Mivis M. Pulido

BREAST CANCER RESISTANCE PROTEIN (BCRP/ABCG2) TRANSPORTS FLUOROQUINOLONE ANTIBIOTICS AND AFFECTS THEIR ORAL AVAILABILITY, PHARMACOKINETICS, AND MILK SECRETION

The breast cancer resistance protein (BCRP/ABCG2) is an ATP-binding cassette drug efflux transporter that extrudes xenotoxins from cells in intestine, liver, mammary gland, and other organs, affecting the pharmacological and toxicological behavior of many compounds, including their secretion into the milk. The purpose of this study was to determine whether three widely used fluoroquinolone antibiotics (ciprofloxacin, ofloxacin, and norfloxacin) are substrates of Bcrp1/BCRP and to investigate the possible role of this transporter in the in vivo pharmacokinetic profile of these compounds and their secretion into the milk. Using polarized cell lines, we found that ciprofloxacin, ofloxacin, and norfloxacin are transported by mouse Bcrp1 and human BCRP. In vivo pharmacokinetic studies showed that the ciprofloxacin plasma concentration was more than 2-fold increased in Bcrp1–/– compared with wild-type mice (1.77 ± 0.73 versus 0.85 ± 0.39 μg/ml, p < 0.01) after oral administration of ciprofloxacin (10 mg/kg). The area under the plasma concentration-time curve in Bcrp1–/– mice was 1.5-fold higher than that in wild-type mice (48.63 ± 5.66 versus 33.10 ± 4.68 min · μg/ml, p < 0.05) after i.v. administration (10 mg/kg). The milk concentration and milk/plasma ratio of ciprofloxacin were 2-fold higher in wild-type than in Bcrp1–/– lactating mice. We conclude that Bcrp1 is one of the determinants for the bioavailability of fluoroquinolones and their secretion into the milk.

Intestinal elimination of albendazole sulfoxide: pharmacokinetic effects of inhibitors.

Albendazole (ABZ) is an anthelmintic drug widely used in human and veterinary medicine. Intestinal and hepatic ABZ metabolism leads to albendazole sulfoxide (ABZSO), the active metabolite. This work examines the mechanism involved in intestinal elimination of ABZSO and their pharmacokinetic consequences in rat and sheep. To assess the drug intestinal elimination, an upper small intestine segment was isolated and perfused in situ with saline, after ABZSO administration (10 mg/kg i.v.). The intestinal clearance of ABZSO was 0.106+/-0.010 ml/min, exhibiting a stereoselective intestinal elimination to (-)ABZSO form. Oxfendazole, ampicillin and cyclosporine significantly reduced the intestinal elimination of ABZSO to 0.079+/-0.008, 0.069+/-0.009 and 0.065+/-0.012 ml/min, respectively. Glucose significantly induced ABZSO intestinal elimination. Pharmacokinetic results showed a clear and statistically significant interaction between ABZ metabolites and drug efflux inhibitors. In rat, an increased area under the curve (AUC) for ABZSO in the groups co-administered with ABZ plus verapamil (43%) and plus ketoconazole (29%) was obtained. In sheep, the AUC for ABZSO in the groups co-administered with the inhibitors were significantly higher 53.68% with verapamil, 78.62% with quinidine, and 50.55% with ivermectin.

Role of ABC Transporters in Veterinary Drug Research and Parasite Resistance

A considerable body of research has been carried out in order to throw light on the pharmacological and toxicological impact of ATP-binding cassette (ABC) drug efflux transporters such as P-glycoprotein and Breast Cancer Resistance Protein (BCRP/ABCG2/MXR). Most studies focus on their role in rendering cancer cells resistant to anticancer drugs. Drug transporters are expressed in many tissues and they are strongly involved in the oral bioavailability, and the hepatobiliary, direct intestinal and renal excretion of many drugs. In veterinary therapy, some anti parasitic drugs and/or their metabolites, such as ivermectin, moxidectin, albendazole sulfoxide, which are widely used, have been shown to be actively transported by efflux pumps. This interaction plays an important role in drug disposition since its inhibition has been shown to increase the drug bioavailability in some domestic species. Moreover, some authors have reported that parasite resistance to anthelmintic drugs may be mediated by parasite P-glycoprotein efflux. In addition, the importance of milk residues for human nutrition has aroused increasing concern about the inadvertent transfer of drugs and other substances into mammary milk of domestic animals, potentially posing a health risk to consumers. Recently, the important role of BCRP in the secretion of its substrates in milk has been demonstrated.

Effect of clotrimazole on microsomal metabolism and pharmacokinetics of albendazole.

Albendazole is a broad spectrum anthelmintic drug widely used in human and veterinary medicine. Intestinal and hepatic albendazole metabolism leads to albendazole sulfoxide (active metabolite) and albendazole sulfone (inactive metabolite) formation. Microsomal sulfonase activity can be abolished by in‐vitro interaction with clotrimazole and pharmacokinetic studies confirm this interaction. After albendazole incubation, albendazole sulfone formation was completely inhibited by 50 μm clotrimazole in intestinal incubations and a 50% inhibition was observed in hepatic incubations. The lower inhibition constant (Ki) value observed in the intestinal incubations (9.4 ± 1.0 μm) compared with the hepatic counterparts (23.3 ± 15.8 μm) pointed to a greater affinity of the enzymatic systems in the intestine. Regarding the formation of albendazole sulfoxide, an inhibition close to 50% was observed in liver and intestine at 10 μm clotrimazole. The pharmacokinetic parameters obtained following the oral co‐administration of albendazole sulfoxide and clotrimazole corroborated the in‐vitro inhibition of albendazole sulfone formation, since the ratio of the area under the plasma concentration‐time curves for the sulfoxide/sulfone (AUCABZSO/AUCABZSO2) was significantly higher (38.1%). In addition, the AUC and Cmax for albendazole sulfone were significantly lower. The effect of clotrimazole was also studied after prolonged treatment. Hepatic microsomal metabolism of albendazole was induced after 10 days of clotrimazole administration, with significant increases in formation of albendazole sulfoxide (40%) and sulfone (27%). These results offer further insight into the metabolism of benzimidazole drugs and highlight the difficulty involved in human therapy with these anthelmintics, since after prolonged treatment the drug interactions are affected differentially.

Improved LC method to determine ivermectin in plasma.

A simple, rapid and sensitive high-performance liquid chromatographic (HPLC) method has been developed to quantify Ivermectin (IVM) in plasma using an isocratic system with fluorescence detection. The method included a fast liquid phase extraction using cold methanol. HPLC separation was carried out by reversed phase chromatography with a mobile phase composed of methanol:acetonitrile:water with 0.2% acetic acid (45:50:5 v/v/v), pumped at flow rate of 2 ml min(-1). Fluorescence detection was performed at 365 nm (excitation) and 475 nm (emission). The calibration curve for IVM was linear from 0.25 to 100 ng ml(-1). The validation method yielded good results regarding linearity, precision, accuracy, specificity and recoveries. The values of the limit of detection (LOD) and limit of quantification (LOQ) were 0.032 and 0.167 ng ml(-1), respectively.

Ginseng increases intestinal elimination of albendazole sulfoxide in the rat.

Herbal products show potential drug interactions, some of them with adverse effects. The main aim of this work was to study the effect of Panax ginseng on the intestinal elimination of the benzimidazole derivative albendazole sulfoxide (ABZSO). An upper small intestine segment was isolated and perfused in situ with saline, while ABZSO solution (10 mg/kg i.v.) was administered intravenously. Blood samples and intestinal secretion were collected over 60 min and analysed by HPLC. The intestinal clearance of ABZSO was 0.106+/-0.010 ml/min. Systemic co-administration of ginseng (10 mg/kg i.v.) increased significantly (P<0.05) the clearance of ABZSO (0.132+/-0.005 ml/min). The increase in ABZSO elimination could be the result of the effect of ginseng on metabolic pathways. These results highlight the interactions between herbal products (sometimes dietary constituents) and drugs such as benzimidazoles, since ginseng modifies the luminal clearance of this anthelminthic drug and could potentially interfere with drugs that undergo the same intestinal processes.