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Analysis of the contributing role of drug transport across biological barriers in the development and treatment of chemotherapy-induced peripheral neuropathy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. Boehringer Ingelheim RCV GmbH & Co KG, Discovery ADME, Drug Discovery Sci, A-1121 Vienna, Austria..ORCID iD: 0000-0002-8702-6654
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. Vilnius Univ, Inst Biomed Sci, Fac Med, Pharm & Pharmacol Ctr, MK Ciurlionio Str 21-27, LT-03101 Vilnius, Lithuania..ORCID iD: 0000-0002-3701-3847
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
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2024 (English)In: Fluids and Barriers of the CNS, E-ISSN 2045-8118, Vol. 21, no 1, article id 13Article in journal (Refereed) Published
Abstract [en]

Background Chemotherapy-induced peripheral neuropathy (CIPN) represents a major unmet medical need that currently has no preventive and/or curative treatment. This is, among others, driven by a poor understanding of the contributive role of drug transport across biological barriers to target-site exposure. Methods Here, we systematically investigated the transport of 11 small-molecule drugs, both, associated and not with CIPN development, at conventional (dorsal root ganglia, sciatic nerve) and non-conventional (brain, spinal cord, skeletal muscle) CIPN sites. We developed a Combinatory Mapping Approach for CIPN, CMA-CIPN, combining in vivo and in vitro elements. Results Using CMA-CIPN, we determined the unbound tissue-to-plasma concentration ratio (K-p,K-uu) and the unbound intracellular-to-extracellular concentration ratio (K-p,K-uu,K-cell), to quantitatively assess the extent of unbound drug transport across endothelial interfaces and parenchymal cellular barriers of investigated CIPN-sites, respectively, in a rat model. The analysis revealed that unique pharmacokinetic characteristics underly time-dependent accumulation of the CIPN-positive drugs paclitaxel and vincristine at conventional (dorsal root ganglia and sciatic nerve) and non-conventional (skeletal muscle) CIPN sites. Investigated CIPN-positive drugs displayed intracellular accumulation contrary to CIPN-negative drugs nilotinib and methotrexate, which lacked this feature in all investigated tissues. Conclusions Hence, high unbound drug intracellular and extracellular exposure at target sites, driven by an interplay of drug transport across the endothelial and parenchymal cellular barriers, is a predisposing factor to CIPN development for CIPN-positive drugs. Critical drug-specific features of unbound drug disposition at various CIPN- sites provide invaluable insights into understanding the pharmacological/toxicological effects at the target-sites which will inform new strategies for monitoring and treatment of CIPN.

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 21, no 1, article id 13
Keywords [en]
Chemotherapy-induced peripheral neuropathy, CIPN, Blood-nerve barrier, Blood-dorsal root ganglion barrier, K-p, K-uu, K-p, K-uu, K-cell, Neuropharmacokinetics
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-523902DOI: 10.1186/s12987-024-00519-7ISI: 001160643100001PubMedID: 38331886OAI: oai:DiVA.org:uu-523902DiVA, id: diva2:1841584
Available from: 2024-02-29 Created: 2024-02-29 Last updated: 2024-02-29Bibliographically approved

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Hu, YangGirdenyte, MildaBällgren, FridaHammarlund-Udenaes, MargaretaLoryan, Irena
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