Document Detail


Small intestinal efflux mediated by MRP2 and BCRP shifts sulfasalazine intestinal permeability from high to low, enabling its colonic targeting.
MedLine Citation:
PMID:  19541926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sulfasalazine is characterized by low intestinal absorption, which essentially enables its colonic targeting and therapeutic action. The mechanisms behind this low absorption have not yet been elucidated. The purpose of this study was to investigate the role of efflux transporters in the intestinal absorption of sulfasalazine as a potential mechanism for its low small-intestinal absorption and colonic targeting following oral administration. The effects of P-glycoprotein (P-gp), multidrug resistance-associated protein 2 (MRP2), and breast cancer resistance protein (BCRP) inhibitors on sulfasalazine bidirectional permeability were studied across Caco-2 cell monolayers, including dose-response analysis. Sulfasalazine in vivo permeability was then investigated in the rat jejunum by single-pass perfusion, in the presence vs. absence of inhibitors. Sulfasalazine exhibited 19-fold higher basolateral-to-apical (BL-AP) than apical-to-basolateral (AP-BL) Caco-2 permeability, indicative of net mucosal secretion. MRP2 inhibitors (MK-571 and indomethacin) and BCRP inhibitors [fumitremorgin C (FTC) and pantoprazole] significantly increased AP-BL and decreased BL-AP sulfasalazine Caco-2 transport in a concentration-dependent manner. No effect was observed with the P-gp inhibitors verapamil and quinidine. The IC50 values of the specific MRP2 and BCRP inhibitors MK-571 and FTC on sulfasalazine secretion were 21.5 and 2.0 microM, respectively. Simultaneous inhibition of MRP2 and BCRP completely abolished sulfasalazine Caco-2 efflux. Without inhibitors, sulfasalazine displayed low (vs. metoprolol) in vivo intestinal permeability in the rat model. MK-571 or FTC significantly increased sulfasalazine permeability, bringing it to the low-high permeability boundary. With both MK-571 and FTC present, sulfasalazine displayed high permeability. In conclusion, efflux transport mediated by MRP2 and BCRP, but not P-gp, shifts sulfasalazine permeability from high to low, thereby enabling its colonic targeting and therapeutic action. To our knowledge, this is the first demonstration of intestinal efflux acting in favor of oral drug delivery.
Authors:
Arik Dahan; Gordon L Amidon
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Publication Detail:
Type:  Journal Article     Date:  2009-06-18
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  297     ISSN:  1522-1547     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-22     Completed Date:  2009-08-25     Revised Date:  2013-06-04    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G371-7     Citation Subset:  IM    
Affiliation:
The University of Michigan College of Pharmacy, Department of Pharmaceutical Sciences, Ann Arbor, Michigan 48109-1065, USA.
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles / pharmacology
ATP-Binding Cassette Transporters / antagonists & inhibitors,  metabolism*
Administration, Oral
Animals
Biological Transport
Caco-2 Cells
Colon / drug effects,  metabolism*
Dose-Response Relationship, Drug
Drug Delivery Systems
Humans
Indoles / pharmacology
Indomethacin / pharmacology
Intestinal Absorption*
Intestine, Small / drug effects,  metabolism*
Kinetics
Male
Multidrug Resistance-Associated Proteins / antagonists & inhibitors,  metabolism*
Neoplasm Proteins / antagonists & inhibitors,  metabolism*
P-Glycoprotein / metabolism
Perfusion
Permeability
Propionates / pharmacology
Quinolines / pharmacology
Rats
Rats, Wistar
Sulfasalazine / administration & dosage,  metabolism*
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/ABCG2 protein, human; 0/Abcc2 protein, rat; 0/Abcg2 protein, rat; 0/Indoles; 0/Multidrug Resistance-Associated Proteins; 0/Neoplasm Proteins; 0/P-Glycoprotein; 0/Propionates; 0/Quinolines; 0/multidrug resistance-associated protein 2; 115104-28-4/verlukast; 53-86-1/Indomethacin; 55387-45-6/tryptoquivaline; 599-79-1/Sulfasalazine; D8TST4O562/pantoprazole

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