Research Highlight: The Fascinating Field of Pharmacokinetics

The SOP’s Dr. Aline Milane studies how the human body affects medications.

By Irina du Quenoy

Dr. Milane’s research feeds directly into her teaching, to the benefit of LAU’s Pharmacy students.

A few years back, thousands of videos were shared on social media of people dumping freezing water on their heads as part of the “ice bucket challenge.” The campaign’s purpose was to raise awareness about the devastating and lethal brain disease ALS.

Organizers wanted to raise $100 million to finance research on why the few available medicines to treat ALS cannot even slow the progression of the disease in some patients. “We have already from our side got interested in this question and published a major finding on the topic that the lack of distribution of those drugs to the brain seem to be highly responsible of this resistance to treatment,” explains LAU Associate Professor of Pharmaceutical Sciences Aline Milane, who is specialized in the area of pharmacokinetics.

“Pharmacokinetics investigates this type of drug properties: like the rate at which drugs get absorbed into the blood and distributed to our organs,” says Dr. Milane. “It also evaluates the elimination of a medication by the liver and kidneys, which is the process through which the drug’s action comes to an end.” More than that, pharmacokinetics “monitors a drug’s concentration in the blood in order to predict, understand and improve the response of a patient to his or her medication,” she adds.

The implications of this type of research for patient outcomes are tremendous. According to Dr. Milane, “patients can differ dramatically in how they respond to a drug.” The varied responses “can go from a total non-response [to desired positive response] to severe adverse effects.” Factors such as age, gender, genetics, among others, “can modify the expression and function of drug transporters and metabolizing enzymes that ensure the absorption, distribution and elimination of the drug by the body.”

While “transporters” in this case are proteins that “transport drugs from the stomach or intestines into the blood and then into the target organ,” the enzymes Dr. Milane refers to are proteins responsible for chemically transforming drugs in the liver in order to activate or terminate their action. Recently, she worked with a team of researchers to conduct a preliminary study on Lebanese patients, investigating genetic mutations that affect concomitantly “two important drug transporters and enzymes governing the pharmacokinetics and response to drugs.” The study was the first of its kind in Lebanon and has led to both conference presentations of the results at the international level and to a further research study.

“The findings are guiding us now in another project,” says Dr. Milane, “investigating the effect of drug interactions and genetic mutations on these and other proteins and thus on the pharmacokinetics of drugs.” More specifically, Dr. Milane recently successfully secured an extramural grant to help investigate the response of Lebanese patients to drugs used to treat depression. The effectiveness of antidepressants is notoriously haphazard, as many patients either do not respond to it at all or respond in adverse ways. Dr. Milane hopes that the results of the current project might help explain this “insufficient response” which is “particularly risky in severely depressed patients, in whom a lack of drug response could aggravate suicidal ideation and suicide attempts.”

As she proceeds further along her path as both a researcher and educator, Dr. Milane notes that “the LAU School of Pharmacy is an ideal environment that fosters excellence in research and encourages faculty members to pursue and develop their research goals and ambitions.” Indeed, her research feeds directly into her teaching, to the benefit of LAU’s Pharmacy students.

“In the classroom, I always use research examples that illustrate how pharmacokinetic concepts are used in practice in order to optimize therapy and solve real-world patient problems,” she says. In doing so, Dr. Milane provides students with an eye-opening reminder that “pharmacy is an evidence-based applied science whose ultimate goal is to improve patient outcomes.”