Stieger Bruno, Gao Bo
Department of Clinical Pharmacology and Toxicology, University Hospital, Rämistrasse 100, Zurich, 8091, Switzerland,
Clin Pharmacokinet. 2015 Mar;54(3):225-42. doi: 10.1007/s40262-015-0241-y.
Drug targets in the central nervous system (CNS) are numerous and important for drug therapy, e.g., of epilepsy or pain. Drugs and other xenobiotics as well as nutrients cannot freely cross the blood-brain barrier or freely enter cells across plasma membranes and therefore require transport systems. This overview summarizes the current knowledge on the expression of drug transporters in barriers shielding the CNS from the systemic circulation and as such controlling the pharmacokinetics of drugs in the CNS. The main drug transporter families covered are SLCO, SCL22A, ABCB, and ABCC, as genes of these families code for numerous drug transporters. While knowledge on messenger RNA expression in humans, rats, and mice is remarkable, there is clearly a gap in knowledge on the subcellular expression of transporters in specific cells in the CNS and in the barriers shielding the CNS from the systemic circulation. Recent methodologic developments including synthesis of drugs and endogenous substances for imaging will in the future allow the investigation of the function and physiologic role of transporters in the CNS including difficult-to-access systems such as the choroid plexus.
中枢神经系统(CNS)中的药物靶点众多,对药物治疗(如癫痫或疼痛的治疗)至关重要。药物及其他外源性物质以及营养物质无法自由穿过血脑屏障,也不能自由穿过质膜进入细胞,因此需要转运系统。本综述总结了目前关于药物转运体在保护中枢神经系统免受全身循环影响从而控制中枢神经系统中药物药代动力学的屏障中的表达的知识。所涵盖的主要药物转运体家族有SLCO、SCL22A、ABCB和ABCC,因为这些家族的基因编码众多药物转运体。虽然在人类、大鼠和小鼠中关于信使核糖核酸表达的知识显著,但在中枢神经系统特定细胞以及保护中枢神经系统免受全身循环影响的屏障中转运体的亚细胞表达方面,知识显然存在空白。包括用于成像的药物和内源性物质合成在内的近期方法学进展,未来将有助于研究转运体在中枢神经系统中的功能和生理作用,包括诸如脉络丛等难以研究的系统。