title: Metabolism of the macrolide immunosuppressant, tacrolimus, by the pig gut mucosa in the Ussing chamber.
abstract: 1. The macrolide tacrolimus (FK506), used as an immunosuppressant, is a cytochrome P450 (CYP) 3A substrate in the liver. The metabolism of tacrolimus and the transport of its metabolites in the pig gut was studied in the Ussing chamber. Tacrolimus and its metabolites were quantified by h.p.l.c./mass spectrometry. 2. In the Ussing chamber, demethyl, didemethyl, hydroxy and hydroxy-demethyl tacrolimus were generated. Their formation was concentration- and time-dependent. The metabolite pattern was not different from that after incubation of tacrolimus with human small intestinal microsomes. 3. The metabolite formation was highest in the duodenum and declined in the order duodenum > jejunum > ileum > colon > stomach. 4. Since tacrolimus metabolism was inhibited by the specific CYP3A inhibitors, troleandomycin and ketoconazole, we concluded that these enzymes are involved in intestinal metabolism of tacrolimus. 5. Tacrolimus metabolites re-entered the mucosa chamber (> 90%) and passed through the small intestinal preparation into the serosa chamber. 6. It is concluded that tacrolimus is metabolized in the intestine, that the metabolites are able to re-enter the gut lumen and also enter into the portal vein and that small intestinal metabolism and transport is at least in part responsible for the low oral bioavailability of tacrolimus.
authors.affiliation: Institut für Allgemeine Pharmakologie, Medizinische Hochschule Hannover, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Lampen
authors.forename: U
authors.initials: U
authors.lastname: Christians
authors.forename: A K
authors.initials: AK
authors.lastname: Gonschior
authors.forename: A
authors.initials: A
authors.lastname: Bader
authors.forename: I
authors.initials: I
authors.lastname: Hackbarth
authors.forename: W
authors.initials: W
authors.lastname: von Engelhardt
authors.forename: K F
authors.initials: KF
authors.lastname: Sewing
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology; D001189:Aryl Hydrocarbon Hydroxylases; D051544:Cytochrome P-450 CYP3A; D065607:Cytochrome P-450 Enzyme Inhibitors; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D005753:Gastric Mucosa / Q000187:drug effects*; D007166:Immunosuppressive Agents / Q000378:metabolism*; D007654:Ketoconazole / Q000494:pharmacology; D010089:Oxidoreductases, N-Demethylating / Q000037:antagonists & inhibitors / Q000378:metabolism; D013552:Swine; D016559:Tacrolimus / Q000031:analogs & derivatives / Q000378:metabolism*; D014217:Troleandomycin / Q000494:pharmacology; D014665:Vasodilator Agents / Q000494:pharmacology; D014700:Verapamil / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D065607:Cytochrome P-450 Enzyme Inhibitors; D007166:Immunosuppressive Agents; D014665:Vasodilator Agents; D003577:Cytochrome P-450 Enzyme System; D014217:Troleandomycin; D014700:Verapamil; D001189:Aryl Hydrocarbon Hydroxylases; D051544:Cytochrome P-450 CYP3A; D010089:Oxidoreductases, N-Demethylating; D007654:Ketoconazole; D016559:Tacrolimus