Characterisation of fasted state gastric and intestinal fluids collected from children

Pawar, Gopal and Papadatou-Soulou, Eleni and Mason, Julie and Muhammed, Rafeeq and Watson, Alison and Cotter, Catherine and Abdullah, Mohammed and Harrad, Stuart and Mackie, Claire and Arien, Tina and Inghelbrecht, Sabine and Batchelor, Hannah (2021) Characterisation of fasted state gastric and intestinal fluids collected from children. European Journal of Pharmaceutics and Biopharmaceutics, 158. pp. 156-165. ISSN 0939-6411 (https://doi.org/10.1016/j.ejpb.2020.11.010)

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Abstract

Fundamental knowledge about the composition of intestinal fluids in paediatric populations is currently unavailable. This study aimed to characterise gastric and intestinal fluid from paediatric populations. Gastric and intestinal fluid samples were obtained during routine clinical endoscopy from paediatric patients at a large teaching hospital. These fluids were characterised to measure the pH; buffer capacity; osmolality; bile acid concentration and composition. A total of 55 children were recruited to the study aged from 11 months to 15 years of age where 53 gastric fluid samples and 40 intestinal fluid samples were obtained. pH values recorded ranged from pH 0.57 to 11.05 (median: 2.50) in gastric fluids and from 0.89 to 8.97 (median: 3.27) in intestinal fluids. The buffer capacity did not change significantly between gastric and intestinal fluids with median values of 12 mM/L/ΔpH for both fluids. Gastric fluid osmolality values ranged from 1 to 615 mOsm/kg, while intestinal fluid values ranged from 35 to 631 mOsm/kg. Gastric fluid bile acid concentrations ranged from 0.002 to 2.3 mM with a median value of 0.017 mM whilst intestinal fluid bile acid concentrations ranged from 0.0008 to 3.3 mM with a median value of 0.178 mM. Glycocholate; taurocholic acid; glycochenodeoxycholate and taurochenodeoxycholate were the most commonly identified bile acids within paediatric intestinal fluids. All compositional components were associated with large inter-individual variability. Further work is required to develop simulated paediatric media and to explore the impact of these media on drug solubility and dissolution.