The drug transporter P-glycoprotein limits oral absorption and brain entry of HIV-1 protease inhibitors.

Article Details

Citation

Kim RB, Fromm MF, Wandel C, Leake B, Wood AJ, Roden DM, Wilkinson GR

The drug transporter P-glycoprotein limits oral absorption and brain entry of HIV-1 protease inhibitors.

J Clin Invest. 1998 Jan 15;101(2):289-94.

PubMed ID
9435299 [ View in PubMed
]
Abstract

Currently available HIV-1 protease inhibitors are potent agents in the therapy of HIV-1 infection. However, limited oral absorption and variable tissue distribution, both of which are largely unexplained, complicate their use. We tested the hypothesis that P-glycoprotein is an important transporter for these agents. We studied the vectorial transport characteristics of indinavir, nelfinavir, and saquinavir in vitro using the model P-glycoprotein expressing cell lines L-MDR1 and Caco-2 cells, and in vivo after intravenous and oral administration of these agents to mice with a disrupted mdr1a gene. All three compounds were found to be transported by P-glycoprotein in vitro. After oral administration, plasma concentrations were elevated 2-5-fold in mdr1a (-/-) mice and with intravenous administration, brain concentrations were elevated 7-36-fold. These data demonstrate that P-glycoprotein limits the oral bioavailability and penetration of these agents into the brain. This raises the possibility that higher HIV-1 protease inhibitor concentrations may be obtained by targeted pharmacologic inhibition of P-glycoprotein transport activity.

DrugBank Data that Cites this Article

Drug Transporters
DrugTransporterKindOrganismPharmacological ActionActions
IndinavirP-glycoprotein 1ProteinHumans
Unknown
Substrate
Inhibitor
Inducer
Details
NelfinavirP-glycoprotein 1ProteinHumans
No
Substrate
Inhibitor
Inducer
Details
QuinidineP-glycoprotein 1ProteinHumans
Unknown
Substrate
Inhibitor
Details