Chen Ying, Agarwal Sagar, Shaik Naveed M, Chen Cliff, Yang Zheng, Elmquist William F
Department of Pharmaceutics, University of Minnesota, 308 Harvard St. SE, Minneapolis, MN 55455, USA.
J Pharmacol Exp Ther. 2009 Sep;330(3):956-63. doi: 10.1124/jpet.109.154781. Epub 2009 Jun 2.
The novel tyrosine kinase inhibitor dasatinib (Sprycel; BMS-354825) is approved for use in imatinib (Gleevec; STI 571)-resistant or -intolerant chronic myelogenous leukemia and may be useful for other tumors in the central nervous system (CNS). The objective of this study was to investigate the role of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) in modulating the CNS penetration of dasatinib. Results from the in vitro studies indicate that cellular delivery of dasatinib is significantly limited by active efflux due to both P-gp and BCRP. Permeability studies indicated greater permeability in the basolateral-to-apical direction than in the apical-to-basolateral direction due to active efflux by P-gp or BCRP. Selective inhibitors of P-gp and BCRP, such as (R)-4-((1aR,6R,10bS)-1,2-difluoro-1,1a,6,10b-tetrahydrodibenzo-(a,e)cyclopropa(c) cycloheptan-6-yl)-alpha-((5-quinoloyloxy)methyl)-1-piperazineethanol, trihydrochloride (zosuquidar; LY335979) and 3-(6-isobutyl-9-methoxy-1,4-dioxo-1,2,3,4,6,7,12,12alpha-octahydropyrazino1',2': 1,6pryrido3,4-bindol-3-yl)-propionic acid tert-butyl ester (Ko143), were able to restore the intracellular accumulation and abolish the directionality in net flux of dasatinib. In vivo brain distribution studies showed that the CNS distribution of dasatinib is limited, with the brain-to-plasma concentration ratios less than 0.12 in wild-type mice, which increased approximately 8-fold in Mdr1a/b(-/-) Bcrp1(-/-) mice. Dasatinib brain distribution was significantly increased in Mdr1a/b(-/-) mice and when wild-type mice were pretreated with LY335979. Simultaneous inhibition of P-gp and BCRP by elacridar [N-(4-[2-(1,2,3,4-tetrahydro-6,7-dimethoxy-2-isoquinolinyl)ethyl]-phenyl)-9,10-dihydro-5-methoxy-9-oxo-4-acridine carboxamide] (GF120918) resulted in a 5-fold increase in brain concentration. These in vitro and in vivo studies demonstrate that dasatinib is a substrate for the important efflux transporters p-glycoprotein and BCRP. These transport systems play a significant role in limiting the CNS delivery of dasatinib and may have direct implications in the treatment of primary and metastatic brain tumors.
新型酪氨酸激酶抑制剂达沙替尼(施达赛;BMS-354825)已被批准用于治疗对伊马替尼(格列卫;STI 571)耐药或不耐受的慢性粒细胞白血病,可能对中枢神经系统(CNS)中的其他肿瘤也有效。本研究的目的是调查P-糖蛋白(P-gp)和乳腺癌耐药蛋白(BCRP)在调节达沙替尼的CNS渗透中的作用。体外研究结果表明,由于P-gp和BCRP的主动外排作用,达沙替尼的细胞摄取受到显著限制。通透性研究表明,由于P-gp或BCRP的主动外排作用,从基底外侧到顶端方向的通透性大于从顶端到基底外侧方向的通透性。P-gp和BCRP的选择性抑制剂,如(R)-4-((1aR,6R,10bS)-1,2-二氟-1,1a,6,10b-四氢二苯并-(a,e)环丙并(c)环庚烷-6-基)-α-((5-喹啉氧基)甲基)-1-哌嗪乙醇三盐酸盐(唑磺达尼;LY335979)和3-(6-异丁基-9-甲氧基-1,4-二氧代-1,2,3,4,6,7,12,12α-八氢吡嗪并[1',2':1,6]吡啶并[3,4-b]吲哚-3-基)-丙酸叔丁酯(Ko143),能够恢复达沙替尼的细胞内蓄积并消除其净通量的方向性。体内脑分布研究表明,达沙替尼在CNS中的分布有限 在野生型小鼠中脑与血浆浓度比小于0.12,而在Mdr1a/b(-/-)Bcrp1(-/-)小鼠中该比值增加了约8倍。在Mdr1a/b(-/-)小鼠中以及野生型小鼠用LY335979预处理后,达沙替尼的脑分布显著增加。艾拉曲泊帕[N-(4-[2-(1,2,3,4-四氢-6,7-二甲氧基-2-异喹啉基)乙基]-苯基)-9,10-二氢-5-甲氧基-9-氧代-4-吖啶甲酰胺](GF120918)同时抑制P-gp和BCRP导致脑浓度增加5倍。这些体外和体内研究表明,达沙替尼是重要外排转运蛋白P-糖蛋白和BCRP的底物。这些转运系统在限制达沙替尼向CNS的递送中起重要作用,可能对原发性和转移性脑肿瘤的治疗有直接影响。
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