Abstract
BackgroundAdenosine triphosphate binding cassette transporters such as P-glycoprotein (PGP) play an important role in drug pharmacokinetics by actively effluxing their substrates at barrier interfaces, including the blood-brain, blood-cerebrospinal fluid (CSF) and placental barriers. For a molecule to access the brain during fetal stages it must bypass efflux transporters at both the placental barrier and brain barriers themselves. Following birth, placental protection is no longer present and brain barriers remain the major line of defense. Understanding developmental differences that exist in the transfer of PGP substrates into the brain is important for ensuring that medication regimes are safe and appropriate for all patients.MethodsIn the present study PGP substrate rhodamine-123 (R123) was injected intraperitoneally into E19 dams, postnatal (P4, P14) and adult rats. Naturally fluorescent properties of R123 were utilized to measure its concentration in blood-plasma, CSF and brain by spectrofluorimetry (Clariostar). Statistical differences in R123 transfer (concentration ratios between tissue and plasma ratios) were determined using Kruskal-Wallis tests with Dunn’s corrections.ResultsFollowing maternal injection the transfer of R123 across the E19 placenta from maternal blood to fetal blood was around 20 %. Of the R123 that reached fetal circulation 43 % transferred into brain and 38 % into CSF. The transfer of R123 from blood to brain and CSF was lower in postnatal pups and decreased with age (brain: 43 % at P4, 22 % at P14 and 9 % in adults; CSF: 8 % at P4, 8 % at P14 and 1 % in adults). Transfer from maternal blood across placental and brain barriers into fetal brain was approximately 9 %, similar to the transfer across adult blood-brain barriers (also 9 %). Following birth when placental protection was no longer present, transfer of R123 from blood into the newborn brain was significantly higher than into adult brain (3 fold, p < 0.05).ConclusionsAdministration of a PGP substrate to infant rats resulted in a higher transfer into the brain than equivalent doses at later stages of life or equivalent maternal doses during gestation. Toxicological testing of PGP substrate drugs should consider the possibility of these patient specific differences in safety analysis.
Highlights
Adenosine triphosphate binding cassette transporters such as P-glycoprotein (PGP) play an important role in drug pharmacokinetics by actively effluxing their substrates at barrier interfaces, including the blood-brain, blood-cerebrospinal fluid (CSF) and placental barriers
For fetal pups the placenta restricted the amount of digoxin that entered the fetal blood, meaning that transfer from blood to brain was high the total transfer from maternal blood to fetal brain was similar to the transfer from adult blood to brain [7]
Linear range of detection To establish the linear range of R123 detection in blood, CSF and brain samples R123 was spiked into the control tissue/fluid
Summary
Adenosine triphosphate binding cassette transporters such as P-glycoprotein (PGP) play an important role in drug pharmacokinetics by actively effluxing their substrates at barrier interfaces, including the blood-brain, blood-cerebrospinal fluid (CSF) and placental barriers. For fetal pups the placenta restricted the amount of digoxin that entered the fetal blood, meaning that transfer from blood to brain was high the total transfer from maternal blood to fetal brain was similar to the transfer from adult blood to brain [7] These results have important implications for the understanding of PGP substrate transfer into the developing brain following administration to pregnant women or newborn children. Digoxin does not solely bind to the PGP transporter and to other transport systems such as Organic Anion Transporting Polypeptide 2 [14] Replicating these findings with other PGP substrates would strengthen our understanding of whether multiple PGP binding molecules follow a similar developmental profile, especially as juvenile stages of development have not been investigated with digoxin and it is not known at what stage PGP substrate transfer into the brain and CSF matures to adult levels
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