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Vol. 282, Issue 1, 162-171, 1997
Faculty of Pharmaceutical Sciences, University of Tokyo, 7-3-1, Hongo Bunkyo-ku, Tokyo, 113, Japan (H.S., Y.S.); Faculty of Pharmaceutical Sciences, University of Tohoku, Aramaki aza-aoba, Aoba-ku, Sendai, Miyagi, 980-77, Japan (T.T.) and Faculty of Pharmaceutical Sciences, University of Kanazawa, 13-1, Takaramachi, Ishikawa, 920, Japan (A.T.)
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Abstract |
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The systemic clearance of many quinolone antibiotics is mainly via metabolism and urinary excretion; by contrast, biliary excretion is a major route of elimination for a new quinolone grepafloxacin (GPFX). Accordingly, we studied the hepatic uptake of GPFX because it is the first step in the drug's hepatobiliary transport. The hepatic uptake of GPFX in vivo after i.v. administration was found to approach the hepatic blood flow, suggesting the existence of an effective hepatic uptake mechanism. To clarify this transport mechanism, GPFX uptake by isolated rat hepatocytes was examined and found to consist of a saturable component (Km 173 µM, Vmax 6.96 nmol/min/mg) and a nonspecific diffusion component. The inhibition of GPFX uptake by ATP-depletors and a lack of effect after replacing Na+ with choline demonstrated that the uptake was an Na+-independent carrier-mediated active process. This uptake was inhibited by other quinolones and for lomefloxacin this was competitive in nature. Mutual inhibition studies were undertaken to investigate whether the transporter for GPFX might be the same as other transporters so far identified. GPFX inhibited the uptake of taurocholic acid, pravastatin (organic anion), cimetidine (organic cation) and ouabain (neutral steroid). However, GPFX uptake was not inhibited by these compounds. Confirmation that GPFX uptake is blood flow limited was obtained by extrapolation of the in vitro data based on mathematical modeling. In conclusion, the effective hepatic uptake of quinolone antibiotics are via carrier-mediated active transport, which is distinct from that involved in the transport of bile acids, organic anions, organic cations or neutral steroids.
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Introduction |
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The systemic clearance of many
NQs is mainly by metabolism and urinary excretion; by contrast, the
biliary clearance of quinolones such as GPFX and SPFX, which have
recently been developed, is larger than their renal clearance
(Matsunaga et al., 1991
; Akiyama et al., 1995a
).
Furthermore, it was reported that there was a great difference in the
liver-to-plasma concentration ratio (Kp) among NQs
(Okezaki et al., 1988
). Hepatic uptake is an important factor determining tissue distribution, the degree of biliary clearance
and the metabolism of a drug. However, the uptake mechanism of NQs by
hepatocytes has not been previously investigated.
A number of transport systems for the hepatic uptake of drugs and
endogenous compounds have been reported (Inoue et al., 1982
; Anwer and Hegner, 1978
; Hagenbuch et al., 1990
, 1991
;
Yamazaki et al., 1992a
, 1993a
, 1996
; Meier, 1995
). A
Na+-coupled secondary active transport system for TCA and
often conjugated bile acids in both rats and humans has recently been
expressed in oocytes and cloned (Ananthanarayanan et al.,
1994
; Hagenbuch and Meier, 1994
). The transport carrier that mediates
the Na+-independent uptake of various non-bile acid organic
anions such as DBSP has also been characterized and cloned (Blom
et al., 1981
; Uehara et al., 1983
; Yamazaki
et al., 1992b
, 1993b
; Jacquemin et al., 1991
,
1994
; Kullak-Ublick et al., 1995
). However, multispecific transport systems are known to be involved in the hepatic uptake of
cationic drugs (Meijer et al., 1990
; Nakamura et
al., 1994
). The substrates for the transporters have been divided
into two types based on their chemical structure, number of charges and lipophilicity (Meijer et al., 1990
; Groothuis and Meijer,
1996
). Expression cloning of the carrier protein for organic cations has been performed (Grundemann et al., 1994
).
NQs are zwitterionic drugs with carboxylic acid and cationic amine
groups that are dissociated at physiological pH (fig.
1). NQs have been reported to be recognized as cationic
compounds by a transporter for reabsorption at the brush-border side of the kidney tubule (Okano et al., 1990
), and NQs are known to
affect the uptake of anionic and cationic compounds through the
basolateral membrane in kidney cells (Ullrich et al., 1993
).
It has also been reported that NQ transport may be mediated by active
transport systems involving absorption of NQ at the brush-border of the intestine (Iseki et al., 1992
; Hirano et al.,
1994
) and uptake from the basolateral side of Caco-2 cells (Griffiths
et al., 1993
, 1994
). Therefore, it is important to clarify
what type of transport system mediates the hepatic uptake of NQs.
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Methods and Materials |
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Chemicals. GPFX (1.17 MBq/µmol, radiochemical purity 97.1%) and [3H]-cimetidine (814 MBq/µmol, 97.2%) were obtained from Amersham International (Buckinghamshire, UK). [3H]-Taurocholic acid (128 MBq/µmol, 98.5%) and [3H]-ouabain (759 MBq/µmol, 98.6%) were purchased from New England Nuclear Corp. (NEN, Boston, MA). [14C]-pravastatin (0.37 MBq/µmol) was kindly donated by Sankyo Company Ltd. (Tokyo, Japan, >95%). [3H]-Quinidine (555 MBq/µmol, 99%) was obtained from American Radiolabeled Chemicals Inc. (St. Louis, MO).
Unlabeled GPFX, OPC-17203 (internal standard for HPLC analysis) (fig. 1), SPFX, LFLX, CPFX, ENX and OFLX were synthesized or purified by Otsuka Pharmaceutical Company (Tokyo, Japan). Taurocholic acid, cimetidine, d-tubocurarine, FCCP, rotenone, DIDS, PCMB, vincristine, quinidine, verapamil and ouabain were purchased from Sigma Chemical Corp (St. Louis, MO). Sodium azide was purchased from Nacalai Tesque (Kyoto, Japan). DBSP was synthesized by Societe d'Etudes et de Recherches Biologiques (Paris, France). ICCT was obtained from Daiichi Pharmaceutical Co., Ltd. (Tokyo, Japan). Collagenase was purchased from Wako Pure Chemical Industries Ltd (Osaka, Japan). All other chemicals were of reagent grade.Cell preparation.
Hepatocytes were isolated from male
Sprague-Dawley rats by the procedure of Baur et al. (1975)
.
After isolation, the hepatocytes were suspended (2 mg protein/ml) at
0°C in albumin-free Krebs-Henseleit buffer supplemented with 12.5 mM
HEPES (pH 7.3). All studies were carried out in the presence of sodium
except for the studies of the effect of sodium on uptake and the
Na+-independent uptake of TCA. Cell viability was routinely
checked by the trypan blue [0.4% (w/v)] exclusion test. We used more
than 90% as a viability criterion, and the mean viability was
93.4 ± 0.4% (mean ± S.E. of 29 different preparations).
Protein concentrations were determined by the method described by
Bradford (1976)
, using the protein assay kit (Bio-Rad, Hercules, CA)
with bovine serum albumin as a standard.
Uptake study.
Uptake of [14C]-GPFX was
initiated by adding the ligand solution (0.5 ml) into the cell
suspension (0.5 ml, 2 mg protein/ml) preincubated at 37°C for 5 min.
At a designated time, the reaction was terminated by separating the
cells from the medium using a centrifugal filtration technique
(Schwenk, 1980
). Briefly, 200-µl aliquots were placed into centrifuge
tubes containing 50 µl 2 N NaOH, covered by 100 µl of a mixture
(density 1.015) of silicone and mineral oil. The samples were then
centrifuged for 15 sec in a tabletop microfuge (10,000 × g, Beckman Instruments Inc., Fullerton, CA). The
centrifugation pelleted the hepatocytes through the oil layer into the
alkaline solution. After the cells had dissolved in the alkaline
solution, the tube was sliced into two and each compartment was
transferred into a scintillation vial. The alkaline compartment was
neutralized with 50 µl 2 N HCl. Then, after addition of the
scintillation cocktail (Atomlight, NEN) to the vials, the radioactivity
in the medium and cells was determined using a liquid scintillation
spectrophotometer (LS 6000SE, Beckman Instruments Inc.)
Effect of medium pH. After isolating and washing the cells, they were suspended in Krebs-Henseleit buffer at pH 7.3 (10 mg protein/ml). Uptake was initiated by the addition of Krebs-Henseleit buffer (0.8 ml), containing [14C]-GPFX that had been preincubated at 37°C for 5 min, to the cell suspension (0.2 ml). The pH of the Krebs-Henseleit buffer was adjusted by dropwise addition of 2 N NaOH or 2 N HCl, and was determined before and after the uptake study.
TLC analysis of [14C]-GPFX after incubation with isolated hepatocytes. The hepatocyte incubation mixture containing [14C]-GPFX was added to ice-cold buffer. After centrifuging the mixture at 200 × g for 2 min, 200 µl of the top layer (medium) was transferred into 600 µl acetonitrile. The whole cell pellet was added to 80% acetonitrile to precipitate proteins. Each aliquot of the extracts from the medium and cells was applied to a TLC plate (Kieselgel 60 F254, Merck, Darmstadt, Germany). Then, the plate was developed with chloroform:methanol:28% ammonia solution (7:3:0.5, v/v/v). The radioactive profiles on the TLC plate were analyzed using a Bio-Imaging analyzer (Bas2000, Fuji Film, Tokyo, Japan).
Estimation of kinetic parameters. The kinetic parameters for GPFX and LFLX uptake were calculated using the following equations:
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(1) |
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(2) |
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(3) |
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(4) |
Hepatic uptake study in vivo.
Under ether
anesthesia, GPFX was administered to male rats (Nihon Ikagaku, Tokyo,
Japan), weighing approximately 250 to 300 g, via the femoral vein
at a dose of 5 mg/kg/2 ml saline (13.9 µmol/kg). Blood samples were
then collected from the femoral artery at designated times over 2 or 3 min with a heparinized syringe and a portion of liver was collected by
biopsy at 30 sec or 1 min. The rats were killed at 2 or 3 min and the
whole liver was excised immediately. A portion of the tissue was
weighed and stored at
30°C until required for assay. Liver samples
were added to nine volumes 75% methanol (w/w) and homogenized. An
internal standard (OPC-17203, 100 ng) (fig. 1) was added to the
homogenate (50 µl) and, after dilution with methanol (200 µl),
samples were centrifuged in a tabletop microfuge. The resulting
supernatants (10 µl) were subjected to HPLC. Plasma samples (25 µl)
were obtained by centrifugation of blood and the internal standard (100 ng) added together with methanol (200 µl) to precipitate a protein.
After centrifugation, the supernatants (10 µl) were subjected to
HPLC. The HPLC conditions and calculation method were as described for
the cell uptake study except that the mobile phase was
acetonitrile:water:phosphoric acid (25:75:0.2, v/v/v).
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(5) |
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(6) |
t) represents the area under the plasma
concentration-time curve from 0 to t, and VE represents the
distribution volume that consists of plasma space and the volume in
which the drug concentration equilibrates instantaneously with that in
plasma. Equation 6 divided by Cp gives
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(7) |
t)/Cp designated as the
integration plot (Kim et al., 1988Estimation of hepatic uptake clearance from in vitro data. Based on the kinetic parameters of GPFX obtained by the fitting procedure described, the PSinflux, in vitro (ml/min/kg rat) was calculated using the following equation:
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(8) |
= 1.25 · 108 cells/g liver (Lin et
al., 1980
= 1.0 · 106 cells/mg protein) and
= 44 g liver/kg rat (Sugita et al., 1982
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(9) |
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= (1 + 4RN · DN)1/2, RN = fB · PSinflux, in vitro/Qh,
DN is the dispersion number (0.17) (Iwatsubo et
al., 1996| |
Results |
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Hepatic uptake of GPFX in vivo.
The time profiles
of TCA and GPFX concentrations in plasma and liver after its i.v.
administration were analyzed kinetically. The values of
CLuptakeplasma of GPFX and TCA were calculated as 45 and 22 ml/min/kg, respectively, from the slope of the corresponding
integration plot (fig. 2). The
CLuptakeblood values, further calculated by taking the
corresponding RB values [1.37 (Akiyama et al.,
1995b
) and 0.55 (M. Kono, H. Suzuki and Y. Sugiyama, unpublished data),
respectively] into consideration, were 33 and 40 ml/min/kg,
respectively. The CLuptakeblood of GPFX (33 ml/min/kg)
was, therefore, similar to the hepatic blood flow (40 ml/min/kg)
estimated from the CLuptakeblood of TCA, which is taken
up by the liver in a blood flow limited manner.
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Time profile of [14C]-GPFX uptake by isolated rat
hepatocytes.
As shown in figure 3, the hepatic
uptake of GPFX by isolated rat hepatocytes was linear up to 1 min and
reached equilibrium at 2 to 5 min. The cell-medium concentration ratio
at equilibrium was calculated to be approximately 35, taking the
intracellular volume (4.3 µl/mg protein) (Yamazaki et al.,
1992b
) into consideration. The determination of the initial uptake
velocity of GPFX was estimated by measuring the total radioactivity,
because TLC analysis indicated that the fraction of unchanged drug to
total radioactivity was more than 90% both in the medium and cells at
1, 2 and 5 min. The initial uptake of GPFX was calculated from the
difference between the uptakes at 15 and 45 sec.
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Concentration-dependence of the initial uptake of
[14C]-GPFX and the effect of other NQs.
The uptake
clearance of GPFX declined as the concentration increased, indicating
that the uptake possessed a saturable component. The kinetic parameters
for equation 1 were as follows: Km 173 ± 33 µM, Vmax 6.96 ± 1.13 nmol/min/mg protein,
Pdif 28.1 ± 4.4 µl/min/mg protein. The kinetics of
GPFX uptake was also examined in the presence of LFLX (1 mM), and the
result is shown as an Eadie-Hofstee plot (fig. 4a).
Equation 3, derived assuming competitive inhibition, was simultaneously
fitted to both sets of uptake data in the presence and absence of LFLX
(1 mM). These fitted lines agreed well with the experimental data (fig.
4a). To clarify the manner of inhibition of LFLX, equation 4 also was
simultaneously fitted to the uptake data sets for GPFX in the absence
and presence of LFLX. Equation 4 was derived assuming noncompetitive
inhibition. Akaike's information criterion (Akaike, 1974
) values of
47 and
43 were obtained from the fitting of equations 3 and 4,
respectively, indicating that competitive inhibition was statistically
superior for describing the data. Also for the uptake of LFLX itself,
saturable and nonsaturable components were observed (fig. 4b), as for
GPFX uptake. The kinetic parameters for LFLX uptake were as follows: Km 436 ± 70 µM, Vmax
8.57 ± 1.26 nmol/min/mg protein, Pdif 13.7 ± 0.4 µl/min/mg protein. Comparison of the Km
value indicated that GPFX had a higher affinity than LFLX. Both
equations 1 and 2 were fitted to the kinetic data, assuming the two
different models consisted of a saturable component and a nonsaturable
diffusion component (equation 1) or a high affinity component and a low affinity component (equation 2). In the case of GPFX, Akaike's information criterion values were, respectively,
32 and
22 for equation 1 and 2, and for LFLX they were
34 and
13. Therefore, equation 1 better fitted the kinetic data of both NQs, suggesting that
the uptake consists of a saturable component and a nonsaturable diffusion component.
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Effects of temperature, sodium, metabolic inhibitor,
sulfhydryl-modifying reagent and anion exchanger inhibitor on the
initial uptake of [14C]-GPFX.
The initial uptake of
[14C]-GPFX at 27 and 0°C was 64 and 10% of that at
37°C, respectively, and the ratio of the uptake at 27 and 37°C
(Q10) was 1.6 (fig. 6). The lack of effect
after sodium replacement in the medium by choline demonstrated that the
uptake was an Na+-independent process. GPFX uptake was
reduced by the presence of metabolic inhibitors (FCCP and sodium azide)
but not by the sulfhydryl-modifying reagent (PCMB) and anion exchanger
inhibitor (DIDS).
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Effect of medium pH on the initial uptake of
[14C]-GPFX.
At a low concentration (5 µM),
[14C]-GPFX uptake did not change at lower values than pH
7.4, but was reduced with increasing pH, reaching 67% at pH 8.3 compared with that at pH 7.4 (fig. 7). However, at a
high concentration (1000 µM) where carrier-mediated uptake was
saturated, [14C]-GPFX uptake showed a minimal reduction
with increasing pH.
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Effects of GPFX on the uptake of substrates for some known
transporters.
GPFX reduced the uptake of TCA both in the presence
and absence of sodium in a concentration-dependent manner (fig.
8a). GPFX also inhibited the uptake of pravastatin and
cimetidine that are, respectively, substrates for organic anion and
organic cation transporters (fig. 8b). In addition, the uptake of
ouabain, a neutral steroid was very effectively and completely
inhibited by GPFX (fig. 8b). The uptake of the amphipathic organic
cation, [3H]-quinidine was almost completely abolished at
200 µM unlabeled quinidine, falling to 4.1 ± 1.3% of the
control group (mean ± S.E. of six determinations in two different
preparations), suggesting that the greater part of this uptake is
saturable. However, GPFX at a concentration of 1 mM, at which its own
uptake is saturated, inhibited quinidine uptake by only 23.8 ± 5.1%.
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Effects of organic anions, organic cations and other compounds on [14C]-GPFX uptake. The bile acid TCA and the organic anion DBSP, pravastatin and ICG did not inhibit GPFX uptake at concentrations where their own uptake should be saturated (table 2). No effect of ouabain on GPFX uptake was observed (table 2). The organic cations cimetidine, d-tubocurarine and PAEB did not inhibit GPFX uptake, but the amphipathic organic cations quinidine, verapamil and vincristine did (table 2).
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Discussion |
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GPFX and SPFX have higher hepatobiliary excretion rates among NQs
that have recently been developed (Matsunaga et al., 1991
; Akiyama et al., 1995a
). The hepatic clearance of drugs is
generally governed by three factors; hepatic blood-flow,
Qh, free fraction in blood, fB, and overall
hepatic intrinsic clearance CLintoverall (Miyauchi
et al., 1987
; Yamazaki et al., 1996
). However,
the distribution of drugs between blood and liver cells does not always proceed under the assumption of rapid equilibrium. In this case, CLintoverall is a hybrid parameter that is described by
equation 10 (Miyauchi et al., 1987
; Yamazaki et
al., 1996
), where PSinflux, PSefflux and
CLint represent the influx clearance from blood to liver, the efflux clearance from liver to blood and the intrinsic biliary excretion and/or metabolic clearance, respectively.
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(10) |
PSefflux).
The hepatic uptake of GPFX was estimated to be so effective in
vivo that about 80% of GPFX was taken up during the first-pass through the liver (fig. 2); this was estimated by comparing hepatic uptake clearance with the hepatic blood-flow rate that was estimated from TCA uptake clearance (fig. 2b). To clarify the effective transport
mechanism of GPFX, studies using isolated rat hepatocytes were carried
out. The cell-to-medium concentration ratio at equilibrium was
approximately 35 (intracellular space: 4.3 µl/mg protein) (Yamazaki
et al., 1992b
), which was comparable with the liver to
unbound plasma concentration ratio (Kpu = approximately 20) (H. Sasabe, Y. Kato, T. Terasaki, A. Tsuji and Y. Sugiyama, unpublished data) estimated in vivo, suggesting that GPFX is
concentratively taken up by the liver (fig. 3). Such uptake may be due
to active transport and/or protein binding in liver cells. The uptake
of GPFX is temperature and concentration dependent, and uptake was reduced to nearly 60% of controls by treatment with FCCP and sodium azide that are known to deplete cellular ATP (fig. 6). This indicates that part of the concentrative uptake is produced by carrier-mediated active transport. However, rotenone did not reduce the uptake of GPFX
significantly (fig. 6). In our laboratory, systematic analysis of
intracellular ATP content has been performed after treatment with FCCP
and rotenone, by changing the treatment time and concentration of the
metabolic inhibitor (Yamazaki et al., 1993a
); the ATP
content is rapidly reduced and the uptake of organic anion is
concomitantly reduced after treatment with FCCP and rotenone. In our
experiment, hepatocytes were treated with rotenone (30 µM) or FCCP (2 µM) for 5 min. In this situation, the intracellular ATP content
declines to 20% (rotenone) and 6% (FCCP) of that in the control, and
FCCP has a stronger effect than rotenone (Yamazaki et al.,
1993a
). Thus, the observation that GPFX uptake is not markedly reduced
by rotenone might indicate that GPFX can be transported in the presence
of a small amount of intracellular ATP.
Kinetic analysis showed that GPFX uptake consists of a saturable
component (Km 173 µM) and a nonspecific
diffusion component (fig. 4). By comparing
Vmax/Km with Pdif, the
contribution of each component to the uptake clearance was calculated
to be nearly 1:1 over the range of therapeutic plasma concentrations
(<5 µM). The saturable component may be predominantly due to active
transport, considering that the reduced uptake by metabolic inhibitors
was roughly 40% of the controls. In rats, as shown in figure 2a, the plasma concentration of unbound GPFX was calculated to be less than 20 µM at 20 sec after bolus i.v. administration with the based on a
fp value of 0.6 (Akiyama et al., 1995b
). This
concentration was approximately 10% of its Km
(173 µM) for uptake, suggesting that the carrier-mediated transport
may also be functioning in in vivo.
The hepatic uptake clearance of GPFX in vivo
(CLuptakeblood) was calculated, based on a mathematical
model (equation 10), using the uptake clearance
(PSinflux, in vitro) obtained from this
in vitro study together with fp, RB
and Qh estimated from the hepatic uptake clearance of TCA
the uptake of which is known to be almost blood flow limited (Iga and
Klaassen, 1982
). The calculated CLuptakeblood (37 ml/min/kg) was close to that (33 ml/min/kg) obtained from integration
plot analysis in vivo. Such a successful extrapolation from
in vitro to in vivo indicates that the
carrier-mediated uptake that was identified from the in
vitro study using isolated hepatocytes, reflects the uptake
in vivo. The value of hepatic blood flow determined from the
uptake clearance of TCA, was 40 ml/min/kg which is smaller than the
usual rat hepatic blood flow, about 60 ml/min/kg (Dedrick et
al., 1973
; Luts et al., 1977
). Part of this difference
might be due to the effect of ether anesthesia. Taking account of the fact that GPFX is so rapidly taken up into liver cells that the uptake
is nearly blood flow limited (fig. 2), it is possible that the hepatic
uptake of GPFX might be reduced by the anesthesia.
GPFX has a carboxyl group and a secondary amine in the piperazine ring
with pKa values of 7.1 and 8.8, respectively (fig. 1). Because of this,
the relationship between GPFX uptake and the pH of the medium was
examined. At a concentration of 1 mM where carrier-mediated uptake is
considered to be saturated, the change in pH did not significantly
affect GPFX uptake, indicating that the uptake by nonspecific diffusion
is relatively independent of the medium pH (fig. 7). At a lower
concentration (5 µM), the reduced uptake at higher pH values seems to
be due to a reduction in carrier-mediated uptake (fig. 7). These
results suggest that the carrier-mediated uptake is not accelerated by
dissociation of the carboxyl group, and that the hepatic uptake of GPFX
is not probably mediated by the H+-antiport system that
requires a H+-gradient from the inside to the outside of
the cell as a driving-force and mediates the hepatic uptake of
N-methylnicotinamide (Moseley et al., 1990
).
There are several reports indicating that NQs can be recognized by
several transport system in various body tissues. For example, reabsorption of OFLX by renal cells through the brush-border membrane was reported to be mediated by an H+-antiport system, as a
cationic compound (Okano et al., 1990
), although NQs
inhibited the transport of cationic compounds N-methylnicotinamide, TEA
and the uptake of anionic compound p-aminohippurate through the
basolateral membrane of renal cells (Ullrich et al., 1993
). The absorption of ENX through the brush-border membrane in intestinal cells was known to be mediated by an active transport system with the
membrane potential as the driving force (Hirano et al.,
1994
). Moreover, an active transporter mediates the uptake of CPFX from the basolateral side of Caco-2 cells (Griffiths et al.,
1993
, 1994
).
In our study, we investigated whether the GPFX uptake system is
identical with known transport systems for conjugated bile acids,
organic anions, organic cations and the neutral steroid ouabain. GPFX
inhibited the Na+-dependent and Na+-independent
transport of TCA (fig. 8a) and the uptake of pravastatin, cimetidine
and ouabain (fig. 8b). At 200 µM, close to the
Km for GPFX uptake, GPFX reduced the TCA uptake
to only 70 to 75% of controls, although at 1 mM (about six times the
Km), approximately 50% of the TCA uptake and
40% of the pravastatin uptake remained uninhibited. We previously
reported that the contribution of passive diffusion was only 10% of
the total uptake of TCA and pravastatin (Yamazaki et al.,
1992a
, 1993b
). Therefore, 1 mM GPFX only partially inhibited the
carrier-mediated uptake of TCA and pravastatin. In the case of
cimetidine uptake, considering that the contribution of passive
diffusion is approximately 25% (Nakamura et al., 1994
), the
carrier-mediated uptake of cimetidine seemed to be inhibited almost
completely by 1 mM GPFX (fig. 8b). Ouabain uptake was also completely
inhibited by GPFX (fig. 8b).
The inhibition of GPFX uptake by the substrates for these transporters
was also examined. The concentrations of inhibitors were chosen so that
the carrier-mediated uptake of the inhibitors would be saturated. The
Km for Na+-dependent and
Na+-independent uptake of TCA was reported to be 15 and 57 µM, respectively (Anwer and Hegner, 1978
). The
Km for DBSP and pravastatin uptake was reported
to be 2 and 29 µM, respectively (Blom et al., 1981
; Yamazaki et al., 1993b
). Thus, the inhibition studies
involving these compounds were carried out at concentrations of
inhibitors ranging from 5 to 100 µM for DBSP and 20 to 500 µM for
pravastatin. GPFX uptake was not inhibited by TCA, DBSP, pravastatin
and ICG at concentrations higher than their Km
value (table 2), suggesting that the GPFX transport system is different
from the transporters for bile acids and organic anions.
It is suggested that a transporter exists for comparatively hydrophilic
monovalent cations and one for hydrophobic multivalent cations. The
compounds for each transporter have been classified as type I and type
II, i.e., cationic and aliphatic methylammonium compounds
such as TEA, PAEB and cimetidine belong to type I, and lipophilic
organic cations with an amino group in the cyclic structure such as
d-tubocurarine belong to type II (Meijer et al.,
1990
; Groothuis et al., 1996
). Moreover, investigations have
been carried out to discover the driving-force and molecular weight of
each transporter by the photoaffinity labeling technique (Mol et
al., 1988
, 1991
, 1992
; Muller et al., 1988
). Inhibition
of GPFX uptake by type I compounds, cimetidine and PAEB was not
observed at high concentrations, 10 times higher than the
Km for their own uptake (table 2). Type II
compounds (d-tubocurarine) did not inhibit GPFX uptake
(table 2), indicating that the GPFX uptake system differs from the
organic cation transporter.
Ouabain (neutral steroid) is known to be taken up by a carrier-mediated
system into the liver and inhibits TCA uptake in a competitive manner
(Okudaira et al., 1988
). Ouabain uptake was completely
inhibited by GPFX (fig. 8b), although ouabain did not inhibit GPFX
uptake at concentrations approximately 15-fold higher than the
Km for its own uptake (table 2). Thus, GPFX and
ouabain may not share the same transporter. Quinidine, verapamil and
vincristine, which are amphipathic cations, inhibited GPFX uptake
concentration dependently (table 2). To study the relationship between
transport systems for GPFX and these compounds, the effect of GPFX on
quinidine uptake was investigated. The hepatic uptake of
[3H]-quinidine was completely abolished by unlabeled
quinidine (200 µM), indicating the possibility that this uptake may
be carrier-mediated. GPFX at a concentration of 1 mM, which can
saturate GPFX uptake (six times the Km), reduced
the quinidine uptake to only 75% of the controls. If these two drugs
share a transporter, quinidine uptake should be reduced by GPFX (1 mM)
to approximately one-seventh (calculated from 1/(1 + I/Km)). Therefore, the transporters for GPFX and
quinidine may differ. These results based on mutual inhibition studies
indicate that the transporter for GPFX uptake is different from the
other transporters so far identified.
Very recently, an oatp has been reported to have a broad substrate
specificity (including not only organic anions but also bile acids,
organic cations and the neutral steroid, ouabain) (Bossyut et
al., 1996). Moreover, it is not currently known if multiple forms
of oatp or multiple transcripts originating in alternative splicing
exist (Jacquemin et al., 1994
). If oatp has multiple forms
that have overlapping substrate specificities, it is reasonable for
oatp to recognize a broad range of multiple substances. GPFX inhibited
the transport of TCA, cimetidine and ouabain, and GPFX uptake was
inhibited by amphipathic organic cations such as quinidine (fig. 8;
table 2). These observations show the possibility that GPFX could be
transported by a form of oatp. However, GPFX uptake was not reduced by
pravastatin, DBSP and ouabain (table 2). These findings may be
explained by the following hypothesis. GPFX is transported by multiple
isoform of oatp although pravastatin, DBSP and ouabain are transported by a single isoform. If the isoform that recognizes pravastatin, DBSP
and ouabain contributes only slightly to GPFX uptake, GPFX could
potently inhibit the uptake of these compounds although they do not
inhibit GPFX uptake, or at least only to a small extent. This
possibility requires further investigation.
Although the transporter for GPFX appeared to be different from those for TCA, pravastatin, cimetidine and ouabain, GPFX inhibited the uptake of all these compounds. Such inhibition may be caused by the following mechanism: GPFX is a highly lipophilic compound so that GPFX may bind to the plasma membrane in close proximity to some transporters for bile acids, organic anions and cations. This may then bring about a change in the environment around the transporters and reduce subsequent transport. If such nonspecific binding to cell surface occurs, it would occur very rapidly. Therefore, it may be estimated from the extrapolated uptake value at zero-time by isolated hepatocytes. The nonspecific binding of GPFX was estimated to be 51.8 µl/mg protein for the time-profile of uptake shown in figure 3. This nonspecific binding of GPFX may be one of the mechanisms for the inhibitory effect of GPFX on the transport of various compounds. An analysis for a concentration dependence of such nonspecific binding was carried out using the data in figure 4a, and the distribution volume representing the nonspecific binding was found to be 49.4 to 55.9 µl/mg protein (mean data of four different experiments) over the concentration rage 5 to 1000 µM. Although the value of nonspecific binding amounts to approximately 10 times the intracellular volume, the nonspecific binding did not exhibit any change at different concentrations of GPFX, indicating that the nonspecific binding of GPFX to hepatocytes was not saturable.
In conclusion, the hepatic uptake of GPFX is by a Na+-independent and carrier-mediated active transport system, and the contribution of carrier-mediated uptake to the total uptake of GPFX is approximately 50% at therapeutic plasma concentrations (<5 µM). None of the transporters for bile acids, organic anions, organic cations or ouabain seems to be responsible for the hepatic uptake of GPFX. Successful extrapolation of in vivo hepatic uptake clearance from in vitro uptake data using isolated hepatocytes confirms that the carrier-mediated transport observed in vitro actually plays a role in the effective hepatic uptake of GPFX in vivo.
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Acknowledgments |
|---|
We thank Dr. Y. Yabuuchi, Dr. S. Yamashita and Mr. M. Odomi in Otsuka Pharmaceutical company for donating labeled and unlabeled grepafloxacin and for valuable discussion.
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Footnotes |
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Accepted for publication March 21, 1997.
Received for publication September 5, 1996.
Send reprint requests to: Dr. Yuichi Sugiyama, Faculty of Pharmaceutical Sciences, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113, Japan.
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Abbreviations |
|---|
NQ, quinolone antibiotics;
GPFX, grepafloxacin;
SPFX, sparfloxacin;
LFLX, lomefloxacin;
OFLX, ofloxacin;
CPFX, ciprofloxacin;
ENX, enoxacin;
TCA, taurocholic acid;
oatp, organic
anion transporting polypeptide;
FCCP, carbonylcyanide-p(trifluoromethoxy)phenyl-hydrazone;
DBSP, dibromosulfophthalein;
DIDS, 4,4
-diisothiocyanatostilbene
2,2
-disulfonic acid;
PCMB, p-chloromercuribenzoic acid;
ICG, indocyanine green;
PAEB, procainamide ethobromide;
TEA, triethylmethylammonium;
HEPES, 4-(2-hydroxyethyl)-1-piperazine
ethanesulfonic acid;
Km, Michaelis-Menten
constant, Vmax, maximum uptake rate;
Pdif, nonspecific uptake clearance;
CL, clearance;
AUC, area under the curve;
Qh, hepatic blood flow;
TLC, thin-layer chromatography;
HPLC, high performance liquid chromatography;
oatp, organic anion
transporting polypeptide.
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References |
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