart failure, is one of the leading causes of death worldwide. Ischemic conditions result in the death of heart muscle cells i.e. cardiomyocytes. Due to their poor regenerative ability, lost cardiomyocytes are replaced with a fibrotic scar. The loss of cardiomyocytes further leads to compensatory mechanisms, including cardiomyocyte hypertrophy and fibrosis. When prolonged, these responses turn maladaptive leading to pathological cardiac remodeling and alterations in cardiac function. In order to achieve better clinical results, discovery of new drug treatments that promote cardiomyocyte regeneration and decrease pathological cardiac remodeling would be invaluable. One potential target is serine/threonine protein kinase AKT (also known as protein kinase B), a key component of the PI3K/AKT signal pathway, which has been shown to be one of the mechanisms regulating heart regeneration and remodeling post-ischemia through its several downstream targets. The aim of this study was to investigate the effects of AKT-targeted compounds with and without endothelin-1-induced hypertrophy on the phenotype of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). The compounds were either commercially available substances linked to AKT regulation, or new experimental compounds synthesized at the Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki. Prior to the hiPSC-CM phenotypic studies, the toxicity of the compounds was investigated using the lactate dehydrogenase (LDH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays in three different cardiac cell models: human cardiac fibroblasts (HCFs), H9c2 cells derived from embryonic rat myocardium, and hiPSC-CMs. Compound-induced proliferative and hypertrophic responses of hiPSC-CMs were studied using immunofluorescence staining and high-content analysis. Toxicity screening of the compounds showed that only AKT045 was concentration-dependently toxic in all three cell types after 24-hour treatment. Based on the toxicity screening, several compounds caused more pronounced concentration-dependent effects in H9c2 cells as compared to hiPSC-CMs and HCFs. The most considerable effects were observed with AKT042 and AKT048, as they decreased the viability of H9c2 myoblasts 46% and 55% at 30 μM concentration, respectively. In phenotypic studies, AKT050 decreased hiPSC-CM proliferation significantly. This result indicated inhibition of AKT and was consistent with previous studies. Commercially available AKT activator SC79 did not induce expected effects, as it tended to attenuate both proliferative and hypertrophic response in hiPSC-CMs. However, AKT activation has been shown to increase both proliferation and hypertrophy in previous studies. Other compounds induced a prohypertrophic rather than an antihypertrophic effect in hiPSC-CMs. Although proliferative responses to other compounds varied slightly, AKT042 and AKT043 seemed to increase the proliferation of hiPSC- CMs. However, the AKT activation or inhibition could not be confirmed in this study and therefore additional studies are needed to assess the full extent of effects and mechanisms of these compounds.
  • Rahikainen, Otto (2023)
    Ramansironta on sähkömagneettisen säteilyn ilmiö, jonka avulla voidaan havaita molekyylivärähdyksiä niistä sironneen valon avulla. Kun sähkömagneettinen säteily kohtaa molekyylin se voi häiritä elektronipilveä ytimen ympärillä ja prosessin lopputuloksena energiaa vapautuu sironneen säteilyn muodossa. Tätä kutsutaan epäelastiseksi sironnaksi. Mikäli sironnassa ei tapahdu fotonin energiassa muutosta kyseessä on elastinen siroaminen. Mikäli näytteeseen menevän ja sironneen fotonin välillä havaitaan energian muutos, käytetään ilmiöstä nimeä epäelastinen Raman sironta. Energian muutosta voidaan mitata, ja saatu spektri antaa tietoa kohdemolekyylistä. Tämän työn tarkoituksena oli tutkia eri Raman-spektroskopiatekniikoiden, lähinnä spontaani-Raman spektroskopian sekä koherentti anti-Stokes Ramanspektroskopian ja mikroskopian soveltuvuutta lääkemolekyylien havaitsemiseen sekä nanopartikkeleiden karakterisoinnissa ja nanopartikkeleiden ja solujen välisten interaktioiden tutkimisessa. Tekniikan vahvuuksiin kuuluu käytön suhteellinen helppous ja CARS-mikroskopian nopeus sekä korkea erotuskyky, mahdollisuus havainnoida solunäytteitä, ja epätodennäköisyys vaurioittaa tutkittavaa kohdetta. Haasteisiin lukeutuu fluoresenssin taipumus häiritä signaalia, spontaani-Raman mikroskopian heikompi erottelukyky, analyysin hitaus sekä tarve valikoida molekyyli, jonka rakenne antaisi vahvan Raman-signaalin. Tutkimuksen alatavoitteina oli sopivan lääkemolekyylin valitseminen nanopartikkeliformulaatioon, nanopartikkeleiden formulointi, niiden karakterisointi Raman-spektroskopiatekniikoilla, ja lopulta tutkia Raman spektroskopian soveltuvuutta nanopartikkeleiden ja lääkeaineen sekä solujen interaktioiden tutkimisessa ja lääkeaineen havaitsemisessa solujen sisältä. Tutkimuksessa uutta on se, että ensimmäistä kertaa polymeerinanopartikkeleiden ja niihin ladattujen lääkeaineiden soluunkulkeutumisen tutkiminen pelkällä Raman-spektroskopialla ilman esim. fluoresoivia merkkiaineita. Tutkimuksen tavoitteen pääasiallisesti täyttyivät. Valitsimme kohdemolekyyliksi klorotaloniilin, fungisidin joka on edullinen ja antaa selvästi tunnistettavan Raman-signaalin. Klorotaloniilille suoritettiin normaalit sytotoksisuuskokeet sekä vapaana lääkeaineena että formuloituina nanopartikkeleina. Nanopartikkelien formulointi onnistui ja molemmat Raman-spektroskopiatekniikat näyttivät selvästi sekä lääkemolekyylin että polymeerin kemikaalispesifiset Raman signaalit. Lääkemolekyylin havaitsemin solujen sisältä onnistui. Polymeerimolekyylit eivät missään vaiheessa kulkeutuneet solujen sisälle. Tämä oli ehkä yllättävää koska käytimme makrofageja, mutta toisaalta myös johdonmukainen muiden tutkimusten kanssa. Raman-tekniikat osoittautuivat hyviksi tutkimusmenetelmiksi, ja erityisesti CARS-mikroskoopin suuri erotuskyky osoittautui hyödylliseksi soluunkulkeutumisen kuvantamisessa.
  • Puranen, Pinja (2023)
    Medical devices play a crucial role in healthcare, yet their importance is underscored by the potential for adverse events that can lead to serious consequences for patients and users. As a result, manufacturers of medical devices are required to actively monitor the safety and performance of their devices after placing them on the market. In response to incidents involving medical devices and their safety, the European Union Medical Device Regulation (MDR) came into force in May 2021, bringing more emphasis to the post-market surveillance (PMS) of medical devices. In this study, the current state of the post-market surveillance system of medical device manufacturers in Finland was investigated by conducting an online questionnaire in 2023. A total of 30 medical device companies participated in the questionnaire for a return rate of 17%. The dataset included manufacturers of different sizes, producing medical devices of all risk classes. To identify differences in the use of post-market surveillance data sources between different types of companies, the two-sided non-parametric Kruskal-Wallis-Test was used. The rest of the data was analysed using descriptive analysis. The post-market surveillance data sources with the highest reported intensity of use included customer complaints and feedback, production monitoring, and regulatory intelligence monitoring, while Post Market Clinical Follow-up and health services research were used significantly less. Significant differences between manufacturers of different device risk classes were identified for three data sources; manufacturers of higher risk class devices were found to utilize these data sources to a higher extent than manufacturers of low-risk devices. The manufacturers of medical devices seem to utilise reactive post-market surveillance data consistently to a high extent. On the other hand, the results suggest that proactive post-market surveillance methods remain underutilised despite the introduction of the MDR. Medical device manufacturers also use post-market surveillance data sources to different extents, in particular with respect to the medical device risk class. Overall, the results indicate that the MDR is bringing more emphasis on post-market surveillance, which in turn has increased the workload of medical device manufacturers.
  • Lindholm, Anni (2023)
    Biologisten lääkkeiden käyttö on merkittävästi lisääntynyt 2000-luvulla, mikä on hoidollisten hyötyjen ohella lisännyt lääkekustannuksia. Vaihtokelpoisten ja halvempien biosimilaarien käyttöä on edistetty koulutuksella, lääkemääräyskäytäntöjen ohjauksella ja lainsäädännöllä. Vuosina 2024–2025 useat avoterveydenhuollossa käytettävät biologiset lääkkeet tulevat apteekissa tapahtuvan lääkevaihdon (apteekkivaihdon) piiriin. Potilaiden näkemykset biologisista lääkkeistä ovat tärkeä tutkimusaihe hoitotulosten, lääkevaihdon, rationaalisen lääkehoidon edistämisen ja lääkepolitiikan kehittämisen näkökulmista. Tutkimuksen tavoitteena oli tutkia potilaiden näkemyksiä biologisten lääkkeiden hinnoista, kustannuksista ja niiden merkityksestä. Tavoitteiden mukaiset tutkimuskysymykset liittyivät: 1) potilaiden preferenssiin lääkkeiden hoidollisesta arvosta lääkkeen hintaan verrattuna (ensisijainen tutkimuskysymys) ja yhteiskunnan lääkesäästöistä, 2) lääkkeiden hinnan merkitykseen lääkevaihdossa (potilaiden taloudellisten taustatekijöiden vaikutus ja euro-määräinen hyväksymis/maksuhalukkuus lääkevaihdossa) ja 3) potilaan oman lääkehoidon kustannettavuuteen. Tutkimus perustui Yliopiston Apteekin (YA) ja Helsingin yliopiston (HY) tammikuussa 2021 toteuttaman kyselytutkimuksen aineistoon. Kyselyyn vastasivat YA:n kanta-asiakkaat sekä Reumaliiton ja IBD- ja muut suolistosairaudet ry:n viestinnän kautta tavoitetut henkilöt. Kysely oli kohdistettu reuma-, IBD- (tulehduksellinen suolistosairaus) ja ihopsoriasispotilaille, jotka käyttivät alkuperäistä biologista lääkettä (BA), biosimilaaria (BS) tai perinteisiä pienimolekyylisiä lääkeitä (PL). Vastaajia oli yhteensä 1338 (BA-käyttäjiä 226, BS-käyttäjiä 71 ja PL-käyttäjiä 1041). Tulosmuuttujina käytettiin yksittäisiä kysymyksiä ja summamuuttujia. Lääkekäyttäjäryhmän ja muiden taustamuuttujien yhteyttä tulosmuuttujiin tutkittiin kaksi- ja monimuuttuja-analyyseillä. Suurin osa (83 %) potilaista oli sitä mieltä, että lääkkeen hinta ei saisi vaikuttaa lääkkeen valintaan biologista lääkettä määrättäessä, ja 62 %:n mielestä biosimilaarien käyttö auttaisi säästämään terveydenhuollon lääkekustannuksissa ja mahdollistaisi suuremman potilasmäärän hoidon biologisilla lääkkeillä. Potilaan taloudelliset taustatekijät eivät olleet monimuuttuja-analyysin perusteella yhteydessä näkemyksiin biologisten lääkkeiden lääkevaihdosta tai kiinnostukseen lääkevaihdosta. Jos biologisen lääkkeen hypoteettinen omavastuuhinta potilaalle olisi 600 euroa vuodessa, 14 % alkuperäisvalmisteen käyttäjistä olisi valmis vaihtamaan biosimilaariin, jos sen kustannus olisi hänelle 30 % nykyistä pienempi. Biosimilaarien käyttäjistä 38 % olisi valmis maksamaan lisää saadakseen alkuperäisvalmisteen. Biologisten lääkkeiden käyttäjillä (BA 36 % ja BS 44 %) oli ollut enemmän taloudellisia ongelmia lääkkeiden ostossa kuin perinteisten lääkkeiden käyttäjillä (25 %) (p <0,001). Potilaat suhtautuivat yleisesti myönteisesti biosimilaarien käyttöön lääkekustannusten hillitsemiseksi, mutta pitivät hoidollisia perusteita hintaa tärkeämpänä. Potilaan taloudelliset tekijät eivät olleet yhteydessä näkemyksiin lääkevaihdosta tai vaihtohalukkuuteen. Merkittävä osa potilaista on kiinnostunut vaihdosta edullisempaan biosimilaariin. Tulokset korostavat biologisiin lääkkeisiin ja lääkevaihtoon liittyvän lääkeinformaation merkitystä.
  • Kaukovuori, Jouni (2021)
    Johdanto: Terveydenhuollon tietojärjestelmiin potilaista kertyvää tieto on hyvä esimerkki massadatasta. Se muodostuu lukuisista yksittäisistä, irrallisista tapahtumista. Potilastiedon toissijaisella hyödyntämisellä tarkoitetaan tiedon käsittelyä muuta tarkoitusta kuin potilaan terveyden edistämistä ja hoitamista varten. Toisiokäytölle on tyypillistä, että pääasiallisena kiinnostuksen kohteena ei ole yksilötason tiedon hyödyntäminen, vaan isommasta potilasjoukosta saatava summatieto, josta yksilön tunnistetiedot on poistettu. Toisiokäyttö mahdollistaa potilastiedon hyödyntämisen esimerkiksi tieteellisessä tutkimuksessa ja tietojohtamisessa. Tavoite: Tutkimuksessa selvitettiin HUSin tietoaltaasta louhitun aineiston avulla, onko tietoaltaaseen tallennetun aineiston avulla mahdollista tutkia lääkehoidon turvallisuutta ja rationaalisuutta sekä selvittää, millaisessa muodossa tietoaltaan data saadaan käyttöön ja millaisia toimenpiteitä datalle tulee tehdä, jotta sitä voidaan hyödyntää potilastiedon analysoinnissa. Aineisto ja menetelmät: Massadatan hyödyntämistä pilotoitiin rekisteritutkimuksessa, jossa esimerkkinä käytettiin opioideja. Rationaalisen lääkehoidon toteutumisen tutkimiseksi määriteltiin lääkeindikaattorit eli tunnusluvut, jotka oli tarkoitettu opioidien lääkehoidon kokonaiskuvan tarkasteluun. Indikaattoreiden avulla luotiin pohja hakuparametreille ja lausekkeille, joita tietoallashaussa käytettiin. Aineisto louhittiin tietoaltaasta maaliskuussa 2020 ja se muodostui opioideja koskevista lääkemääräysmerkinnöistä, jotka oli kirjattu potilastietojärjestelmään 1.1.2015-31.12.2019. Tulokset: Tietoallashausta saatiin 321 000 potilaan opioidimääräysdataa yhteensä noin 1,73 miljoonaa riviä. Kotiutumisen yhteydessä annetut opioidireseptit rajattiin jatkoanalyysin ulkopuolelle, sillä niitä koskeva tieto ei ollut rakenteisessa muodossa. Sairaalassa annettuja säännöllisiä opioidilääkemääräyksiä koskeva aineisto oli noin 258 000 riviä. Dataa siivottiin, järjesteltiin ja validoitiin data-analyysiä varten. Toimenpiteistä huolimatta data ei soveltunut indikaattorien laskentaan. Johtopäätökset: Tietoallasaineiston käytön mahdollisuudet rationaalisen ja turvallisen lääkehoidon tutkimukseen olivat tämän tutkimuksen perusteella rajalliset. Massadata-aineiston saattaminen tutkimuksellisesti hyödynnettävään muotoon vaatii menetelmän, joka pitää sisällään useita työvaiheita ja niiden kehittäminen vaatii tietoteknistä erityisasiantuntemusta. Vaikka dataa saatiin paljon, yksittäisen potilaan opioidilääkehoidosta ei saatu kokonaiskuvaa, koska merkittävä osa datasta oli rakenteettomassa muodossa. Potilastiedon toissijaisen hyödyntämisen kannalta aineiston rakenteisen osan merkittävimmät käytön esteet liittyivät datan laatuun ja luotettavuuteen. Jotta tietoaltaasta saatava aineisto soveltuisi toisiokäyttöön tai tieteelliseen tutkimukseen, pitää sekä potilastietojärjestelmän merkintä- ja kirjaamistapoja yhtenäistää sekä data tulisi tallentaa tietoaltaaseen yhä rakenteisemmassa muodossa.
  • Erkkilä, Outi (2023)
    Physiologically based pharmacokinetic modelling (PBPK) can be used to predict pharmacokinetic behaviour of new drug molecules in human. PBPK model represents the body anatomically and physiologically with compartments connected to each other and combines those to drug specific parameters. PBPK modelling can be used to predict the absorption, disposition, and time-concentration profiles of drug molecules. The purpose of the study was to build a PBPK model for new drug molecule under research (compound A) and predict pharmacokinetics in human, to support the selection of dosing interval, formulation, and sampling time points for the first clinical trial. In this work it is described the building of the model in the ”bottom-up”-approach using in vitro parameters in GastroPlusTM-software. The modelling was done also for preclinical species (mouse, rat, dog) comparing the simulations to the observed in vivo data, which gave the confidence to the methods used in the modelling also for human. The model was first built for systemic kinetics and thereafter it was used for predicting pharmacokinetics after oral dosing. Parameters of systemic kinetics were compared also to the predictions from allometric scaling. Based on the preclinical species the most predictive method for the volume of distribution of compound A was the method by Lukacova, which predicted the volume of distribution to be moderate in human (1.7 l/kg). From the in vitro-to-in vivo -extrapolation methods the most predictive method to predict the clearance was the method by Poulin, which predicted low clearance in human (8.1-14.3 l/h). Empirical scaling factors based on the preclinical data were not needed, as the models predicted well the observed in vivo data. Allometric methods predicted the systemic kinetic parameters to be in the similar range. Advanced compartmental absorption transit -model (ACAT) integrated to GastroPlusTM-software predicted the absorption after oral dosing well in the preclinical species (predicted/observed ratio 0.8-1.3 for systemic exposure) despite the low solubility of the compound A. The model predicted the absorption in human to be sensitive to particle size and absorption rate to be clearly affected by the particle size. The feeding status was also predicted to affect on the absorption with larger particle sizes. The gut metabolism was not predicted to limit the oral exposure notably, whereas moderate bioavailability was predicted to be achievable. Compound A could be given in a capsule if the target particle size distribution could be achieved. The built PBPK-model can be used in the future to predict the first clinical doses by comparing the predicted plasma concentrations to in vitro pharmacodynamic parameters and to the plasma concentrations needed for efficacy in the pharmacodynamic models. The model can also be used to predict the drug-drug interactions.
  • Haapalainen, Joonatan (2022)
    Traditional 2D cell cultivating vessels and experimental models cannot often simulate natural chemical and physical environment of different cell types. For example, availability of oxygen, chemical gradients, messaging molecules, fluid pressure, flow and surface topography are factors that may affect significantly in cell differentiation, growth, cellular structure, and metabolism. Modular bioreactors like Quasi-Vivo® -system can be used to simulate these factors. Liposomes are particles of phospholipid bilayer with aqueous space enclosed within. They can be modified in numerous ways, like loading them with hydrophobic and hydrophilic molecules, changing their transition temperature or coating them according to different needs. Doxorubicin is effective and widely used cytostatic agent, but when administered as a free drug it has often severe side-effects, like cardiotoxicity. Goal of this thesis is to determine appropriate manufacturing parameters and verify adequate shelf-life of ICG-Doxorubicin liposomes, that they are applicable for future in vitro experiments. Then survival of HepG2 cell line under flow in Quasi-Vivo®-equipment is determined, after which A549 and HepG2 will be then combined into one two-cell model. Finally, a simple illumination experiment in this cell model with previously made liposomes is conducted, and the effect in whole system is examined. Using protocol presented in this thesis it is possible to produce successfully and repeatedly liposomes with both ICG and doxorubicin encapsulation over 70%. Their shelf-life was at least 14 days when stored in 4°C protected from light. This was determined to be sufficient for in vitro testing. Cultivating A549 and HepG2 cell lines combined in the same system with shared media and fluid flow conditions was successful. Neither of the cell lines show significant difference in viability when compared to static control. When light-activating liposomes are administered to the system and then illuminated, from preliminary results we can see significant difference in drug effect. Both illuminated chambers and off-target chambers connected via Quasi-Vivo® show increased suppression, which shows promise that this in vitro model would be useful for future experiments.
  • Ollinkangas, Joni (2022)
    The problems caused by hypromellose in sterile filtration of ophthalmic products in the pharmaceutical industry were investigated. The research project was performed at NextPharma Oy's ophthalmics manufacturing facility in Tampere during the autumn of 2020. Hypromellose is an excipient commonly used in ophthalmic products as a viscosity enhancer to prolong the contact time of the preparation on the eye surface. In the ophthalmics compounding process, hypromellose is first dispersed by slowly sprinkling it into a hot solution and thoroughly mixing, after which the solution is cooled to room temperature. During cooling, the hypromellose dissolves and gels, increasing the viscosity of the solution. Incomplete dispersion or dissolution of hypromellose during the manufacturing process can slow down the filtration rate or even clog the filter completely due to undissolved hypromellose polymer material. Hypromellose is an industrially produced cellulose derivative that often contains some amounts of unreacted cellulose and other sparingly soluble polymer particles as impurities, which can also cause problems in filtration processes. Sterile filtration is a commonly used sterilization method for ophthalmic products, in which the prepared bulk solution is filtered through a 0.1 to 0.2 µm pore size filter membrane into a sterile receiving vessel. Due to the very small pore size, sterile filters are easily clogged if the solution contains poorly dissolved material. The purpose of this work was to collect additional information on the possible causes of clogging caused by hypromellose and to determine whether the filterability of a solution containing hypromellose can be improved by optimizing the manufacturing process parameters. The design of experiments was prepared, creating a two-level full-factorial test matrix without replicates and with three centre points. Four different process parameters were used (mixing time, mixing speed, dispersion temperature, and cooling temperature). Minimum and maximum levels for the parameters were obtained in the initial tests, after which the test solutions were prepared and filtered in a randomized order according to the test matrix. The aim of the screening was to find out which parameters were affecting the filterability and what would be their optimal combination that would maximize the filtration rate and the yield of filtration. Finally, the optimized parameters were used to test different batches of hypromellose, comparing the results to previous filtration tests. Additionally, an alternative hypromellose dispersion method was tested to minimize the amount of insoluble material remained during the dispersion and cooling steps. Of the parameters tested, mixing speed was the least significant, while cooling temperature had the most effect on the filtration results. The solutions with lower cooling temperature had better filtration results, which may be due to reduced aggregation of hypromellose due to increased hydration of the polymer chains. The temperature behaviour of hypromellose solutions could be an interesting subject for further investigation. Longer mixing times and higher dispersion temperatures produced slightly better filtration results on average, but the differences were not statistically significant. Most challenging in the study was controlling the temperature and mixing of the solutions, and the retention of insoluble hypromellose material at the walls of the compounding vessel. The alternative dispersion method gave promising preliminary results, but the method still requires further testing. It would be important to also find the root cause of the filter clogging mechanism e.g., by further analysing the clogged filter membrane. The study provided additional useful information of the behaviour of hypromellose solutions in solution preparations and during sterile filtration, which has been helpful in solving production problems.
  • Iljin, Arto (2023)
    Changes in environmental and psychological factors have greatly influenced human eating behavior, leading to increasing rates of overeating. In the long-term continuous overeating causes the body to accumulate an excess amount of body fat tissue, which is a leading factor in the development of obesity and obesity related diseases that reduce the quality of life. Despite the available treatment options, the prevalence of obesity has been increasing worldwide. In avoiding obesity and obesity-related diseases, it is crucial to understand the outside factors which lead to obesity and the mechanisms which regulate body energy balance. The brain's serotonin system seems to play a significant role in regulating both energy balance and the tendency that promotes an overeating type of eating behavior. The properties of psychedelics to affect human's emotional state and thus modulate behavioral patterns through the brain's serotonin system has aroused interest in psychedelics for their possibilities in treating eating behaviors that promote overeating which results in obesity. This study aimed to examine the dose-dependent effect of three different psychedelics on eating behavior in mice and evaluate their potential drug therapy properties in overeating indulged obesity. In total, 16 female mice were trained to perform in an operant setting used in behavioral experiments measuring appetite and motivation for food reinforcers. The psychedelic-derived changes were observed in mice's eating behaviors by reward deliveries received during the trials. The examined psychedelics (lysergic acid diethylamide (LSD), psilocybin (PSI), and 25CN-NBOH) showed no statistically significant changes in the mice's eating behavior in terms of appetite and motivation. However, while statistically non-significant, some changes in hunger and motivation were observed in the mice, for example, in days followed by the dosage of the psychedelics. These results indicate no effect on appetite and food motivation by the studied psychedelics.
  • Heikura, Veera (2023)
    Solids most commonly come in two broad forms: crystalline or amorphous. Crystalline solids have a regular, organized long-range structure of atoms and crystals, and are characterized by having a distinct shape, specific volume, and melting point. They can also have multiple polymorphs. On the other hand, amorphous solids do not usually have a regular long-range atomic and crystal structure and their molecules are more easily separated, which makes them more soluble in their surroundings compared to crystalline solids. However, despite this, short-range order can also occur. To improve the solubility of crystalline solids, co-amorphous systems can be created by mixing together two or more chemically different compounds in a way that they don't form a regular crystalline structure, but rather an irregular, amorphous one. Co-amorphous systems can be analyzed qualitatively or quantitatively. Qualitative analysis is often the main focus when studying amorphous matter, as it can be difficult to accurately quantify these materials using techniques based on crystal structures. Additionally, many amorphous systems are made up of complex mixtures of polymers with different chemical and physical properties. This study aimed to determine the most effective method for obtaining quantitative information about the co-amorphization of indomethacin and tryptophan. Three analytical techniques were used for this purpose: differential scanning calorimetry (DSC), X-ray powder diffraction (XRPD), and Raman spectroscopy. The co-amorphous system was created by mixing together α-indomethacin and tryptophan, γ-indomethacin and tryptophan, and amorphous indomethacin and tryptophan. This study showed that DSC, XRPD, and Raman spectroscopy are effective in providing quantitative information about crystallinity and crystal size. These techniques were able to accurately detect and characterize discrete residual crystals, and were able to measure and quantify the amount of these substances. Even though these methods may not be able to detect nanoscale structures with precision, they still provided valuable information about the crystalline and amorphous nature of the samples studied. Additionally, the fact that similar quantitative results were obtained using different analysis methods further supports the reliability of these techniques. Of all the techniques discussed, Raman spectroscopy was able to identify even small residual crystals, resulting in the highest calculated crystallinity percentage.
  • Monola, Julia (2022)
    Native nanofibrillated cellulose is wood-derived, animal-free biocompatible biomaterial which has proved the suitability of nanoscale cellulose fiber based hydrogels for 3D cell culturing and wound healing applications. The problem of freeze-drying nanofibrillated cellulose hydrogel (NFCh) has been the aggregation of the hydrophilic fibrils of the NFC during freeze-drying, which leads deformed freeze-dried cake and unsuccessful reconstitution of the sample. Molecular Dynamic (MD) simulations have been earlier applied in formulation design of NFCh for freeze-drying successfully by screening excipients based on their attraction to the surface of NFCh. The weakness of MD simulations is it can only model the fresh formulation system intend to freeze-dry, but not the actual freeze-drying process and the effect of it and the excipients to the material. To evaluate the protecting properties of excipients and therefore the accuracy of the MD simulations detailed information about changes in the physical state and molecular orientation of the formulation before and after freeze-drying is needed. Non-invasive and label-free Raman spectroscopy can be used to determine vibrational modes of molecules to investigate changes in molecular orientation of the material. The aim of this study was to investigate the possible molecular changes induced by freeze-drying of NFCh-based formulations utilizing Raman spectroscopy and evaluate the connection of the results to MD simulations. NFCh with different excipients was freeze-dried and physicochemical properties, rheology and Raman signal were measured before and after freeze-drying and compared to the literature of MD simulations. The principal component analysis (PCA) was done to the Raman spectra and differences evaluated. The spectra of all formulations differed before and after freeze-drying, and more detailed analysis was done to two most potential 0.8% NFCh based formulations, lactose 300 mM and lactose 250 mM + glycine 50 mM. They had great attraction to NFCh in MD simulations and very similar rheological properties before and after freeze-drying and reconstitution. The spectra of different state of both formulations different on areas between 400 - 500 cm-1 and 850 - 900 cm-1 based on PCA analysis contributing the mutarotation of lactose during freeze-drying and reconstitution. Freeze-drying and the absence of water molecules in NFCh formulation favor different ratios of β and α anomers than the fresh hydrated state which could be detected utilizing Raman spectroscopy. Therefore, Raman spectroscopy was confirmed to be a sensitive option to assess subtle changes in molecular orientation in fresh, freeze-dried, and reconstituted NFCh-based formulations, resulting in a detail knowledge of the molecular behavior of excipients which could be applied in MD simulations and design of better freeze-drying formulations in future.
  • Kekki, Roosa (2024)
    Light-sensitive liposomes have gained attention for their ability to deliver cargo to tissues, offering spatiotemporal control over drug release. Red-light wavelengths have been utilized as an external trigger in light-sensitive reactive oxygen species (ROS)-mediated drug delivery, due to their favorable properties, such as the low light absorption by tissue chromophores. The ROS-sensitive drug delivery systems use photosensitizers (PS), which upon light exposure generate ROS in the presence of molecular oxygen. Palladium(II)phthalocyanine (Pd(II)PC), a new second-generation photosensitizer, can upon light irradiation generate relatively high singlet oxygen concentrations, enabling the efficient oxidation of the unsaturated lipids. The oxidation of the lipids leads to the disruption of the liposome bilayer and eventually, the release of the encapsulated cargo. To gain deeper insight on the phthalocyanine-labeled liposomes in drug delivery, a red light-triggered cationic liposome formulation encapsulating Pd(II)PC was formulated. The characteristics of the liposomes, the release mechanisms, and the release quantities of calcein (623 Da) and fluorescent-conjugated dextrans (4 000-70 000 Da) were studied following red-light exposer with 630 nm, 450 mW/cm2 laser while utilizing varying Pd(II)PC-loading quantities. Following oxygen removal and temperature-induced release studies, the mechanism of release of the liposomes was principally observed to be light-triggered reactive oxygen species-mediated. In the light-induced release studies an effective release of the calcein, and a relatively effective release of the Rhodamine B dextrans (10 kDa, 70 kDa) were observed from the liposomes via the Pd(II)PC-generated and reactive oxygen species-mediated oxidation of the unsaturated lipids. The release of the biomacromolecules from the liposomes was observed to require longer irradiation times than that of calcein. The longer irradiation times likely lead to deeper oxidation of the unsaturated phospholipids, resulting in a comprehensive eruption of the liposome bilayer. The comprehensive eruption of the liposome bilayer eventually enables the sufficient release of biomacromolecules from the liposomes.
  • Reponen, Sannamari (2021)
    Biologisten lääkkeiden tarjonta ja käyttö ovat lisääntyneet voimakkaasti viimeisen vuosikymmenen aikana. Biologiset lääkkeet voivat parantaa reumasairauksien ja useiden muiden pitkäaikaissairauksien hoitotuloksia. Biologiset lääkkeet ovat yleensä perinteisiä pienimolekyylisiä lääkkeitä kalliimpia, ja siksi biologisen alkuperäislääkkeen kanssa kliinisesti samanarvoiseksi kehitettyjen edullisempien biosimilaarien käyttöä pyritään edistämään osana rationaalista lääkehoitoa. Potilaan näkemyksillä ja niiden huomioimisella on hoitoon sitoutumisen ja hoidon tulosten kannalta suuri merkitys. Potilaiden näkemyksistä ja kokemuksista biologisista lääkkeistä ja niiden vaihdosta on melko vähän tutkimuksia. Tutkimuksen tavoitteena oli tutkia reumapotilaiden tietämystä ja näkemyksiä biologisista lääkkeistä ja biosimilaareista sekä kokemuksia niiden ei-lääketieteellisestä lääkevaihdosta. Lisäksi tutkittiin reumapotilaiden uskomuksia omasta lääkityksestään, halukkuutta osallistua lääkitykseen liittyvään päätöksentekoon lääkärin kanssa ja biologisten reumalääkkeiden käyttäjien lääketiedon lähteitä. Tutkimus toteutettiin sähköisenä kyselynä Yliopiston Apteekin kanta-asiakkaille ja kertomalla siitä Reumaliiton ja IBD- ja muut suolistosairaudet ry:n viestinnässä 18.–30.1.2021. Kohderyhmänä olivat aikuiset avoterveydenhuollon reuma-, IBD- ja muut suolistosairaus-, sekä ihopsoriasispotilaat, jotka käyttivät adalimumabin tai etanerseptin alkuperäistä biologista lääkettä (BA) tai biosimilaaria (BS) tai ainoastaan perinteisiä pienimolekyylisiä lääkeitä (PL). Tässä tutkimuksessa tarkasteltiin vastauksia 260 reumapotilaalta, joista biologisia lääkkeitä oli käyttänyt 75 (BA-käyttäjiä 35, BS-käyttäjiä 40) ja perinteisiä lääkkeitä 185. Ei-lääketieteellisen lääkevaihdon kokeneita oli 17. Tutkimuksen teoreettisena viitekehyksenä käytettiin terveysuskomusmallia. Ensisijaiset lopputulosmuuttujat olivat faktorianalyysillä muodostettuja summamuuttujia. Erot lääkekäyttäjäryhmien (BA, BS, PL) välillä ja taustamuuttujien vaikutukset testattiin tilastollisilla analyyseillä. Vastanneista potilaista 94 % tunnisti biologisen lääkkeen käsitteen, mutta biosimilaari-käsite tunnettiin huonommin (34 %). Suurin osa potilaista (73–78 %) luotti biosimilaarien olevan ominaisuuksiltaan samankaltaisia alkuperäisvalmisteiden kanssa. Lääkärin tekemään biologisten lääkkeiden vaihtoon luotettiin enemmän (89 %) kuin mahdollisesti apteekissa tehtävään vaihtoon (40 %). Tutkimuksessa todetut kokemukset biologisten lääkkeiden vaihdosta biosimilaariin olivat pääosin positiivisia. Tutkimuksen reumapotilailla oli hyvä tietämys biologisista lääkkeistä, mutta he tunsivat huonommin biosimilaarin käsitteen ja mitä biosimilaarit ovat. Heillä oli yleisesti ottaen luottavainen näkemys siitä, että biosimilaari on ominaisuuksiltaan alkuperäisvalmistetta vastaava lääke. Biologisten ei-lääketieteelliseen vaihtoon suhtauduttiin melko myönteisesti, mutta lääkärin toteuttamaan lääkevaihtoon suhtauduttiin luottavaisemmin kuin mahdollisesti apteekeissa tehtävään vaihtoon. Lisää tutkimustietoa tarvitaan muun muassa potilaiden biosimilaareihin kohdistuvan epävarmuuden syistä.
  • Tauriainen, Emma (2023)
    Silmätipat ovat silmälääkkeiden yleisin annostelumuoto, mutta silmään imeytyvän lääkeaineen osuus jää pieneksi. Esimerkiksi glaukoomaa sairastaa maailmanlaajuisesti noin 80 miljoonaa potilasta, mutta glaukoomalääkkeiden hyötyosuus etukammiossa on vain 1–7 %. Päällimmäiset syyt heikkoon hyötyosuuteen ovat lääkeaineen nopea poistuminen silmän pinnalta mm. systeemiverenkiertoon sekä sarveiskalvon heikko läpäisevyys. Tästä syystä lääkeaineen permeaatio sarveiskalvon läpi on ollut tutkimuksen kiinnostuksen kohteena. Lääkeaine voi imeytyä silmän pinnalta etukammioon sarveiskalvon läpi passiivisella diffuusiolla ja aktiivisesti transporttereiden välityksellä. On vielä pitkälti epäselvää, että mitä transporttereita löytyy aktiivisena ihmisen sarveiskalvosta ja että kuinka paljon eri lääkeaineet hyödyntävät transporttereita imeytyessään. Tämän tutkimuksen tarkoituksena oli kartoittaa transportterien aktiivisuutta ihmisen sarveiskalvon epiteelisolulinjassa (HCE) sekä kanin eristetyssä sarveiskalvossa. Tutkimuksessa käytettiin radioleimattuja lääkeaineita, joita käytetään silmälääkkeenä (kliinisesti tai tutkimusvaiheessa) ja joiden tiedetään olevan eräiden transporttereiden substraatteja ja/tai inhibiittoreita. HCE-soluilla tehtiin in vitro aika-lineaarisuus- ja inhibitiosolunottokokeita ja kanin eristetyllä sarveiskalvolla permeabiliteettikokeita ex vivo. Tulosten mukaan kaikilla lääkeaineilla näyttäisi olevan aktiivista kuljetusta HCE-soluissa, mutta aktiivisen kuljetuksen osuus ja että mitkä transportterit ovat vastuussa kuljetuksesta, on epäselvää. Kiinnostava tulos oli, että inhibiittoreista MK-571 inhiboi metotreksaatin solunottoa HCE-soluissa sekä permeabiliteettia kanin sarveiskalvon läpi apikaali-basolateraalisuunnassa. Tulokset viittaavat influksitransportterien inhibitioon, mutta tarkempia johtopäätöksiä on hankala tehdä. Silmän ja sarveiskalvon transportteritutkimus on vielä alkutekijöissä ja lisää tutkimustietoa aiheesta tarvitaan.
  • Jaakkonen, Liina (2022)
    OATP1B1 is an influx transporter that is predominantly expressed in the liver, and it mediates the uptake of many clinically important endogenous compounds and drugs from portal vein blood into hepatocytes. OATP1B1-mediated uptake affects the rate of hepatic elimination of substrate drugs, directly affecting their plasma concentrations. Some naturally occurring single nucleotide variants (SNVs) in the SLCO1B1 gene encoding OATP1B1 can alter the transport function of the transporter resulting in alterations in pharmacokinetics, efficiency and toxicity of substrate drugs. The aim of this master´s thesis was to examine the effect of four naturally occurring SNVs of the SLCO1B1 gene on transport activity, expression, and localization of the OATP1B1 transporter in vitro. SNVs 170G>A (R57Q), 388A>G (N130D), 452A>G (N151S) and 758G>A (R253Q) were created using site-directed mutagenesis in the SLCO1B1 gene presenting in the pENTR221 plasmid. Recombinante baculoviruses were produced in Sf9 cells using the Bac-to-Bac® Baculovirus Expression System and used to transduce HEK293 cells for the overexpression of OATP1B1 wild type and variant proteins. An uptake assay was used to study the transport activity of the OATP1B1 variants in HEK293 cells. Western blotting was used to study the expression of OATP1B1 proteins in membrane vesicles. Immunofluorescence staining was used to determine the localization of OATP1B1 wild type and variants in HEK293 cells. Transport activity of the OATP1B1 variants R57Q and R253Q was significantly decreased compared to wild type. In contrast, transport activity of the N130D ja N151S variants was not significantly altered. The reasons for the changes in transport activity could not be reliably estimated due to the failure to measure the expression levels of OATP1B1 proteins by Western blotting. However, immunofluorescence microscopy revealed that the localization and expression of the all the studied OATP1B1 in baculovirus transduced HEK293 cells were comparable to the wild type. The results of this master´s thesis indicate that SNVs 170G>A and 758G>A can impair the transport activity and substrate uptake functions of OATP1B1 in vitro. Additional in vitro studies of transport activity, expression and localization of the variants R57Q and R253Q will be required to confirm these results. In the future, the R57Q and R253Q variants should be also studied for their possible clinical significance in pharmacokinetics and pharmacodynamics of substrate drugs, as SNVs 170G>A and 758G>A may increase the exposure and the risk for adverse effects of OATP1B1 substrate drugs.