Faculty of Pharmaceutical Sciences, University of Tokyo, 7-3-1, Hongo Bunkyo-ku, Tokyo, 113, Japan (H.S., Y.S.);
Faculty of
Pharmaceutical Sciences, University of Tohoku, Aramaki aza-aoba,
Aoba-ku, Sendai, Miyagi, 980-77, Japan (T.T.) and
Faculty of
Pharmaceutical Sciences, University of Kanazawa, 13-1, Takaramachi,
Ishikawa, 920, Japan (A.T.)
The systemic clearance of many quinolone antibiotics is mainly via
metabolism and urinary excretion; by contrast, biliary excretion is a
major route of elimination for a new quinolone grepafloxacin (GPFX).
Accordingly, we studied the hepatic uptake of GPFX because it is the
first step in the drug's hepatobiliary transport. The hepatic uptake
of GPFX in vivo after i.v. administration was found to
approach the hepatic blood flow, suggesting the existence of an
effective hepatic uptake mechanism. To clarify this transport mechanism, GPFX uptake by isolated rat hepatocytes was examined and
found to consist of a saturable component (Km
173 µM, Vmax 6.96 nmol/min/mg) and a nonspecific
diffusion component. The inhibition of GPFX uptake by ATP-depletors and
a lack of effect after replacing Na+ with choline
demonstrated that the uptake was an Na+-independent
carrier-mediated active process. This uptake was inhibited by other
quinolones and for lomefloxacin this was competitive in nature. Mutual
inhibition studies were undertaken to investigate whether the
transporter for GPFX might be the same as other transporters so far
identified. GPFX inhibited the uptake of taurocholic acid, pravastatin
(organic anion), cimetidine (organic cation) and ouabain (neutral
steroid). However, GPFX uptake was not inhibited by these compounds.
Confirmation that GPFX uptake is blood flow limited was obtained by
extrapolation of the in vitro data based on mathematical modeling. In conclusion, the effective hepatic uptake of quinolone antibiotics are via carrier-mediated active transport, which is distinct from that involved in the transport of bile acids, organic anions, organic cations or neutral steroids.
 |
Introduction |
The systemic clearance of many
NQs is mainly by metabolism and urinary excretion; by contrast, the
biliary clearance of quinolones such as GPFX and SPFX, which have
recently been developed, is larger than their renal clearance
(Matsunaga et al., 1991
; Akiyama et al., 1995a
).
Furthermore, it was reported that there was a great difference in the
liver-to-plasma concentration ratio (Kp) among NQs
(Okezaki et al., 1988
). Hepatic uptake is an important factor determining tissue distribution, the degree of biliary clearance
and the metabolism of a drug. However, the uptake mechanism of NQs by
hepatocytes has not been previously investigated.
A number of transport systems for the hepatic uptake of drugs and
endogenous compounds have been reported (Inoue et al., 1982
; Anwer and Hegner, 1978
; Hagenbuch et al., 1990
, 1991
;
Yamazaki et al., 1992a
, 1993a
, 1996
; Meier, 1995
). A
Na+-coupled secondary active transport system for TCA and
often conjugated bile acids in both rats and humans has recently been
expressed in oocytes and cloned (Ananthanarayanan et al.,
1994
; Hagenbuch and Meier, 1994
). The transport carrier that mediates
the Na+-independent uptake of various non-bile acid organic
anions such as DBSP has also been characterized and cloned (Blom
et al., 1981
; Uehara et al., 1983
; Yamazaki
et al., 1992b
, 1993b
; Jacquemin et al., 1991
,
1994
; Kullak-Ublick et al., 1995
). However, multispecific transport systems are known to be involved in the hepatic uptake of
cationic drugs (Meijer et al., 1990
; Nakamura et
al., 1994
). The substrates for the transporters have been divided
into two types based on their chemical structure, number of charges and lipophilicity (Meijer et al., 1990
; Groothuis and Meijer,
1996
). Expression cloning of the carrier protein for organic cations has been performed (Grundemann et al., 1994
).
NQs are zwitterionic drugs with carboxylic acid and cationic amine
groups that are dissociated at physiological pH (fig.
1). NQs have been reported to be recognized as cationic
compounds by a transporter for reabsorption at the brush-border side of the kidney tubule (Okano et al., 1990
), and NQs are known to
affect the uptake of anionic and cationic compounds through the
basolateral membrane in kidney cells (Ullrich et al., 1993
).
It has also been reported that NQ transport may be mediated by active
transport systems involving absorption of NQ at the brush-border of the intestine (Iseki et al., 1992
; Hirano et al.,
1994
) and uptake from the basolateral side of Caco-2 cells (Griffiths
et al., 1993
, 1994
). Therefore, it is important to clarify
what type of transport system mediates the hepatic uptake of NQs.
 |
Methods and Materials |
Chemicals.
GPFX (1.17 MBq/µmol, radiochemical
purity 97.1%) and [3H]-cimetidine (814 MBq/µmol,
97.2%) were obtained from Amersham International (Buckinghamshire,
UK). [3H]-Taurocholic acid (128 MBq/µmol, 98.5%) and
[3H]-ouabain (759 MBq/µmol, 98.6%) were purchased from
New England Nuclear Corp. (NEN, Boston, MA).
[14C]-pravastatin (0.37 MBq/µmol) was kindly donated by
Sankyo Company Ltd. (Tokyo, Japan, >95%).
[3H]-Quinidine (555 MBq/µmol, 99%) was obtained from
American Radiolabeled Chemicals Inc. (St. Louis, MO).
Unlabeled GPFX, OPC-17203 (internal standard for HPLC analysis) (fig.
1), SPFX, LFLX, CPFX, ENX and OFLX were synthesized or purified by
Otsuka Pharmaceutical Company (Tokyo, Japan). Taurocholic acid,
cimetidine, d-tubocurarine, FCCP, rotenone, DIDS, PCMB, vincristine, quinidine, verapamil and ouabain were purchased from Sigma
Chemical Corp (St. Louis, MO). Sodium azide was purchased from Nacalai
Tesque (Kyoto, Japan). DBSP was synthesized by Societe d'Etudes et de
Recherches Biologiques (Paris, France). ICCT was obtained from
Daiichi Pharmaceutical Co., Ltd. (Tokyo, Japan). Collagenase was
purchased from Wako Pure Chemical Industries Ltd (Osaka, Japan). All
other chemicals were of reagent grade.
Cell preparation.
Hepatocytes were isolated from male
Sprague-Dawley rats by the procedure of Baur et al. (1975)
.
After isolation, the hepatocytes were suspended (2 mg protein/ml) at
0°C in albumin-free Krebs-Henseleit buffer supplemented with 12.5 mM
HEPES (pH 7.3). All studies were carried out in the presence of sodium
except for the studies of the effect of sodium on uptake and the
Na+-independent uptake of TCA. Cell viability was routinely
checked by the trypan blue [0.4% (w/v)] exclusion test. We used more
than 90% as a viability criterion, and the mean viability was
93.4 ± 0.4% (mean ± S.E. of 29 different preparations).
Protein concentrations were determined by the method described by
Bradford (1976)
, using the protein assay kit (Bio-Rad, Hercules, CA)
with bovine serum albumin as a standard.
Uptake study.
Uptake of [14C]-GPFX was
initiated by adding the ligand solution (0.5 ml) into the cell
suspension (0.5 ml, 2 mg protein/ml) preincubated at 37°C for 5 min.
At a designated time, the reaction was terminated by separating the
cells from the medium using a centrifugal filtration technique
(Schwenk, 1980
). Briefly, 200-µl aliquots were placed into centrifuge
tubes containing 50 µl 2 N NaOH, covered by 100 µl of a mixture
(density 1.015) of silicone and mineral oil. The samples were then
centrifuged for 15 sec in a tabletop microfuge (10,000 × g, Beckman Instruments Inc., Fullerton, CA). The
centrifugation pelleted the hepatocytes through the oil layer into the
alkaline solution. After the cells had dissolved in the alkaline
solution, the tube was sliced into two and each compartment was
transferred into a scintillation vial. The alkaline compartment was
neutralized with 50 µl 2 N HCl. Then, after addition of the
scintillation cocktail (Atomlight, NEN) to the vials, the radioactivity
in the medium and cells was determined using a liquid scintillation
spectrophotometer (LS 6000SE, Beckman Instruments Inc.)
The time-course of GPFX uptake was plotted as an uptake value (µl/mg
protein) that was obtained by dividing the amount taken up by its
concentration in the medium. The initial uptake velocity of GPFX was
calculated using a linear regression of points between 15 and 45 sec,
for cimetidine (0.1 µM), pravastatin (7 µM), ouabain (0.1 µM) and
quinidine (0.2 µM) the value was estimated using data taken at 20 and
60 sec, at 30 sec and 3 min, and at 20 and 60 sec, respectively.
Na+-dependent and Na+-independent uptake of TCA
was also assessed by the same method. To determine the
Na+-independent uptake of TCA, the study was performed in
the absence of sodium, using Krebs-Henseleit buffer in which the NaCl
and NaHCO3 were isotonically replaced with choline chloride
and choline bicarbonate, respectively. The initial uptake velocity of
TCA was calculated using points taken at 30 and 90 sec. Previous
studies in our laboratory with TCA, cimetidine, pravastatin and ouabain have demonstrated that uptake was linear under these conditions (Yamazaki et al., 1992a
, 1993b
; Nakamura et al.,
1994
; Okudaira et al., 1988
). In addition, the time profile
of quinidine uptake was determined to confirm that its uptake was
linear (data not shown).
In the LFLX uptake study, LFLX both in the medium and cells was
determined using HPLC. The medium (50 µl) and neutralized cell
solution (50 µl) were combined with CPFX (500 ng) (fig. 1) as an
internal standard and four volumes of methanol were added to
precipitate protein. After centrifugation, the supernatants (10 µl)
were subjected to HPLC, using a TSKgel ODS-80TM column (4.6 mm I.D. × 15 cm, Tosoh, Tokyo, Japan). The mobile phase was acetonitrile:water:phosphoric acid (17:83:0.2, v/v/v) at a flow rate of
1 ml/min; LFLX was detected by fluorescence (excitation 285 nm,
emission 448 nm) and, the concentration was calculated from the
internal standard (CPFX) peak area ratio using a calibration curve.
Effect of medium pH.
After isolating and washing the cells,
they were suspended in Krebs-Henseleit buffer at pH 7.3 (10 mg
protein/ml). Uptake was initiated by the addition of Krebs-Henseleit
buffer (0.8 ml), containing [14C]-GPFX that had been
preincubated at 37°C for 5 min, to the cell suspension (0.2 ml). The
pH of the Krebs-Henseleit buffer was adjusted by dropwise addition of 2 N NaOH or 2 N HCl, and was determined before and after the uptake
study.
TLC analysis of [14C]-GPFX after incubation with
isolated hepatocytes.
The hepatocyte incubation mixture containing
[14C]-GPFX was added to ice-cold buffer. After
centrifuging the mixture at 200 × g for 2 min, 200 µl of the top layer (medium) was transferred into 600 µl
acetonitrile. The whole cell pellet was added to 80% acetonitrile to
precipitate proteins. Each aliquot of the extracts from the medium and
cells was applied to a TLC plate (Kieselgel 60 F254, Merck, Darmstadt,
Germany). Then, the plate was developed with chloroform:methanol:28%
ammonia solution (7:3:0.5, v/v/v). The radioactive profiles on the TLC
plate were analyzed using a Bio-Imaging analyzer (Bas2000, Fuji Film,
Tokyo, Japan).
Estimation of kinetic parameters.
The kinetic parameters for
GPFX and LFLX uptake were calculated using the following equations:
|
(1)
|
|
(2)
|
where V0 is the initial uptake rate of the drug
(pmol/min/mg protein), S is the drug concentration in the medium
(µM), Km is the Michaelis-Menten constant
(µM), Vmax is the maximum uptake rate (pmol/min/mg
protein) and Pdif is the nonspecific uptake clearance
(µl/min/mg protein). The above equation was fitted to the uptake data
sets by an iterative nonlinear least-squares method using a MULTI
program (Yamaoka et al., 1981
) to obtain estimates of the
kinetic parameters. The input data were weighted as the reciprocal of
the observed values and the Damping Gauss Newton method was used for
the fitting algorithm.
Apparent kinetic parameters (Km, app,
Vmax, app and Pdif, app) for GPFX uptake in
the presence of LFLX were also estimated by the same method. To
investigate the inhibitory constants (Ki) and
the type of inhibition of LFLX on GPFX uptake, the following equations
were simultaneously fitted to both uptake data sets in the absence and
presence of LFLX.
|
(3)
|
|
(4)
|
Equations 3 and 4 were derived assuming competitive and
noncompetitive inhibition, respectively. The LFLX concentration (I in
equations 3 and 4) as inhibitor was kept constant (1 mM). The fitted
line was converted to the V0/S vs V0
form (Eadie-Hofstee plot).
In the inhibition studies of GPFX uptake by NQs at several
concentrations, the data for the uptake velocity and inhibitor concentration were fitted to equation 3 using a MULTI program (Yamaoka
et al., 1981
) to obtain the Ki for GPFX uptake.
The drug concentration (S), and the Km and
Vmax values obtained in the kinetic study of GPFX were
fixed. The values of Ki and Pdif
were obtained by fitting.
Hepatic uptake study in vivo.
Under ether
anesthesia, GPFX was administered to male rats (Nihon Ikagaku, Tokyo,
Japan), weighing approximately 250 to 300 g, via the femoral vein
at a dose of 5 mg/kg/2 ml saline (13.9 µmol/kg). Blood samples were
then collected from the femoral artery at designated times over 2 or 3 min with a heparinized syringe and a portion of liver was collected by
biopsy at 30 sec or 1 min. The rats were killed at 2 or 3 min and the
whole liver was excised immediately. A portion of the tissue was
weighed and stored at
30°C until required for assay. Liver samples
were added to nine volumes 75% methanol (w/w) and homogenized. An
internal standard (OPC-17203, 100 ng) (fig. 1) was added to the
homogenate (50 µl) and, after dilution with methanol (200 µl),
samples were centrifuged in a tabletop microfuge. The resulting
supernatants (10 µl) were subjected to HPLC. Plasma samples (25 µl)
were obtained by centrifugation of blood and the internal standard (100 ng) added together with methanol (200 µl) to precipitate a protein.
After centrifugation, the supernatants (10 µl) were subjected to
HPLC. The HPLC conditions and calculation method were as described for
the cell uptake study except that the mobile phase was
acetonitrile:water:phosphoric acid (25:75:0.2, v/v/v).
In the case of TCA, [3H]-TCA was administered at a dose
of 370 kBq/3.85 nmol/kg/2 ml saline to rats with a cannula in their bile ducts. A portion of liver was collected by biopsy at 30 sec or 1 min, and the whole liver along with the bile duct were excised at 1.5 or 2 min and homogenized together.
When the hepatic uptake was measured over a short period during which
efflux, excretion and metabolism are negligible, the uptake rate of the
drug can be described by the following equation:
|
(5)
|
where Xt is the amount of unchanged drug in the
liver at time t, CLuptakeplasma is the hepatic uptake
clearance and Cp is the plasma concentration of unchanged
drug. Integration of equation 5 gives
|
(6)
|
where AUC(0
t) represents the area under the plasma
concentration-time curve from 0 to t, and VE represents the
distribution volume that consists of plasma space and the volume in
which the drug concentration equilibrates instantaneously with that in
plasma. Equation 6 divided by Cp gives
|
(7)
|
The CLuptakeplasma value can be obtained from
the initial slope of a plot of Xt/Cp
vs AUC(0
t)/Cp designated as the
integration plot (Kim et al., 1988
; Yanai et al.,
1990
). The CLuptakeplasma obtained is based on the
plasma concentration of the drug. Therefore, the
CLuptakeblood for the concentration in whole blood is
calculated by dividing the CLuptakeplasma by the
RB of the drug, where RB is blood-to-plasma
concentration ratio.
Estimation of hepatic uptake clearance from in vitro
data.
Based on the kinetic parameters of GPFX obtained by the
fitting procedure described, the
PSinflux, in vitro (ml/min/kg rat) was
calculated using the following equation:
|
(8)
|
where
= 1.25 · 108 cells/g liver (Lin et
al., 1980
),
= 1.0 · 106 cells/mg protein) and
= 44 g liver/kg rat (Sugita et al., 1982
). The
in vivo uptake CLuptakeblood (ml/min/kg rat)
for blood concentration was estimated from the in vitro
uptake PSinflux, in vitro using the dispersion
model (equation 9) (Roberts and Rowland, 1986
):
|
(9)
|
where
= (1 + 4RN · DN)1/2, RN = fB · PSinflux, in vitro/Qh,
DN is the dispersion number (0.17) (Iwatsubo et
al., 1996
) and fB is the unbound fraction of GPFX in
blood (0.44) (Akiyama et al., 1995b
) and is obtained by
dividing plasma unbound fraction fp (0.60) by
blood-to-plasma concentration ratio RB (1.37).
Qh is the hepatic blood flow in rats (40 ml/min/kg rat),
and was obtained from the hepatic uptake clearance of
[3H]-TCA when the TCA uptake process is assumed to be
blood flow limited.
 |
Results |
Hepatic uptake of GPFX in vivo.
The time profiles
of TCA and GPFX concentrations in plasma and liver after its i.v.
administration were analyzed kinetically. The values of
CLuptakeplasma of GPFX and TCA were calculated as 45 and 22 ml/min/kg, respectively, from the slope of the corresponding
integration plot (fig. 2). The
CLuptakeblood values, further calculated by taking the
corresponding RB values [1.37 (Akiyama et al.,
1995b
) and 0.55 (M. Kono, H. Suzuki and Y. Sugiyama, unpublished data),
respectively] into consideration, were 33 and 40 ml/min/kg,
respectively. The CLuptakeblood of GPFX (33 ml/min/kg)
was, therefore, similar to the hepatic blood flow (40 ml/min/kg)
estimated from the CLuptakeblood of TCA, which is taken
up by the liver in a blood flow limited manner.

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Fig. 2.
Time profiles of (a) radioactive concentrations in
plasma ( ) and liver ( ) after a single i.v. administration of GPFX
to rats and (b) the hepatic uptake of GPFX ( ) or
[3H]-TCA ( ) as integration plots. Initial slopes of
GPFX and TCA represent CLuptake 1.03 ml/min/g liver and
0.494 ml/min/g liver, respectively. Each plot and vertical bar
represent the mean ± S.E. of three determinations.
|
|
Time profile of [14C]-GPFX uptake by isolated rat
hepatocytes.
As shown in figure 3, the hepatic
uptake of GPFX by isolated rat hepatocytes was linear up to 1 min and
reached equilibrium at 2 to 5 min. The cell-medium concentration ratio
at equilibrium was calculated to be approximately 35, taking the
intracellular volume (4.3 µl/mg protein) (Yamazaki et al.,
1992b
) into consideration. The determination of the initial uptake
velocity of GPFX was estimated by measuring the total radioactivity,
because TLC analysis indicated that the fraction of unchanged drug to
total radioactivity was more than 90% both in the medium and cells at
1, 2 and 5 min. The initial uptake of GPFX was calculated from the
difference between the uptakes at 15 and 45 sec.

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Fig. 3.
Time profiles of GPFX uptake (5 µM) by isolated rat
hepatocytes and effects of temperature. Uptake of
[14C]-GPFX was measured by incubating isolated rat
hepatocytes in Krebs-Henseleit buffer (pH 7.3) containing
[14C]-GPFX 5 µM at 37°C ( ) or 0°C ( ) after
preincubation for 5 min. The uptake value means the cellular uptake
divided by extracellular concentration. Each plot and vertical bar
represent the mean ± S.E. of three determinations.
|
|
Concentration-dependence of the initial uptake of
[14C]-GPFX and the effect of other NQs.
The uptake
clearance of GPFX declined as the concentration increased, indicating
that the uptake possessed a saturable component. The kinetic parameters
for equation 1 were as follows: Km 173 ± 33 µM, Vmax 6.96 ± 1.13 nmol/min/mg protein,
Pdif 28.1 ± 4.4 µl/min/mg protein. The kinetics of
GPFX uptake was also examined in the presence of LFLX (1 mM), and the
result is shown as an Eadie-Hofstee plot (fig. 4a).
Equation 3, derived assuming competitive inhibition, was simultaneously
fitted to both sets of uptake data in the presence and absence of LFLX
(1 mM). These fitted lines agreed well with the experimental data (fig.
4a). To clarify the manner of inhibition of LFLX, equation 4 also was
simultaneously fitted to the uptake data sets for GPFX in the absence
and presence of LFLX. Equation 4 was derived assuming noncompetitive
inhibition. Akaike's information criterion (Akaike, 1974
) values of
47 and
43 were obtained from the fitting of equations 3 and 4,
respectively, indicating that competitive inhibition was statistically
superior for describing the data. Also for the uptake of LFLX itself,
saturable and nonsaturable components were observed (fig. 4b), as for
GPFX uptake. The kinetic parameters for LFLX uptake were as follows: Km 436 ± 70 µM, Vmax
8.57 ± 1.26 nmol/min/mg protein, Pdif 13.7 ± 0.4 µl/min/mg protein. Comparison of the Km
value indicated that GPFX had a higher affinity than LFLX. Both
equations 1 and 2 were fitted to the kinetic data, assuming the two
different models consisted of a saturable component and a nonsaturable
diffusion component (equation 1) or a high affinity component and a low affinity component (equation 2). In the case of GPFX, Akaike's information criterion values were, respectively,
32 and
22 for equation 1 and 2, and for LFLX they were
34 and
13. Therefore, equation 1 better fitted the kinetic data of both NQs, suggesting that
the uptake consists of a saturable component and a nonsaturable diffusion component.

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Fig. 4.
Eadie-Hofstee plot of GPFX uptake (a) by isolated rat
hepatocytes in the absence ( ) and presence ( ) of LFLX (1 mM) and
(b) Eadie-Hofstee plot of LFLX uptake. Uptake of
[14C]-GPFX was measured at concentrations of 5, 50, 100, 150, 200, 300, 500 and 1000 µM GPFX, in the presence or absence of 1 mM LFLX, and the LFLX uptake was done at 0.05, 0.3, 1, 2 and 3 mM LFLX.
Uptake clearance (V0/S, PSinf) was calculated
by dividing the initial uptake velocity (V0) by the GPFX
concentration (S) in the medium. Each plot and vertical bar represents
the mean ± S.E. of six determinations in two different
preparations.
|
|
Furthermore, the inhibition of GPFX uptake was studied over a wide
concentration range of LFLX. GPFX uptake was inhibited in a
concentration-dependent fashion by LFLX (fig. 5).
Equation 3, assuming competitive inhibition was fitted to the uptake
data. The Ki value of LFLX for GPFX uptake was
468 µM, which was comparable with the Km (436 µM) for LFLX uptake, suggesting that the uptake of these compounds
may be mediated by the same transporter.

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Fig. 5.
Effects of LFLX on the GPFX uptake (5 µM) by the
isolated rat hepatocytes. Uptake of [14C]-GPFX was
measured in the presence of 0.3, 1, 3 and 5 mM LFLX or its absence.
Each bar represents the mean ± S.E. of six determinations in two
different preparations. * P < .05, ** P < .01 (significantly different from controls using Dunnett's test).
|
|
Other NQs (SPFX, CPFX, ENX and OFLX) also inhibited
[14C]-GPFX uptake in a concentration-dependent manner
(table 1), the inhibitory effect was greatest for GPFX.
Effects of temperature, sodium, metabolic inhibitor,
sulfhydryl-modifying reagent and anion exchanger inhibitor on the
initial uptake of [14C]-GPFX.
The initial uptake of
[14C]-GPFX at 27 and 0°C was 64 and 10% of that at
37°C, respectively, and the ratio of the uptake at 27 and 37°C
(Q10) was 1.6 (fig. 6). The lack of effect
after sodium replacement in the medium by choline demonstrated that the
uptake was an Na+-independent process. GPFX uptake was
reduced by the presence of metabolic inhibitors (FCCP and sodium azide)
but not by the sulfhydryl-modifying reagent (PCMB) and anion exchanger
inhibitor (DIDS).

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Fig. 6.
Effects of sodium, temperature and metabolic
inhibitors on the GPFX (5 µM) uptake by isolated rat hepatocytes.
Uptake of [14C]-GPFX was measured at 37, 27 or 0°C in
the presence or absence of inhibitor. Each bar represents the mean ± S.E. of seven determinations in two different preparations.
* P < .05, ** P < .01 (significantly different from
controls using Dunnett's test).
|
|
Effect of medium pH on the initial uptake of
[14C]-GPFX.
At a low concentration (5 µM),
[14C]-GPFX uptake did not change at lower values than pH
7.4, but was reduced with increasing pH, reaching 67% at pH 8.3 compared with that at pH 7.4 (fig. 7). However, at a
high concentration (1000 µM) where carrier-mediated uptake was
saturated, [14C]-GPFX uptake showed a minimal reduction
with increasing pH.

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Fig. 7.
Effect of extracellular pH on uptake of GPFX (5 µM)
by isolated rat hepatocytes. Uptake of [14C]-GPFX was
measured by incubating isolated rat hepatocytes in Krebs-Henseleit
buffer (pH 6.2-8.3) containing 5 µM ( ) or 1 mM ( )
[14C]-GPFX. Each plot and vertical bar represents the
mean ± S.E. of six determinations in two different preparations.
The dotted and dashed line represents the dissociated and protonized
percentage for the carboxyl and amino group (pKa = 7.1 and 8.8) of
GPFX, respectively. * P < .05 (significantly different from
PSinf in 5 µM at pH 7.3 using Dunnett's test).
|
|
Effects of GPFX on the uptake of substrates for some known
transporters.
GPFX reduced the uptake of TCA both in the presence
and absence of sodium in a concentration-dependent manner (fig.
8a). GPFX also inhibited the uptake of pravastatin and
cimetidine that are, respectively, substrates for organic anion and
organic cation transporters (fig. 8b). In addition, the uptake of
ouabain, a neutral steroid was very effectively and completely
inhibited by GPFX (fig. 8b). The uptake of the amphipathic organic
cation, [3H]-quinidine was almost completely abolished at
200 µM unlabeled quinidine, falling to 4.1 ± 1.3% of the
control group (mean ± S.E. of six determinations in two different
preparations), suggesting that the greater part of this uptake is
saturable. However, GPFX at a concentration of 1 mM, at which its own
uptake is saturated, inhibited quinidine uptake by only 23.8 ± 5.1%.

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Fig. 8.
Effects of GPFX on the uptake of TCA (0.2 µM),
pravastatin (7 µM), cimetidine (0.1 µM) and ouabain (0.2 µM) by
isolated rat hepatocytes. [3H]-TCA uptake was determined
in the presence and absence of sodium. Both Na+-dependent
uptake ((a) ) (the uptake in the presence minus that in the absence
of sodium ions) and Na+-independent uptake ((a) ) are
plotted. The uptake of [14C]-pravastatin ((b) ),
[3H]-cimetidine ((b) ) and [3H]-ouabain
((b) ) were determined in the presence of sodium. Each plot and
vertical bar represents the mean ± S.E. of four determinations in
two different experiments. * P < .05, ** P < .01 (significantly different from controls using Dunnett's test).
|
|
Effects of organic anions, organic cations and other compounds on
[14C]-GPFX uptake.
The bile acid TCA and the organic
anion DBSP, pravastatin and ICG did not inhibit GPFX uptake at
concentrations where their own uptake should be saturated (table
2). No effect of ouabain on GPFX uptake was observed
(table 2). The organic cations cimetidine, d-tubocurarine
and PAEB did not inhibit GPFX uptake, but the amphipathic organic
cations quinidine, verapamil and vincristine did (table 2).
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TABLE 2
Effects of TCA, organic anions, organic cations and ouabain on the
uptake of GPFX (5 µM) by isolated rat hepatocytes
|
|
 |
Discussion |
GPFX and SPFX have higher hepatobiliary excretion rates among NQs
that have recently been developed (Matsunaga et al., 1991
; Akiyama et al., 1995a
). The hepatic clearance of drugs is
generally governed by three factors; hepatic blood-flow,
Qh, free fraction in blood, fB, and overall
hepatic intrinsic clearance CLintoverall (Miyauchi
et al., 1987
; Yamazaki et al., 1996
). However,
the distribution of drugs between blood and liver cells does not always proceed under the assumption of rapid equilibrium. In this case, CLintoverall is a hybrid parameter that is described by
equation 10 (Miyauchi et al., 1987
; Yamazaki et
al., 1996
), where PSinflux, PSefflux and
CLint represent the influx clearance from blood to liver, the efflux clearance from liver to blood and the intrinsic biliary excretion and/or metabolic clearance, respectively.
|
(10)
|
Accordingly, the rate-limiting step in
CLintoverall depends on the relative values of
PSefflux and CLint. For example,
CLintoverall is governed by only the influx ability
(PSinflux) in the case where CLint is much
larger than PSefflux (CLint
PSefflux).
The hepatic uptake of GPFX was estimated to be so effective in
vivo that about 80% of GPFX was taken up during the first-pass through the liver (fig. 2); this was estimated by comparing hepatic uptake clearance with the hepatic blood-flow rate that was estimated from TCA uptake clearance (fig. 2b). To clarify the effective transport
mechanism of GPFX, studies using isolated rat hepatocytes were carried
out. The cell-to-medium concentration ratio at equilibrium was
approximately 35 (intracellular space: 4.3 µl/mg protein) (Yamazaki
et al., 1992b
), which was comparable with the liver to
unbound plasma concentration ratio (Kpu = approximately 20) (H. Sasabe, Y. Kato, T. Terasaki, A. Tsuji and Y. Sugiyama, unpublished data) estimated in vivo, suggesting that GPFX is
concentratively taken up by the liver (fig. 3). Such uptake may be due
to active transport and/or protein binding in liver cells. The uptake
of GPFX is temperature and concentration dependent, and uptake was reduced to nearly 60% of controls by treatment with FCCP and sodium azide that are known to deplete cellular ATP (fig. 6). This indicates that part of the concentrative uptake is produced by carrier-mediated active transport. However, rotenone did not reduce the uptake of GPFX
significantly (fig. 6). In our laboratory, systematic analysis of
intracellular ATP content has been performed after treatment with FCCP
and rotenone, by changing the treatment time and concentration of the
metabolic inhibitor (Yamazaki et al., 1993a
); the ATP
content is rapidly reduced and the uptake of organic anion is
concomitantly reduced after treatment with FCCP and rotenone. In our
experiment, hepatocytes were treated with rotenone (30 µM) or FCCP (2 µM) for 5 min. In this situation, the intracellular ATP content
declines to 20% (rotenone) and 6% (FCCP) of that in the control, and
FCCP has a stronger effect than rotenone (Yamazaki et al.,
1993a
). Thus, the observation that GPFX uptake is not markedly reduced
by rotenone might indicate that GPFX can be transported in the presence
of a small amount of intracellular ATP.
Kinetic analysis showed that GPFX uptake consists of a saturable
component (Km 173 µM) and a nonspecific
diffusion component (fig. 4). By comparing
Vmax/Km with Pdif, the
contribution of each component to the uptake clearance was calculated
to be nearly 1:1 over the range of therapeutic plasma concentrations
(<5 µM). The saturable component may be predominantly due to active
transport, considering that the reduced uptake by metabolic inhibitors
was roughly 40% of the controls. In rats, as shown in figure 2a, the plasma concentration of unbound GPFX was calculated to be less than 20 µM at 20 sec after bolus i.v. administration with the based on a
fp value of 0.6 (Akiyama et al., 1995b
). This
concentration was approximately 10% of its Km
(173 µM) for uptake, suggesting that the carrier-mediated transport
may also be functioning in in vivo.
The hepatic uptake clearance of GPFX in vivo
(CLuptakeblood) was calculated, based on a mathematical
model (equation 10), using the uptake clearance
(PSinflux, in vitro) obtained from this
in vitro study together with fp, RB
and Qh estimated from the hepatic uptake clearance of TCA
the uptake of which is known to be almost blood flow limited (Iga and
Klaassen, 1982
). The calculated CLuptakeblood (37 ml/min/kg) was close to that (33 ml/min/kg) obtained from integration
plot analysis in vivo. Such a successful extrapolation from
in vitro to in vivo indicates that the
carrier-mediated uptake that was identified from the in
vitro study using isolated hepatocytes, reflects the uptake
in vivo. The value of hepatic blood flow determined from the
uptake clearance of TCA, was 40 ml/min/kg which is smaller than the
usual rat hepatic blood flow, about 60 ml/min/kg (Dedrick et
al., 1973
; Luts et al., 1977
). Part of this difference
might be due to the effect of ether anesthesia. Taking account of the fact that GPFX is so rapidly taken up into liver cells that the uptake
is nearly blood flow limited (fig. 2), it is possible that the hepatic
uptake of GPFX might be reduced by the anesthesia.
GPFX has a carboxyl group and a secondary amine in the piperazine ring
with pKa values of 7.1 and 8.8, respectively (fig. 1). Because of this,
the relationship between GPFX uptake and the pH of the medium was
examined. At a concentration of 1 mM where carrier-mediated uptake is
considered to be saturated, the change in pH did not significantly
affect GPFX uptake, indicating that the uptake by nonspecific diffusion
is relatively independent of the medium pH (fig. 7). At a lower
concentration (5 µM), the reduced uptake at higher pH values seems to
be due to a reduction in carrier-mediated uptake (fig. 7). These
results suggest that the carrier-mediated uptake is not accelerated by
dissociation of the carboxyl group, and that the hepatic uptake of GPFX
is not probably mediated by the H+-antiport system that
requires a H+-gradient from the inside to the outside of
the cell as a driving-force and mediates the hepatic uptake of
N-methylnicotinamide (Moseley et al., 1990
).
There are several reports indicating that NQs can be recognized by
several transport system in various body tissues. For example, reabsorption of OFLX by renal cells through the brush-border membrane was reported to be mediated by an H+-antiport system, as a
cationic compound (Okano et al., 1990
), although NQs
inhibited the transport of cationic compounds N-methylnicotinamide, TEA
and the uptake of anionic compound p-aminohippurate through the
basolateral membrane of renal cells (Ullrich et al., 1993
). The absorption of ENX through the brush-border membrane in intestinal cells was known to be mediated by an active transport system with the
membrane potential as the driving force (Hirano et al.,
1994
). Moreover, an active transporter mediates the uptake of CPFX from the basolateral side of Caco-2 cells (Griffiths et al.,
1993
, 1994
).
In our study, we investigated whether the GPFX uptake system is
identical with known transport systems for conjugated bile acids,
organic anions, organic cations and the neutral steroid ouabain. GPFX
inhibited the Na+-dependent and Na+-independent
transport of TCA (fig. 8a) and the uptake of pravastatin, cimetidine
and ouabain (fig. 8b). At 200 µM, close to the
Km for GPFX uptake, GPFX reduced the TCA uptake
to only 70 to 75% of controls, although at 1 mM (about six times the
Km), approximately 50% of the TCA uptake and
40% of the pravastatin uptake remained uninhibited. We previously
reported that the contribution of passive diffusion was only 10% of
the total uptake of TCA and pravastatin (Yamazaki et al.,
1992a
, 1993b
). Therefore, 1 mM GPFX only partially inhibited the
carrier-mediated uptake of TCA and pravastatin. In the case of
cimetidine uptake, considering that the contribution of passive
diffusion is approximately 25% (Nakamura et al., 1994
), the
carrier-mediated uptake of cimetidine seemed to be inhibited almost
completely by 1 mM GPFX (fig. 8b). Ouabain uptake was also completely
inhibited by GPFX (fig. 8b).
The inhibition of GPFX uptake by the substrates for these transporters
was also examined. The concentrations of inhibitors were chosen so that
the carrier-mediated uptake of the inhibitors would be saturated. The
Km for Na+-dependent and
Na+-independent uptake of TCA was reported to be 15 and 57 µM, respectively (Anwer and Hegner, 1978
). The
Km for DBSP and pravastatin uptake was reported
to be 2 and 29 µM, respectively (Blom et al., 1981
; Yamazaki et al., 1993b
). Thus, the inhibition studies
involving these compounds were carried out at concentrations of
inhibitors ranging from 5 to 100 µM for DBSP and 20 to 500 µM for
pravastatin. GPFX uptake was not inhibited by TCA, DBSP, pravastatin
and ICG at concentrations higher than their Km
value (table 2), suggesting that the GPFX transport system is different
from the transporters for bile acids and organic anions.
It is suggested that a transporter exists for comparatively hydrophilic
monovalent cations and one for hydrophobic multivalent cations. The
compounds for each transporter have been classified as type I and type
II, i.e., cationic and aliphatic methylammonium compounds
such as TEA, PAEB and cimetidine belong to type I, and lipophilic
organic cations with an amino group in the cyclic structure such as
d-tubocurarine belong to type II (Meijer et al.,
1990
; Groothuis et al., 1996
). Moreover, investigations have
been carried out to discover the driving-force and molecular weight of
each transporter by the photoaffinity labeling technique (Mol et
al., 1988
, 1991
, 1992
; Muller et al., 1988
). Inhibition
of GPFX uptake by type I compounds, cimetidine and PAEB was not
observed at high concentrations, 10 times higher than the
Km for their own uptake (table 2). Type II
compounds (d-tubocurarine) did not inhibit GPFX uptake
(table 2), indicating that the GPFX uptake system differs from the
organic cation transporter.
Ouabain (neutral steroid) is known to be taken up by a carrier-mediated
system into the liver and inhibits TCA uptake in a competitive manner
(Okudaira et al., 1988
). Ouabain uptake was completely
inhibited by GPFX (fig. 8b), although ouabain did not inhibit GPFX
uptake at concentrations approximately 15-fold higher than the
Km for its own uptake (table 2). Thus, GPFX and
ouabain may not share the same transporter. Quinidine, verapamil and
vincristine, which are amphipathic cations, inhibited GPFX uptake
concentration dependently (table 2). To study the relationship between
transport systems for GPFX and these compounds, the effect of GPFX on
quinidine uptake was investigated. The hepatic uptake of
[3H]-quinidine was completely abolished by unlabeled
quinidine (200 µM), indicating the possibility that this uptake may
be carrier-mediated. GPFX at a concentration of 1 mM, which can
saturate GPFX uptake (six times the Km), reduced
the quinidine uptake to only 75% of the controls. If these two drugs
share a transporter, quinidine uptake should be reduced by GPFX (1 mM)
to approximately one-seventh (calculated from 1/(1 + I/Km)). Therefore, the transporters for GPFX and
quinidine may differ. These results based on mutual inhibition studies
indicate that the transporter for GPFX uptake is different from the
other transporters so far identified.
Very recently, an oatp has been reported to have a broad substrate
specificity (including not only organic anions but also bile acids,
organic cations and the neutral steroid, ouabain) (Bossyut et
al., 1996). Moreover, it is not currently known if multiple forms
of oatp or multiple transcripts originating in alternative splicing
exist (Jacquemin et al., 1994
). If oatp has multiple forms
that have overlapping substrate specificities, it is reasonable for
oatp to recognize a broad range of multiple substances. GPFX inhibited
the transport of TCA, cimetidine and ouabain, and GPFX uptake was
inhibited by amphipathic organic cations such as quinidine (fig. 8;
table 2). These observations show the possibility that GPFX could be
transported by a form of oatp. However, GPFX uptake was not reduced by
pravastatin, DBSP and ouabain (table 2). These findings may be
explained by the following hypothesis. GPFX is transported by multiple
isoform of oatp although pravastatin, DBSP and ouabain are transported by a single isoform. If the isoform that recognizes pravastatin, DBSP
and ouabain contributes only slightly to GPFX uptake, GPFX could
potently inhibit the uptake of these compounds although they do not
inhibit GPFX uptake, or at least only to a small extent. This
possibility requires further investigation.
Although the transporter for GPFX appeared to be different from those
for TCA, pravastatin, cimetidine and ouabain, GPFX inhibited the uptake
of all these compounds. Such inhibition may be caused by the following
mechanism: GPFX is a highly lipophilic compound so that GPFX may bind
to the plasma membrane in close proximity to some transporters for bile
acids, organic anions and cations. This may then bring about a change
in the environment around the transporters and reduce subsequent
transport. If such nonspecific binding to cell surface occurs, it would
occur very rapidly. Therefore, it may be estimated from the
extrapolated uptake value at zero-time by isolated hepatocytes. The
nonspecific binding of GPFX was estimated to be 51.8 µl/mg protein
for the time-profile of uptake shown in figure 3. This nonspecific
binding of GPFX may be one of the mechanisms for the inhibitory effect
of GPFX on the transport of various compounds. An analysis for a
concentration dependence of such nonspecific binding was carried out
using the data in figure 4a, and the distribution volume representing
the nonspecific binding was found to be 49.4 to 55.9 µl/mg protein
(mean data of four different experiments) over the concentration rage 5 to 1000 µM. Although the value of nonspecific binding amounts to approximately 10 times the intracellular volume, the nonspecific binding did not exhibit any change at different concentrations of GPFX,
indicating that the nonspecific binding of GPFX to hepatocytes was not
saturable.
In conclusion, the hepatic uptake of GPFX is by a
Na+-independent and carrier-mediated active transport
system, and the contribution of carrier-mediated uptake to the total
uptake of GPFX is approximately 50% at therapeutic plasma
concentrations (<5 µM). None of the transporters for bile acids,
organic anions, organic cations or ouabain seems to be responsible for
the hepatic uptake of GPFX. Successful extrapolation of in
vivo hepatic uptake clearance from in vitro uptake data
using isolated hepatocytes confirms that the carrier-mediated transport
observed in vitro actually plays a role in the effective
hepatic uptake of GPFX in vivo.
We thank Dr. Y. Yabuuchi, Dr. S. Yamashita and Mr. M. Odomi in
Otsuka Pharmaceutical company for donating labeled and unlabeled grepafloxacin and for valuable discussion.
Accepted for publication March 21, 1997.
Received for publication September 5, 1996.
NQ, quinolone antibiotics;
GPFX, grepafloxacin;
SPFX, sparfloxacin;
LFLX, lomefloxacin;
OFLX, ofloxacin;
CPFX, ciprofloxacin;
ENX, enoxacin;
TCA, taurocholic acid;
oatp, organic
anion transporting polypeptide;
FCCP, carbonylcyanide-p(trifluoromethoxy)phenyl-hydrazone;
DBSP, dibromosulfophthalein;
DIDS, 4,4
-diisothiocyanatostilbene
2,2
-disulfonic acid;
PCMB, p-chloromercuribenzoic acid;
ICG, indocyanine green;
PAEB, procainamide ethobromide;
TEA, triethylmethylammonium;
HEPES, 4-(2-hydroxyethyl)-1-piperazine
ethanesulfonic acid;
Km, Michaelis-Menten
constant, Vmax, maximum uptake rate;
Pdif, nonspecific uptake clearance;
CL, clearance;
AUC, area under the curve;
Qh, hepatic blood flow;
TLC, thin-layer chromatography;
HPLC, high performance liquid chromatography;
oatp, organic anion
transporting polypeptide.