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P-glycoprotein-Based Loperamide-Cyclosporine Drug Interaction at the Rat Blood-Brain Barrier: Prediction from In Vitro Studies and Extrapolation to Humans.
MedLine Citation:
PMID:  22316009     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We have shown that the rat can quantitatively predict the verapamil-cyclopsorine A (CsA) drug-drug interaction (DDI) at the human blood-brain barrier (BBB). In addition, the potency (EC50) of CsA to inhibit rat BBB P-gp can be predicted from in vitro studies in MDRI-transfected cells. To assess if these excellent agreements extend to other substrates, we determined the magnitude of P-gp-based DDI at the rat BBB between loperamide (Lop) or its metabolite, N-desmethyl Lop (dLop), and escalating CsA blood concentrations. The percent increase in the brain:blood Lop concentration ratio was described by the Hill equation, Emax=2000%, EC50=7.1 µM and γ=3.7. The potency (EC50) of CsA to inhibit P-gp at the rat BBB was independent of the substrate used (verapamil, Lop, or dLop). Like the verapamil-CsA DDI, the potency (EC50) of CsA to inhibit rat BBB P-gp could be predicted from studies in MDRI-transfected cells. When 11C-Lop was co-administered with a 10 mg/kg i.v. infusion of CsA 1yielding ~5.6 uM CsA blood concentration) to healthy volunteers, the brain distribution of 11C-radioactivity was increased by 110% 1. When corrected for diffusible Lop metabolite(s), this translates into an increase in 11C-Lop brain distribution of 457%. Based on our rat data, we estimated a remarkably similar value at 5.6 μM blood CsA concentration, 588% increase in Lop brain distribution. These data support our conclusion that the rat is a promising model to predict P-gp based DDI at the human BBB.
Authors:
Peng Hsiao; Jashvant D Unadkat
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-8
Journal Detail:
Title:  Molecular pharmaceutics     Volume:  -     ISSN:  1543-8392     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101197791     Medline TA:  Mol Pharm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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