BACKGROUND AND PURPOSEAn ATP-binding cassette (ABC) transporter, breast cancer resistance protein (BCRP)/ABCG2, limits oral bioavailability of sulphasalazine. Here we examined the effect of curcumin, the principal curcuminoid of turmeric, on oral bioavailability of microdoses and therapeutic doses of sulphasalazine in humans. EXPERIMENTAL APPROACHEffects of curcumin were measured on the ATP-dependent sulphasalazine uptake by hBCRP-expressing membrane vesicles and on oral bioavailability of sulphasalazine in wild-type and Bcrp(-/-) mice. Eight healthy Japanese subjects received an oral dose of sulphasalazine suspension (100 mg) or tablets (2 g) alone or after curcumin tablets (2 g). Uptake of sulphasalazine was studied in HEK293 cells transfected with the influx transporter (OATP)2B1. KEY RESULTSCurcumin was a potent hBCRP inhibitor in vitro (Ki 0.70 Ϯ 0.41 mM). Curcumin increased the area under the curve (AUC)0-8 of plasma sulphasalazine eightfold in wild-type mice at 300 and 400 mg·kg -1 , but not in Bcrp(-/-) mice. Curcumin increased AUC0-24 of plasma sulphasalazine 2.0-fold at microdoses and 3.2-fold at therapeutic doses in humans. Non-linearity of the dose-exposure relationship was observed between microdoses and therapeutic doses of sulphasalazine. Sulphasalazine was a substrate for OATP2B1 (Km 1.7 Ϯ 0.3 mM). Its linear index (dose/Km) at the therapeutic dose was high and may saturate OATP2B1. CONCLUSIONS AND IMPLICATIONSCurcumin can be used to investigate effects of BCRP on oral bioavailability of drugs in humans. Besides the limited dissolution, OATP2B1 saturation is a possible mechanism underlying non-linearity in the dose-exposure relationship of sulphasalazine. AbbreviationsABC, ATP-binding cassette; AUC, area under the curve; BCRP, breast cancer resistance protein; CLtot, total body clearance; Ki, inhibition constant Km, Michaelis constant; MRP2, multidrug resistance-associated protein 2; OATP, organic anion-transporting polypeptide; SNP, single nucleotide polymorphism BJP British Journal of Pharmacology

The organic cation/carnitine transporter OCTN2 mediates transport of carnitine and organic cations in Na ϩ -dependent and Na ϩ -independent manners, respectively. However, the mechanism of molecular recognition of different substrates has not been clarified yet. We previously found a single amino acid change in OCTN2, Ser467Cys (S467C), in the Japanese population and observed a decreased carnitine transport but unchanged organic cation transport compared with wild type. Therefore, we conducted detailed kinetic and functional analyses of the substrate recognition sites of wild-type and S467C-mutant OCTN2. The K m value for carnitine of S467C-mutant was increased about 15-fold over that of the wild type. Mutual inhibition kinetics of carnitine and tetraethylammonium (TEA) were not completely competitive, suggesting that the binding sites are very close to each other, but not identical. Several organic anions such as valproate, as well as organic cations, significantly inhibited carnitine and TEA uptake by OCTN2, and valproate showed Na ϩ -dependent inhibition of OCTN2-mediated TEA uptake. The Na ϩ -activation kinetics of the S467C mutant was similar to that of the wild type. Furthermore, a significant decrease of the TEA uptake-inhibitory potency of valproate was observed in S467C-mutant OCTN2. These observations suggest that the decrease in affinity of S467C-mutant OCTN2 for carnitine was caused by functional alteration of the anion (carboxyl moiety of carnitine) recognition site located in trans-membrane domain 11, which is closely related to the Na ϩ -binding site, on OCTN2 protein. These results demonstrate that OCTN2 has functional sites for carnitine and Na ϩ and that the carnitine-binding site is involved, in part, in the recognition of organic cations.

OCTN2 (SLC22A5), an organic cation/carnitine transporter, is widely distributed throughout the body, including the brain. In the present study, the involvement of OCTN2 in acetyl-L-carnitine (ALCAR) permeation across the blood-brain barrier (BBB) was examined using a microdialysis method in mouse. OCTN2 function was examined by comparison of wild-type mice with jvs mice, which express defective OCTN2 and are considered a model for primary systemic carnitine deficiency. Zero-net-flux method analysis indicated higher in vivo recovery of ALCAR and lower physiological ALCAR concentration in thalamus extracellular fluid (ECF) in jvs mice compared with wild-type mice. Externally added ALCAR showed significantly slower initial uptake across the BBB in jvs mouse. These results indicated that OCTN2 is functionally involved in ALCAR transfer across the BBB. Total radioactivity in ECF after i.v. administration of radiolabelled ALCAR remained constant for the rest of the experimental period. Accordingly, our results indicate that ALCAR is transported from blood to brain ECF by OCTN2 at least in part, and its concentration in brain ECF is regulated by other events such as protein binding and anabolic reactions in the brain, as well as by transport across the BBB.

In our study, the known interindividual variability in oseltamivir metabolism was not explained by CES1A genetic polymorphisms, but are likely the result of other factors. While one subject was found to exhibit an approximate tenfold higher AUC than the other subjects, no abnormal behaviors were associated with the increased oseltamivir plasma concentrations. Further studies are required to reveal the cause of individual differences in CES1A metabolism and the abnormal behavioral effects of oseltamivir.

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