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建立用于预测药物潜在胆汁淤积作用的肝胆汁酸处理机制生物动力学模型。

Development of a mechanistic biokinetic model for hepatic bile acid handling to predict possible cholestatic effects of drugs.

机构信息

Pharmacokinetics, Toxicology and Targeting, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.

Department of Pharmacology and Toxicology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.

出版信息

Eur J Pharm Sci. 2018 Mar 30;115:175-184. doi: 10.1016/j.ejps.2018.01.007. Epub 2018 Jan 5.

Abstract

Drug-induced liver injury (DILI) is a common reason for drug withdrawal from the market. An important cause of DILI is drug-induced cholestasis. One of the major players involved in drug-induced cholestasis is the bile salt efflux pump (BSEP; ABCB11). Inhibition of BSEP by drugs potentially leads to cholestasis due to increased (toxic) intrahepatic concentrations of bile acids with subsequent cell injury. In order to investigate the possibilities for in silico prediction of cholestatic effects of drugs, we developed a mechanistic biokinetic model for human liver bile acid handling populated with human in vitro data. For this purpose we considered nine groups of bile acids in the human bile acid pool, i.e. chenodeoxycholic acid, deoxycholic acid, the remaining unconjugated bile acids and the glycine and taurine conjugates of each of the three groups. Michaelis-Menten kinetics of the human uptake transporter Na-taurocholate cotransporting polypeptide (NTCP; SLC10A1) and BSEP were measured using NTCP-transduced HEK293 cells and membrane vesicles from BSEP-overexpressing HEK293 cells. For in vitro-in vivo scaling, transporter abundance was determined by LC-MS/MS in these HEK293 cells and vesicles as well as in human liver tissue. Other relevant human kinetic parameters were collected from literature, such as portal bile acid levels and composition, bile acid synthesis and amidation rate. Additional empirical scaling was applied by increasing the excretion rate with a factor 2.4 to reach near physiological steady-state intracellular bile acid concentrations (80μM) after exposure to portal vein bile acid levels. Simulations showed that intracellular bile acid concentrations increase 1.7 fold in the presence of the BSEP inhibitors and cholestatic drugs cyclosporin A or glibenclamide, at intrahepatic concentrations of 6.6 and 20μM, respectively. This simplified model provides a tool for a first indication whether drugs at therapeutic concentrations might cause cholestasis by inhibiting BSEP.

摘要

药物性肝损伤(DILI)是药物退出市场的常见原因。DILI 的一个重要原因是药物性胆汁淤积。参与药物性胆汁淤积的主要因素之一是胆汁盐外排泵(BSEP;ABCB11)。药物对 BSEP 的抑制可能导致胆汁淤积,原因是肝内胆汁酸浓度升高(毒性),随后导致细胞损伤。为了研究药物引起胆汁淤积作用的计算机预测的可能性,我们开发了一个基于人类肝脏胆汁酸处理的机制生物动力学模型,其中使用了人类体外数据。为此,我们考虑了人类胆汁酸库中的九组胆汁酸,即鹅脱氧胆酸、脱氧胆酸、其余未结合的胆汁酸以及每组三种胆汁酸的甘氨酸和牛磺酸缀合物。使用 NTCP 转导的 HEK293 细胞和过表达 BSEP 的 HEK293 细胞的膜囊泡测量了人类摄取转运蛋白 Na-牛磺胆酸共转运多肽(NTCP;SLC10A1)和 BSEP 的米氏动力学。为了进行体外到体内的比例缩放,通过 LC-MS/MS 在这些 HEK293 细胞和囊泡以及人类肝组织中确定了转运体的丰度。其他相关的人类动力学参数从文献中收集,例如门静脉胆汁酸水平和组成、胆汁酸合成和酰胺化率。通过增加排泄率 2.4 倍来应用额外的经验比例缩放,以达到暴露于门静脉胆汁酸水平后接近生理稳态的细胞内胆汁酸浓度(80μM)。模拟表明,在肝内浓度分别为 6.6 和 20μM 时,BSEP 抑制剂和胆汁淤积药物环孢素 A 或格列本脲存在的情况下,细胞内胆汁酸浓度增加 1.7 倍。这个简化的模型提供了一种工具,可以初步判断在治疗浓度下,药物是否可能通过抑制 BSEP 引起胆汁淤积。

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