An increasing number of examples in the literature suggest that the in vivo duration of drug action not only depends on macroscopic pharmacokinetic properties like plasma half-life and the time needed to equilibrate between the plasma and the effect compartments, but is also influenced by long-lasting target binding and rebinding. The present review combines information from different research areas and simulations to explore the nature of these mechanisms and the conditions in which they are most prevalent. Simulations reveal that these latter phenomena become especially influential when there is no longer sufficient free drug around to maintain high levels of receptor occupancy. There is not always a direct link between slow dissociation and long-lasting in vivo target protection, as the rate of free drug elimination from the effect compartment is also a key influencing factor. Local phenomena that hinder the diffusion of free drug molecules away from their target may allow them to consecutively bind to the same target and/or targets nearby (denoted as 'rebinding') even when their concentration in the bulk phase has already dropped to insignificant levels. The micro-anatomic properties of many effect compartments are likely to intensify this phenomenon. By mimicking the complexity of tissues, intact cells offer the opportunity to investigate both mechanisms under the same, physiologically relevant conditions.
Abbreviations2D and 3D, two-dimensional and three-dimensional; BSA, bovine serum albumin; Emax, maximal effect; GPCR, G protein coupled receptor; KD, equilibrium dissociation constant for bimolecular drug-target binding; kf, effective forward rate coefficient; koff, first-order dissociation rate constant of drug-target complex; kon, second-order association rate constant of drug-target complex; kr, effective reverse rate coefficient; PD, pharmacodynamics; PET, positron emission tomography; PK, pharmacokinetics; SPECT, Single photon emission computed tomography; t, residence time of drug-target complex; t1/2, half-life
IntroductionThere are increasing examples in the literature illustrating that the long-lasting clinical action of drugs not only depends on their macroscopic pharmacokinetic properties like their plasma half-life and the time needed to equilibrate between the plasma and the effect compartments, but also on their ability to bring about long-lasting target binding. Less known but equally important are local phenomena that cause the drug molecules to accumulate near the target and/or hinder their free three-dimensional (3D) diffusion away from that target. Such hindrance may allow the same drug molecule to consecutively bind to the same target and/or targets nearby even when the free drug concentration further away has already dropped to insignificant levels. Information about the pharmacodynamic and local pharmacokinetic mechanisms that may contribute to long-lasting drug action is widely BJP British Journal of Pharmacology DOI:10.1111DOI:10. /j.1476DOI:10. -5381.2010 488 British Journal of Ph...