Maeda Kazuya
Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Sciences, The University of Tokyo.
Biol Pharm Bull. 2015;38(2):155-68. doi: 10.1248/bpb.b14-00767.
Nobody doubts the importance of organic anion transporting polypeptide (OATP)1B1 and 1B3 in the clinical pharmacokinetics of substrate drugs. Based on the theory of pharmacokinetics, even if a drug is eliminated from the body by extensive metabolism, the rate-determining process of the hepatic intrinsic clearance of OATP substrates is often hepatic uptake. Because of their broad substrate specificities, once the functions of OATP1B1 or OATP1B3 are altered by several kinds of special occasions such as drug-drug interactions (DDI) and genetic polymorphisms of transporter genes, the hepatic clearance of many kinds of structurally-unrelated drugs is expected to be changed. In some cases, these alterations of pharmacokinetics lead to modified pharmacological effects and adverse reactions such as statin-induced myotoxicity and the glucose-lowering effect of anti-diabetes drugs. Thus, appropriate methods with which to quantitatively predict the changes in plasma and tissue concentrations of drugs are needed in the process of drug development. As for DDI, a static model that takes into consideration of the theoretically-maximum unbound inhibitor concentration is often used for the sensitive detection of possible DDI risks and this method has been adopted in several regulatory guidance/guidelines on DDI. Regarding genetic polymorphisms, the effects of SLCO1B1 c.388A>G and c.521T>C on the pharmacokinetics of substrate drugs have been extensively investigated. Even though there are some discrepancies, c.521T>C generally decreased hepatic uptake activity, while c.388A>G tended to slightly increase it. This article briefly summarizes the current status of research on hepatic OATP1B1 and OATP1B3 and the clinical significance of their functions.
没人会质疑有机阴离子转运多肽(OATP)1B1和1B3在底物药物临床药代动力学中的重要性。根据药代动力学理论,即使一种药物通过广泛代谢从体内消除,OATP底物肝内在清除率的限速过程通常是肝脏摄取。由于它们具有广泛的底物特异性,一旦OATP1B1或OATP1B3的功能因药物相互作用(DDI)和转运体基因的基因多态性等几种特殊情况而改变,多种结构不相关药物的肝清除率预计会发生变化。在某些情况下,这些药代动力学改变会导致药理作用和不良反应的改变,如他汀类药物引起的肌毒性和抗糖尿病药物的降糖作用。因此,在药物研发过程中需要合适的方法来定量预测药物在血浆和组织中的浓度变化。对于DDI,一种考虑理论上最大非结合抑制剂浓度的静态模型通常用于灵敏检测可能的DDI风险,并且该方法已被纳入一些关于DDI的监管指南中。关于基因多态性,SLCO1B1 c.388A>G和c.521T>C对底物药物药代动力学的影响已得到广泛研究。尽管存在一些差异,但c.521T>C通常会降低肝脏摄取活性,而c.388A>G则倾向于使其略有增加。本文简要总结了肝脏OATP1B1和OATP1B3的研究现状及其功能的临床意义。