Inhibition of P-glycoprotein enhances transport of imipramine across the blood-brain barrier: microdialysis studies in conscious freely moving rats (original) (raw)

P.1.e.004 Chronic stress and antidepressant treatment have opposite effects on P-glycoprotein at the blood-brain barrier

European Neuropsychopharmacology, 2009

The multi-drug efflux transporter P-glycoprotein is expressed in high concentrations at the blood-brain barrier and has a major function in the transport of drugs. In a recent PET-study evidence was found for an increased function of P-glycoprotein at the blood-brain barrier in medicated patients suffering from major depressive disorder. We used small-animal PET and [ 11 C]-verapamil to study P-glycoprotein function at the blood-brain barrier of rats, either being administered as venlafaxine, an antidepressant, or subjected to chronic stress, a factor contributing to the development of depression. In a first experiment, male Wistar rats underwent a three-week foot shock procedure as a model of human depression. In a second experiment, rats were chronically treated with the antidepressant venlafaxine (25 mg/kg/d via an implanted osmotic minipump). In both experiments, a [ 11 C]-verapamil PET scan was performed. In the chronically stressed rats, the distribution volume (V T ) of [ 11 C]-verapamil was significantly increased, whereas treatment with venlafaxine had the opposite effect and caused a significant reduction in V T . The changes in V T could not be attributed to the influx rate constant (K 1 ). Our data suggest that P-glycoprotein function at the blood-brain barrier is inhibited by chronic stress and increased by chronic administration of venlafaxine.

Influence of P-glycoprotein inhibition on the distribution of the tricyclic antidepressant nortriptyline over the blood-brain barrier

Human Psychopharmacology: Clinical and Experimental, 2005

The distribution of the antidepressant drug nortriptyline (NT) and its main metabolite E-10-hydroxy-nortriptyline (E-10-OH-NT) across the blood-brain barrier was considered in relation to inhibition of the multidrug transporter P-glycoprotein (P-gp). Rats received NT in doses of 25 mg/kg orally, 10 mg/kg i.p. or 25 mg/kg i.p. Half the rats were treated with the Pglycoprotein inhibitor cyclosporine A (CsA) (200 mg/kg) 2 h prior to NT administration, and the other half served as a control group. NT and the metabolite were extracted from brain and serum by liquid-liquid extraction and analysed by HPLC with UV-detection. The brain to serum ratio of NT was increased in the CsA treated groups (22.3-26.8) compared with the control groups (16.5-22.7), the difference being statistically significant in two of the three experiments ( p < 0.05). Increased brain-serum ratios were also found for E-10-OH-NT, but the differences were not statistically significant. These results suggest that inhibition of P-gp by CsA increases the accumulation of NT in the brain. Administration of the antipsychotic drug risperidone (0.5 mg/kg s.c.), which is a P-gp substrate, instead of CsA did not exert any measurable influence on the blood-brain ratio of NT concentrations.

Transport mechanisms for the antidepressant citalopram in brain microvessel endothelium

Brain Research, 1999

Blood-brain barrier transport of the selective serotonin reuptake inhibitor and antidepressant, citalopram, was studied using monolayers of bovine brain microvessel endothelial cells (BMECs). This study provides for the first time, evidence of a transport mechanism for a selective serotonin reuptake inhibitor (SSRI). Carrier-mediated transport, efflux mechanisms, as well as inhibition of metabolizing enzymes of citalopram were investigated. Citalopram transport was saturable and temperaturedependent suggesting that passage of the drug across BMECs was mediated by a carrier mechanism. Since the apical to basolateral and basolateral to apical permeability coefficients were similar and cyclosporin A, a P-glycoprotein inhibitor, does not modify the transport of citalopram, it appeared that no active efflux systems were involved in this transport. Citalopram is only available as a racemic drug and its pharmacological effect resides mainly in the S-(+)-enantiomer. However, the passage of citalopram enantiomers across BMEC monolayers was not stereoselective. Finally, inhibition of the metabolizing enzymes of citalopram and monoamine oxidases did not modify the permeation of citalopram across BMECs. Collectively, our results suggested that citalopram crosses the blood-brain barrier via a non-stereoselective, bidirectional and symmetrical carrier-mediated mechanism without influences of active efflux mechanisms or monoamine oxidases.

Locally increased P-glycoprotein function in major depression: a PET study with [11C]verapamil as a probe for P-glycoprotein function in the blood–brain barrier

The International Journal of Neuropsychopharmacology, 2009

The aetiology of depressive disorder remains unknown, although genetic susceptibility and exposure to neurotoxins are currently being discussed as possible contributors to this disorder. In normal circumstances, the brain is protected against bloodborne toxic influences by the blood-brain barrier, which includes the molecular efflux pump P-glycoprotein (P-gp) in the vessel wall of brain capillaries. We hypothesized that P-gp function in the blood-brain barrier is changed in patients with major depression. Positron emission tomography was used to measure brain uptake of [ 11 C]verapamil, which is normally expelled from the brain by P-gp. Cerebral volume of distribution (V T) of [ 11 C]verapamil was used as a measure of P-gp function. Both region-of-interest (ROI) analysis and voxel analysis using statistical parametric mapping (SPM2) were performed to assess regional brain P-gp function. We found that patients with a major depressive episode, using antidepressants, compared to healthy controls showed a significant decrease of [ 11 C]verapamil uptake in different areas throughout the brain, in particular in frontal and temporal regions. The decreased [ 11 C]verapamil uptake correlates with an increased function of the P-gp protein and may be related to chronic use of psychotropic drugs. Our results may explain why treatment-resistant depression can develop.

Chronic stress and antidepressant treatment have opposite effects on P-glycoprotein at the blood--brain barrier: an experimental PET study in rats

Journal of Psychopharmacology, 2010

The multi-drug efflux transporter P-glycoprotein is expressed in high concentrations at the blood-brain barrier and has a major function in the transport of drugs. In a recent PET-study evidence was found for an increased function of P-glycoprotein at the blood-brain barrier in medicated patients suffering from major depressive disorder. We used small-animal PET and [ 11 C]-verapamil to study P-glycoprotein function at the blood-brain barrier of rats, either being administered as venlafaxine, an antidepressant, or subjected to chronic stress, a factor contributing to the development of depression. In a first experiment, male Wistar rats underwent a three-week foot shock procedure as a model of human depression. In a second experiment, rats were chronically treated with the antidepressant venlafaxine (25 mg/kg/d via an implanted osmotic minipump). In both experiments, a [ 11 C]-verapamil PET scan was performed. In the chronically stressed rats, the distribution volume (V T ) of [ 11 C]-verapamil was significantly increased, whereas treatment with venlafaxine had the opposite effect and caused a significant reduction in V T . The changes in V T could not be attributed to the influx rate constant (K 1 ). Our data suggest that P-glycoprotein function at the blood-brain barrier is inhibited by chronic stress and increased by chronic administration of venlafaxine.

Effects of the Binding of Imipramine to Erythrocytes and Plasma Proteins on Its Transport Through the Rat Blood-Brain Barrier

Journal of Neurochemistry, 1988

Brain extraction of a tricyclic antidepressant, imipramine, was investigated using the carotid injection technique in the rat. The extent to which drug binding to plasma proteins and erythrocytes could inhibit the brain extraction was measured. Equilibrium dialysis showed that imipramine is highly bound to human serum albumin (HSA), a,-acid glycoprotein (AAG), lipoproteins, and erythrocytes. The free dialyzable drug fraction was inversely related to the protein concentration. Despite this degree of binding, no significant ireduction in the brain extraction of the drug was observed in the presence of HSA, lipoprotein, or erythrocytes. Only AAG reduced the brain

Selective drug transport and P-glycoprotein activity in an in vitro blood-brain barrier model

Toxicology in Vitro, 1995

To determine whether compounds are able to reach the neural microenvironment, a blood-brain barrier (BBB) co-culture model has been recently developed with bovine brain capillary endothelial cells and newborn rat astrocytes. In this study, the permeability of confluent endothelial cells to various compounds and the functional activity of P-glycoprotein (P-gp), an ATP-dependent pump known to efflux drugs from multidrug-resistant tumoral cells, was assessed. The permeability of the lipophilic compounds imipramine and sulpiride differed in relation to their structure. A good correlation was observed with in uiuo brain extraction levels. P-gp activity was estimated by measuring the uptake of ['Hlvinblastine by the endothelial cells, with or without verapamil, which is known to reverse drug resistance. Intracellular accumulation of the vinca alkaloid was strongly increased after addition of verapamil, suggesting that P-gp is active in these cells. These results provide further support for the use of the co-culture model of bovine brain endothelial cells and rat astrocytes to screen new centrally active drugs.

Verapamil P-glycoprotein Transport across the Rat Blood-Brain Barrier: Cyclosporine, a Concentration Inhibition Analysis, and Comparison with Human Data

Journal of Pharmacology and Experimental Therapeutics, 2006

To predict the magnitude of P-glycoprotein (P-gp)-based drug interactions at the human blood-brain barrier (BBB), rodent studies are routinely conducted where P-gp is chemically inhibited. For such studies to be predictive of interactions at the human BBB, the plasma concentration of the P-gp inhibitor must be comparable with that observed in the clinic. Therefore, we determined the in vivo EC 50 of P-gp inhibition at the rat BBB using verapamil as a model P-gp substrate and cyclosporine A (CsA) as the model P-gp inhibitor. Under isoflurane anesthesia, male Sprague-Dawley rats were administered i.v. CsA to achieve pseudo steady-state CsA blood concentrations ranging from 0 to ϳ12 M. Then, an i.v. tracer dose of [ 3 H]verapamil was administered, and 20 min after verapamil administration, the animals were sacrificed for determination of blood, plasma, and brain 3 H radioactivity by scintillation counting. The percentage increase in the brain/blood 3 H radioactivity (relative to 0 M CsA) was described by the Hill equation with E max , 1290%; EC 50 , 7.2 M; and ␥, 3.8. Previously, using [ 11 C]verapamil, we have shown that the human brain/blood 11 C radioactivity was increased by 79% at 2.8 M CsA blood concentration. At an equivalent CsA blood concentration, the rat brain/blood 3 H radioactivity was increased by a remarkably similar extent of 75%. This is the first time that an in vivo CsA EC 50 of P-gp inhibition at the rat BBB has been determined and the magnitude of such inhibition was compared between the rat and the human BBB at the same blood CsA concentration.

Effects of Sertraline and Fluoxetine on P-Glycoprotein at Barrier Sites: In Vivo and In Vitro Approaches

PLoS ONE, 2013

Background and Purpose: Retention of substances from systemic circulation in the brain and testes are limited due to high levels of P-glycoprotein (P-gp) in the luminal membranes of brain and testes capillary endothelial cells. From a clinical perspective, P-gp rapidly extrudes lipophilic therapeutic agents, which then fail to reach efficacious levels. Recent studies have demonstrated that acute administration of selective serotonin reuptake inhibitors (SSRI) can affect P-gp function, in vitro and in vivo. However, little is known concerning the time-course of these effects or the effects of different SSRI in vivo. Experimental Approach: The P-gp substrate, tritiated digoxin ([ 3 H] digoxin), was co-administered with fluoxetine or sertraline to determine if either compound increased drug accumulation within the brains and testes of mice due to inhibition of P-gp activity. We undertook parallel studies in endothelial cells derived from brain microvessels to determine the dose-response and time-course of effects.