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  • Title: A Mathematical simulation to explain the coordinated functions of efflux and metabolism limiting the transport of anti-HIV agents across Caco-2 cells.
    Author: Patel J, Hussain A, Pal D, Mitra AK.
    Journal: Am J Ther; 2004; 11(2):114-23. PubMed ID: 14999363.
    Abstract:
    OBJECTIVES: The purpose of this study was to simulate a mathematical model that explains the coordinated function of P-glycoprotein (P-gp) and/or CYP3A4 in human intestinal enterocytes. In addition, this study aimed to determine the efflux interactions of anti-HIV protease inhibitors. METHODS: Human colon carcinoma-derived Caco-2 cells were selected as a model system to evaluate the effects of P-gp-mediated efflux of HIV protease inhibitors. Anti-HIV agents ritonavir and saquinavir were selected as model drugs to determine efflux interactions. An absorption-metabolism classification system is hence proposed based on substrate specificities of drugs toward P-gp and/or CYP3A4 and their probable interactions with other compounds. RESULTS: Enhanced apical to basal (A-B) ritonavir transport was observed on coadministration of saquinavir. Saturable, concentration-dependent inhibition of ritonavir efflux from Caco-2 monolayers was also observed with saquinavir. The IC(50) values of ritonavir (as a self-inhibitor) and saquinavir from dose-response curves, estimated by fitting the data to nonlinear equations, were found to be 7.15 and 33.2 micromol/L, respectively. The respective K(i) values determined were 8.5 and 28.91 micromol/L. The experimentally obtained K(i) values decreased in the close approximation with the IC(50) values. CONCLUSION: Proposed mathematical simulations may prove to be a useful tool in predicting drug interactions by inhibition of P-gp mediated efflux and CYP3A4-mediated metabolism.
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