1
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Lentzas A, de Gooijer MC, Zuidema S, Meurs A, Çitirikkaya CH, Venekamp N, Beijnen JH, van Tellingen O. ATP-binding cassette transporter inhibitor potency and substrate drug affinity are critical determinants of successful drug delivery enhancement to the brain. Fluids Barriers CNS 2024; 21:62. [PMID: 39103921 DOI: 10.1186/s12987-024-00562-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 07/28/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Pharmacotherapy for brain diseases is severely compromised by the blood-brain barrier (BBB). ABCB1 and ABCG2 are drug transporters that restrict drug entry into the brain and their inhibition can be used as a strategy to boost drug delivery and pharmacotherapy for brain diseases. METHODS We employed elacridar and tariquidar in mice to explore the conditions for effective inhibition at the BBB. Abcg2;Abcb1a/b knockout (KO), Abcb1a/b KO, Abcg2 KO and wild-type (WT) mice received a 3 h i.p. infusion of a cocktail of 8 typical substrate drugs in combination with elacridar or tariquidar at a range of doses. Abcg2;Abcb1a/b KO mice were used as the reference for complete inhibition, while single KO mice were used to assess the potency to inhibit the remaining transporter. Brain and plasma drug levels were measured by LC-MS/MS. RESULTS Complete inhibition of ABCB1 at the BBB is achieved when the elacridar plasma level reaches 1200 nM, whereas tariquidar requires at least 4000 nM. Inhibition of ABCG2 is more difficult. Elacridar inhibits ABCG2-mediated efflux of weak but not strong ABCG2 substrates. Strikingly, tariquidar does not enhance the brain uptake of any ABCG2-subtrate drug. Similarly, elacridar, but not tariquidar, was able to inhibit its own brain efflux in ABCG2-proficient mice. The plasma protein binding of elacridar and tariquidar was very high but similar in mouse and human plasma, facilitating the translation of mouse data to humans. CONCLUSIONS This work shows that elacridar is an effective pharmacokinetic-enhancer for the brain delivery of ABCB1 and weaker ABCG2 substrate drugs when a plasma concentration of 1200 nM is exceeded.
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Affiliation(s)
- Aristeidis Lentzas
- Division of Pharmacology, The Netherlands Cancer Institute, Room H3.010, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Mark C de Gooijer
- Division of Pharmacology, The Netherlands Cancer Institute, Room H3.010, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M1 3WE, UK
- The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
| | - Stefanie Zuidema
- Division of Pharmacology, The Netherlands Cancer Institute, Room H3.010, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Amber Meurs
- Division of Pharmacology, The Netherlands Cancer Institute, Room H3.010, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Ceren H Çitirikkaya
- Division of Pharmacology, The Netherlands Cancer Institute, Room H3.010, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
| | - Nikkie Venekamp
- Division of Pharmacology, The Netherlands Cancer Institute, Room H3.010, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands
- Department of Pharmacy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jos H Beijnen
- Department of Pharmacy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Universiteitsweg 99, Utrecht, 3584 CG, The Netherlands
| | - Olaf van Tellingen
- Division of Pharmacology, The Netherlands Cancer Institute, Room H3.010, Plesmanlaan 121, Amsterdam, 1066 CX, The Netherlands.
- Mouse Cancer Clinic, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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2
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Hermann R, Krajcsi P, Fluck M, Seithel-Keuth A, Bytyqi A, Galazka A, Munafo A. Review of Transporter Substrate, Inhibitor, and Inducer Characteristics of Cladribine. Clin Pharmacokinet 2021; 60:1509-1535. [PMID: 34435310 PMCID: PMC8613159 DOI: 10.1007/s40262-021-01065-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 12/23/2022]
Abstract
Cladribine is a nucleoside analog that is phosphorylated in its target cells (B- and T-lymphocytes) to its active adenosine triphosphate form (2-chlorodeoxyadenosine triphosphate). Cladribine tablets 10 mg (Mavenclad®) administered for up to 10 days per year in 2 consecutive years (3.5-mg/kg cumulative dose over 2 years) are used to treat patients with relapsing multiple sclerosis. The ATP-binding cassette, solute carrier, and nucleoside transporter substrate, inhibitor, and inducer characteristics of cladribine are reviewed in this article. Available evidence suggests that the distribution of cladribine across biological membranes is facilitated by a number of uptake and efflux transporters. Among the key ATP-binding cassette efflux transporters, only breast cancer resistance protein has been shown to be an efficient transporter of cladribine, while P-glycoprotein does not transport cladribine well. Intestinal absorption, distribution throughout the body, and intracellular uptake of cladribine appear to be exclusively mediated by equilibrative and concentrative nucleoside transporters, specifically by ENT1, ENT2, ENT4, CNT2 (low affinity), and CNT3. Renal excretion of cladribine appears to be most likely driven by breast cancer resistance protein, ENT1, and P-glycoprotein. The latter may play a role despite its poor cladribine transport efficiency in view of the renal abundance of P-glycoprotein. There is no evidence that solute carrier uptake transporters such as organic anion transporting polypeptides, organic anion transporters, and organic cation transporters are involved in the transport of cladribine. Available in vitro studies examining the inhibitor characteristics of cladribine for a total of 13 major ATP-binding cassette, solute carrier, and CNT transporters indicate that in vivo inhibition of any of these transporters by cladribine is unlikely.
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Affiliation(s)
- Robert Hermann
- Clinical Research Appliance (cr.appliance), Heinrich-Vingerhut-Weg 3, 63571, Gelnhausen, Germany.
| | | | | | | | | | | | - Alain Munafo
- Institute of Pharmacometrics, an Affiliate of Merck KGaA, Lausanne, Switzerland
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3
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Shubbar MH, Penny JI. Therapeutic drugs modulate ATP-Binding cassette transporter-mediated transport of amyloid beta (1-42) in brain microvascular endothelial cells. Eur J Pharmacol 2020; 874:173009. [PMID: 32061744 DOI: 10.1016/j.ejphar.2020.173009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/28/2020] [Accepted: 02/10/2020] [Indexed: 01/07/2023]
Abstract
Deposition of amyloid-β peptide (Aβ(1-42)) is a hallmark of Alzheimer's disease. Clearance of Aβ(1-42), across the blood-brain barrier (BBB), is mediated by ATP-binding Cassette (ABC) efflux transporters. Many therapeutic drugs inhibit ABC transporters, but little is known of the effect of therapeutic drugs on Aβ(1-42) transport across BBB endothelial cells. The effects of selected, widely prescribed, therapeutic drugs on ABCB1, ABCC5 and ABCG2 activities were determined by measuring intracellular levels of calcein, GS-MF, and Hoechst 33342 respectively in primary porcine brain endothelial cells (PBECs). The ability of ABCB1, ABCC5 and ABCG2 to transport Aβ(1-42) was determined using fluorescent Aβ(1-42). The ability of the ABCB1, ABCC5 and ABCG2 inhibitor telmisartan to modify transcellular Aβ(1-42) transport was investigated using PBEC monolayers housed in Transwell® inserts. Treatment of PBECs with ABC transporter inhibitory drugs (indomethacin, olanzapine, chlorpromazine, telmisartan, pantoprazole, quinidine, sulfasalazine and nefazodone) increased Aβ(1-42) intracellular accumulation. Inhibition of ABCB1, ABCC5 and ABCG2 by telmisartan increased Aβ(1-42) transport in the apical to basal direction and reduced its transport in basal to apical direction in PBEC monolayers. ABCB1, ABCC5 and ABCG2 mediate the efflux transport of Aβ(1-42) in BBB endothelial cells. Inhibition of ABC transporters by therapeutic drugs, at plasma concentrations, could decrease Aβ(1-42) clearance from brain, across BBB endothelial cells into blood, and potentially influence levels of the Aβ(1-42) peptide within the brain.
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Affiliation(s)
- Maryam H Shubbar
- Division of Pharmacy & Optometry, University of Manchester, Manchester, M13 9PT, UK.
| | - Jeffrey I Penny
- Division of Pharmacy & Optometry, University of Manchester, Manchester, M13 9PT, UK
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4
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The Impact of Endogenous Breast Cancer Resistance Protein on Human P-Glycoprotein-Mediated Transport Assays Using LLC-PK1 Cells Transfected With Human P-Glycoprotein. J Pharm Sci 2019; 108:1085-1089. [DOI: 10.1016/j.xphs.2018.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/19/2018] [Accepted: 10/08/2018] [Indexed: 01/13/2023]
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5
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Abstract
As a result of an increasing aging population, the number of individuals taking multiple medications simultaneously has grown considerably. For these individuals, taking multiple medications has increased the risk of undesirable drug–drug interactions (DDIs), which can cause serious and debilitating adverse drug reactions (ADRs). A comprehensive understanding of DDIs is needed to combat these deleterious outcomes. This review provides a synopsis of the pharmacokinetic (PK) and pharmacodynamic (PD) mechanisms that underlie DDIs. PK-mediated DDIs affect all aspects of drug disposition: absorption, distribution, metabolism and excretion (ADME). In this review, the cells that play a major role in ADME and have been investigated for DDIs are discussed. Key examples of drug metabolizing enzymes and drug transporters that are involved in DDIs and found in these cells are described. The effect of inhibiting or inducing these proteins through DDIs on the PK parameters is also reviewed. Despite most DDI studies being focused on the PK effects, DDIs through PD can also lead to significant and harmful effects. Therefore, this review outlines specific examples and describes the additive, synergistic and antagonistic mechanisms of PD-mediated DDIs. The effects DDIs on the maximum PD response (Emax) and the drug dose or concentration (EDEC50) that lead to 50% of Emax are also examined. Significant gaps in our understanding of DDIs remain, so innovative and emerging approaches are critical for overcoming them.
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Affiliation(s)
- Arthur G Roberts
- Pharmaceutical and Biomedical Sciences, University of Georgia, Athens, GA, USA,
| | - Morgan E Gibbs
- Pharmaceutical and Biomedical Sciences, University of Georgia, Athens, GA, USA,
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6
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Pace J, Nelson J, Ray A, Hu Y. Verapamil-induced breakdown of the blood-brain barrier presenting as a transient right middle cerebral artery syndrome. Interv Neuroradiol 2017; 23:601-604. [PMID: 28956514 DOI: 10.1177/1591019917729822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A middle-aged patient presented for elective embolization of an incidentally found right internal carotid aneurysm. An angiogram was performed, during which the left internal carotid artery was visualized to evaluate a second, small aneurysm. During the embolization of the right internal carotid artery aneurysm, a catheter-induced vasospasm was identified that prompted treatment with intra-arterial verapamil. The procedure was uncomplicated; a postoperative rotational flat-panel computed tomography scan was performed on the angiography table that demonstrated right hemisphere contrast staining. The patient developed a right middle cerebral artery (MCA) syndrome after extubation with repeat cerebral angiography negative for occlusion and magnetic resonance imaging negative for stroke. The patient was observed for 48 hours, during which time the patient had slowly improved. At a six-week follow up visit, the patient had fully recovered. We present an interesting case of a verapamil-induced breakdown of the blood-brain barrier and self-limited right MCA syndrome.
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Affiliation(s)
- Jonathan Pace
- 24575 University Hospitals Cleveland Medical Center , Neurological Institute, Department of Neurological Surgery, Cleveland, OH, USA
| | - Jeffrey Nelson
- 24575 University Hospitals Cleveland Medical Center , Neurological Institute, Department of Neurological Surgery, Cleveland, OH, USA
| | - Abhishek Ray
- 24575 University Hospitals Cleveland Medical Center , Neurological Institute, Department of Neurological Surgery, Cleveland, OH, USA
| | - Yin Hu
- 24575 University Hospitals Cleveland Medical Center , Neurological Institute, Department of Neurological Surgery, Cleveland, OH, USA
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7
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Durante M, Frosini M, Fusi F, Neri A, Sticozzi C, Saponara S. In vitro vascular toxicity of tariquidar, a potential tool for in vivo PET studies. Toxicol In Vitro 2017; 44:241-247. [PMID: 28746893 DOI: 10.1016/j.tiv.2017.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 07/17/2017] [Accepted: 07/19/2017] [Indexed: 02/07/2023]
Abstract
The P-glicoprotein (P-gp) inhibitor tariquidar is used to detect functional alterations of blood brain barrier pumps in PET imaging. The doses required, however, up to 4-fold higher than those already used in clinical trials to reverse multidrug resistance, cause syncopal episode and hypotension. Therefore, the effects of these doses toward the vasculature were investigated and an in-depth analysis of tariquidar-mediated effects on A7r5 and EA.hy926 cells viability, on the mechanical activity of freshly and cultured rat aorta rings and on L-type Ca2+ current [ICa(L)] of A7r5 cells has been performed. In both A7r5 and EA.hy926 cells, tariquidar was not cytotoxic up to 1μM concentration. On the contrary, at 10μM, it caused apoptosis already after 24h treatment. In fresh aorta rings, 10μM tariquidar partially relaxed phenylephrine-, but not 60mM K+ (K60)-induced contraction. In rings treated with 10μM tariquidar for 7days, the contractile response to both phenylephrine and K60 remained unchanged. Finally, tariquidar did not modify ICa1.2 intensity and kinetics. In conclusion, Tariquidar might exert both cytotoxic and acute, weak vascular effects at concentrations comparable to those employed in PET imaging. This implies that caution should be exercised when using it as diagnostic tool.
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Affiliation(s)
- Miriam Durante
- Dipartimento di Scienze della Vita, Università degli Studi di Siena, Via A. Moro 2, 53100 Siena, Italy
| | - Maria Frosini
- Dipartimento di Scienze della Vita, Università degli Studi di Siena, Via A. Moro 2, 53100 Siena, Italy
| | - Fabio Fusi
- Dipartimento di Scienze della Vita, Università degli Studi di Siena, Via A. Moro 2, 53100 Siena, Italy
| | - Annalisa Neri
- Dipartimento di Scienze della Vita, Università degli Studi di Siena, Via A. Moro 2, 53100 Siena, Italy
| | - Claudia Sticozzi
- Dipartimento di Scienze della Vita, Università degli Studi di Siena, Via A. Moro 2, 53100 Siena, Italy
| | - Simona Saponara
- Dipartimento di Scienze della Vita, Università degli Studi di Siena, Via A. Moro 2, 53100 Siena, Italy.
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8
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Tsai CF, Chen MH, Wang YP, Lu CL. Reply. Gastroenterology 2017; 152:2077-2078. [PMID: 28552402 DOI: 10.1053/j.gastro.2017.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Chia-Fen Tsai
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Po Wang
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Liang Lu
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
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9
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Assaraf J, Weiss N, Thabut D. Proton Pump Inhibitor Administration Triggers Encephalopathy in Cirrhotic Patients by Modulating Blood-Brain Barrier Drug Transport. Gastroenterology 2017; 152:2077. [PMID: 28478148 DOI: 10.1053/j.gastro.2016.10.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 10/23/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Julie Assaraf
- Unité de Soins Intensifs d'Hépato-gastroentérologie, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Nicolas Weiss
- Brain Liver Pitié-Salpêtrière Study Group and Unité de Réanimation Neurologique, Fédération de Neurologie, Pôle des Maladies du Système Nerveux, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Dominique Thabut
- Unité de Soins Intensifs d'Hépato-gastroentérologie and Brain Liver Pitié-Salpêtrière Study Group, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France
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10
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Matsuda A, Karch R, Bauer M, Traxl A, Zeitlinger M, Langer O. A Prediction Method for P-glycoprotein-Mediated Drug-Drug Interactions at the Human Blood-Brain Barrier From Blood Concentration-Time Profiles, Validated With PET Data. J Pharm Sci 2017; 106:2780-2786. [PMID: 28385544 DOI: 10.1016/j.xphs.2017.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/22/2017] [Accepted: 03/27/2017] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to establish physiologically based pharmacokinetic models to predict in humans the brain concentration-time profiles and P-glycoprotein (Pgp)-mediated brain drug-drug interactions between the model Pgp substrate (R)-[11C]verapamil (VPM), the model dual Pgp/breast cancer resistance protein (BCRP) substrate [11C]tariquidar (TQD), and the Pgp inhibitor tariquidar. The model predictions were validated with results from positron emission tomography studies in humans. Using these physiologically based pharmacokinetic models, the differences between predicted and observed areas under the concentration-time curves (AUC) of VPM and TQD in the brain were within a 1.2-fold and 2.5-fold range, respectively. Also, brain AUC increases of VPM and TQD after Pgp inhibitor administration were predicted with 2.5-fold accuracy when in vitro inhibition constant or half-maximum inhibitory concentration values of tariquidar were used. The predicted rank order of the magnitude of AUC increases reflected the results of the clinical positron emission tomography studies. Our results suggest that the established models can predict brain exposure from the respective blood concentration-time profiles and rank the magnitude of the Pgp-mediated brain drug-drug interaction potential for both Pgp and Pgp/BCRP substrates in humans.
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Affiliation(s)
- Akihiro Matsuda
- Department of Clinical Pharmacology, Medical University of Vienna, A-1090 Vienna, Austria
| | - Rudolf Karch
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, A-1090 Vienna, Austria
| | - Martin Bauer
- Department of Clinical Pharmacology, Medical University of Vienna, A-1090 Vienna, Austria
| | - Alexander Traxl
- Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, A-2444 Seibersdorf, Austria
| | - Markus Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, A-1090 Vienna, Austria
| | - Oliver Langer
- Department of Clinical Pharmacology, Medical University of Vienna, A-1090 Vienna, Austria; Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, A-2444 Seibersdorf, Austria; Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, A-1090 Vienna, Austria.
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11
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Disdier C, Devoy J, Cosnefroy A, Chalansonnet M, Herlin-Boime N, Brun E, Lund A, Mabondzo A. Tissue biodistribution of intravenously administrated titanium dioxide nanoparticles revealed blood-brain barrier clearance and brain inflammation in rat. Part Fibre Toxicol 2015; 12:27. [PMID: 26337446 PMCID: PMC4559366 DOI: 10.1186/s12989-015-0102-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 08/24/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Notwithstanding increasing knowledge of titanium dioxide nanoparticles (TiO2 NPs) passing through biological barriers, their biodistribution to the central nervous system (CNS) and potential effects on blood-brain barrier (BBB) physiology remain poorly characterized. METHODS Here, we report time-related responses from single-dose intravenous (IV) administration of 1 mg/kg TiO2 NPs to rats, with particular emphasis on titanium (Ti) quantification in the brain. Ti content in tissues was analyzed using inductively coupled plasma mass spectrometry. Integrity and functionality of the BBB as well as brain inflammation were characterized using a panel of methods including RT-PCR, immuno-histo chemistry and transporter activity evaluation. RESULTS Biokinetic analysis revealed Ti biopersistence in liver, lungs and spleen up to one year after TiO2 NPs administration. A significant increase of Ti in the brain was observed at early end points followed by a subsequent decrease. In-depth analysis of Ti in the total brain demonstrated quantitative Ti uptake and clearance by brain microvasculature endothelial cells (BECs) with minimal translocation in the brain parenchyma. The presence of Ti in the BECs did not affect BBB integrity, despite rapid reversible modulation of breast cancer resistance protein activity. Ti biopersistence in organs such as liver was associated with significant increases of tight junction proteins (claudin-5 and occludin), interleukin 1β (IL-1β), chemokine ligand 1 (CXCL1) and γ inducible protein-10 (IP-10/CXCL10) in BECs and also increased levels of IL-1β in brain parenchyma despite lack of evidence of Ti in the brain. These findings mentioned suggest potential effect of Ti present at a distance from the brain possibly via mediators transported by blood. Exposure of an in vitro BBB model to sera from TiO2 NPs-treated animals confirmed the tightness of the BBB and inflammatory responses. CONCLUSION Overall, these findings suggest the clearance of TiO2 NPs at the BBB with persistent brain inflammation and underscore the role of Ti biopersistence in organs that can exert indirect effects on the CNS dependent on circulating factors.
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Affiliation(s)
- Clémence Disdier
- CEA, Direction des Sciences du Vivant, iBiTec-S, Service de Pharmacologie et d'Immunoanalyse, Equipe Pharmacologie Neurovasculaire, 91191, Gif-sur-Yvette, France
| | - Jérôme Devoy
- INRS, Département Polluants et Santé, Rue du Morvan, CS 60027, 54519, Vandœuvre Cedex, France
| | - Anne Cosnefroy
- CEA, Direction des Sciences du Vivant, iBiTec-S, Service de Pharmacologie et d'Immunoanalyse, Equipe Pharmacologie Neurovasculaire, 91191, Gif-sur-Yvette, France
| | - Monique Chalansonnet
- INRS, Département Polluants et Santé, Rue du Morvan, CS 60027, 54519, Vandœuvre Cedex, France
| | - Nathalie Herlin-Boime
- DSM, IRAMIS, NIMBE (UMR 3685), laboratory of Nanometric Structures, CEA Saclay, 91191, Gif/Yvette, France
| | - Emilie Brun
- Laboratoire de Chimie Physique, UMR CNRS 8000, Université de Paris-Sud, 91405, Orsay, France
| | - Amie Lund
- Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - Aloïse Mabondzo
- CEA, Direction des Sciences du Vivant, iBiTec-S, Service de Pharmacologie et d'Immunoanalyse, Equipe Pharmacologie Neurovasculaire, 91191, Gif-sur-Yvette, France.
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12
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Wanek T, Römermann K, Mairinger S, Stanek J, Sauberer M, Filip T, Traxl A, Kuntner C, Pahnke J, Bauer F, Erker T, Löscher W, Müller M, Langer O. Factors Governing P-Glycoprotein-Mediated Drug-Drug Interactions at the Blood-Brain Barrier Measured with Positron Emission Tomography. Mol Pharm 2015. [PMID: 26202880 PMCID: PMC4566129 DOI: 10.1021/acs.molpharmaceut.5b00168] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
![]()
The
adenosine triphosphate-binding cassette transporter P-glycoprotein
(ABCB1/Abcb1a) restricts at the blood–brain barrier (BBB) brain
distribution of many drugs. ABCB1 may be involved in drug–drug
interactions (DDIs) at the BBB, which may lead to changes in brain
distribution and central nervous system side effects of drugs. Positron
emission tomography (PET) with the ABCB1 substrates (R)-[11C]verapamil and [11C]-N-desmethyl-loperamide and the ABCB1 inhibitor tariquidar has allowed
direct comparison of ABCB1-mediated DDIs at the rodent and human BBB.
In this work we evaluated different factors which could influence
the magnitude of the interaction between tariquidar and (R)-[11C]verapamil or [11C]-N-desmethyl-loperamide at the BBB and thereby contribute to previously
observed species differences between rodents and humans. We performed in vitro transport experiments with [3H]verapamil
and [3H]-N-desmethyl-loperamide in ABCB1
and Abcb1a overexpressing cell lines. Moreover we conducted in vivo PET experiments and biodistribution studies with
(R)-[11C]verapamil and [11C]-N-desmethyl-loperamide in wild-type mice without and with
tariquidar pretreatment and in homozygous Abcb1a/1b(−/−) and heterozygous Abcb1a/1b(+/−) mice. We found no differences for in vitro transport of [3H]verapamil and [3H]-N-desmethyl-loperamide by ABCB1 and Abcb1a and its inhibition
by tariquidar. [3H]-N-Desmethyl-loperamide
was transported with a 5 to 9 times higher transport ratio than [3H]verapamil in ABCB1- and Abcb1a-transfected cells. In vivo, brain radioactivity concentrations were lower for
[11C]-N-desmethyl-loperamide than for
(R)-[11C]verapamil. Both radiotracers
showed tariquidar dose dependent increases in brain distribution with
tariquidar half-maximum inhibitory concentrations (IC50) of 1052 nM (95% confidence interval CI: 930–1189) for (R)-[11C]verapamil and 1329 nM (95% CI: 980–1801)
for [11C]-N-desmethyl-loperamide. In homozygous Abcb1a/1b(−/−) mice brain radioactivity
distribution was increased by 3.9- and 2.8-fold and in heterozygous Abcb1a/1b(+/−) mice by 1.5- and 1.1-fold,
for (R)-[11C]verapamil and [11C]-N-desmethyl-loperamide, respectively, as compared
with wild-type mice. For both radiotracers radiolabeled metabolites
were detected in plasma and brain. When brain and plasma radioactivity
concentrations were corrected for radiolabeled metabolites, brain
distribution of (R)-[11C]verapamil and
[11C]-N-desmethyl-loperamide was increased
in tariquidar (15 mg/kg) treated animals by 14.1- and 18.3-fold, respectively,
as compared with vehicle group. Isoflurane anesthesia altered [11C]-N-desmethyl-loperamide but not (R)-[11C]verapamil metabolism, and this had a
direct effect on the magnitude of the increase in brain distribution
following ABCB1 inhibition. Our data furthermore suggest that in the
absence of ABCB1 function brain distribution of [11C]-N-desmethyl-loperamide but not (R)-[11C]verapamil may depend on cerebral blood flow. In conclusion,
we have identified a number of important factors, i.e., substrate
affinity to ABCB1, brain uptake of radiolabeled metabolites, anesthesia,
and cerebral blood flow, which can directly influence the magnitude
of ABCB1-mediated DDIs at the BBB and should therefore be taken into
consideration when interpreting PET results.
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Affiliation(s)
- Thomas Wanek
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria
| | - Kerstin Römermann
- Department of Pharmacology, Toxicology & Pharmacy, University of Veterinary Medicine Hannover , Hannover, Germany.,Department of Clinical Pharmacology, Medical University of Vienna , Vienna, Austria
| | - Severin Mairinger
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria
| | - Johann Stanek
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria.,Department of Clinical Pharmacology, Medical University of Vienna , Vienna, Austria
| | - Michael Sauberer
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria
| | - Thomas Filip
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria
| | - Alexander Traxl
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria
| | - Claudia Kuntner
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria
| | - Jens Pahnke
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS) , Oslo, Norway.,Lübeck Institute of Experimental Dermatology, University of Lübeck , Lübeck, Germany
| | - Florian Bauer
- Department of Medicinal Chemistry, University of Vienna , Vienna, Austria
| | - Thomas Erker
- Department of Medicinal Chemistry, University of Vienna , Vienna, Austria
| | - Wolfgang Löscher
- Department of Pharmacology, Toxicology & Pharmacy, University of Veterinary Medicine Hannover , Hannover, Germany
| | - Markus Müller
- Department of Clinical Pharmacology, Medical University of Vienna , Vienna, Austria
| | - Oliver Langer
- Health & Environment Department, AIT Austrian Institute of Technology GmbH , Seibersdorf, Austria.,Department of Clinical Pharmacology, Medical University of Vienna , Vienna, Austria
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13
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Approaching complete inhibition of P-glycoprotein at the human blood-brain barrier: an (R)-[11C]verapamil PET study. J Cereb Blood Flow Metab 2015; 35:743-6. [PMID: 25669913 PMCID: PMC4420865 DOI: 10.1038/jcbfm.2015.19] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/11/2015] [Accepted: 01/20/2015] [Indexed: 01/25/2023]
Abstract
As P-glycoprotein (Pgp) inhibition at the blood-brain barrier (BBB) after administration of a single dose of tariquidar is transient, we performed positron emission tomography (PET) scans with the Pgp substrate (R)-[(11)C]verapamil in five healthy volunteers during continuous intravenous tariquidar infusion. Total distribution volume (VT) of (R)-[(11)C]verapamil in whole-brain gray matter increased by 273 ± 78% relative to baseline scans without tariquidar, which was higher than previously reported VT increases. During tariquidar infusion whole-brain VT was comparable to VT in the pituitary gland, a region not protected by the BBB, which suggested that we were approaching complete Pgp inhibition at the human BBB.
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14
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Poirier A, Cascais AC, Bader U, Portmann R, Brun ME, Walter I, Hillebrecht A, Ullah M, Funk C. Calibration of In Vitro Multidrug Resistance Protein 1 Substrate and Inhibition Assays as a Basis to Support the Prediction of Clinically Relevant Interactions In Vivo. Drug Metab Dispos 2014; 42:1411-22. [DOI: 10.1124/dmd.114.057943] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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15
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Umeyama Y, Fujioka Y, Okuda T. Clarification of P-glycoprotein inhibition-related drug–drug interaction risks based on a literature search of the clinical information. Xenobiotica 2014; 44:1135-44. [DOI: 10.3109/00498254.2014.928958] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Schrickx JA. Spinosad is a potent inhibitor of canine P-glycoprotein. Vet J 2014; 200:195-6. [DOI: 10.1016/j.tvjl.2014.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 01/24/2014] [Accepted: 01/26/2014] [Indexed: 12/24/2022]
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17
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Schrickx JA, Fink-Gremmels J. Inhibition of P-glycoprotein by psychotherapeutic drugs in a canine cell model. J Vet Pharmacol Ther 2014; 37:515-7. [DOI: 10.1111/jvp.12111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 01/14/2014] [Indexed: 01/16/2023]
Affiliation(s)
- J. A. Schrickx
- Faculty of Veterinary Medicine; Institute for Risk Assessment Sciences; Utrecht University; Utrecht The Netherlands
| | - J. Fink-Gremmels
- Faculty of Veterinary Medicine; Institute for Risk Assessment Sciences; Utrecht University; Utrecht The Netherlands
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18
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Ball K, Bouzom F, Scherrmann JM, Walther B, Declèves X. Physiologically based pharmacokinetic modelling of drug penetration across the blood-brain barrier--towards a mechanistic IVIVE-based approach. AAPS JOURNAL 2013; 15:913-32. [PMID: 23784110 DOI: 10.1208/s12248-013-9496-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 05/09/2013] [Indexed: 01/09/2023]
Abstract
Predicting the penetration of drugs across the human blood-brain barrier (BBB) is a significant challenge during their development. A variety of in vitro systems representing the BBB have been described, but the optimal use of these data in terms of extrapolation to human unbound brain concentration profiles remains to be fully exploited. Physiologically based pharmacokinetic (PBPK) modelling of drug disposition in the central nervous system (CNS) currently consists of fitting preclinical in vivo data to compartmental models in order to estimate the permeability and efflux of drugs across the BBB. The increasingly popular approach of using in vitro-in vivo extrapolation (IVIVE) to generate PBPK model input parameters could provide a more mechanistic basis for the interspecies translation of preclinical models of the CNS. However, a major hurdle exists in verifying these predictions with observed data, since human brain concentrations can't be directly measured. Therefore a combination of IVIVE-based and empirical modelling approaches based on preclinical data are currently required. In this review, we summarise the existing PBPK models of the CNS in the literature, and we evaluate the current opportunities and limitations of potential IVIVE strategies for PBPK modelling of BBB penetration.
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Affiliation(s)
- Kathryn Ball
- Centre de Pharmacocinétique et Métabolisme, Groupe de Recherche Servier, Orléans, France
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