Combined PET and microdialysis for in vivo estimation of drug blood-brain barrier transport and brain unbound concentrations

ABSTRACT Methods to investigate blood‐brain barrier transport and pharmacologically active drug concentrations in the human brain are limited and data translation between species is challenging. Hence, there is a need to further develop the read‐out of techniques like positron emission tomography (PET) for studying neuropharmacokinetics. PET has a high translational applicability from rodents to man and measures total drug concentrations in vivo. The aim of the present study was to investigate the possibility of translating total drug concentrations, acquired through PET, to unbound concentrations, resembling those measured in the interstitial fluid by microdialysis sampling. Simultaneous PET scanning and brain microdialysis sampling were performed in rats throughout a 60 min infusion of [N‐methyl‐11C]oxycodone in combination with a therapeutic dose of oxycodone and during a 60 min follow up period after the end of infusion. The oxycodone concentrations acquired with PET were converted into unbound concentrations by compensating for brain tissue binding and brain intracellular distribution, using the unbound volume of distribution in brain (Vu,brain), and were compared to microdialysis measurements of unbound concentrations. A good congruence between the methods was observed throughout the infusion. However, an accumulating divergence in the acquired PET and microdialysis data was apparent and became more pronounced during the elimination phase, most likely due to the passage of radioactive metabolites into the brain. In conclusion, the study showed that PET can be used to translate non‐invasively measured total drug concentrations into unbound concentrations as long as the contribution of radiolabelled metabolites is minor or can be compensated for. HIGHLIGHTSOxycodone was studied in rat brain by simultaneous microdialysis and PET imaging.Total concentrations measured by PET were converted to unbound drug concentrations.Active brain uptake of oxycodone was verified with both PET and microdialysis.PET has the potential to accurately determine blood‐brain barrier drug transport.Neuro PET enables animal to human translation of effective drug concentrations.

[1]  Maree T. Smith,et al.  Comparison of the Pharmacokinetics of Oxycodone and Noroxycodone in Male Dark Agouti and Sprague–Dawley Rats: Influence of Streptozotocin-Induced Diabetes , 2005, Pharmaceutical Research.

[2]  E. D. De Lange Utility of CSF in translational neuroscience , 2013, Journal of Pharmacokinetics and Pharmacodynamics.

[3]  Gary M Pollack,et al.  Regional differences in capillary density, perfusion rate, and P-glycoprotein activity: a quantitative analysis of regional drug exposure in the brain. , 2009, Biochemical pharmacology.

[4]  T. Terasaki,et al.  Diphenhydramine active uptake at the blood-brain barrier and its interaction with oxycodone in vitro and in vivo. , 2011, Journal of pharmaceutical sciences.

[5]  U. Simonsson,et al.  The use of liquid chromatography/mass spectrometry for quantitative analysis of oxycodone, oxymorphone and noroxycodone in Ringer solution, rat plasma and rat brain tissue. , 2004, Rapid communications in mass spectrometry : RCM.

[6]  Yanfeng Wang,et al.  The Simultaneous Estimation of the Influx and Efflux Blood-Brain Barrier Permeabilities of Gabapentin Using a Microdialysis-Pharmacokinetic Approach , 1996, Pharmaceutical Research.

[7]  B. Långström,et al.  Species Differences in Blood-Brain Barrier Transport of Three Positron Emission Tomography Radioligands with Emphasis on P-Glycoprotein Transport , 2009, Drug Metabolism and Disposition.

[8]  T. Maurer,et al.  Influence of nonspecific brain and plasma binding on CNS exposure: implications for rational drug discovery , 2002, Biopharmaceutics & drug disposition.

[9]  M. W. Sadiq,et al.  Oxymorphone active uptake at the blood-brain barrier and population modeling of its pharmacokinetic-pharmacodynamic relationship. , 2013, Journal of pharmaceutical sciences.

[10]  Takashi Suzuki,et al.  Quantitative targeted absolute proteomics of human blood–brain barrier transporters and receptors , 2011, Journal of neurochemistry.

[11]  U. Bredberg,et al.  In Vitro Methods for Estimating Unbound Drug Concentrations in the Brain Interstitial and Intracellular Fluids , 2007, Drug Metabolism and Disposition.

[12]  E. Jonsson,et al.  BRAIN DISTRIBUTION OF CETIRIZINE ENANTIOMERS: COMPARISON OF THREE DIFFERENT TISSUE-TO-PLASMA PARTITION COEFFICIENTS: Kp, Kp,u, AND Kp,uu , 2006, Drug Metabolism and Disposition.

[13]  C. Kuntner,et al.  Pharmacokinetic modeling of P-glycoprotein function at the rat and human blood–brain barriers studied with (R)-[11C]verapamil positron emission tomography , 2012, EJNMMI Research.

[14]  B. Hosten,et al.  Diphenhydramine as a selective probe to study H+-antiporter function at the blood–brain barrier: Application to [11C]diphenhydramine positron emission tomography imaging , 2017, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[15]  Marc Laruelle,et al.  Combining PET Biodistribution and Equilibrium Dialysis Assays to Assess the Free Brain Concentration and BBB Transport of CNS Drugs , 2012, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[16]  Sanjiv Sam Gambhir,et al.  AMIDE: a free software tool for multimodality medical image analysis. , 2003, Molecular imaging.

[17]  T. Maurer,et al.  Use of Plasma and Brain Unbound Fractions to Assess the Extent of Brain Distribution of 34 Drugs: Comparison of Unbound Concentration Ratios to in Vivo P-Glycoprotein Efflux Ratios , 2007, Drug Metabolism and Disposition.

[18]  Maree T. Smith,et al.  SEX DIFFERENCES IN THE PHARMACOKINETICS, OXIDATIVE METABOLISM AND ORAL BIOAVAILABILITY OF OXYCODONE IN THE SPRAGUE‐DAWLEY RAT , 2008, Clinical and experimental pharmacology & physiology.

[19]  J. Arrowsmith,et al.  Trial Watch: Phase II and Phase III attrition rates 2011–2012 , 2013, Nature Reviews Drug Discovery.

[20]  J B Bassingthwaighte,et al.  Contribution of labeled carbon dioxide to PET imaging of carbon-11-labeled compounds. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[21]  U. Simonsson,et al.  Oxycodone pharmacokinetics and pharmacodynamics in the rat in the presence of the P-glycoprotein inhibitor PSC833. , 2005, Journal of pharmaceutical sciences.

[22]  B. Walther,et al.  Development of a physiologically based pharmacokinetic model for the rat central nervous system and determination of an in vitro-in vivo scaling methodology for the blood-brain barrier permeability of two transporter substrates, morphine and oxycodone. , 2012, Journal of pharmaceutical sciences.

[23]  A. Doran,et al.  Diphenhydramine has similar interspecies net active influx at the blood-brain barrier. , 2014, Journal of pharmaceutical sciences.

[24]  Ulf Bredberg,et al.  Measurement of Unbound Drug Exposure in Brain: Modeling of pH Partitioning Explains Diverging Results between the Brain Slice and Brain Homogenate Methods , 2011, Drug Metabolism and Disposition.

[25]  Margareta Hammarlund-Udenaes,et al.  Blood–Brain Barrier Transport Helps to Explain Discrepancies in In Vivo Potency between Oxycodone and Morphine , 2008, Anesthesiology.

[26]  W. Löscher,et al.  Dose-response assessment of tariquidar and elacridar and regional quantification of P-glycoprotein inhibition at the rat blood-brain barrier using (R)-[11C]verapamil PET , 2010, European Journal of Nuclear Medicine and Molecular Imaging.

[27]  B. Jansson,et al.  In-depth neuropharmacokinetic analysis of antipsychotics based on a novel approach to estimate unbound target-site concentration in CNS regions: link to spatial receptor occupancy , 2016, Molecular Psychiatry.

[28]  T. Terasaki,et al.  Quantitative atlas of blood-brain barrier transporters, receptors, and tight junction proteins in rats and common marmoset. , 2013, Journal of pharmaceutical sciences.

[29]  Gunnar Antoni,et al.  Synthesis of [1‐11C]propyl and [1‐11C]butyl iodide from [11C]carbon monoxide and their use in alkylation reactions , 2006 .

[30]  An Vermeulen,et al.  Mechanistic Understanding of Brain Drug Disposition to Optimize the Selection of Potential Neurotherapeutics in Drug Discovery , 2014, Pharmaceutical Research.

[31]  Ulf Bredberg,et al.  Development of a High-Throughput Brain Slice Method for Studying Drug Distribution in the Central Nervous System , 2009, Drug Metabolism and Disposition.

[32]  T. Terasaki,et al.  Involvement of the Pyrilamine Transporter, a Putative Organic Cation Transporter, in Blood-Brain Barrier Transport of Oxycodone , 2008, Drug Metabolism and Disposition.

[33]  K. Read,et al.  Receptor Occupancy and Brain Free Fraction , 2009, Drug Metabolism and Disposition.

[34]  Stina Syvänen,et al.  On The Rate and Extent of Drug Delivery to the Brain , 2007, Pharmaceutical Research.

[35]  D. Selley,et al.  Pharmacokinetics and Pharmacodynamics of Seven Opioids in P-Glycoprotein-Competent Mice: Assessment of Unbound Brain EC50,u and Correlation of in Vitro, Preclinical, and Clinical Data , 2007, Journal of Pharmacology and Experimental Therapeutics.

[36]  M. Hammarlund-Udenaes,et al.  The use of a deuterated calibrator for in vivo recovery estimations in microdialysis studies. , 2008, Journal of pharmaceutical sciences.

[37]  Aiman Abrahim,et al.  Combined PET and microdialysis for in vivo assessment of intracellular drug pharmacokinetics in humans. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[38]  D. Scott,et al.  Species Independence in Brain Tissue Binding Using Brain Homogenates , 2011, Drug Metabolism and Disposition.

[39]  T. Terasaki,et al.  In‐vivo Blood‐brain Barrier Transport of a Novel Adrenocorticotropic Hormone Analogue, Ebiratide, Demonstrated by Brain Microdialysis and Capillary Depletion Methods , 1992, The Journal of pharmacy and pharmacology.

[40]  E. Kharasch,et al.  Pharmacokinetics and pharmacodynamics of oral oxycodone in healthy human subjects: Role of circulating active metabolites , 2006, Clinical pharmacology and therapeutics.

[41]  D. Mankoff,et al.  Analysis of 2-carbon-11-thymidine blood metabolites in PET imaging. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[42]  M. Sudhakar,et al.  Carbon dioxide transport , 2005 .

[43]  R. Klocke Carbon Dioxide Transport , 2011 .

[44]  Phil Jeffrey,et al.  Improving the in Vitro Prediction of in Vivo Central Nervous System Penetration: Integrating Permeability, P-glycoprotein Efflux, and Free Fractions in Blood and Brain , 2006, Journal of Pharmacology and Experimental Therapeutics.

[45]  S. Apparsundaram,et al.  Unbound Brain Concentration Determines Receptor Occupancy: A Correlation of Drug Concentration and Brain Serotonin and Dopamine Reuptake Transporter Occupancy for Eighteen Compounds in Rats , 2009, Drug Metabolism and Disposition.

[46]  U. Simonsson,et al.  In Vivo Blood-Brain Barrier Transport of Oxycodone in the Rat: Indications for Active Influx and Implications for Pharmacokinetics/Pharmacodynamics , 2006, Drug Metabolism and Disposition.

[47]  Stina Syvänen,et al.  Using PET studies of P-gp function to elucidate mechanisms underlying the disposition of drugs. , 2010, Current topics in medicinal chemistry.

[48]  Adriaan A. Lammertsma,et al.  Reproducible Analysis of Rat Brain PET Studies Using an Additional [18F]NaF Scan and an MR-Based ROI Template , 2012, International journal of molecular imaging.

[49]  J. Fowler,et al.  A simple, rapid method for the preparation of [11C]formaldehyde. , 2008, Angewandte Chemie.