Quantitative prediction of drug disposition for uridine diphosphate-glucuronosyltransferase substrates using humanized mice.

Drug clearance and drug-drug interactions (DDIs) are important in the pharmacokinetic assessment of investigational drugs, yet predicting in vivo fraction metabolized (fm) and DDI intensity remains challenging, particularly for low-clearance compounds. This study demonstrates how human liver chimeric mice (hu-PXB mice) can predict CYP2C9-mediated drug disposition for low-clearance compounds in humans. To estimate human in vitro CYP2C9 fraction metabolized (fm,CYP2C9,in vitro), 3 CYP2C9 substrates (phenytoin, tolbutamide, and warfarin) were incubated in human hepatocytes with or without sulfaphenazole (CYP2C9 inhibitor). The fm,CYP2C9,in vitro was calculated based on hepatic intrinsic clearance. For in vivo estimation (fm,CYP2C9,in vivo), clinical DDI data obtained using CYP2C9 inhibitors were analyzed to calculate fm,CYP2C9,in vivo based on observed clearance changes. To evaluate human DDI predictability, the 3 drugs were administered intravenously to hu-PXB and SCID mice with or without CYP2C9 inhibitors (sulfaphenazole or tienilic acid). Clearance changes were calculated and compared among humans, hu-PXB mice, and SCID mice. Results showed that fm,CYP2C9,in vitro values for phenytoin and tolbutamide were overestimated compared to fm,CYP2C9,in vivo, whereas warfarin could not be evaluated under current conditions. Hu-PXB mice demonstrated a better correlation with humans in both clearance changes and absolute values compared to SCID mice. Notably, hu-PXB mice predicted CYP2C9-mediated DDI magnitude within 15% of clinical values and predicted clearance for CYP2C9 substrates within 2-fold of clinical values. These findings establish hu-PXB mice as a reliable preclinical model for predicting human CYP2C9-mediated drug disposition. SIGNIFICANCE STATEMENT: Human liver chimeric mice can accurately predict the clearance and magnitude of drug-drug interaction for CYP2C9 substrate drugs. Findings from humanized mice enable the selection of better candidates in drug discovery and facilitate the design of efficient clinical trials for investigational drugs.

Glucuronides of drugs often accumulate during long term therapy. The hydrolysis of glucuronides can be catalysed by beta-glucuronidase, an enzyme expressed in many tissues and body fluids in humans. The possible contribution of beta-glucuronidase to drug disposition in humans has not been assessed in a systematic manner, but this enzyme may be able to release, locally or systemically, the active or inactive parent compound from drug glucuronides, thereby modifying the disposition and action of these drugs. Based on the information available on the localisation, expression and variability of beta-glucuronidase, the concept of beta-glucuronidase-mediated drug metabolism is outlined in this article using examples from the literature. Since some issues surrounding the beta-glucuronidase-mediated deconjugation of drug glucuronides still need to be clarified in humans, additional data from animal models supporting this concept have been included. Moreover, as beta-glucuronidase has already been proven to be useful in tumour specific bioactivation of glucuronide prodrugs of anticancer agents, we also focus on anticancer prodrug approaches utilising beta-glucuronidase. This review summarises the role of beta-glucuronidase in drug disposition and drug targeting in humans.

Organic anion transporting polypeptide (OATP)1B1 and OATP1B3 (OATP1B) are clinically important transporters that mediate active hepatic uptake for a broad range of drugs and endogenous compounds and play a pivotal role in hepatic disposition and drug-drug interactions (DDIs) of substrate drugs. Efforts have been made on developing humanized transgenic OATP1B rodent models to mechanistically understand the role of OATP1B in drug disposition and DDIs. However, the lack of robust OATP1B functional activities limits their utility. We therefore developed humanized OATP1B1 and OATP1B3 and double-humanized OATP1B1/1B3 rat models in an Oatp1a1/1a4/1b2 knockout rat background. The knockout of rat Oatp1a1/1a4/1b2 and humanized transgenic overexpression of OATP1B1 and OATP1B3 in rat liver did not cause profound compensatory changes in gene expression of other transporters and metabolizing enzymes. The protein expression of OATP1B1 and OATP1B3 in humanized OATP1B rat liver was 4.7-fold and 22.3-fold higher than those reported in human liver tissues, respectively, and higher than those reported in humanized OATP1B mice. This has subsequently led to a robust in vitro and in vivo functional activity for a range of OATP1B substrate drugs. A translational analysis indicated a good correlation between in vitro hepatic uptake clearance measured in these models and human hepatocytes after correcting for OATP1B protein expression. Furthermore, these humanized OATP1B rats predicted the relative contribution of OATP1B in hepatic uptake of several OATP1B substrate drugs. Overall, these data suggest that our humanized OATP1B rat model is a promising tool to study OATP1B-mediated drug disposition in humans, advancing preclinical to clinical translation. SIGNIFICANCE STATEMENT: Humanized OATP1B1 and OATP1B3 and double-humanized OATP1B1/1B3 rat models were successfully generated and characterized in an Oatp1a1/1a4/1b2 knockout rat background. These novel humanized OATP1B models demonstrate greater functional activity than the existing humanized OATP1B rodent models, enabling evaluation of human OATP1B activity in vitro and in vivo in a preclinical setting. This study showed that these models are promising tools to improve the prediction of OATP1B-mediated hepatic uptake and DDIs in humans.

Fraction metabolized (fm ) and fraction transported (ft ) are important for understanding drug-drug interactions (DDIs) in drug discovery and development. However, current in vitro systems cannot accurately estimate in vivo fm due to inability to reflect the ft by efflux transporters (ft,efflux ). This study demonstrates how CYP3A-mediated DDI for CYP3A/P-gp substrates can be predicted using Hu-PXB mice as human liver chimeric mice. For estimating human in vitro fm by CYP3A enzyme (fm,CYP3A,in vitro ), six drugs, including CYP3A/P-gp substrates (alprazolam, cyclosporine, docetaxel, midazolam, prednisolone, and theophylline) and human hepatocytes were incubated with or without ketoconazole as a CYP3A inhibitor. We calculated fm,CYP3A,in vitro based on hepatic intrinsic clearance. To estimate human in vivo fm,CYP3A (fm,CYP3A,in vivo ), we collected information on clinical DDI caused by ketoconazole for these six drugs. We calculated fm,CYP3A,in vivo using the change of total clearance (CLtotal ). For evaluating the human DDI predictability, the six drugs were administered intravenously to Hu-PXB and SCID mice with or without ketoconazole. We calculated the change of CLtotal caused by ketoconazole. We compared the CLtotal change in humans with that in Hu-PXB and SCID mice. The fm,CYP3A,in vitro was overestimated compared to the fm,CYP3A,in vivo . Hu-PXB mice showed much better correlation in the change of CLtotal with humans (R2 = 0.95) compared to SCID mice (R2 = 0.0058). CYP3A-mediated DDI can be predicted by correctly estimating human fm,CYP3A,in vivo using Hu-PXB mice. These mice could be useful predicting hepatic fm and ft,efflux .

Neutralizing Antibodies Against Hepatitis C Virus and Their Role in Vaccine Immunity

The hepatitis E virus (HEV) is responsible for 20 million infections worldwide per year. Although, HEV infection is mostly self-limiting, immunocompromised individuals may evolve toward chronicity. The lack of an efficient small animal model has hampered the study of HEV and the discovery of anti-HEV therapies. Furthermore, new HEV strains, infectious to humans, are being discovered. Human liver-chimeric mice have greatly aided in the understanding of HEV, but only two genotypes (HEV-1 and HEV-3) have been studied in this model. Moreover, the immunodeficient nature of this mouse model does not allow full investigation of the virus and all aspects of its interaction with the host. Recent studies have shown the susceptibility of regular and nude Balb/c mice to a HEV-4 strain (KM01). This model should allow the investigation of the interplay between HEV and the adaptive immune system of its host, and potential immune-mediated complications. Here, we assess the susceptibility of human liver-chimeric and non-humanised mice to a different HEV-4 strain (BeSW67HEV4-2008). We report that humanised mice could be readily infected with this isolate, resulting in an infection pattern comparable to HEV-3 infection. Despite these results and in contrast to KM01, non-humanised mice were not susceptible to infection with this viral strain. Further investigation, using other HEV-4 isolates, is needed to conclusively determine HEV-4 tropism and mouse susceptibility.

Potent broadly neutralizing antibody VIR-3434 controls hepatitis B and D virus infection and reduces HBsAg in humanized mice

During the past several years, important advances have been made in our understanding of the mechanisms that regulate the expression of genes that determine drug clearance, including phase I and phase II drug-metabolising enzymes and drug transporters. Orphan nuclear receptors have been recognised as key mediators of drug-induced changes in both metabolism and efflux mechanisms. In this review, we summarise recent findings regarding the function of nuclear receptors in regulating drug-metabolising and transport systems, and the relevance of these receptors to clinical drug-drug interactions and the development of new drugs. Emphasis is given to two newly recognised 'orphan' receptors (the pregnane X receptor [PXR] and the constitutive androstane receptor [CAR]) and their regulation of cytochrome P450 enzymes, such as CYP3A4, CYP2Cs and CYP2B6; and transporters, such as P-glycoprotein (MDR1), multidrug resistance-associated proteins (MRPs) and organic anion transporter peptide 2 (OATP2). Although 'cross-talk' occurs between these two receptors and their target sequences, significant species differences exist between ligand-binding and activation profiles for both receptors, and PXR appears to be the predominant or 'master' regulator of hepatic drug disposition in humans. Several important physiological processes, such as cholesterol synthesis and bile acid metabolism, are also tightly controlled by certain ligand-activated orphan nuclear receptors (farnesoid X receptor [FXR] and liver X receptor [LXR]). In general, their ability to bind a broad range of ligands and regulate an extensive array of genes that are involved in drug clearance and disposition makes these orphan receptors attractive targets for drug development. Drugs have the capacity to alter nuclear receptor expression (modulators) and/or serve as ligands for the receptors (agonists or antagonists), and thus can have synergistic or antagonistic effects on the expression of drug-metabolising enzymes and transporters. Coadministration of drugs that are nuclear receptor agonists or antagonists can lead to severe toxicity, a loss of therapeutic efficacy or an imbalance in physiological substrates, providing a novel molecular mechanism for drug-drug interactions.

Characterization of drug disposition in humans using novel in vitro methodologies based on the Extended Clearance Model

Hepatitis E virus (HEV) is the most common cause of viral hepatitis globally, and it is an emerging pathogen in developed countries. In vivo studies of HEV have long been hindered due to the lack of an efficient small animal model. Recently, human liver chimeric mice were described as an elegant model to study chronic HEV infection. HEV infection was established in mice with humanized liver that were challenged with stool preparations containing HEV genotype (gt)1 and/or gt3. An increase in viral load and the level of HEV Ag in mouse samples were markers of active infection. Plasma-derived HEV preparations were less infectious. The kinetics of HEV ORF2 Ag during HEV infection and its impact on HEV diagnosis were described in this model. In addition, the nature of HEV particles and HEV ORF2 Ag were characterized. Moreover, humanized mice were used to study the impact of HEV infection on the hepatic innate transcriptome and evaluation of anti-HEV therapies. This review highlights recent advances in the HEV field gathered from well-established experimental mouse models, with an emphasis on this model as a tool for elucidating the course of HEV infection, the study of the HEV life cycle, the interaction of the virus with the host, and the evaluation of new anti-HEV therapies.

The hepatitis E virus (HEV) is responsible for approximately 20 million infections per year worldwide. Although most infected people can spontaneously clear an HEV infection, immune-compromised individuals may evolve towards chronicity. Chronic HEV infection can be cured using ribavirin, but viral isolates with low ribavirin sensitivity have recently been identified. Although some HEV isolates can be cultured in vitro, in vivo studies are essentially limited to primates and pigs. Since the use of these animals is hampered by financial, practical and/or ethical concerns, we evaluated if human liver chimeric mice could serve as an alternative. Humanised mice were inoculated with different HEV-containing preparations. Chronic HEV infection was observed after intrasplenic injection of cell culture-derived HEV, a filtered chimpanzee stool suspension and a patient-derived stool suspension. The viral load was significantly higher in the stool compared with the plasma. Overall, the viral titre in genotype 3-infected mice was lower than that in genotype 1-infected mice. Analysis of liver tissue of infected mice showed the presence of viral RNA and protein, and alterations in host gene expression. Intrasplenic injection of HEV-positive patient plasma and oral inoculation of filtered stool suspensions did not result in robust infection. Finally, we validated our model for the evaluation of novel antiviral compounds against HEV using ribavirin. Human liver chimeric mice can be infected with HEV of different genotypes. This small animal model will be a valuable tool for the in vivo study of HEV infection and the evaluation of novel antiviral molecules.

Drug biliary clearance (CLbile) in vivo is among the most difficult pharmacokinetic parameters to predict accurately and quantitatively because biliary excretion is influenced by metabolic enzymes, transporters, and passive diffusion across hepatocyte membranes. The purpose of this study is to demonstrate the use of Hu-FRG mice [Fah-/-/Rag2-/-/Il2rg-/- (FRG) mice transplanted with human-derived hepatocytes] to quantitatively predict human organic anion transporting polypeptide (OATP)-mediated drug disposition and CLbile To predict OATP-mediated disposition, six OATP substrates (atorvastatin, fexofenadine, glibenclamide, pitavastatin, pravastatin, and rosuvastatin) were administered intravenously to Hu-FRG and Mu-FRG mice (FRG mice transplanted with mouse hepatocytes) with or without rifampicin as an OATP inhibitor. We calculated the hepatic intrinsic clearance (CLh,int) and the change of hepatic clearance (CLh) caused by rifampicin (CLh ratio). We compared the CLh,int of humans with that of Hu-FRG mice and the CLh ratio of humans with that of Hu-FRG and Mu-FRG mice. For predicting CLbile, 20 compounds (two cassette doses of 10 compounds) were administered intravenously to gallbladder-cannulated Hu-FRG and Mu-FRG mice. We evaluated the CLbile and investigated the correlation of human CLbile with that of Hu-FRG and Mu-FRG mice. We found good correlations between humans and Hu-FRG mice in CLh,int (100% within threefold) and CLh ratio (R2 = 0.94). Moreover, we observed a much better relationship between humans and Hu-FRG mice in CLbile (75% within threefold). Our results suggest that OATP-mediated disposition and CLbile can be predicted using Hu-FRG mice, making them a useful in vivo drug discovery tool for quantitatively predicting human liver disposition. SIGNIFICANCE STATEMENT: OATP-mediated disposition and biliary clearance of drugs are likely quantitatively predictable using Hu-FRG mice. The findings can enable the selection of better drug candidates and the development of more effective strategies for managing OATP-mediated DDIs in clinical studies.

Previous articleNext article No AccessNew Biological BooksDrug Disposition in Humans: The Basis of Clinical Pharmacology. William A. Creasey Marcus M. ReidenbergMarcus M. Reidenberg Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by The Quarterly Review of Biology Volume 55, Number 1Mar., 1980 Published in association with Stony Brook University Article DOIhttps://doi.org/10.1086/411718 Views: 2Total views on this site Copyright 1980 Stony Brook Foundation, Inc.PDF download Crossref reports no articles citing this article.

Interspecies variation in drug disposition can be considered to be a function of species body weight. Therefore, it is possible to establish allometric relationships between pharmacokinetic parameters and species body weight. Interspecies scaling of pharmacokinetic data yielded from laboratory animals can often provide reliable predictions of pharmacokinetic parameters and drug disposition in humans. Significant correlations between 3'-azido-3'-deoxythymidine (AZT) pharmacokinetic parameters (total clearance, renal clearance, nonrenal clearance and steady-state volume of distribution) from mice, rats, dogs, monkeys and humans and body weight were found. Plasma AZT concentration versus chronological time profiles were markedly different for each species. However, when chronological time was converted to pharmacokinetic (physiologic) time these profiles were superimposible. These results demonstrate that interspecies pharmacokinetic scaling can be used to estimate plasma AZT concentrations in humans and can be used to design initial dosage regimens.

The ATP-binding cassette (ABC) transporter superfamily comprises membrane proteins that translocate a variety of substrates across extra- and intra-cellular membranes, and act as efflux proteins. ABC transporters are characterised by the presence of genetic polymorphisms mainly represented by single nucleotide polymorphisms (SNPs), some of which having an impact on their activity. Besides physiological substances, drugs are also substrates of some ABC transporters, mainly ABCB1, ABCC1, ABCC2, ABCC3 and ABCG2. Identifying the impact of these polymorphisms on the pharmacokinetics (PK) of these drugs may have important clinical implications, certainly for those characterised by a narrow therapeutic index and significant inter- and intra-patient PK variability. This review focuses specifically on ABCB1 and ABCC2 and critically analyses important publications dealing with the influence of ABCB1 and/or ABCC2 polymorphisms on drug disposition in humans. For different reasons discussed in this paper, the effect of ABCB1 and/or ABCC2 polymorphisms on drug concentrations in blood is not always easy to interpret and to correlate with pharmacological effects. In contrast, intracellular or target tissue drug concentrations appear more directly influenced by these polymorphisms, as illustrated with intralymphocyte concentrations for immunosupressants and antiretrovirals or with cerebrospinal fluid (CSF) concentrations for antiepileptics and antidepressants. Further research on intracellular and/or target tissue drug concentrations are still needed to better characterise the PK-PG (pharmacogenetics) relationship involving ABC transporters.