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In Vitro and In Vivo Evidence for Amphotericin B as a P-Glycoprotein Substrate on the Blood-Brain Barrier

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单位: [1]Fudan Univ, Dept Infect Dis, Huashan Hosp, Shanghai 200433, Peoples R China [2]Fudan Univ, Dept Pharmaceut, Sch Pharm, Shanghai 200433, Peoples R China [3]Chinese Japanese Friendship Hosp, Inst Clin Med Res, Beijing, Peoples R China [4]Fudan Univ, Clin Mycol Lab, Dept Dermatol, Huashan Hosp, Shanghai 200433, Peoples R China
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Amphotericin B (AMB) has been a mainstay therapy for fungal infections of the central nervous system, but its use has been limited by its poor penetration into the brain, the mechanism of which remains unclear. In this study, we aimed to investigate the role of P-glycoprotein (P-gp) in AMB crossing the blood-brain barrier (BBB). The uptake of AMB by primary brain capillary endothelial cells in vitro was significantly enhanced after inhibition of P-gp by verapamil. The impact of two model P-gp inhibitors, verapamil and itraconazole, on brain/plasma ratios of AMB was examined in both uninfected CD-1 mice and those intracerebrally infected with Cryptococcus neoformans. In uninfected mice, the brain/plasma ratios of AMB were increased 15 min (3.5 versus 2.0; P < 0.05) and 30 min (5.2 versus 2.8; P < 0.05) after administration of verapamil or 45 min (6.0 versus 3.9; P < 0.05) and 60 min (5.4 versus 3.8; P < 0.05) after itraconazole administration. The increases in brain/plasma ratios were also observed in infected mice treated with AMB and P-gp inhibitors. The brain tissue fungal CFU in infected mice were significantly lower in AMB-plus-itraconazole or verapamil groups than in the untreated group (P < 0.005), but none of the treatments protected the mice from succumbing to the infection. In conclusion, we demonstrated that P-gp inhibitors can enhance the uptake of AMB through the BBB, suggesting that AMB is a P-gp substrate.

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出版当年[2013]版:
大类 | 2 区 医学
小类 | 2 区 微生物学 2 区 药学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 微生物学 2 区 药学
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出版当年[2012]版:
Q1 MICROBIOLOGY Q1 PHARMACOLOGY & PHARMACY
最新[2023]版:
Q1 PHARMACOLOGY & PHARMACY Q2 MICROBIOLOGY

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第一作者单位: [1]Fudan Univ, Dept Infect Dis, Huashan Hosp, Shanghai 200433, Peoples R China
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