Drug Metabolism and Pharmacokinetics, Division of Preclinical Innovation (DPI), National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, Rockville, MD, USA.
Expert Opin Drug Metab Toxicol. 2022 Jul-Aug;18(7-8):483-505. doi: 10.1080/17425255.2022.2112175. Epub 2022 Sep 9.
INTRODUCTION: Nucleoside analogs are an important class of antiviral agents. Due to the high hydrophilicity and limited membrane permeability of antiviral nucleoside/nucleotide analogs (AVNAs), transporters play critical roles in AVNA pharmacokinetics. Understanding the properties of these transporters is important to accelerate translational research for AVNAs. AREAS COVERED: The roles of key transporters in the pharmacokinetics of 25 approved AVNAs were reviewed. Clinically relevant information that can be explained by the modulation of transporter functions is also highlighted. EXPERT OPINION: Although the roles of transporters in the intestinal absorption and renal excretion of AVNAs have been well identified, more research is warranted to understand their roles in the distribution of AVNAs, especially to immune privileged compartments where treatment of viral infection is challenging. P-gp, MRP4, BCRP, and nucleoside transporters have shown extensive impacts in the disposition of AVNAs. It is highly recommended that the role of transporters should be investigated during the development of novel AVNAs. Clinically, co-administered inhibitors and genetic polymorphism of transporters are the two most frequently reported factors altering AVNA pharmacokinetics. Physiopathology conditions also regulate transporter activities, while their effects on pharmacokinetics need further exploration. Pharmacokinetic models could be useful for elucidating these complicated factors in clinical settings.
简介:核苷类似物是一类重要的抗病毒药物。由于抗病毒核苷/核苷酸类似物(AVNAs)具有高亲水性和有限的膜通透性,转运蛋白在 AVNA 的药代动力学中起着关键作用。了解这些转运蛋白的特性对于加速 AVNAs 的转化研究至关重要。
涵盖领域:本文综述了 25 种已批准的 AVNAs 的药代动力学中关键转运体的作用。还强调了可以通过转运体功能调节来解释的临床相关信息。
专家意见:尽管转运体在 AVNAs 的肠道吸收和肾排泄中的作用已得到充分证实,但仍需要更多的研究来了解它们在 AVNAs 分布中的作用,特别是在免疫特权部位,这些部位的病毒感染治疗具有挑战性。P-糖蛋白、MRP4、BCRP 和核苷转运体已显示出对 AVNAs 处置的广泛影响。强烈建议在开发新型 AVNAs 时应研究转运体的作用。临床上,转运体的抑制剂和遗传多态性是最常报道的两种改变 AVNA 药代动力学的因素。生理病理状况也调节转运体的活性,但其对药代动力学的影响需要进一步探索。药代动力学模型可用于阐明临床环境中的这些复杂因素。
Expert Opin Drug Metab Toxicol. 2022
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