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The model was derived from adult patient data and bridged to children based on commonly used allometric principles and a published maturation function for CYP2C9.
Scaling to children was achieved by adding bodyweight to the adult model using allometric scaling [ 22], and addition of a published maturation function for CYP2C9 enzyme activity [ 10].
A recent study developed a model-based approach to individualise midazolam dose based on in vivo maturation function for CYP3A mediated clearance from birth to adulthood.
To develop a maturation function for drug glucuronidation in children, that can be used in population and physiologically based modeling approaches, the physiological and physicochemical basis of a semiphysiological glucuronidation function for children was untangled using Simcyp.
As liver volume and UGT2B7 ontogeny are the main drivers of UGT2B7-mediated glucuronidation and as the maturation profile of liver volume is well established, an improved function for UGT2B7 ontogeny in the PBPK model can be obtained by subtracting the maturation function for liver volume from the semiphysiological glucuronidation function in children.
We have theoretically adapted the adult model [ 20] for use in children [ 21] through allometric weight scaling of clearance and volume of distribution [ 22], and addition of a published maturation function for CYP2C9 enzyme activity [ 10] to handle the influence of enzyme ontogeny in neonates and infants [ 9].
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We therefore investigated whether maturation functions for metabolic pathways can be obtained from pediatric population PK covariate models that are based on in vivo outcome measures.
As such, pediatric population PK modeling, which is based on in vivo outcome measures, can indeed provide maturation functions for pediatric PBPK models.
In addition, the results obtained can be used to establish the information that can be provided by population pediatric covariate models for maturation functions of elimination pathways in PBPK models.
Pop-PK approaches frequently use allometric scaling and a single fitted maturation function to account for age-dependent changes in systemic clearance.
Osteocytes are linked metabolically and electrically through gap junctions composed primarily of connexin 43, which are required for osteocyte maturation, function, and survival [ 18].
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