PT  - JOURNAL ARTICLE
AU  - Johan Nicolaï
AU  - Tom De Bruyn
AU  - Louise Thevelin
AU  - Patrick Augustijns
AU  - Pieter Annaert
TI  - Transport-Metabolism Interplay of Atazanavir in Rat Hepatocytes
AID  - 10.1124/dmd.115.068114
DP  - 2016 Mar 01
TA  - Drug Metabolism and Disposition
PG  - 389--397
VI  - 44
IP  - 3
4099  - http://dmd.aspetjournals.org/content/44/3/389.short
4100  - http://dmd.aspetjournals.org/content/44/3/389.full
SO  - Drug Metab Dispos2016 Mar 01; 44
AB  - The aim of this study was to explore the mechanisms governing the intra- to extracellular unbound concentration ratio (Kpu,u) for the HIV protease inhibitor atazanavir (ATV) in rat hepatocytes. We had previously proposed a new method to determine Kpu,u by using the unbound Km values from metabolism studies with suspended rat hepatocytes and rat liver microsomes. Following that method, we determined that the value of ATV Kpu,u was 0.32, indicating that ATV hepatocellular clearance is uptake rate–limited. This hypothesis was supported by the linear correlation between Kpu,u and active uptake clearance (P = 0.04; R2=0.82) in the presence of increasing concentrations of the uptake transport inhibitor losartan. Moreover, in contrast to an expected increase of Kpu,u upon inhibition of ATV metabolism, a decrease of Kpu,u was observed, suggesting an increased impact of sinusoidal efflux. In summary, involvement of active uptake transport does not guarantee high intracellular accumulation; however, it has a key role in regulating intracellular drug concentrations and drug metabolism. These findings will help improve future in vitro–to–in vivo extrapolations and likewise physiologically based pharmacokinetic models.