评估在耐药性癫痫中过度表达的人多药耐药相关蛋白(MRP1、2 和 5)对常见抗癫痫药物的转运。

Evaluation of transport of common antiepileptic drugs by human multidrug resistance-associated proteins (MRP1, 2 and 5) that are overexpressed in pharmacoresistant epilepsy.

机构信息

Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Bünteweg 17, D-30559 Hannover, Germany.

出版信息

Neuropharmacology. 2010 Jun;58(7):1019-32. doi: 10.1016/j.neuropharm.2010.01.007. Epub 2010 Jan 18.

Abstract

Resistance to antiepileptic drugs (AEDs) is one of the most serious problems in the treatment of epilepsy. Accumulating experimental evidence suggests that increased expression of the drug efflux transporter P-glycoprotein (Pgp) at the blood-brain barrier may be involved in the mechanisms leading to AED resistance. In addition to Pgp, increased expression of several multidrug resistance-associated proteins (MRPs) has been determined in epileptogenic brain regions of patients with pharmacoresistant epilepsy. However, it is not known whether AEDs are substrates for MRPs. In the present experiments, we evaluated whether common AEDs are transported by human MRPs (MRP1, 2 and 5) that are overexpressed in AED resistant epilepsy. For this purpose, we used a highly sensitive assay (concentration equilibrium transport assay; CETA) in polarized kidney cell lines (LLC, MDCKII) transfected with human MRPs. The assay was validated by known MRP substrates, including calcein-AM (MRP1), vinblastine (MRP2) and chloromethylfluorescein diacetate (CMFDA; MRP5). The directional transport determined with these drugs in MRP-transfected cell lines could be blocked with the MRP inhibitor MK571. However, in contrast to transport of known MRP substrates, none of the common AEDs (carbamazepine, valproate, levetiracetam, phenytoin, lamotrigine and phenobarbital) used in this study was transported by MRP1, MRP2 or MRP5. A basolateral-to-apical transport of valproate, which could be inhibited by MK571 and probenecid, was determined in LLC cells (both wildtype and transfected), but the specific transporter involved was not identified. The data indicate that common AEDs are not substrates for human MRP1, MRP2 or MRP5, at least in the in vitro models used in this study.

摘要

抗癫痫药物(AEDs)耐药是癫痫治疗中最严重的问题之一。越来越多的实验证据表明,血脑屏障中药物外排转运体 P 糖蛋白(Pgp)的表达增加可能与导致 AED 耐药的机制有关。除了 Pgp 外,在耐药性癫痫患者的致痫脑区还确定了几种多药耐药相关蛋白(MRPs)的表达增加。然而,尚不清楚 AED 是否是 MRPs 的底物。在本实验中,我们评估了常见的 AED 是否被在 AED 耐药性癫痫中过表达的人 MRPs(MRP1、2 和 5)转运。为此,我们使用了一种高度敏感的测定法(浓度平衡转运测定法;CETA),在过表达人 MRP 的极化肾细胞系(LLC、MDCKII)中进行。该测定法通过已知的 MRP 底物(包括 calcein-AM [MRP1]、长春碱 [MRP2] 和氯甲基荧光素二乙酸酯 [CMFDA;MRP5])进行了验证。用这些药物在 MRP 转染细胞系中确定的方向转运可以被 MRP 抑制剂 MK571 阻断。然而,与已知的 MRP 底物的转运相反,本研究中使用的所有常见 AED(卡马西平、丙戊酸钠、左乙拉西坦、苯妥英钠、拉莫三嗪和苯巴比妥)均未被 MRP1、MRP2 或 MRP5 转运。在 LLC 细胞(野生型和转染型)中确定了丙戊酸钠的基底外侧至顶端的转运,该转运可以被 MK571 和丙磺舒抑制,但未鉴定出涉及的特定转运体。这些数据表明,常见的 AED 不是人 MRP1、MRP2 或 MRP5 的底物,至少在本研究中使用的体外模型中是这样。

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