The liver and kidney, the major clearance organs in the human body, express drug transporters, which are involved in uptake and subsequent efflux processes. Their transport activities are critical factors for the systemic exposure and elimination pathways of their substrate drugs. Overall, hepatobiliary transport of organic anions consists of three processes: sinusoidal uptake, sinusoidal efflux, and canalicular efflux. Pharmacokinetic analysis, using blood concentration-time profile, provides only intrinsic clearance for overall transport. In contrast, by determining concentration-time profile of drugs in the liver, intrinsic clearances for each process can be evaluated separately. This is particularly important for the investigation of rate-determining process, drug-drug interaction mechanisms, and determination of the in vitro/in vivo scaling factor for each process in humans. Further, time profiles of drugs in the brain provide the uptake and efflux clearances of drugs in the brain, which contribute to the deep understanding in the transport mechanisms of drugs across the human blood-brain barrier (BBB). Imaging technologies, such as single-photon emission computed tomography
Invited Speaker AbstractsDrug Metabolism Reviews, 2011; 43(S1): 2-21 (SPECT) and positron emission tomography (PET), enable the evaluation of time profile of the tissue concentration in a noninvasive manner, using radiolabeled ligands with short half-lives. Such technologies have been used for the diagnosis of tissue function, neurodegenerative illnesses, and tumor. Particularly, the high sensitivity and exceptional spatial-temporal resolution of PET make it an extremely useful tool for estimating the in vivo function of drug transporters in various tissues over time after intravenous administration of a radiolabeled drug. Recently, there is growing interest in the use of these imaging technologies for pharmacokinetic analysis of drug disposition in humans. Several SPECT and PET probes for drug transporters have been developed and applied to pharmacokinetic analysis of hepatobiliary transport and BBB transport in humans. This symposium will illustrate the recent progress in molecular-imaging technologies and their application to the quantitative transporter research in humans.Although considerable evidence is available from rodents (e.g., mdr1a/b(-/-) mice) that P-glycoprotein (P-gp) is important at the blood-brain barrier (BBB) in excluding drugs from the brain, the pharmacological and physiological importance of this transporter at the human BBB has not been quantified. For example, recent evidence suggests that P-gp may be important in the removal of beta-amyloid from the brain, a factor that is important in causing Alzheimer's disease. Thus, this raises the following question: Is P-gp activity at the BBB compromised in Alzheimer's disease? Moreover, if P-gp at the human BBB is as important as that in rodents in excluding drugs from the brain, then the potential for clinically significant drug interactions is high. Such interactions c...