In Vivo Evidence for Carrier-Mediated Efflux Transport of 3′-Azido-3′-Deoxythymidine and 2′,3′-Dideoxyinosine Across the Blood-Brain Barriervia a Probenecid-Sensitive Transport System1

  1. Katsuko Takasawa,
  2. Tetsuya Terasaki2,
  3. Hiroshi Suzuki and
  4. Yuichi Sugiyama
  1. Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, The University of Tokyo, Hongo 7–3-1, Bunkyo-ku, Tokyo 113, Japan

    Abstract

    By analyzing the amount of ligand remaining in the brain after microinjection into the brain cortex, the apparent efflux rate constants (K eff) of 3′-azido-3′-deoxythymidine (AZT) and 2′,3′-dideoxyinosine (DDI) across the blood-brain barrier at low concentrations were determined to be 0.0317 ± 0.0068 min−1 and 0.0253 ± 0.0037 min−1, respectively. At higher concentrations, efflux exhibited saturation. The concentration of unlabeled DDI to inhibit 50% of the saturable efflux of [3H]DDI was found to be 11.3 ± 5.7 μM, assuming that DDI diffused into the same volume of brain as that of trypan blue after intracerebral administration. The efflux rate of [3H]AZT from the brain was significantly inhibited by DDI, probenecid, p-aminohippuric acid, benzylpenicillin and 4,4′-diisothiocyanatostilbene-2,2′-disulfonic acid, but not by thymidine. Moreover, the efflux rate of [3H]DDI was significantly inhibited by AZT and probenecid, but not by deoxyinosine and inosine. After intracerebroventricular injection, the apparent efflux clearances of [3H]AZT and [3H]DDI from the cerebrospinal fluid were significantly inhibited by the coadministration of probenecid. However, intracerebroventricularly administered probenecid had no effect on the efflux of [3H]AZT and [3H]DDI from the brain after intracerebral microinjection, which suggested that the efflux transport system of the blood-cerebrospinal fluid barrier is not responsible for the elimination of AZT and DDI from the cerebral cortex. These results provide kinetic evidence that AZT and DDI are transported from brain into circulating blood across the blood-brain barriervia a probenecid-sensitive carrier-mediated efflux transport system.

    Footnotes

    • Send reprint requests to: Yuichi Sugiyama. Ph.D., Professor, Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, The University of Tokyo, Hongo 7–3-1, Bunkyo-ku, Tokyo 113, Japan.

    • 1 This work was supported in part by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture, Japan and by grants from the Japan Health Sciences Foundation Drug Innovation Project. This work was presented in part at the 115th Annual Meeting of the Pharmaceutical Society of Japan, at Sendai, Japan, March, 1995.

    • 2 Present address: Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Tohoku University, Aoba, Aramakiaza Aoba-ku, Sendai 980–77, Japan.

    • Abbreviations:
      AZT
      3′-azido-3′-deoxythymidine
      [3H]AZT
      [methyl-3H]AZT
      DDI
      2′,3′-dideoxyinosine
      [3H]DDI
      [2′,3′-3H(N)]DDI
      BBB
      blood-brain barrier
      BCSFB
      blood-cerebrospinal fluid barrier
      BEI
      brain efflux index
      CSF
      cerebrospinal fluid
      DIDS
      4,4′-diisothiocyanatostilbene-2,2′-disulfonic acid
      PAH
      p-aminohippuric acid
      PCG
      benzylpenicillin
      Par2
      parietal cortex, area 2
      CNS
      central nervous system
      HIV
      human immunodeficiency virus
      AIDS
      acquired immunodeficiency disease syndrome
      HPLC
      high-performance liquid chromatography
      icv
      intracerebroventricular
      Veff
      efflux rate
      Knon
      nonsaturable efflux clearance
      Keff
      efflux rate constant
      • Received July 22, 1996.
      • Accepted December 16, 1996.
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