title: Impact of Transporter Polymorphisms on Drug Development: Is It Clinically Significant?
abstract: Drug transporters are becoming increasingly recognized as relevant to the drug development process. This may be a reflection of increasing target complexity and the need for high-affinity interaction with drug targets that minimize off-target side effects. Moreover, as new molecular entities (NMEs) become larger in size and amphipathic in nature, interaction with drug transporters, both uptake as well as efflux, becomes increasingly likely. In some cases transporters may limit the absorption or organ-specific entry of NMEs, whereas in other cases transporters may enhance their absorption or tissue accumulation. Indeed, in some cases, transporters may prove to be a therapeutic target. Accordingly, a better understanding of potentially clinically relevant drug transporter polymorphisms earlier in the drug development process is highly desirable. In this review we examine key transporters that are important to the absorption, distribution, and excretion of a large number of drugs in clinical use. Importantly, we provide our assessment of the potential impact of known polymorphisms in such transporters and discuss whether there is sufficient evidence to incorporate these polymorphisms in the drug development process.
authors.affiliation: Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.
authors.forename: Cheynne
authors.initials: C
authors.lastname: McLean
authors.affiliation: Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.|Department of Medicine, Western University, London, Ontario, Canada.
authors.forename: Aze
authors.initials: A
authors.lastname: Wilson
authors.affiliation: Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.|Department of Medicine, Western University, London, Ontario, Canada.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Kim
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics / Q000378:metabolism; D000818:Animals; D055808:Drug Discovery / Q000379:methods / Q000639:trends*; D004347:Drug Interactions / Q000502:physiology; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000378:metabolism*; D026901:Membrane Transport Proteins / Q000235:genetics* / Q000378:metabolism*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000378:metabolism*; D011110:Polymorphism, Genetic / Q000502:physiology*
chemical_list: D018435:ATP Binding Cassette Transporter, Subfamily B; D026901:Membrane Transport Proteins; D004364:Pharmaceutical Preparations
keywords: drug development; drug transporters; pharmacogenomics