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Shen H, Huo R, Zhang Y, Wang L, Tong N, Chen W, Paris AJ, Mensah K, Chen M, Xue Y, Li W, Sinz M. A Pilot Study To Assess the Suitability of Riboflavin As a Surrogate Marker of Breast Cancer Resistance Protein in Healthy Participants. J Pharmacol Exp Ther 2024; 390:162-173. [PMID: 38296646 DOI: 10.1124/jpet.123.002015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/31/2023] [Accepted: 01/08/2024] [Indexed: 02/02/2024] Open
Abstract
We recently showed that riboflavin is a selected substrate of breast cancer resistance protein (BCRP) over P-glycoprotein (P-gp) and demonstrated its prediction performance in preclinical drug-drug interaction (DDI) studies. The aim of this study was to investigate the suitability of riboflavin to assess BCRP inhibition in humans. First, we assessed the substrate potential of riboflavin toward other major drug transporters using established transfected cell systems. Riboflavin is a substrate for organic anion transporter (OAT)1, OAT3, and multidrug and toxin extrusion protein (MATE)2-K, with uptake ratios ranging from 2.69 to 11.6, but riboflavin is not a substrate of organic anion-transporting polypeptide (OATP)1B1, OATP1B3, organic cation transporter (OCT)2, and MATE1. The effects of BMS-986371, a potent in vitro inhibitor of BCRP (IC 50 0.40 μM), on the pharmacokinetics of riboflavin, isobutyryl carnitine, and arginine were then examined in healthy male adults (N = 14 or 16) after oral administration of methotrexate (MTX) (7.5 mg) and enteric-coated (EC) sulfasalazine (SSZ) (1000 mg) alone or in combination with BMS-986371 (150 mg). Oral administration of BMS-986371 increased the area under the plasma concentration-time curves (AUCs) of rosuvastatin and immediate-release (IR) SSZ to 1.38- and 1.51-fold, respectively, and significantly increased AUC(0-4h), AUC(0-24h), and C max of riboflavin by 1.25-, 1.14-, and 1.11-fold (P-values of 0.003, 0.009, and 0.025, respectively) compared with the MTX/SSZ EC alone group. In contrast, BMS-986371 did not significantly influence the AUC(0-24h) and C max values of isobutyryl carnitine and arginine (0.96- to 1.07-fold, respectively; P > 0.05). Overall, these data indicate that plasma riboflavin is a promising biomarker of BCRP that may offer a possibility to assess drug candidate as a BCRP modulator in early drug development. SIGNIFICANCE STATEMENT: Endogenous compounds that serve as biomarkers for clinical inhibition of breast cancer resistance protein (BCRP) are not currently available. This study provides the initial evidence that riboflavin is a promising BCRP biomarker in humans. For the first time, the value of leveraging the substrate of BCRP with acceptable prediction performance in clinical studies is shown. Additional clinical investigations with known BCRP inhibitors are needed to fully validate and showcase the utility of this biomarker.
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Affiliation(s)
- Hong Shen
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Runlan Huo
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Yueping Zhang
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Linna Wang
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Nian Tong
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Weiqi Chen
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Andrew J Paris
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Kofi Mensah
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Min Chen
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Yongjun Xue
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Wenying Li
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
| | - Michael Sinz
- Departments of Drug Metabolism and Pharmacokinetics (H.S., Y.Z., M.S.), Clinical Pharmacology, Pharmacometrics, and Bioanalysis (R.H., L.W., M.C., Y.X.), Development Biotransformation (N.T., W.C., W.L.), and Early Clinical Development (A.J.P., K.M.), Bristol Myers Squibb, Princeton, New Jersey
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Galetin A, Brouwer KLR, Tweedie D, Yoshida K, Sjöstedt N, Aleksunes L, Chu X, Evers R, Hafey MJ, Lai Y, Matsson P, Riselli A, Shen H, Sparreboom A, Varma MVS, Yang J, Yang X, Yee SW, Zamek-Gliszczynski MJ, Zhang L, Giacomini KM. Membrane transporters in drug development and as determinants of precision medicine. Nat Rev Drug Discov 2024; 23:255-280. [PMID: 38267543 DOI: 10.1038/s41573-023-00877-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/26/2024]
Abstract
The effect of membrane transporters on drug disposition, efficacy and safety is now well recognized. Since the initial publication from the International Transporter Consortium, significant progress has been made in understanding the roles and functions of transporters, as well as in the development of tools and models to assess and predict transporter-mediated activity, toxicity and drug-drug interactions (DDIs). Notable advances include an increased understanding of the effects of intrinsic and extrinsic factors on transporter activity, the application of physiologically based pharmacokinetic modelling in predicting transporter-mediated drug disposition, the identification of endogenous biomarkers to assess transporter-mediated DDIs and the determination of the cryogenic electron microscopy structures of SLC and ABC transporters. This article provides an overview of these key developments, highlighting unanswered questions, regulatory considerations and future directions.
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Affiliation(s)
- Aleksandra Galetin
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, The University of Manchester, Manchester, UK.
| | - Kim L R Brouwer
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Kenta Yoshida
- Clinical Pharmacology, Genentech Research and Early Development, South San Francisco, CA, USA
| | - Noora Sjöstedt
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Lauren Aleksunes
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA
| | - Xiaoyan Chu
- Department of Pharmacokinetics, Dynamics, Metabolism, and Bioanalytics, Merck & Co., Inc., Rahway, NJ, USA
| | - Raymond Evers
- Preclinical Sciences and Translational Safety, Johnson & Johnson, Janssen Pharmaceuticals, Spring House, PA, USA
| | - Michael J Hafey
- Department of Pharmacokinetics, Dynamics, Metabolism, and Bioanalytics, Merck & Co., Inc., Rahway, NJ, USA
| | - Yurong Lai
- Drug Metabolism, Gilead Sciences Inc., Foster City, CA, USA
| | - Pär Matsson
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrew Riselli
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Hong Shen
- Department of Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb Research and Development, Princeton, NJ, USA
| | - Alex Sparreboom
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Manthena V S Varma
- Pharmacokinetics, Dynamics and Metabolism, Medicine Design, Worldwide R&D, Pfizer Inc, Groton, CT, USA
| | - Jia Yang
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Xinning Yang
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Sook Wah Yee
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
| | | | - Lei Zhang
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Kathleen M Giacomini
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA.
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Miyazaki K, Sasaki A, Mizuuchi H. Advances in the Evaluation of Gastrointestinal Absorption Considering the Mucus Layer. Pharmaceutics 2023; 15:2714. [PMID: 38140055 PMCID: PMC10747107 DOI: 10.3390/pharmaceutics15122714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Because of the increasing sophistication of formulation technology and the increasing polymerization of compounds directed toward undruggable drug targets, the influence of the mucus layer on gastrointestinal drug absorption has received renewed attention. Therefore, understanding the complex structure of the mucus layer containing highly glycosylated glycoprotein mucins, lipids bound to the mucins, and water held by glycans interacting with each other is critical. Recent advances in cell culture and engineering techniques have led to the development of evaluation systems that closely mimic the ecological environment and have been applied to the evaluation of gastrointestinal drug absorption while considering the mucus layer. This review provides a better understanding of the mucus layer components and the gastrointestinal tract's biological defense barrier, selects an assessment system for drug absorption in the mucus layer based on evaluation objectives, and discusses the overview and features of each assessment system.
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Affiliation(s)
- Kaori Miyazaki
- DMPK Research Laboratories, Innovative Research Division, Mitsubishi Tanabe Pharma Corporation, 1000 Kamoshida, Aoba-ku, Yokohama 227-0033, Japan; (A.S.); (H.M.)
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Translatability of in vitro Inhibition Potency to in vivo P-Glycoprotein Mediated Drug Interaction Risk. J Pharm Sci 2023; 112:1715-1723. [PMID: 36682487 DOI: 10.1016/j.xphs.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/22/2023]
Abstract
P-glycoprotein (P-gp) may limit oral drug absorption of substrate drugs due to intestinal efflux. Therefore, regulatory agencies require investigation of new chemical entities as possible inhibitors of P-gp in vitro. Unfortunately, inter-laboratory and inter-assay variability have hindered the translatability of in vitro P-gp inhibition data to predict clinical drug interaction risk. The current study was designed to evaluate the impact of potential IC50 discrepancies between two commonly utilized assays, i.e., bi-directional Madin-Darby Canine Kidney-MDR1 cell-based and MDR1 membrane vesicle-based assays. When comparing vesicle- to cell-based IC50 values (n = 28 inhibitors), non-P-gp substrates presented good correlation between assay formats, whereas IC50s of P-gp substrates were similar or lower in the vesicle assays. The IC50s obtained with a cell line expressing relatively low P-gp aligned more closely to those obtained from the vesicle assay, but passive permeability of the inhibitors did not appear to influence the correlation of IC50s, suggesting that efflux activity reduces intracellular inhibitor concentrations. IC50s obtained between two independent laboratories using the same assay type showed good correlation. Using the G-value (i.e., ratio of estimated gut concentration-to-inhibition potency) >10 cutoff recommended by regulatory agencies resulted in minimal differences in predictive performance, suggesting this cutoff is appropriate for either assay format.
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Taskar KS, Yang X, Neuhoff S, Patel M, Yoshida K, Paine MF, Brouwer KL, Chu X, Sugiyama Y, Cook J, Polli JW, Hanna I, Lai Y, Zamek-Gliszczynski M. Clinical Relevance of Hepatic and Renal P-gp/BCRP Inhibition of Drugs: An International Transporter Consortium Perspective. Clin Pharmacol Ther 2022; 112:573-592. [PMID: 35612761 PMCID: PMC9436425 DOI: 10.1002/cpt.2670] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/16/2022] [Indexed: 12/11/2022]
Abstract
The role of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) in drug-drug interactions (DDIs) and limiting drug absorption as well as restricting the brain penetration of drugs with certain physicochemical properties is well known. P-gp/BCRP inhibition by drugs in the gut has been reported to increase the systemic exposure to substrate drugs. A previous International Transporter Consortium (ITC) perspective discussed the feasibility of P-gp/BCRP inhibition at the blood-brain barrier and its implications. This ITC perspective elaborates and discusses specifically the hepatic and renal P-gp/BCRP (referred as systemic) inhibition of drugs and whether there is any consequence for substrate drug disposition. This perspective summarizes the clinical evidence-based recommendations regarding systemic P-gp and BCRP inhibition of drugs with a focus on biliary and active renal excretion pathways. Approaches to assess the clinical relevance of systemic P-gp and BCRP inhibition in the liver and kidneys included (i) curation of DDIs involving intravenously administered substrates or inhibitors; (ii) in vitro-to-in vivo extrapolation of P-gp-mediated DDIs at the systemic level; and (iii) curation of drugs with information available about the contribution of biliary excretion and related DDIs. Based on the totality of evidence reported to date, this perspective supports limited clinical DDI risk upon P-gp or BCRP inhibition in the liver or kidneys.
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Affiliation(s)
- Kunal S. Taskar
- Drug Metabolism and Pharmacokinetics, IVIVT, GlaxoSmithKline, Stevenage, UK
| | - Xinning Yang
- Office of Clinical Pharmacology, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD
| | - Sibylle Neuhoff
- Certara UK Ltd, Simcyp Division, 1 Concourse Way, Level 2-Acero, Sheffield, S1 2BJ, UK
| | - Mitesh Patel
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - Kenta Yoshida
- Clinical Pharmacology, Genentech Early Research and Development, South San Francisco, CA 94080, USA
| | - Mary F. Paine
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA
| | - Kim L.R. Brouwer
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Xiaoyan Chu
- Department of ADME and Discovery Toxicology, Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033 USA
| | - Yuichi Sugiyama
- Laboratory of Quantitative System PK/Pharmacodynamics, School of Pharmacy, Kioicho campus, Josai International University, Tokyo 102-0093, Japan
| | - Jack Cook
- Clinical Pharmacology, Global Product Development, Pfizer Inc., Groton, Connecticut, USA
| | - Joseph W. Polli
- Global Medical Sciences, ViiV Healthcare, Research Triangle Park NC USA
| | - Imad Hanna
- Pharmacokinetic Sciences-Oncology, Novartis Institute for Biomedical Research, East Hanover, NJ
| | - Yurong Lai
- Drug Metabolism, Gilead Sciences Inc. Foster City, CA USA
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Volpe DA, Joshi A, Arya V. Do differences in cell lines and methods used for calculation of IC 50 values influence categorisation of drugs as P-glycoprotein substrates and inhibitors? Xenobiotica 2022; 52:751-757. [PMID: 36218364 DOI: 10.1080/00498254.2022.2135040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In vitro bidirectional assays are employed to determine whether a drug is a substrate and/or inhibitor of P-glycoprotein (P-gp) transport. Differences between cell lines and calculation methods can lead to variations in the determination of efflux ratios (ER) and IC50 values used to classify a drug as a P-gp substrate and inhibitor, respectively.Information was collected from the literature on ER and IC50 values with digoxin as the probe substrate using different cell lines and inhibition calculation methods. Predictive performance was evaluated by comparing [Igut]/IC50 ratios versus reported in vivo results.For known P-gp substrates, 50% of the drugs had their highest ER value in MDCK-MDR1 cells while 81% had their lowest ER value in Caco-2 cells. For 30 drugs with inhibition data, lower mean IC50 values were often observed with the Caco-2 cells and calculations based on ER. Based on the cut-off criteria of [Igut]/IC50 ≥ 10, there were no significant differences in positive or negative predictive values based on either cell line or calculation method for the drugs.Within this limited dataset, differences between cell lines or IC50 calculation methods do not seem to impact the prediction of in vivo P-gp inhibitor classification.
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Affiliation(s)
- Donna A Volpe
- Office of Clinical Pharmacology, US Food and Drug Administration, Silver Spring, MD, USA
| | - Abhay Joshi
- Office of Clinical Pharmacology, US Food and Drug Administration, Silver Spring, MD, USA
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Yang X, Reynolds K, Madabushi R, Huang SM. Current Perspective on Residual Knowledge Gaps in the Assessment of Transporter-Mediated Drug Interactions. Clin Pharmacol Ther 2022; 112:450-452. [PMID: 35722741 DOI: 10.1002/cpt.2671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/24/2022] [Indexed: 11/09/2022]
Abstract
Assessment of transporter-mediated drug-drug interaction (DDI) is integral to drug development. A risk-based approach leveraging in vitro, in vivo, and in silico information is used to evaluate the DDI liability of drugs and inform the instructions of use. While tremendous advances have been made in recent decades, there are knowledge gaps warranting further research. Herein, we focus on select areas to advance assessment of DDI potential for drugs as substrates, inhibitors, or inducers of certain transporters.
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Affiliation(s)
- Xinning Yang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kellie Reynolds
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Rajanikanth Madabushi
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Shiew-Mei Huang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
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Yabut J, Houle R, Wang S, Liaw A, Katwaru R, Collier H, Hittle L, Chu X. Selection of an optimal in vitro model to assess P-gp inhibition: comparison of vesicular and bi-directional transcellular transport inhibition assays. Drug Metab Dispos 2022; 50:909-922. [PMID: 35489778 DOI: 10.1124/dmd.121.000807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022] Open
Abstract
The multidrug resistance protein 1 (MDR1) P-glycoprotein (P-gp) is a clinically important transporter. In vitro P-gp inhibition assays have been routinely conducted to predict the potential for clinical drug-drug interactions (DDIs) mediated by P-gp. However, high inter- laboratory and inter-system variability of P-gp IC50 data limits accurate prediction of DDIs using static models and decision criteria recommended by regulatory agencies. In this study, we calibrated two in vitro P-gp inhibition models: vesicular uptake of N-methyl-quinidine (NMQ) in MDR1 vesicles and bidirectional transport (BDT) of digoxin in Lilly Laboratories Cell Porcine Kidney 1 cells overexpressing MDR1 (LLC-MDR1) using a total of 48 P-gp inhibitor and non-inhibitor drugs, and digoxin DDI data from 70 clinical studies. Refined thresholds were derived using receiver operating characteristic (ROC) analysis and their predictive performance was compared with the decision frameworks proposed by regulatory agencies and selected reference. Furthermore, the impact of various IC50 calculation methods and non-specific binding of drugs on DDI prediction was evaluated. Our studies suggest that the concentration of inhibitor based on highest approved dose dissolved in 250 ml divided by IC50(I2/IC50) is sufficient to predict P-gp related intestinal DDIs. IC50 obtained from vesicular inhibition assay with a refined threshold of I2/IC50 {greater than or equal to} 25.9 provides comparable predictive power than those measured by net secretory flux and efflux ratio in LLC-MDR1 cells. We therefore recommend vesicular P-gp inhibition as our preferred method given its simplicity, lower variability, higher assay throughput, and more direct estimation of in vitro kinetic parameters than BDT assay. Significance Statement We have conducted comprehensive calibration of two in vitro P-gp inhibition models: uptake in MDR1 vesicles and bidirectional transport in LLC-MDR1 cell monolayers to predict DDIs. Our studies suggest that IC50s obtained from vesicular inhibition with a refined threshold of I2/IC50 ≥ 25.9 provide comparable predictive power than those in LLC-MDR1 cells. We therefore recommend vesicular P-gp inhibition as preferred method given its simplicity, lower variability, higher assay throughput, and more direct estimation of in vitro kinetic parameters.
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Affiliation(s)
| | | | | | | | | | | | | | - Xiaoyan Chu
- Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck & Co., Inc., United States
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Vourvahis M, Byon W, Chang C, Le V, Diehl A, Graham D, Tripathy S, Raha N, Luo L, Mathialagan S, Dowty M, Rodrigues AD, Malhotra B. Evaluation of the Effect of Abrocitinib on Drug Transporters by Integrated Use of Probe Drugs and Endogenous Biomarkers. Clin Pharmacol Ther 2022; 112:665-675. [PMID: 35344588 PMCID: PMC9540496 DOI: 10.1002/cpt.2594] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/14/2022] [Indexed: 12/29/2022]
Abstract
Abrocitinib is an oral Janus kinase 1 (JAK1) inhibitor currently approved in the United Kingdom for the treatment of moderate‐to‐severe atopic dermatitis (AD). As patients with AD may use medications to manage comorbidities, abrocitinib could be used concomitantly with hepatic and/or renal transporter substrates. Therefore, we assessed the potential effect of abrocitinib on probe drugs and endogenous biomarker substrates for the drug transporters of interest. In vitro studies indicated that, among the transporters tested, abrocitinib has the potential to inhibit the activities of P‐glycoprotein (P‐gp), breast cancer resistance protein (BCRP), organic anion transporter 3 (OAT3), organic cation transporter 1 (OCT1), and multidrug and toxin extrusion protein 1 and 2K (MATE1/2K). Therefore, subsequent phase I, two‐way crossover, open‐label studies in healthy participants were performed to assess the impact of abrocitinib on the pharmacokinetics of the transporter probe substrates dabigatran etexilate (P‐gp), rosuvastatin (BCRP and OAT3), and metformin (OCT2 and MATE1/2K), as well as endogenous biomarkers for MATE1/2K (N1‐methylnicotinamide (NMN)) and OCT1 (isobutyryl‐L‐carnitine (IBC)). Co‐administration with abrocitinib was shown to increase the plasma exposure of dabigatran by ~ 50%. In comparison, the plasma exposure and renal clearance of rosuvastatin and metformin were not altered with abrocitinib co‐administration. Similarly, abrocitinib did not affect the exposure of NMN or IBC. An increase in dabigatran exposure suggests that abrocitinib inhibits P‐gp activity. By contrast, a lack of impact on plasma exposure and/or renal clearance of rosuvastatin, metformin, NMN, or IBC suggests that BCRP, OAT3, OCT1, and MATE1/2K activity are unaffected by abrocitinib.
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Affiliation(s)
| | | | | | - Vu Le
- Pfizer Inc., New York, New York, USA
| | | | | | | | | | - Lina Luo
- Pfizer Inc., Groton, Connecticut, USA
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Rocha-Pereira C, Ghanem CI, Silva R, Casanova AG, Duarte-Araújo M, Gonçalves-Monteiro S, Sousa E, Bastos MDL, Remião F. P-glycoprotein activation by 1-(propan-2-ylamino)-4-propoxy-9H-thioxanthen-9-one (TX5) in rat distal ileum: ex vivo and in vivo studies. Toxicol Appl Pharmacol 2020; 386:114832. [PMID: 31756430 DOI: 10.1016/j.taap.2019.114832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/14/2019] [Accepted: 11/16/2019] [Indexed: 12/30/2022]
Abstract
In vitro studies showed that 1-(propan-2-ylamino)-4-propoxy-9H-thioxanthen-9-one (TX5) increases P-glycoprotein (P-gp) expression and activity in Caco-2 cells, preventing xenobiotic toxicity. The present study aimed at investigating TX5 effects on P-gp expression/activity using Wistar Han rats: a) in vivo, evaluating intestinal P-gp activity; b) ex vivo, evaluating P-gp expression in ileum brush border membranes (BBM) and P-gp activity in everted intestinal sacs; c) ex vivo, evaluating P-gp activity in everted intestinal sacs of the distal and proximal ileum. TX5 (30 mg/kg, b.w.), gavage, activated P-gp in vivo, given the significant decrease in the AUC of digoxin (0.25 mg/kg, b.w.). The efflux of rhodamine 123 (300 μM), a P-gp fluorescent substrate, significantly increased in TX5-treated everted sacs from the distal portion of the rat ileum, when P-gp activity was evaluated in the presence of TX5 (20 μM), an effect abolished by the P-gp inhibitor verapamil (100 μM). No increases on P-gp expression or activity were found in TX5-treated BBM of the distal ileum and everted distal sacs, respectively, 24 h after TX5 (10 mg/kg, b.w.) administration. In vivo, no differences were found on digoxin portal concentration between control (digoxin 0.025 mg/kg, b.w., intraduodenal) and TX5-treated (digoxin+TX5 20 μM, intraduodenal) rats. The observed discrepancies in digoxin results can be related to differences in TX5 dose administered and used methodologies. Thus, the results show that TX5 activates P-gp at the distal portion of the rat ileum, and, at the higher dose tested (30 mg/kg, b.w.), seems to modulate in vivo the AUC of P-gp substrates.
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Affiliation(s)
- Carolina Rocha-Pereira
- UCIBIO/REQUIMTE, Laboratório de Toxicologia, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Carolina I Ghanem
- Instituto de Investigaciones Farmacológicas (ININFA), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, CONICET, Buenos Aires, Argentina.
| | - Renata Silva
- UCIBIO/REQUIMTE, Laboratório de Toxicologia, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Alfredo G Casanova
- Unidad de Toxicología, Departamento de Fisiología y Farmacología, Universidad de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain.
| | - Margarida Duarte-Araújo
- LAQV/REQUIMTE, Departamento de Imuno-Fisiologia e Farmacologia, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Salomé Gonçalves-Monteiro
- LAQV/REQUIMTE, Laboratório de Farmacologia, Departamento de Ciências do Medicamento, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Emília Sousa
- CIIMAR, Laboratório de Química Orgânica e Farmacêutica, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Maria de Lourdes Bastos
- UCIBIO/REQUIMTE, Laboratório de Toxicologia, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Fernando Remião
- UCIBIO/REQUIMTE, Laboratório de Toxicologia, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
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