Assessment of active transport of HIV protease inhibitors in various cell lines and the in vitro blood--brain barrier.
OBJECTIVE
To investigate the involvement of P-glycoprotein (Pgp) and the multidrug resistance-associated protein (MRP) on the active transport of the HIV protease inhibitors amprenavir, ritonavir and indinavir.


METHODS
The transport behaviour of ritonavir, indinavir and amprenavir in the presence and absence of Pgp modulators and probenecid was investigated in an in vitro blood--brain barrier (BBB) co-culture model and in monolayers of LLC-PK1, LLC-PK1:MDR1, LLC-PK1:MRP1 and Caco-2 cells.


RESULTS
All three HIV protease inhibitors showed polarized transport in the BBB model, LLC-PK1:MDR1 and Caco-2 cell line. The Pgp modulators SDZ-PSC 833, verapamil and LY 335979 inhibited polarized transport, although their potency was dependent on both the cell model and the HIV protease inhibitor used. Ritonavir and indinavir also showed polarized transport in the LLC-PK1 and LLC-PK1:MRP1 cell line, which could be inhibited by probenecid. HIV protease inhibitors were not able to inhibit competitively polarized transport of other HIV protease inhibitors in the LLC-PK1:MDR1 cell line.


CONCLUSIONS
Amprenavir, ritonavir and indinavir are mainly actively transported by Pgp, while MRP also plays a role in the transport of ritonavir and indinavir. This indicates that inhibition of Pgp could be useful therapeutically to increase HIV protease inhibitor concentrations in the brain and in other tissues and cells expressing Pgp. The HIV protease inhibitors were not able to inhibit Pgp-mediated efflux when given simultaneously, suggesting that simultaneous administration of these drugs will not increase the concentration of antiretroviral drugs in the brain.
van der Sandt
I C
IC
Leiden/Amsterdam Center for Drug Research, Division of Pharmacology, Leiden University, Leiden, the Netherlands.
Vos
C M
CM
Nabulsi
L
L
Blom-Roosemalen
M C
MC
Voorwinden
H H
HH
de Boer
A G
AG
Breimer
D D
DD
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000502:physiology*; D018528:ATP-Binding Cassette Transporters; D000818:Animals; D001253:Astrocytes / Q000378:metabolism*; D001693:Biological Transport, Active; D001812:Blood-Brain Barrier / Q000502:physiology*; D018938:Caco-2 Cells; D002219:Carbamates; D002417:Cattle; D002461:Cell Line, Transformed; D002478:Cells, Cultured; D018920:Coculture Techniques; D003524:Cyclosporins / Q000494:pharmacology; D003986:Dibenzocycloheptenes / Q000494:pharmacology; D004730:Endothelium, Vascular / Q000378:metabolism*; D005663:Furans; D017320:HIV Protease Inhibitors / Q000493:pharmacokinetics*; D006801:Humans; D019469:Indinavir / Q000493:pharmacokinetics; D018374:LLC-PK1 Cells; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D011339:Probenecid / Q000037:antagonists & inhibitors / Q000494:pharmacology; D011804:Quinolines / Q000494:pharmacology; D051381:Rats; D017208:Rats, Wistar; D019438:Ritonavir / Q000493:pharmacokinetics; D013449:Sulfonamides / Q000493:pharmacokinetics; D013552:Swine; D014700:Verapamil / Q000494:pharmacology
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D018528:ATP-Binding Cassette Transporters; D002219:Carbamates; D003524:Cyclosporins; D003986:Dibenzocycloheptenes; D005663:Furans; D017320:HIV Protease Inhibitors; D019469:Indinavir; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D011339:Probenecid; D011804:Quinolines; D019438:Ritonavir; D013449:Sulfonamides; D014700:Verapamil; C095108:amprenavir; C095179:zosuquidar trihydrochloride; C070272:valspodar