TY - JOUR T1 - Molecular and Physical Mechanisms of First-Pass Extraction JF - Drug Metabolism and Disposition JO - Drug Metab Dispos SP - 161 LP - 166 VL - 27 IS - 2 AU - Stephen D. Hall AU - Kenneth E. Thummel AU - Paul B. Watkins AU - Kenneth S. Lown AU - Leslie Z. Benet AU - Mary F. Paine AU - Robert R. Mayo AU - D. Kim Turgeon AU - David G. Bailey AU - Robert J. Fontana AU - Steven A. Wrighton Y1 - 1999/02/01 UR - http://dmd.aspetjournals.org/content/27/2/161.abstract N2 - This is a report of a symposium held at the March 1997 meeting of the American Society for Pharmacology and Therapeutics in San Diego. Our understanding of the events that control first-pass drug elimination in humans has increased tremendously by two sequential discoveries. First, cytochrome P-450s 3A4 and 5 are expressed at high concentrations in both hepatocytes and upper intestinal enterocytes, and therefore limit the systemic availability of many drugs. Second, P-glycoprotein is expressed at the lumenal surface of the intestinal epithelium and therefore also acts to oppose the absorption of unchanged drug. The following discussion brings together our current understandings of these interrelated phenomena to aid a more complete picture of how they may contribute both qualitatively and quantitatively to first-pass elimination. The American Society for Pharmacology and Experimental Therapeutics ER -