Document Detail

Protease inhibitors atazanavir, lopinavir and ritonavir are potent blockers, but poor substrates, of ABC transporters in a broad panel of ABC transporter-overexpressing cell lines.
MedLine Citation:
PMID:  20551216     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: A possible mechanism for HIV therapy failure is the efflux of HIV drugs from viral target cells or certain body compartments by ATP-binding cassette (ABC) transporters, allowing ongoing viral replication. Here, we investigated the interaction between protease inhibitors (PIs) and ABC transporters. METHODS: To explore the potential blocking capacity of PIs, we exposed cells overexpressing multidrug resistance 1 P-glycoprotein (MDR1 P-gp), multidrug resistance protein 1 (MRP1) and breast cancer resistance protein (BCRP) to established cytotoxic substrates with or without one of the PIs atazanavir, lopinavir or ritonavir. Furthermore, to assess whether PIs serve as substrates, cell growth-inhibitory effects of these PIs were evaluated on cells overexpressing 1 of 11 ABC transporters and their parental counterparts. RESULTS: Atazanavir, lopinavir and ritonavir were highly effective in reversing resistance against established substrates in cells overexpressing MDR1 P-gp and MRP1, and, to a lesser extent, BCRP. Concurrently, however, PIs appeared to be relatively poor substrates for ABC transporters. Only a moderate level of resistance to atazanavir was observed in cells overexpressing MRP6 and MRP9 [resistance factor (RF): 2.0-2.6]. Cells overexpressing MDR1 P-gp, MRP3, MRP4 and MRP5 displayed low levels of resistance to atazanavir (RF: 1.3-1.7); MRP7- and MRP9-overexpressing cells to lopinavir (RF: 1.4-1.5); and MRP9-overexpressing cells to ritonavir (RF: 1.4). CONCLUSIONS: PIs can act as potent blockers of MDR1 P-gp, MRP1 and BCRP, but they are poor substrates for 11 ABC transporters. Consequently, ABC transporters are unlikely to play a major role in PI failure, but still may contribute to drug-specific adverse events and drug-drug interactions.
Wouter F W Bierman; George L Scheffer; Antoinet Schoonderwoerd; Gerrit Jansen; Michiel A van Agtmael; Sven A Danner; Rik J Scheper
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Publication Detail:
Type:  Journal Article     Date:  2010-06-15
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  65     ISSN:  1460-2091     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  England    
Other Details:
Languages:  eng     Pagination:  1672-80     Citation Subset:  IM    
Department of Internal Medicine, VU University Medical Center, Secretariaat Inwendige Geneeskunde, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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MeSH Terms
ATP-Binding Cassette Transporters / antagonists & inhibitors*
Cell Line
Drug Resistance, Multiple / drug effects
Enzyme Inhibitors / metabolism*
HIV Protease Inhibitors / metabolism*
Oligopeptides / metabolism*
Pyridines / metabolism*
Pyrimidinones / metabolism*
Ritonavir / metabolism*
Reg. No./Substance:
0/ATP-Binding Cassette Transporters; 0/Enzyme Inhibitors; 0/HIV Protease Inhibitors; 0/Oligopeptides; 0/Pyridines; 0/Pyrimidinones; 0/Ritonavir; 192725-17-0/lopinavir; 198904-31-3/atazanavir

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