In Vitro Interactions of Epacadostat and its Major Metabolites with Human Efflux and Uptake Transporters: Implications for Pharmacokinetics and Drug Interactions
作者:Qiang Zhang、Yan Zhang、Jason Boer、Jack G. Shi、Peidi Hu、Sharon Diamond、Swamy Yeleswaram
DOI:10.1124/dmd.116.074609
日期:2017.6
Epacadostat (EPAC) is a first-in-class, orally active inhibitor of the enzyme indoleamine 2,3-dioxygenase 1 and has demonstrated promising clinical activity. In humans, three major plasma metabolites have been identified: M9 (a glucuronide-conjugate), M11 (a gut microbiota metabolite), and M12 (a secondary metabolite formed from M11). It is proposed, based on the human pharmacokinetics of EPAC, that the biliary excretion of M9, the most abundant metabolite, leads to the enterohepatic circulation of EPAC. Using various in vitro systems, we evaluated in the present study the vitro interactions of EPAC and its major metabolites with major drug transporters involved in drug absorption and disposition. EPAC is a substrate for efflux transporters P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP), but it is not a substrate for hepatic uptake transporters [organic anion transporting polypeptides OATP1B1 and OATP1B3]. The low permeability of M9 suggests an essential role for transporters in its disposition. M9 is likely excreted from hepatocytes into bile via multidrug resistance–associated protein 2 (MRP2) and BCRP, excreted into blood via MRP3, and transported from blood back into hepatocytes via OATP1B1 and OATP1B3. M11 and M12 are not substrates for P-gp, OATP1B1 or OATP1B3, and M11, but not M12, is a substrate for BCRP. With respect to inhibition of drug transporters, the potential of EPAC, M9, M11, and M12 to cause clinical drug-drug interactions via inhibition of P-gp, BCRP, OATP1B1, OATP1B3, OAT1, OAT3, or organic cation transporter 2 was estimated to be low. The current investigation underlines the importance of metabolite-transporter interactions in the disposition of clinically relevant metabolites, which may have implications for the pharmacokinetics and drug interactions of parent drugs.
E
PACadostat(E
PAC)是一种首创的口服活性酶
抑制剂,针对色
氨酸2,3-双氧酶1,已显示出良好的临床活性。在人体中,已确认三种主要的血浆代谢物:M9(
葡萄糖醛酸结合物)、M11(肠道微
生物代谢物)和M12(由M11形成的二次代谢物)。根据E
PAC在人体中的药代动力学,提出M9作为最丰富的代谢物通过胆汁排泄,导致E
PAC的肠肝循环。在本研究中,我们使用各种体外系统评估了E
PAC及其主要代谢物与参与药物吸收和分布的主要药物转运体的体外相互作用。E
PAC是外排转运体P-糖蛋白(P-gp)和乳腺癌耐药蛋白(BCRP)的底物,但不是肝脏摄取转运体[有机阴离子转运
多肽 O
ATP1B1 和 O
ATP1B3]的底物。M9的低渗透性表明转运体在其分布中的重要作用。M9可能通过多药耐药相关蛋白2(MRP2)和BCRP从肝细胞排泄到胆汁中,通过MRP3排泄到血液中,并通过O
ATP1B1和O
ATP1B3从血液运输回肝细胞。M11和M12不是P-gp、O
ATP1B1或O
ATP1B3的底物,而M11(而不是M12)是BCRP的底物。关于对药物转运体的抑制,E
PAC、M9、M11和M12通过抑制P-gp、BCRP、O
ATP1B1、O
ATP1B3、OAT1、OAT3或有机阳离子转运体2引起临床药物相互作用的潜力被估计为低。这项研究强调了代谢物与转运体相互作用在临床相关代谢物分布中的重要性,这可能对母药的药代动力学和药物相互作用产生影响。