Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology and toxikology Student: Zuzana Matiašková Supervisor: doc. PharmDr. Martina Čečková, Ph.D. Title of diploma thesis: Role of selected ABC and SLC transporters in transmembrane permeability of maraviroc: effect on transport in placenta Antiretroviral drug maraviroc is an inhibitor of CCR5-trophic HIV virus and belongs to the group of entry inhibitors. Nowadays, maraviroc is administered as part of combination antiretroviral therapy (cART) primarily in adults, children over the age of two and pregnant women to reduce the risk of transmission of HIV to the fetus. The knowledge of interactions of maraviroc with drug transporters in placenta is crucial for optimizing the therapy during pregnancy, both in terms of efficacy and potential adverse effects. Maraviroc is known substrate of ABCB1 transporter, which plays a protective role to the fetus by its efflux activity in the apical membrane of trophoblast. However, the results of recent study employing dually perfused human placenta suggest involvement of other transport mechanisms in the maraviroc transplacental pharmaocokinetics, especially those operating in the opposite direction to ABCB1. The aim of this study was to evaluate in vitro studies whether, besides ABCB1,...

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Arginine transport is primarily mediated by the cationic amino acid transporters (CATs) in mammalian cells, but in aves the y+, b0,+ and B0,+ transport systems have also been observed. Arginine is the limiting catabolic substrate required for the production of nitric oxide (NO), a highly reactive compound that acts as a signaling molecule or killing compound. NO is synthesized by inducible nitric oxide synthase (iNOS) by macrophages for pathogen clearance. In mammals, CAT-2B is responsible for ARG import in the macrophage for NO synthesis, but the chicken CAT-2B isoform does not transport ARG. Therefore the objective of these studies was to identify the CAT(s) involved in mediating ARG uptake during a NO response in the chicken macrophage. Experiments were performed to measure: 1) ARG transporter mRNA and NO production from three sources of macrophages (HD11 cell line, n=6; primary 32d Cobb 500, n=8; Hyline W36, n=7) in response to Escherichia coli lipopolysaccharide (LPS); 2) the effect of CAT over-expression on NO production in response to LPS (HD11 cell line; n=8). In response to LPS iNOS mRNA abundance increased (P<0.05) 8.5-fold in the HD11 macrophages, 3.22-fold in broiler macrophages and 2.79-fold in layer macrophages. In all cells, CAT-1 was induced and CAT-2A increased (P<0.05) between 1.28 and 1.68-fold. CAT-2B was not detected at any time point or treatment condition. In the virally transformed chicken macrophage cell line (HD11) CAT-3 mRNA was induced, but in primary cells CAT-3 increased (P<0.05) 1.27-fold in broilers and 1.23-fold in layers. Transiently transfected chicken macrophages produce NO independent of LPS treatment by 6h, mock transfected controls did not respond by 6h. In the presence of LPS, CAT-1 transfected macrophages produced 50.0% more NO than mock transfected cells (P<0.05). CAT-2A and CAT-3 transfected macrophages produced only 17.6% and 72.1% of the total NO produced by controls (P<0.05). These results indicate that CAT-1 and CAT-3 are both sufficient to sustain ARG import for NO production in the chicken macrophage, but that CAT-1 produces a maximal response. These results also show that iNOS, despite its name, is constitutively present and can be activated by induction of CATs to import ARG.

The outer membrane (OM) of P. aeruginosa is a semi-permeable barrier that contributes to antibiotic resistance by reducing uptake. Finding strategies to circumvent this barrier is a major challenge. One approach involves screening in physiologically relevant conditions to identify novel activity in existing molecules. We discovered that thiostrepton (TS), a thiopeptide antibiotic with no reported activity against Gram-negative bacteria, hijacks the pyoverdine siderophore transporters FpvA and FpvB to cross the OM under iron limitation to inhibit translation. Using TS, we subsequently showed that FpvB is not primarily a pyoverdine transporter, but rather a promiscuous transporter for siderophores ferrichrome and ferrioxamine B. Our work with TS suggested that other thiopeptides may use siderophore transporters for entry into the cell. This hypothesis led to a screen to identify other thiopeptides with activity against P. aeruginosa, uncovering two other thiopeptides, thiocillin and micrococcin, that use the ferrioxamine transporter FoxA for uptake. We discovered another siderophore, bisucaberin, could also use FoxA for uptake and our collaborators solved the crystal structure of bisucaberin bound to FoxA. Through biochemical approaches, we characterized how FoxA accommodates structurally distinct ligands. Finally, we screened known large natural product antibiotics with no pseudomonal activity under nutrient limitation and discovered that the glycopeptide vancomycin inhibits growth by blocking peptidoglycan crosslinking. This pilot screen emphasizes the importance of screening for antibiotics under physiologically relevant conditions to avoid overlooking potential hits. Overall, the findings from these studies can be used to guide medicinal chemistry efforts to develop novel siderophore-antibiotic conjugates for the treatment of P. aeruginosa infections. These results also help us gain a deeper understanding of the mechanism of binding and uptake through siderophore transporters and the range of substrates that can be taken up. / Dissertation / Doctor of Philosophy (PhD) / Antibiotic resistance is a growing crisis that threatens modern medicine, and it is becoming more challenging to discover truly new antibiotics to combat this threat. Intrinsic resistance conferred by the outer membrane of Gram-negative bacteria restricts the entry of many antibiotics, especially larger antibiotics that would otherwise inhibit the growth of Gram-positive bacteria. Consequently, there are fewer treatment options for infections caused by Gram-negative bacteria and developing new antibiotics that can cross the outer membrane remains a significant challenge in drug discovery. My work describes the discovery of a class of antibiotics that can bypass the outer membrane using specific outer-membrane nutrient transporters. Using biochemical, structural biology, fluorescence microscopy, and molecular biology techniques, we uncover the molecular determinants of uptake of these antibiotics for their respective transporters. These results can inform the design of novel narrow-spectrum antibiotics that can overcome the outer membrane barrier to combat antimicrobial resistance.

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My research deals with the interplay between metabolism and transport of resveratrol and its metabolites. It takes into account the role of uptake and efflux transporters and enterohepatic circulation in the disposition of resveratrol and conjugated metabolites of resveratrol. The issue of enzyme- and transporter-mediated drug-drug interaction (DDI) is also addressed. Chapter 1 presents an introduction to resveratrol, its biological activities as well as its interactions with enzymes and transporters. It provides a background for enzyme inhibition. It also explains the hypotheses and describes in short, the studies performed. Chapter 2 is based on P450 enzyme inhibition. In the first part of this chapter, we explored the ability of sandwich cultured cryopreserved human hepatocytes to predict inhibition parameters and drug-drug interaction (DDI) values. Two lots of cryopreserved human hepatocytes were used to predict inhibition parameters. The predicted DDI values were compared with those reported in literature and clinical studies and were found to be within 1.5 fold of those reported in clinical studies. The second part of this chapter focuses on the potential of resveratrol or resveratrol-3-glucuronide (R3G) to inhibit CYP2C8. CYP2C8 has been found to be inhibited by glucuronide metabolite such as gemfibrozil-O-β-glucuronide and clopidogrel-β-glucuronide. Hence, we examined the potential of resveratrol, R3G and resveratrol-3-sulfate (R3S) to inhibit CYP2C8. We found that resveratrol, R3G and R3S inhibited CYP2C8 in a reversible manner. Chapter 3 details studies performed in human cancer cell lines (HT-29 and Caco-2) to study the role of uptake transporters in the disposition of resveratrol and R3G. Western blotting was initially performed to examine the expression of OATP1B transporters in cancer cell lines. Uptake studies were performed in HT-29 and Caco-2 cell lines with atorvastatin as a positive control. Both, western blots and uptake studies were inconclusive in detecting the presence of OATP1B transporters. Our studies showed that resveratrol undergoes passive diffusion and sulfation in Caco-2 cell line. The uptake of R3G in Caco-2 cell line was not detectable. In chapter 4, we evaluated the impact of inhibition of efflux transporters on the disposition of resveratrol, R3G and R3S. Mrp2 and bcrp inhibition studies were performed in mice and resveratrol, R3G and R3S were monitored using LC-MS/MS. Non-compartmental analysis was performed to obtain pharmacokinetic parameters. We observed that the inhibition of efflux transporters had a greater impact on area under the curve (AUC) of R3S as compared to R3G and resveratrol. Resveratrol and R3G have been shown to undergo enterohepatic circulation (EHC). This occurs due to the action of gut bacterial β-glucuronidase. This enzyme converts the glucuronide metabolite into parent, which is reabsorbed into enterocytes. The impact of inhibition of gut bacterial β-glucuronidase due to antibiotics was studied in chapter 5. Elimination of gut microbiome was attempted by using a combination of neomycin and bacitracin. Non-compartmental analysis was performed on the observed data. There was no observable difference in the AUCs of resveratrol, R3G and R3S. Chapter 6 deals with simulations performed using an existing pharmacokinetic model to explain the data obtained upon transporter and EHC inhibition. The simulations showed that the inhibition of transporters seemed to decrease the elimination rate constant of R3G and R3S. In summary, we investigated the impact of transporters on pharmacokinetics of resveratrol and its major metabolites. We also investigated P450 inhibition in sandwich cultured human hepatocytes and the potential of resveratrol, R3G and R3S to inhibit rCYP2C8. We were able to show that inhibition of transporters does impact pharmacokinetics of R3S and R3G. / Pharmaceutical Sciences

Chemotherapy related neurotoxicity is the decrease in cognitive function observed in patients receiving chemotherapy for breast cancer. For cancers with higher survival rates such as breast cancer, quality of life for patients after treatment cessation is a major concern. In studies performed in our laboratory, we reported cognitive deficiencies in male Swiss-Webster mice on administering 75 mg/kg 5-FU with 3.2 mg/kg MTX and these deficits were significantly greater than groups receiving either drug alone or in another higher dose combination. The probable mechanisms for the reported drug-drug interaction (DDI) between 5-FU and MTX could be either pharmacokinetic (PK) or pharmacological. Since the reported study consists of a combination of two drugs, it is imperative to determine if the PK of either drug was altered. On performing the PK based study we established the nature of the DDI to be PK based. We observed statistically significant changes for PK parameters clearance and apparent volume of distribution. Since, 5-FU and MTX are high clearance drugs, uptake transporters responsible for presenting the drugs to the clearing organs are the limiting factors for their clearance. Therefore, for any PK based interactions observed between 5-FU and MTX in the different dose groups a highly probable mechanism would be interactions at the site of uptake transporters. Based on the physicochemical properties of 5-FU and MTX and the results observed form the PK study, we hypothesized transporter-based interactions to be a probable mechanism for the observed DDI. From the transporter based studies we hypothesized 5-FU probably inhibited the uptake of MTX's transport across the blood brain barrier (BBB). To date the transport of MTX and other similar folates has not been characterized extensively. However, MTX is a very close analogue for reduced folates and therefore shares the transporter reduced folate carrier-1 (Rfc-1) expressed abundantly at the BBB, with endogenous reduced folates. Hence we hypothesized the decreased exposure of MTX in the presence of 5-FU would most probably be as a result of inhibition of uptake transporters such as Rfc-1. Finally, we developed a mathematical PK model for MTX to predict appropriately drug concentrations in the plasma and the brain tissue. The utility of the model was to support the hypothesized interactions responsible for the observed PK data. This models utility is to provide the PK component for the future PK-pharmacodynamic models, which would narrow the gap between the reported cognitive deficits and the PK results reported in this dissertation. / Pharmaceutical Sciences