A Novel Monocarboxylate Transporter Inhibitor as a Potential Treatment Strategy for γ-Hydroxybutyric Acid Overdose

Pharm Res. 2015 Jun;32(6):1894-906. doi: 10.1007/s11095-014-1583-0. Epub 2014 Dec 6.

Abstract

Purpose: Monocarboxylate transporter (MCT) inhibition represents a potential treatment strategy for γ-hydroxybutyric acid (GHB) overdose by blocking its renal reabsorption in the kidney. This study further evaluated the effects of a novel, highly potent MCT inhibitor, AR-C155858, on GHB toxicokinetics/toxicodynamics (TK/TD).

Methods: Rats were administered GHB (200, 600 or 1500 mg/kg i.v. or 1500 mg/kg po) with and without AR-C155858. Breathing frequency was continuously monitored using whole-body plethysmography. Plasma and urine samples were collected up to 8 h. The effect of AR-C155858 on GHB brain/plasma partitioning was also assessed.

Results: AR-C155858 treatment significantly increased GHB renal and total clearance after intravenous GHB administration at all the GHB doses used in this study. GHB-induced respiratory depression was significantly improved by AR-C155858 as demonstrated by an improvement in the respiratory rate. AR-C155858 treatment also resulted in a significant reduction in brain/plasma partitioning of GHB (0.1 ± 0.03) when compared to GHB alone (0.25 ± 0.02). GHB CLR and CLoral (CL/F) following oral administration were also significantly increased following AR-C155858 treatment (from 1.82 ± 0.63 to 5.74 ± 0.86 and 6.52 ± 0.88 to 10.2 ± 0.75 ml/min/kg, respectively).

Conclusion: The novel and highly potent MCT inhibitor represents a potential treatment option for GHB overdose.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Animals
  • Antidotes / pharmacology*
  • Brain / metabolism
  • Cell Line
  • Drug Overdose / drug therapy*
  • Drug Overdose / metabolism
  • Kidney / drug effects*
  • Kidney / metabolism
  • Male
  • Metabolic Clearance Rate
  • Monocarboxylic Acid Transporters / antagonists & inhibitors*
  • Monocarboxylic Acid Transporters / metabolism
  • Rats, Sprague-Dawley
  • Renal Reabsorption / drug effects
  • Respiratory Insufficiency / chemically induced
  • Respiratory Insufficiency / drug therapy*
  • Respiratory Insufficiency / metabolism
  • Respiratory Insufficiency / physiopathology
  • Respiratory Rate / drug effects
  • Sodium Oxybate / administration & dosage
  • Sodium Oxybate / pharmacokinetics
  • Sodium Oxybate / toxicity*
  • Thiophenes / pharmacology*
  • Tissue Distribution
  • Uracil / analogs & derivatives*
  • Uracil / pharmacology

Substances

  • AR C155858
  • Antidotes
  • Monocarboxylic Acid Transporters
  • Thiophenes
  • Uracil
  • Sodium Oxybate