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• W3081566520 endingPage "1190" @default.
• W3081566520 startingPage "1183" @default.
• W3081566520 abstract "Estimation of unbound drug concentration in the brain (C_u,brain) is an essential part of central nervous system (CNS) drug development. As a surrogate for C_u,brain in humans and nonhuman primates, drug concentration in cerebrospinal fluid (C_CSF) collected by lumbar puncture is often used; however, the predictability of C_u,brain by lumbar C_CSF is unclear, particularly for substrates of the active efflux transporter P-glycoprotein (P-gp). Here, we measured lumbar C_CSF in cynomolgus monkey after single intravenous administration of 10 test compounds with varying P-gp transport activities. The in vivo lumbar cerebrospinal fluid (CSF)-to-plasma unbound drug concentration ratios (K_{p,uu,lumbar CSF}) of nonsubstrates or weak substrates of P-gp were in the range 0.885–1.34, whereas those of good substrates of P-gp were in the range 0.195–0.458 and were strongly negatively correlated with in vitro P-gp transport activity. Moreover, concomitant treatment with a P-gp inhibitor, zosuquidar, increased the K_{p,uu,lumbar CSF} values of the good P-gp substrates, indicating that P-gp–mediated active efflux contributed to the low K_{p,uu,lumbar CSF} values of these compounds. Compared with the drug concentrations in the cisternal CSF and interstitial fluid (ISF) that we previously determined in cynomolgus monkeys, the lumbar C_CSF were more than triple for two and all of the good P-gp substrates examined, respectively. Although lumbar C_CSF may overestimate cisternal CSF and ISF concentrations of good P-gp substrates, lumbar C_CSF allowed discrimination of good P-gp substrates from the weak and nonsubstrates and can be used to estimate the impact of P-gp–mediated active efflux on drug CNS penetration. <h3>SIGNIFICANCE STATEMENT</h3> This is the first study to systematically evaluate the penetration of various P-glycoprotein (P-gp) substrates into lumbar cerebrospinal fluid (CSF) in nonhuman primates. Lumbar CSF may contain >3-fold higher concentrations of good P-gp substrates than interstitial fluid (ISF) and cisternal CSF but was able to discriminate the good substrates from the weak or nonsubstrates. Because lumbar CSF is more accessible than ISF and cisternal CSF in nonhuman primates, these findings will help increase our understanding of drug central nervous system penetration at the nonclinical stage." @default.
• W3081566520 created "2020-09-08" @default.
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• W3081566520 date "2020-08-29" @default.
• W3081566520 modified "2023-10-02" @default.
• W3081566520 title "Impact of P-Glycoprotein–Mediated Active Efflux on Drug Distribution into Lumbar Cerebrospinal Fluid in Nonhuman Primates" @default.
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• W3081566520 doi "https://doi.org/10.1124/dmd.120.000099" @default.
• W3081566520 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/32862147" @default.
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