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Vol. 281, Issue 1, 304-314, 1997
Faculty of Pharmaceutical Sciences, University of Tokyo, Tokyo,
Japan (X.-Y.C., Y.K., K.N., Y.S.), and
Drug Metabolism and Analytical
Chemistry Research Center, Developmental Research Laboratories, Daiichi
Pharmaceutical Co., Ltd., Tokyo, Japan (K.-I.S., H.H.)
Irinotecan,
7-ethyl-10-[4-(1-piperidino)-1-piperidino]-carbonyloxycamptothecin
(CPT-11), is a potent anticancer drug that is increasingly used in
chemotherapy. A frequent limiting side effect involves gastrointestinal
toxicity (diarrhea), which is thought to be related to the biliary
excretion of CPT-11 and its metabolites. Accordingly, the biliary
excretion mechanisms for both the lactone and carboxylate forms of
CPT-11 and its metabolites, SN-38 and its glucuronide (SN38-Glu), were
investigated using Sprague-Dawley (SD) rats and Eisai
hyperbilirubinemic rats (EHBR), with the latter being mutant rats with
a genetic deficiency of the canalicular multispecific organic anion
transporter. After i.v. administration of CPT-11, the biliary excretion
clearance, defined as the biliary excretion rate normalized to the
hepatic concentration, of both the lactone and carboxylate forms of
SN38-Glu was much lower in EHBR. The biliary excretion clearance for
the carboxylate form of both CPT-11 and SN-38 was also substantially smaller in EHBR and showed marked saturation with increasing dose only
in SD rats. On the other hand, the biliary excretion clearance for the
lactone forms of CPT-11 and SN-38 showed only a minimal difference in
EHBR, compared with SD rats. These results suggest that, for the
carboxylate form of CPT-11 and SN-38 and the carboxylate and lactone
forms of SN38-Glu, there exists a specific transport system at the bile
canalicular membrane that is deficient in EHBR. To confirm this
hypothesis, the uptake of these substrates by isolated hepatic
canalicular membrane vesicles (CMV) was examined. ATP-dependence was
clearly observed for the uptake of these four compounds by CMV prepared
from SD rats but not by CMV from EHBR. In addition, the compounds
inhibited the ATP-dependent uptake of
S-(2,4-dinitrophenyl) glutathione by CMV from SD rats,
in a concentration-dependent manner. These results suggest that the biliary excretion of the carboxylate forms of CPT-11 and SN-38 and the
carboxylate and lactone forms of SN38-Glu is mediated by the
multispecific organic anion transporter, which is deficient in EHBR.
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