Liu Houfu, Sahi Jasminder
Mechanistic Safety and Disposition, Platform Technology and Science, GlaxoSmithKline R&D, Shanghai, China.
Projects, Standards & Innovation, Asia Pacific DSAR, Sanofi, Shanghai, China.
J Clin Pharmacol. 2016 Jul;56 Suppl 7:S11-22. doi: 10.1002/jcph.703.
Hepatic drug transporters can play an important role in pharmacokinetics and the disposition of therapeutic drugs and endogenous substances. Altered function of hepatic drug transporters due to drug-drug interactions (DDIs), genetic polymorphisms, and disease states can often result in a change in systemic and/or tissue exposure and subsequent pharmacological/toxicological effects of their substrates. Regulatory agencies including the US Food and Drug Administration, European Medicines Agency, and Japan Pharmaceuticals and Medical Devices Agency have issued guidance for industry on drug interaction studies, which contain comprehensive recommendations on in vitro and in vivo study tools and cutoff values to evaluate the DDI potential of new molecular entities mediated by hepatic drug transporters. In this report we summarize the latest regulatory and scientific progress of hepatic drug transporters in clinical DDIs, pharmacogenetics, drug-induced liver injury (DILI), as well as methods for predicting transporter-mediated pharmacokinetics and DDIs.
肝脏药物转运体在药代动力学以及治疗药物和内源性物质的处置过程中发挥着重要作用。药物-药物相互作用(DDIs)、基因多态性和疾病状态导致的肝脏药物转运体功能改变,常常会引起其底物的全身和/或组织暴露变化,以及随后的药理学/毒理学效应改变。包括美国食品药品监督管理局、欧洲药品管理局和日本药品与医疗器械管理局在内的监管机构已发布了关于药物相互作用研究的行业指南,其中包含有关体外和体内研究工具以及评估由肝脏药物转运体介导的新分子实体DDI潜力的截断值的全面建议。在本报告中,我们总结了肝脏药物转运体在临床DDIs、药物遗传学、药物性肝损伤(DILI)方面的最新监管和科学进展,以及预测转运体介导的药代动力学和DDIs的方法。