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View eBook - Absorption Systems
Discover Clarity in Transporters Transporter Reference Guide 3rd Edition 3rd Ed with 20ition FDA & 12 EMA Guidan ce Translating cellular science into human outcomes with the most definitive assay systems Transporter Reference Guide • Overview • Intestinal Transporters • Hepatic Transporters • Renal Transporters • Concentration Selection • FAQs • Glossary Exton, PA 19341 Tel: +1 610-280-7300 Scotland, UK Tel: +44 7403 713697 San Diego, CA 92111 Tel: +1 858-560-9000 absorption.com © 2012 Absorption Systems Panama City, Panama Tel: +1 484-576-6143 Discover Clarity in Transporters: Transporter Reference Guide 3rd Edition, October 2012 Produced and Published by Absorption Systems Exton, Pennsylvania, 19341 +1.610.280.7300 absorption.com © 2010, 2011, 2012, Absorption Systems All Rights Reserved. CellPort Technologies ® is a registered trademark of Absorption Systems. Any unauthorized reprint or use of this material is prohibited. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system without express written permission from Absorption Systems. Every reasonable attempt has been made to identify owners of copyright. Errors or omissions will be corrected in subsequent editions. Electronic version available online: absorption.com/cellport_ebook Written requests for reprint or other permission should be emailed to: [email protected] About Absorption Systems Absorption Systems assists pharmaceutical and medical device companies in identifying and overcoming ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity) barriers in the development of drugs and medical devices. The company’s mission is to continually develop innovative research tools that can be used to accurately predict human outcomes or to explain unanticipated human outcomes when they occur. The CellPort Technologies® platform, a suite of human cell-based test systems for drug transporter characterization, exemplifies Absorption Systems’ commitment to innovation. The company’s facilities are strategically located on both US coasts and Panama, and encompass nearly 65,000 sq. ft., servicing hundreds of customers throughout the world. For more information on the company’s comprehensive contract services and applied research programs, please visit absorption.com. Preclinical Services & Capabilities Lead Optimization Physicochemical Properties Permeability Stability Metabolism and Transporters Binding and Distribution Formulation Assessment Bioavailability and Exposure | rodent, non-rodent Candidate Selection Formulation Development PK and Biodistribution | multiple species and dose routes Barriers to Bioavailability In Situ and Isolated Organ Perfusion | rat: brain, liver, intestine Ex Vivo Tissue Permeability | intestinal, dermal, ocular, buccal, nasal, vaginal IND- and NDA-Enabling Transporter-Based Drug Interactions BCS Permeability and Solubility Classification for Biowaivers Metabolism-Based Drug Interactions Metabolite ID and Production Medical Device Testing Toxicology Bioanalysis Bioanalytical Support from Discovery through Clinical GLP and Non-GLP Services Portfolio for Substrate Assessments Transporter CellPort Test System Caco-2 vs. CPT-B1; proprietary BCRP knockdown Caco-2 cells BCRP (ABCG2) Caco-2; human colon adenocarcinoma BCRP-MDCK vs. MDCK; canine kidney cells transfected with human BCRP Caco-2 vs. CPT-M1; proprietary MRP2 knockdown Caco-2 cells ABC MRP2 (ABCC2) Caco-2 vs. CPT-P1; proprietary P-gp knockdown Caco-2 cells P-gp (MDR1, ABCB1) Caco-2; human colon adenocarcinoma SLC MDR1-MDCK vs. MDCK; canine kidney cells transfected with human P-gp 4 BSEP (ABCB11) hBSEP-expressing vesicles; membrane vesicles derived from recombinant baculovirus-infected insect cells OATP1B1 (SLC01B1) OATP1B1-HEK293; human embryonic kidney cells transfected with OATP1B1*1A or OATP1B1*1B OATP1B3 (SLC01B3) OATP1B3-HEK293; human embryonic kidney cells transfected with OATP1B3*1 or OATP1B3*2 PepT1 (SLC15A1) Caco-2; induced human colon adenocarcinoma MCT (SLC16A) Caco-2; human colon adenocarcinoma OCT2 (SLC22A2) OCT2-HEK293; human embryonic kidney cells transfected with OCT2 OAT3 (SLC22A8) OAT3-HEK293; human embryonic kidney cells transfected with OAT3 OAT1 (SLC22A6) OAT1-HEK293; human embryonic kidney cells transfected with OAT1 OCT1 (SLC22A1) OCT1-HEK293; human embryonic kidney cells transfected with OCT1 OATP1A2 (SLC21A3) OATP1A2-HEK293; human embryonic kidney cells transfected with OATP1A2 OATP2B1 (SLC02B1) OATP2B1-HEK293; human embryonic kidney cells transfected with OATP2B1 MATE1 (SLC47A1) MATE1-HEK293; human embryonic kidney cells transfected with MATE1 MATE2K (SLC47A2) MATE2K-HEK293; human embryonic kidney cells transfected with MATE2K NTCP (SLC10A1) NTCP-HEK293; human embryonic kidney cells transfected with NTCP absorption.com/cellport © 2012 Absorption Systems. All rights reserved. CellPort Advantage • Specific transporter knockdown eliminates dependence on non-specific chemical inhibitors • Enables waiver of clinical DDI studies based on drug-specific factors • Enables waiver of clinical DDI studies based on drug-specific factors • Highly sensitive test system • Specific transporter knockdown eliminates dependence on non-specific chemical inhibitors • Enables waiver of clinical DDI studies based on drug-specific factors • Specific transporter knockdown eliminates dependence on non-specific chemical inhibitors • Enables waiver of clinical DDI studies based on drug-specific factors • Enables waiver of clinical DDI studies based on drug-specific factors • Highly sensitive test system • Also predicts intrinsic brain permeation potential • Inside-out vesicles increase sensitivity of the test system through direct access to the transporter •Robust expression of the transporter in vesicles from over-expressing cells • Prevalent clinically relevant genetic variants • Prevalent clinically relevant genetic variants • Highly sensitive test system with induced PepT1 expression • Optimize oral exposure of peptide pro-drugs • Optimize oral absorption of carboxylic acids • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 5 Services Portfolio for Inhibitor Assessments Transporter CellPort Test System CPT-P1; proprietary P-gp knockdown Caco-2 cells ABC BCRP (ABCG2) BCRP-MDCK; canine kidney cells transfected with human BCRP CPT-B1; proprietary BCRP knockdown Caco-2 cells P-gp (MDR1, ABCB1) Caco-2; human colon adenocarcinoma SLC MDR1-MDCK; canine kidney cells transfected with human P-gp 6 BSEP (ABCB11) hBSEP-expressing vesicles; membrane vesicles derived from recombinant baculovirus-infected insect cells OATP1B1 (SLC01B1) OATP1B1-HEK293; human embryonic kidney cells transfected with OATP1B1*1A or OATP1B1*1B OATP1B3 (SLC01B3) OATP1B3-HEK293; human embryonic kidney cells transfected with OATP1B3*1 or OATP1B3*2 PepT1 (SLC15A1) Caco-2; induced human colon adenocarcinoma Amino Acid (ASC System A&B,0,+ LAT) Caco-2; human colon adenocarcinoma OCT2 (SLC22A2) OCT2-HEK293; human embryonic kidney cells transfected with OCT2 OAT3 (SLC22A8) OAT3-HEK293; human embryonic kidney cells transfected with OAT3 OAT1 (SLC22A6) OAT1-HEK293; human embryonic kidney cells transfected with OAT1 OCT1 (SLC22A1) OCT1-HEK293; human embryonic kidney cells transfected with OCT1 OATP1A2 (SLC21A3) OATP1A2-HEK293; human embryonic kidney cells transfected with OATP1A2 OATP2B1 (SLC02B1) OATP2B1-HEK293; human embryonic kidney cells transfected with OATP2B1 MATE1 (SLC47A1) MATE1-HEK293; human embryonic kidney cells transfected with MATE1 MATE2K (SLC47A2) MATE2K-HEK293; human embryonic kidney cells transfected with MATE2K NTCP (SLC10A1) NTCP-HEK293; human embryonic kidney cells transfected with NTCP absorption.com/cellport © 2012 Absorption Systems. All rights reserved. CellPort Advantage • More definitive test system with less interference from P-gp • Specific clinically relevant probe combined with proprietary definitive test system • Clinically relevant probe • More definitive test system with less interference from BCRP • Clinically relevant probe • Clinically relevant probe • Clinically relevant probe • Inside-out vesicles allow low permeability compounds direct access to the transporter •Validated using clinically relevant inhibitors • Prevalent clinically relevant genetic variants • Prevalent clinically relevant genetic variants • Highly sensitive test system with induced PepT1 expression • Optimize oral absorption of amino acid pro-drugs • Probes established for small, cationic and large neutral amino acids • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Physiologically relevant human kidney cell line • Stably transfected with well-characterized phenotype • Human cell line • Stably transfected with well-characterized phenotype absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 7 Overview Drug Transporters Are Challenging Researchers studying drug transporters continue to grapple with a lack of definitive tools, unlike drug metabolism, which has a plethora of highly specific pharmacologic reagents and assay systems. Nearly all available transporter probe substrates and inhibitors interact with multiple transporters. Some transporters have multiple binding sites, which can result in substratedependent inhibition as has been reported for drug-metabolizing CYP enzymes and some transporters. Therefore, reliance on probe substrates and inhibitors can potentially lead to false negatives. In recognition of this, the new FDA Draft Guidance on drug interaction studies is less reliant on chemical inhibitors to identify the transporters mediating drug efflux than was the previous (2006) draft guidance. The new EMA Guideline even provides a non-inclusive list of assay formats that could be considered: “(over-)expressing the transporter in vector systems and comparing to normal vectors, using selective inhibitors to inhibit one specific transporter, inhibiting transporter expression either by knocking out the gene or through the use of silencing mRNA, etc”. This acceptance of alternative test systems by both regulatory agencies demonstrates that the industry is in pursuit of definitive solutions like CellPort Technologies® to make drugs safer by predicting DDIs reliably before they happen. Why Do the FDA and EMA Care about Transporters? Two reasons: pharmacokinetics and drug interactions. Presumably the latter is more important. You need to know what potential drug interactions to watch for and which ones you might have to test for in a clinical trial. For example, any new drug that inhibits members of the OATP uptake transporter family will probably have to be tested alongside a statin in a clinical trial. BCRP MRP2 Understanding different phases of drug transport and metabolism is essential for drug safety evaluation. Phase 3 Gut Lumen P-gp Drug Phase 0 Drug Nuclear Receptors Phase 2 Metabolism Phase 1 Metabolism Adapted from Gut 2003; 52: 1788-95 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Portal Blood 9 We Understand What the FDA and EMA Expect with Regard to In Vitro Transporter Data. That brings us to CellPort Technologies, the suite of transporter assay systems from Absorption Systems: • Unique, patented human cell lines in which we have achieved stable knockdown of one efflux transporter at a time: BCRP, P-gp, MRP2. We use them in the vectorial transport format in two different ways: 1. Efflux ratio in control vs. knockdown cells identifies which efflux transporter(s) handle a test compound. 2. Using the probe substrate, cladribine, in P-gp knockdown cells, we have a “cleaner” BCRP inhibition assay with less interference by P-gp. • Human cell lines in which important transporters are over-expressed: • OATP1B1 • OCT1 • OAT1 • P-gp • OATP1B3 • OCT2 • OAT3 • BCRP Why Evaluate Transporters? Transporters can have an enormous influence on the pharmacokinetics of drugs that are substrates, either limiting their intestinal absorption, mediating their excretion via bile or urine, or determining how much gets into the brain, cancer cells, or placenta. By influencing drug concentration levels in plasma or at pharmacological sites of action, drug transporters may significantly impact both safety and efficacy. 10 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. If your compound is a substrate of an uptake or efflux transporter, it could be susceptible to drug-drug interactions with co-administered drugs that are either substrates or inhibitors of the same transporter. This could require dose adjustment, particularly for a drug with a narrow therapeutic index. If your compound is a substrate or inhibitor of a transporter, it could alter the pharmacokinetics of co-administered drugs that are substrates of the same transporter. The evaluation of drug transporters is of critical importance in drug development, and is part of the FDA’s and EMA’s regulatory review process. The FDA and EMA now expect to see in vitro data on drug interactions with transporters in NDA filings. Data from in vitro drug interaction studies can help determine the likelihood of clinical drug-drug interactions, design appropriate in vivo drug interaction studies (if necessary), and establish appropriate labeling. Examples of clinical drug-drug interactions mediated by transporters: Interacting Drugs Affected Drug Consequence Effects on Transporter(s) Quinidine Digoxin Digoxin Exposure 1.7-fold h P-glycoprotein (P-gp, MDR1) Inhibition Rifampin Digoxin Digoxin Exposure 30% i P-gp Induction Dronedarone Digoxin Digoxin Exposure 2.6-fold h P-gp Inhibition Probenecid Cephradine Cephradine Exposure 3.6-fold h Organic Anion Transporter (OAT) Inhibition Cimetidine Metformin Metformin Exposure 1.4-fold h Organic Cation Transporter (OCT) Inhibition Cyclosporine Rosuvastatin Rosuvastatin Exposure 7-fold h Organic Anion Transporting Polypeptide (OATP) Inhibition & Breast Cancer Resistance Protein (BCRP) Inhibition Lopinavir/ Ritonavir Rosuvastatin Rosuvastatin Exposure 2-fold h OATP Inhibition Table adapted from “Membrane Transporters in Drug Development: Comment on the Report from the International Transporter Consortium (ITC)”, Lei Zhang, Ph.D., Office of Clinical Pharmacology, Office of Translational Sciences; Center for Drug Evaluation and Research, Food and Drug Administration; AAPS Webinar; July 29, 2010 Besides evaluating liabilities for drug-drug interactions, transporters are also studied as targets for drug delivery. The broad substrate specificities of intestinal uptake transporters such as PepT1, OATP2B1, and amino acid transporters, provide great potential for targeted delivery of amino acid-based drugs and pro-drugs. See Intestinal Transporters section for additional details. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 11 Localization of Human Transporters Brain P-gp, BCRP, MRP2, OATP2B1, ASC/LAT Liver (Canalicular) P-gp, BCRP, MRP2, BSEP Liver (Sinusoidal) OCT1, OATP1B1, OATP1B3, NTCP Kidney (Basolateral) OCT2, OAT1, OAT3 Intestinal Lumen P-gp, BCRP, MRP2, OCT1, OATP2B1, PepT1, ASC/LAT Kidney (Apical) P-gp, BCRP, MRP2, OATP2B1, PepT1, ASC/LAT, MATE 12 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Regulatory Perspective on Transporters Since the issuance of the new FDA Draft Guidance on Drug Interaction Studies (February 2012) and European Medicines Agency Guideline on the Investigation of Drug Interactions (June 2012), it has been made apparent that these two groups share a much more harmonized view on what transporters are of greatest importance as related to drug-drug interactions. Recommendations from these organizations are summarized in the following table: P-gp BCRP MRP BSEP OATP1B1 OATP1B3 OCT1 OCT2 OAT1 OAT3 MATE1/2 FDA Guidance 2012 EMA Guideline 2012 a a a a* a a a a* a a a a* a a a* a* a a a a Absorption Systems Portfolio a a a a a a a a a a a *When appropriate absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 13 Substrate Decision Tree TheFDAandEMArecommendevaluationofallNCEsassubstratesofat leasttwotransporters: All NCEs Determine whether NME is a P-gp and/or BCRP substrate in vitro Hepatic or biliary secretion major? e.g., ≥25% of total clearance or unknown? Renal active secretion major? e.g., ≥25% of total clearance or unknown? Determine whether NME is an OATP1B1 and/or OATP1B3 substrate in vitro Determine whether NME is an OAT1, OAT3 and/or OCT2 substrate in vitro Othertransporters(e.g.MRP2)mayneedtobestudiedbasedonknowledgeof otherdrugsinthesametherapeuticclass. Inhibitor Decision Tree TheFDAandEMArecommendevaluationofallNCEsforinhibitionofatleast fourtransporters: All NCEs P-gp and BCRP inhibitor evaluation OATP1B1 and OATP1B3 inhibitor evaluation OAT1, OAT3, and OCT2 inhibitor evaluation Inhibitor evaluation for other transporters (i.e. BSEP, OCT1, MATEs) when appropriate Adapted from: FDA Draft Guidance on Drug Interaction Studies. February 2012. EMA Guidlines on the Investigation of Drug Interactions. June 2012. 14 absorption.com/cellport ©2012AbsorptionSystems.Allrightsreserved. Which Transporter and When? Lead Generation Lead Optimization Candidate Selection Toxicology & Safety FTIH to Phase II P-gp (ABCB1) OAT1 (SLC22A6) BCRP (ABCG2) OAT3 (SLC22A8 OATP1B1 (SLCO1B1) OCT1 (SLC22A1) OATP1B3 (SLCO1B3) OCT2 (SLC22A2) Phase III & Final Launch BSEP Adapted from presentation by Joseph Polli and Caroline Lee General considerations for which transporters to evaluate and when should include: therapeutic area (potential co-medications), product profile, development plan, clearance route (hepatic vs. renal), chemical structure, and physicochemical properties. Because it is recommended to evaluate all NCEs as inhibitors of P-gp, BCRP, OATP1B1, OATP1B3, OAT1, OAT3, and OCT2, and as substrates of P-gp and BCRP, it makes sense to investigate these transporters relatively early in drug development. Knowing if your compound is a potential substrate or inhibitor of one of these transporters can help you plan clinical studies down the road. If there is evidence of significant hepatic/biliary clearance, then substrate assessment of OATPs should be performed. Similarly, if renal clearance is important, then OAT and OCT substrate interaction should be assessed. Depending on the cholestatic potential of the compound, it may be important to evaluate BSEP. If your compound is found to interact with one or more transporters, there may be implications for drug labeling and additional studies (clinical studies or non-clinical mechanistic studies) may be required. Based on drug-specific properties (solubility, permeability, metabolism), it may be possible to waive clinical DDI studies, even if your compound is a transporter substrate. Find more information on biowaivers in the intestinal transporters section. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 15 Tools for Investigating Transporters Methodsforelucidatingtransporterinteractionsinclude: Clinical Methods Non Clinical Methods •ComparativePK •ATPaseActivity •PolymorphicVariants •Cell-basedAssays •KnockoutAnimals •Vesicles AshighlightedbytheFDA’sCriticalPathInitiative,in vitrostudiesarepartof anintegratedapproachtoreduceunnecessaryclinicalstudies. “Inmanycases,negativefindingsfromearlyin vitro andearlyclinicalstudiescaneliminatetheneedforlater clinicalinvestigationsofdrug-druginteractionpotential.” FDA Draft Guidance, Feb. 2012 Whilenegativein vitroresultscanprecludetheneedforclinicaldrug-drug interaction(DDI)studies,insomecasesitisalsopossibletowaiveclinical studiesforcompoundsthatdointeractwithtransporters(findmoreinformation onbiowaiversintheintestinaltransporterssection).IfclinicalDDIstudies arerequired,thenin vitroresultsmayserveasthebasisfordesignofthose studies.Similarly,theresultsofclinicalDDIstudieshelptoexplainandrefine predictivein vitromodelsortools. In Vitro Model/Tools Explain In Vivo DDI Studies Predict Adapted from “Transporter-Mediated Drug-Drug Interactions (DDIs)”, Lei Zhang, Ph.D., CDER, FDA, Clinical Pharmacology Advisory Committee Meeting, Atlanta, GA, March 17, 2010. 16 absorption.com/cellport ©2012AbsorptionSystems.Allrightsreserved. For efflux transporter interaction assessments, Absorption Systems uses both unidirectional (basolateral-to-apical) and bidirectional assay formats specified by the FDA, as illustrated below. Each assay plate typically contains 12 or 24 dual assay chambers. Cells are cultured on polycarbonate filters until they reach confluence and differentiate to form a confluent monolayer. At that time, a sample of the monolayers is tested for barrier properties and transporter activity as a quality control measure for the batch. Apical Chamber Basolateral Chamber Filter Cell Monolayer In addition to Caco-2, other polarized epithelial cell lines, such as knockdown Caco-2 lines, MDR1-transfected MDCK, BCRP-transfected MDCK, and MDCK, are used in a similar assay format. All of Absorption Systems’ cell lines are extensively characterized and validated to ensure rugged, reproducible results. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 17 During efflux transporter substrate assessments, the test compound is added to the buffer solution of the apical chamber for apical-to-basolateral (A¨B) transport assessment (the physiological absorptive direction) or to the basolateral chamber for basolateral-to-apical (B¨A) transport assessment (the efflux or secretory direction). The rate of transport or flux is divided by the drug concentration in the dosing chamber to derive an apparent permeability (Papp) value. If a compound is passively transported, the Papp values measured in either direction should be approximately equal and the efflux ratio (the B¨A Papp divided by the A¨B Papp) should be close to 1. •Efflux ratios > 2 suggest the cells are actively secreting the drug into the apical chamber. Papp = dCr /dt x vr A x Co •Efflux ratios < 0.5 suggest active absorption of the drug from the apical chamber. ER = Papp (B¨A) Papp (A¨B) •When two cell lines are evaluated in parallel (such as wild-type and transporter knockdown cells), the relative efflux ratio (RER) is calculated. RER = RWT RKD For inhibition evaluation with efflux transporters, the unidirectional (basolateralto-apical) or bidirectional permeability of a probe substrate is evaluated in the presence and absence of a test compound. The following equations are applicable when the bidirectional format is used: Efflux Ratio (ER) = Papp (B¨A) Papp (A¨B) Papp (B¨A) Corrected Efflux = -1 Ratio (CER ) Papp (A¨B) 18 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. If the corrected efflux ratio of the probe substrate (CER) is reduced by more than 50% in the presence of the highest concentration of the test compound (CER/TC), then the compound is likely an inhibitor, and an IC50 evaluation should proceed. For example, for P-gp inhibition assessment, the corrected efflux ratio of digoxin (CERD) is evaluated: (CERD - CERD/TC ) x 100 ≥ 50% CERD For uptake transporter interaction assessments, cellular uptake is evaluated in 24-well plates. For substrate evaluation, buffer containing the test compound is added to the well and incubated for various durations. At a given time point, dosing solution is aspirated, the cells are washed, and lysis buffer is used to collect the cells from the well. The influx rate (IR) of the test compound into the cells is evaluated. Influx rate is the concentration of test compound normalized to protein content and incubation time. The influx rate ratio (IRR) is then calculated by comparing uptake in the transfected and vector control cell lines: Influx Rate Ratio (IRR) = IRTF IRVC • IRR values > 2.0 indicate that the compound is being actively taken up into the cells by the uptake transporter of interest • Substrate classification is further confirmed by a challenge with an inhibitor at a single time point. Inhibition >50% supports a positive substrate classification IR: Influx rate (concentration of probe substrate normalized to protein content) TF: Transfected Cells VC: Vector Control Cells absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 19 For inhibitor evaluation, the format is similar to that used for substrate assessment. In inhibition assessments, however, a single duration is used that has been optimized for each probe substrate. The IR of a probe substrate is evaluated in the presence and absence of a test compound. Net influx rate (NIR) and percent inhibition are calculated: Net Influx Rate (NIR) = IRTF - IR vc Percent Inhibition = 1- NIRTC NIRw/outTC x 100 • Inhibition >50% suggests that the test compound is an inhibitor of the uptake transporter IR: Influx rate (concentration of probe substrate normalized to protein content) TF: Transfected Cells VC: Vector Control Cells TC: Test Compound 20 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. CellPort Technologies: Innovative Solution for a More Definitive Assay System We selected a human cell line (Caco-2, C2BBE1 clone) expressing the efflux transporters P-gp, BCRP, and MRP2, and have knocked down the expression of one transporter at a time. This was achieved using short hairpin RNA (shRNA) in a lentiviral vector, an approach that is capable of producing stable phenotypes. Lentiviral Particle Nucleus mRNA Dicer RNase III mRNA Cleavage Suppression siRNA RISC siRNA Targeting Our cell lines for evaluation of hepatic and renal uptake transporters were created by stable transfection of transporter genes into HEK293 cells. For initial set-up, stable transfections are more laborious and challenging than transient transfections. However, they result in permanent insertion into the genome, allowing us to fully characterize the phenotype of our cells. You can benefit from Absorption Systems’ well-characterized, stable cell lines, which are ready to go. All of Absorption Systems’ cell lines have been extensively characterized and validated: Molecular Biology for Phenotypic Expression • Quantitative PCR for mRNA expression • Western blot for protein expression • Immunofluorescence for protein localization Assay Window and Phenotype Stability • Growth rate • Passage number • Days in culture • Assay window Appropriate and Robust Functional Expression • Bidirectional transport and/or uptake • Polarization and barrier properties absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 21 Our CellPort Analytics™ database captures up to ten years of data for our cell lines. This tool helps us ensure our cell lines are behaving optimally, according to stringent criteria we’ve established based on extensive knowledge and experience. Knockdown cell lines can be evaluated in different ways. For example, as a standalone model the P-gp knockdown is a cleaner BCRP assay system. Or, when used in combination with control cells, it can identify P-gp substrates. P-gp WT BCRP P-gp-KD MRP2 BCRP-KD VS VS VS 22 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. MRP2-KD Absorption Systems Has the Tools You Need. Absorption Systems offers validated assays for investigating all of the transporters recommended by the FDA and the EMA. We also offer an array of other transporters, such as PepT1, OATP2B1, MCT, NTCP, and amino acid transporters. Drug Safety Absorption Systems Portfolio P-gp BCRP MRP2 BSEP OATP1B1 OATP1B3 OCT1 OCT2 OAT1 OAT3 MATE1 MATE2K a a a a a a a a a a a a Drug Delivery PepT1 Amino Acid OATP1A2 OATP2B1 a a a a Radiolabel and fluorescent probe substrates are available absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 23 Intestinal Transporters Overview Intestinal Transporters absorption.com/cellport © 2012 Absorption Systems. All rights reserved. P-gp BCRP MRP3 MRP2 ASBT PepT1 OATP MCT1 OST Blood OCT1 Intestine ASC/LAT Due to ubiquitous expression of P-gp (MDR1, ABCB1) and BCRP (ABCG2), the current FDA and EMA guidelines recommend evaluation of interaction (both substrate and inhibitor assessment) with these efflux transporters. 25 Test Systems for Intestinal Efflux Transporters For evaluation of intestinal efflux transporters, CellPort Technologies is an optimal test system. CellPort is an innovative solution that provides a more definitive assay system. Using shRNA-mediated interference in a lentiviral vector, efflux transporters BCRP, P-gp, and MRP2 were individually and stably knocked down in human Caco-2 cells. CPT-B1 = CellPort BCRP knockdown CPT-P1 = CellPort P-gp knockdown CPT-M1 = CellPort MRP2 knockdown Transporter Knockdown is Selective and Effective Based on quantitative PCR, knockdown of targeted transporter is specific and significant, while the expression of other transporters is maintained at normal levels. mRNA Expression Relative to Parental Caco-2 1.2 0.8 0.6 0.4 0.2 0.0 26 ■ CPT-M1 ■ CPT-B1 ■ CPT-P1 1.0 MRP2 P-gp BCRP absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Fluorescent (green) antibody is specific for the cell-surface protein, BCRP. Nuclei are stained blue with DAPI. BCRP is clearly knocked down in CPT-B1. Fluorescence in parental Caco-2 Fluorescence in vector control No green fluorescence in CPT-B1 Similar immunofluorescence images demonstrate knockdown of P-gp in CPT-P1 cells. Parental Caco-2 CPT-P1 % of Efflux Ratio vs. Caco-2 Bidirectional permeability of probe substrates demonstrates appropriate knockdown of transporter function. 140 130 120 110 100 90 80 70 60 50 40 30 20 10 0 ■ CPT-M1 ■ CPT-B1 ■ CPT-P1 E3S Digoxin absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 27 Functional data verify comparable BCRP function, P-gp function, and barrier properties between parental Caco-2 cells and vector control cells. Transport Properties Vector Control Parental Caco-2 Estrone-3-Sulfate (E3S) Efflux E3S A¨B Papp 0.74 0.63 E3S B¨A Papp 10.36 10.69 14 17 Digoxin A¨B Papp 0.33 0.20 Digoxin B¨A Papp 8.24 3.69 25 19 E3S Efflux Ratio Digoxin Efflux Digoxin Efflux Ratio Barrier properties Atenolol A¨B Papp 0.39 0.35 Propranolol A¨B Papp 13.88 22.4 446 477 TEER Characteristics of Knockdown Cells Typical data for CPT-B1, CPT-P1, and vector control cells are shown below: Control CPT-B1 Digoxin Efflux Ratio 18.65 21.50 CPT-P1 4.99 Estrone-3-sulfate (E3S) Efflux Ratio 25.58 2.60 40.21 TEER 477 556 543 Atenolol A¨B Papp 0.13 0.41 0.33 Propranolol A¨B Papp 17.2 23.2 17.23 CPT-B1: 1. low E3S efflux (i.e., low BCRP function) 2. remaining E3S transport completely inhibited by the selective BCRP inhibitor FTC 3. high digoxin efflux (i.e., normal P-gp function) 4. good barrier properties. CPT-P1: 1. low digoxin efflux ratio (i.e., P-gp function) 2. high E3S efflux (i.e., normal BCRP function) 3. good barrier properties. 28 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Caco-2 Validation and Ruggedness Testing Based on our validation data, Caco-2 cell monolayers used between days 21 and 28 post-seeding and seeded between passages 58 and 76 are suitable for testing. Our validation of Caco-2 cells included an evaluation of digoxin efflux ratios in the presence and absence of cyclosporine A (CsA) to assess P-gp function. Digoxin is a known substrate of P-gp and CsA is a known inhibitor. Monolayers were tested for digoxin efflux in bidirectional permeability assays on multiple batches of cells at different passage numbers and days in culture. Digoxin exhibited an efflux ratio >10, which was reduced to approximately 1 in the presence of CsA. These results confirm the presence of P-gp-mediated efflux activity in Caco-2 cells 21 to 28 days after seeding. The efflux function of P-gp was consistently observed throughout the tested range of passages. Prior to an assay, each batch of cells undergoes quality control testing. The permeabilities of control compounds digoxin, E3S, atenolol (low permeability marker), propranolol (high permeability marker), and lucifer yellow are measured. Each monolayer used in a transport experiment is verified by a pre-experiment TEER measurement and by calculating the Papp of a monolayer integrity marker compound after the experiment. Caco-2 Cell Batch Certification Criteria Atenolol Papp ≤ 0.5 Propranolol Papp 10 – 30 Lucifer Yellow Papp ≤ 0.4 Digoxin Ratio: Papp (B¨A) / Papp (A¨B) > 10 E3S Ratio: Papp (B¨A) / Papp (A¨B) ≥ 25 Pre-Experiment TEER Value Post-Experiment Lucifer Yellow Papp 450 – 650 ≤ 0.8 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 29 MDR1-MDCK Validation and Ruggedness Testing Expression of human and canine P-gp in MDR1-MDCK cells and parental MDCK cells as a function of cell passage number (from 10 to 50) was characterized and verified by Western blot, RT-PCR, and sequence analysis. The expression levels of human and canine P-gp were similar between passages 10 to 50 in MDR1-MDCK cells as was the expression of canine P-gp in parental MDCK cells. P15 P15’ P25 P25’ P35 P35’ P45 P45’ (-) (+) Fig.1 Effect of cell passage (P) on expression of human P-gp in MDR1-MDCK with colchicine and without colchicine (’). (-) negative control MDCKII cells, and (+) positive control purified human P-gp protein control. An immunoblot analysis of human P-gp protein expression (20 μg protein/ lane) was done by using a species-specific monoclonal antibody for human P-gp. Canine P-gp was detected in both parental MDCK and MDR1-MDCK cells. There was no apparent difference in canine P-gp mRNA expression levels between the two cell lines. As a test for efflux pump function, the permeabilities of rhodamine123 (Rh123) and digoxin were similar in cells from different passages and at different days after seeding. Protein and mRNA levels for human P-gp in MDR1-MDCK cells were similar across different passages. Results using known P-gp inhibitors correlated with the rank order of their P-gp affinities. The data demonstrate that the MDR1-MDCK cell line is a rugged in vitro model for P-gp interaction assays. 30 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Cells between 7 and 11 days of growth are used for transport assays. The quality of every batch of monolayers is certified using control compounds prior to release for use. Each monolayer used in a transport experiment is verified by a pre-experiment TEER measurement and by calculating the Papp of a monolayer integrity marker compound after the experiment. MDR1-MDCK Cell Batch Certification Criteria Atenolol Papp < 0.5 Propranolol Papp 10-30 Lucifer Yellow Papp < 0.4 Digoxin Papp A¨B < 0.1 Digoxin Ratio: Papp (B¨A) / Papp (A¨B) >100 Pre-Experiment TEER Value ≥1400 Post-Experiment Lucifer Yellow Papp ≤ 0.8 MDCK Cell Batch Certification Criteria Atenolol Papp < 0.5 Propranolol Papp 10-30 Lucifer Yellow Papp < 0.4 Digoxin Ratio: Papp (B¨A) / Papp (A¨B) 10 to 50 Pre-Experiment TEER Value ≥1400 Post-Experiment Lucifer Yellow Papp ≤ 0.8 IC50 Evaluation in Validated Test Systems A series of known P-gp inhibitors with varying potencies was tested using several validated cell-based test systems and IC50 values were determined. The commonly used P-gp inhibitors CsA, ketoconazole, GF120918, and verapamil were evaluated in Caco-2, MDR1-MDCK, and MDCK cell monolayers with digoxin as the probe substrate. IC50 values were calculated according to six different methods to identify the least variable approach, used to establish our internal protocol. While the sensitivities of the cell lines varied due to P-gp expression levels, the rank order of inhibitor potency was maintained and was reproducible. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 31 Current Challenges A multitude of challenges exist with current in vitro test systems. When cells express multiple efflux transporters, identifying which transporter mediates drug efflux is difficult. Interpreting results from non-human cells in which a human transporter is over-expressed is complicated by the background of a non-human version of the same transporter. Chemical Inhibitors Lack Specificity Almost all known chemical inhibitors of drug transporters interact with multiple transporters. Non-specific pharmacologic probes can only confirm the involvement of a transporter but cannot identify which one is responsible for efflux of your test compound. The Best Solution to Overcome Today’s Challenges CellPort Technologies has an innovative solution for efflux with a more definitive assay system. CellPort is an innovative technology funded by FDA grants to provide more definitive transporter data. By selective knockdown of specific efflux transporters, CellPort eliminates dependence on non-selective chemical inhibitors. Current Challenges Collaborator Test systems in which transporters are over-expressed can lead to artifacts Chemical inhibitors lack specificity and require optimization Transporter phenotyping: Human cell lines express multiple efflux transporters Promiscuous probe substrates make it difficult to assess inhibition potential 32 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. The Absorption Systems Advantage Not all in vitro cell systems are ideal for in vitro drug investigations. Absorption Systems offers a variety of different cell models to best mimic the target in vivo site. Over-expressing cell lines may exaggerate drug-drug transporter interactions. However, if the drug targets a tissue type that over-expresses certain transporters, these cell lines may be ideal. This can also provide valuable information regarding SAR. By having the ability to run several well-characterized in vitro systems in parallel, Absorption Systems is better equipped to predict in vivo outcomes. Exaggerated Response 80 Relative Efflux Ratio (RER) 40 Caco-2 vs CPT-P1 MDR1-MDCK vs MDCK 20 Exaggerated Response 15 10 Positive Classification 5 0 Negative Classification Digoxin Atenolol False Negative Fexofenadine Loperamide absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Labetalol 33 Selecting the appropriate in vitro tool is critical for predicting and/or explaining clinical drug-drug interactions. AstraZeneca’s thrombin inhibitor, ximelagatran, is a pro-drug that is metabolized to the active drug, melagatran, in the liver. Both pro-drugs and drugs are actively secreted into bile. After the drug was approved, a clinical drug interaction with erythromycin became evident, which was unanticipated based on in vitro CYP metabolism studies. To investigate this phenomenon, bidirectional permeability of ximelagatran was assessed across Caco-2, CPT-P1 (P-gp knockdown), and CPT-M1 (MRP2 knockdown) cell monolayers. Intracellular accumulation of ximelagatran and its metabolites was also measured. Effects of P-gp and MRP2 Knockdown on Intracellular Accumulation of Melagatran 4000 Melagatran (pmol) 3000 n AgB n B gA 2000 1000 0 Vector Control Ximel OH-mel Et-mel Melagatran Digoxin P-gp Knockdown Caco-2 47 7 NA 97 36 MRP2 Knockdown Efflux Ratio CPT-P1 CPT-M1 5 42 1 10 NA NA 6 96 7 39 As highlighted above, the efflux ratio of ximelagatran and its metabolites were all substantially reduced in P-gp knockdown cells but not in MRP2 knockdown cells, indicating that ximelagatran and melagatran are substrates of P-gp. This fact explains the observed clinical interaction with erythromycin, a known inhibitor of P-gp. With multiple transporters present and the ability to generate metabolites inside the cell, CellPort provided an ideal platform to investigate this phenomenon. 34 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Waiving Clinical Studies Class II Class I Ketoprofen Naproxen Carbamazepine Class IV Propranolol Verapamil Metoprolol Class III Furosemide Hydrochlorothiazide Low Per meab il it y High Translating Cellular Science into Human Outcomes Absorption Systems’ Caco-2 cells are uniquely validated for both transporter interaction assessment and BCS classification. This test system may allow you to waive clinical DDI studies and/or human BA/BE studies based on certain drug-specific properties (high solubility, high permeability, high metabolism). Only Absorption Systems’ validated Caco-2 system provides the most accurate threshold for permeability classification. Ranitidine Cimetidine Atenolol Vancomycin Solubility Low High absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 35 We Can Make In Vivo Interaction Studies Unnecessary. According to the 2000 FDA BCS Guidance, compounds that are classified as Class I (highly soluble, highly permeable) are eligible for BCS biowaivers. For such compounds, the rate and extent of drug absorption is unlikely to be affected by drug dissolution and/or GI residence time, and in vivo bioequivalence studies (for new formulations, etc.) may be waived based on in vitro permeability and solubility data. Furthermore, for BCS Class I compounds, it is unlikely that absorption will be limited by efflux transporters. Thus, it may be possible to waive clinical DDI studies as well: “If in vitro experiments demonstrate that an NME is a P-gp substrate, additional drug-specific factors may be considered before determining whether an in vivo drug interaction study is warranted. For example, the bioavailability of the BCS Class I or BDDCS Class I NMEs that are highly soluble, highly permeable, and highly metabolized may not be significantly affected by a co-administered drug that is a P-gp inhibitor, and thus, an in vivo interaction study may not be needed.” L. Zhang et al., “Predicting Drug-Drug Interactions: An FDA Perspective” (2009) The AAPS Journal Absorption Systems has conducted over 125 in vitro BCS studies for classification and biowaivers over the last 10 years. Absorption Systems BCS Studies by Year 2011 60 55 50 45 40 2010 2008 2009 2007 2006 2005 2004 2002 36 2003 35 30 25 20 15 10 5 0 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Asdemonstratedbyourvalidationdata,Caco-2accuratelypredictshuman intestinalabsorption.Caco-2Pappvaluescorrelatewithhumanfraction absorbeddatafromtheliterature(seebelow).Forthisreason,in vitroCaco-2 testingisareliablesurrogateforin vivobioequivalencestudies.Infact,more than90%ofthenon-clinicaldatasubmittedandacceptedforbiowaivers isbasedonCaco-2.Caco-2testingisasprevalentashumanPKdatafor biowaiversubmissions. Human Fab vs. Caco-2 AgB P for 61 compounds % fraction absorbed orally in humans (literature data) app 100 90 80 Highly Absorbed 70 60 50 40 30 20 10 I 0I I I 0.1 1 10 100 Caco-2 AgB Papp (x10-6cm/s, log scale) absorption.com/cellport ©2012AbsorptionSystems.Allrightsreserved. 37 Three Steps to BCS Our validated 3-step study design allows for early identification of BCS biowaiver candidates and optimization of protocol elements. These steps include: 1.Pre-qualification and determination of the eligibility of test compound for BCS biowaiver. Your go/no-go decision point. 2.Protocol optimization and conduct of FDA-required experiments to establish protocol for pivotal studies. 3.GLP BCS classification of permeability and/or solubility. Our Uniquely Validated Caco-2 Cells May Allow You to Waive Clinical P-gp/BCRP Studies and/or Human BA/BE Studies. Redefining the threshold for permeability classification The threshold defined by Absorption Systems’ High Permeability Internal Standard (HPIS) is the lowest available. This novel internal standard has a Papp value about 7-fold lower than metoprolol and fraction absorbed > 95% in humans. Multiple biowaivers have been accepted using this novel HPIS. Caco-2 Papp (x 10-6 cm/s) 100 10 Antipyrine: Metoprolol: Pindolol: Papp ~63 Papp ~28 Papp ~17 Minoxidil: Papp ~4 1 Our High Permeability Internal Standard (HPIS) identifies high permeability at a lower threshold. 0.1 0.01 High 38 Low absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Translating Cellular Science into Human Outcomes Here’s an example of how and which clinical studies you could potentially waive by using Absorption Systems’ dually validated Caco-2 test system: P-gp Interaction Study BCRP Interaction Study Substrate Assessment • Caco-2 vs. CPT-P1 Substrate Assessment • Caco-2 vs. CPT-B1 Inhibition Assessment • Caco-2 • Probe Substrate: Digoxin Inhibition Assessment • CPT-P1 • Probe Substrate: Cladribine BCS Classification Study • Caco-2 BCS Classification Study • Caco-2 Cells Possibly Waive • Clinical P-gp Study • Human BA/BE Possibly Waive • Clinical BCRP Study • Human BA/BE absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 39 A Decade of BCS History Our extensive experience continues to facilitate innovative solutions and enable in vitro classification for a broader range of drugs. This, combined with our 10-day turnaround for pre-qualification and our cost-effective designs, saves you time and money. Just a few reasons why Absorption Systems averages more than 30 BCS studies each year. January 2011 May 2010 2009 December 2008 July 2008 • Present educational seminar to FDA new drug reviewers • FDA recommends biowaivers for cytotoxic drugs and highly variable drugs • Present educational seminar to FDA generic drug reviewers • FDA inspection results in ANDA pre-qualification 2007 • FDA audits again to confirm choice of HPIS 2006 • Addition of pH 6.5 option and introduction of new HPIS 2003 - 2005 Summer 2002 Fall 2001 Spring 2001 August 2000 40 • FDA audits again • Cross-validate assay based on customer and FDA feedback • Our first BCS customer receives biowaiver approval • FDA audits first BCS study conducted at Absorption Systems • Conduct first customer-sponsored BCS study • Validate Caco-2 for BCS • FDA issues BCS Guidance absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Test Systems for Intestinal Uptake Transporters Transporters for peptides, amino acids, monocarboxylic acids, and vitamins are often exploited for targeted drug delivery. The most well-studied intestinal uptake transporter, PepT1, regulates transport of protein digestion products (di- and tri-peptides), as well as peptidomimetic drugs (β-lactam antibiotics, renin inhibitors, and nonpeptide pro-drugs). Induced PepT1 expression is observed in patients with ulcerative colitis, Crohn’s disease, and short-bowel syndrome. PepT1 expression is also modified as a result of nutritional and metabolic alterations. Another important class of intestinal uptake transporters is the amino acid uptake transporters. In addition to naturally occurring amino acids, these transporters are known to transport drugs such as L-DOPA, melphalan, triiodothyronine, thyroxine, gapabentin, and valacyclovir. They are classified on the basis of their functional differences: Amino Acid Uptake Transporter Characteristics Substrate Na+-dependent ASC, System A Ala-preferring, small neutral amino acids Alanine Na+-dependent ASC, System B0,+ Neutral and cationic amino acids preferring Arginine Na+-independent LAT Large neutral amino acids preferring Phenylalanine The broad substrate specificity of these uptake transporters provides great potential for targeted drug delivery of amino acid-based drugs and pro-drugs. For example, valacylovir is a pro-drug formed by esterifying the 3-hydroxyl group of acyclovir with L-valine. Valacyclovir increases the oral bioavailability of acyclovir (an antiviral nucleoside) 3-5 fold. Its uptake is mediated by the PepT1 and amino acid B0,+ transporters. Caco-2 cells can be used to evaluate these transporters as, upon differentiation, these cells are morphologically and functionally similar to the absorptive epithelial cells of the small intestine. Absorption Systems has optimized the induction of PepT1 via GlySar teatment. We’ve shown this induction to increase uptake of PepT1 substrates like cephalexin by ~90%. Ref: Katragadda S et al., International Journal of Pharmaceutics 362 (2008) 93-101 Bhardwaj R et al., JPET 314 (2005) 1093-1100. Adibi S, AJPGI 285 (2003) G779-G788 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 41 Transporter Reference Card: P-gp Transporter: P-gp (P-glycoprotein, MDR1, ABCB1) Key Facts: Most-studied transporter; suggested for evaluation by FDA and EMA; ABC efflux transporter Localization: Ubiquitous (intestine, kidney, liver, etc.) CellPort Advantage: • Stable P-gp knockdown eliminates dependence on promiscuous chemical inhibitors. • Transfected MDCK is a highly sensitive test system. • Provides the potential to waive clinical DDI studies based on drugspecific factors. Only Absorption Systems’ validated Caco-2 system provides the most accurate threshold for permeability class (see section on waiving clinical studies). Substrate Evaluation Substrate Evaluation Recommended for all NCEs Caco-2 vs. CPT-P1 (P-gp knockdown) Caco-2 +/- chemical inhibitors Test Systems Available MDR1-MDCK vs. MDCK MDR1-MDCK +/- chemical inhibitors CPT-B1 (BCRP knockdown) +/- chemical inhibitors Assay Type Bidirectional permeability of test compound at multiple concentrations Positive Control Substrate Digoxin Chemical Inhibitors CsA or ketoconazole Inhibitor Evaluation Inhibitor Evaluation Recommended for all NCEs CPT-B1 (BCRP knockdown) Test Systems Available Caco-2 MDR1-MDCK 42 Assay Type Unidirectional or bidirectional permeability of probe substrate +/- test compound; IC50 evaluation when applicable Probe Substrate Digoxin or 3H-digoxin Positive Control Inhibitors CsA or ketoconazole absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Reference Card: BCRP Transporter: BCRP (Breast Cancer Resistance Protein, ABCG2) Key Facts: Suggested for evaluation by FDA and EMA; ABC efflux transporter Localization: Ubiquitous (intestine, kidney, liver, etc.) CellPort Advantage: •Stable BCRP knockdown eliminates dependence on promiscuous chemical inhibitors. • Transfected MDCK is a highly sensitive test system. •Provides the potential to waive clinical DDI studies based on drugspecific factors. Only Absorption Systems’ validated Caco-2 system provides the most accurate threshold for permeability class (see section on waiving clinical studies). Substrate Evaluation Substrate Evaluation Recommended for all NCEs Caco-2 vs. CPT-B1 (BCRP knockdown) CPT-P1 (P-gp knockdown) +/- chemical inhibitors Test Systems Available Caco-2 +/- chemical inhibitors BCRP-MDCK vs. MDCK BCRP-MDCK +/- chemical inhibitors Assay Type Bidirectional permeability of test compound at multiple concentrations Positive Control Substrate LC-MS/MS: Cladribine Fluorescent: Pheophorbide A Chemical Inhibitors Ko143 or FTC Inhibitor Evaluation Inhibitor Evaluation Recommended for all NCEs CPT-P1 (P-gp knockdown) Test Systems Available Caco-2 BCRP-MDCK Assay Type Unidirectional or bidirectional permeability of probe substrate +/- test compound; IC50 when applicable Probe Substrate LC-MS/MS: Cladribine Fluorescent: Pheophorbide A Positive Control Inhibitors Ko143 or FTC absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 43 Transporter Reference Card: MRP2 Transporter: MRP2 (Multidrug Resistance Protein, ABC2) Key Facts: ABC efflux transporter Localization: Ubiquitous (intestine, kidney, liver, etc.) CellPort Advantage: •Stable MRP2 knockdown eliminates dependence on promiscuous chemical inhibitors. •Provides the potential to waive clinical DDI studies based on drugspecific factors. Only Absorption Systems’ validated Caco-2 system provides the most accurate threshold for permeability class (see section on waiving clinical studies). Substrate Evaluation Substrate Evaluation Recommended for all NCEs Caco-2 vs. CPT-M1 (MRP2 knockdown) Test Systems Available CPT-P1 (P-gp knockdown) +/- chemical inhibitors Caco-2 +/- chemical inhibitors Assay Type Bidirectional permeability of test compound at multiple concentrations Positive Control Substrate CDCFDA Chemical Inhibitor MK571 Inhibitor Evaluation 44 Inhibitor Evaluation Recommended for all NCEs Test Systems Available Caco-2 Assay Type Unidirectional or bidirectional permeability of probe substrate +/- test compound; IC50 evaluation when applicable Probe Substrate CDCFDA Positive Control Inhibitor MK571 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Reference Card: PepT1 Transporter: PepT1 (peptide transporter, SLC15A1) Key Facts: Proton-dependent, oligopeptide solute carrier Localization: Intestinal brush border CellPort Advantage: •Highly sensitive test system with induced PepT1 expression •Caco-2 is a human cell line; no interference from animal transporters. •Optimize absorption of peptide pro-drugs. Substrate Evaluation Substrate Evaluation Recommended for amino acids, peptides, and pro-drugs Test Systems Available Caco-2 cells induced with 48-hour GlySar treatment Assay Type Unidirectional (AgB) permeability assessment of test compound +/- GlySar with pH gradient; optional evaluation of concentration dependence, induced vs. wild-type cells Positive Control Substrate Valacyclovir Chemical Inhibitor GlySar Inhibitor Evaluation Inhibitor Evaluation Recommended for amino acids, peptides, and pro-drugs Test Systems Available Caco-2 cells induced with 48-hour GlySar treatment Assay Type Unidirectional (AgB) permeability assessment of probe substrate +/- test compound with pH gradient Probe Substrate Valacyclovir Positive Control Inhibitor GlySar absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 45 Transporter Reference Card: Amino Acid Uptake Transporters Transporter: ASC, LAT Key Facts: Na+-dependent ASC, System A; Ala-preferring, small neutral amino acids Na+-dependent ASC, System B0,+; neutral and cationic amino acids preferring Na+-independent LAT; large neutral amino acids preferring Localization: Intestinal brush border, brain, placenta, kidney, heart CellPort Advantage: •Probes established for small cationic and large neutral amino acids. •Optimize absorption of amino acid pro-drugs. Inhibitor Evaluation Inhibitor Evaluation Recommended for amino acids and pro-drugs Test Systems Available Caco-2 cells Assay Type Uptake of probe substrate +/- test compound in Caco-2 cells Probe Substrate 3 Positive Control Inhibitor H-Amino Acid (Alanine, Phenylalanine, or Arginine) Unlabeled amino acid (Alanine, Phenylalanine, or Arginine) Note: Mannitol is marker for non-specific entrapment 46 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Reference Card: OATP1A2 Transporter: OATP1A2 (SLC21A3) Key Facts: Solute-linked organic anion transporter; broad substrate specificity Localization: Intestine, kidney, liver and brain CellPort Advantage: •HEK293 is a human cell line; no interference from animal transporters. •Use stable transfection rather than transient for consistent gene expression in the same cell line over time, avoiding the caveats associated with repetitive transient transfection. Substrate Evaluation Substrate Evaluation Recommended when appropriate based on test compound properties Test Systems Available OATP1A2-HEK293 cells vs. control Assay Type Uptake of test compound in OATP1A2-transfected cells vs. control Positive Control Substrate Atorvastatin Chemical Inhibitor Ritonavir Inhibitor Evaluation Inhibitor Evaluation Recommended when appropriate based on test compound properties Test Systems Available OATP1A2-HEK293 cells vs. control Assay Type Uptake of probe substrate +/- test compound in OATP1A2-transfected cells vs. control; single concentration or IC50 Probe Substrate Atorvastatin Positive Control Inhibitor Ritonavir absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 47 Transporter Reference Card: OATP2B1 Transporter: OATP2B1 (SLCO2B1) Key Facts: Solute-linked organic anion transporter; narrow substrate specificity Localization: Intestine, kidney, liver CellPort Advantage: •HEK293 is a human cell line; no interference from animal transporters. •Use stable transfection rather than transient for consistent gene expression in the same cell line over time, avoiding the caveats associated with repetitive transient transfection. Substrate Evaluation Substrate Evaluation Recommended when appropriate based on test compound properties Test Systems Available OATP2B1-HEK293 cells vs. control Assay Type Uptake of test compound in OATP2B1-transfected cells vs. control Positive Control Substrate Rosuvastatin Chemical Inhibitors Atorvastatin Inhibitor Evaluation 48 Inhibitor Evaluation Recommended when appropriate based on test compound properties Test Systems Available OATP2B1-HEK293 cells vs. control Assay Type Uptake of probe substrate +/- test compound in OATP2B1-transfected cells vs. control; single concentration or IC50 Probe Substrate Rosuvastatin Positive Control Inhibitors Atorvastatin absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Hepatic Transporters Overview Hepatic Uptake Transporters MRP3 P-g p BSEP P Bile TE1 MA MR P2 MRP6 OST BCR MRP4 NTCP OATP2B1 OATP1B3 OATP1B1 OAT7 OAT2 Blood OCT1 The FDA and EMA both recommend OATP1B1 (SLCO1B1) and OATP1B3 (SLCO1B3) inhibitor assessment for all NCEs. In addition to OATP1B1 and OATP1B3, the EMA recommends assessment of BSEP. Both agencies agree that other transporters should be evaluated for inhibition when appropriate. If hepatic clearance is significant, then evaluation of an NCE as a substrate for OAT1B1 and OAT1B3 is additionally recommended. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 49 Test Systems for Hepatic Uptake Transporters We have cell lines that were created by over-expressing hepatic OATP1B1, OATP1B3, or OCT1 in HEK293 human embryonic kidney cells. For OATP1B1 and OATP1B3, we have both wild-type and mutant variants. We use these models for uptake assays, to evaluate substrate and inhibitor potential. OATP1B1 Recombinant Over-expression OATP1B1*1A Wild-type variant OATP1B1*1B A388G mutation OATP1B3 Recombinant Over-expression OATP1B3*1 Wild-type variant OATP1B3*2 T334G and G669A mutations Vector Control Control Plasmid Transfection Identical plasmid without coding sequence Nuclei are stained blue with DAPI. OATP1B1 on the surface of the cells is stained green with a fluorescent antibody. There is no green fluorescence in the vector control cells, whereas the transfected cells show robust OATP1B1 expression. OATP1B1-transfected HEK Cells DAPI OATP1B1 Mock-transfected DAPI 50 OATP1B1 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. DAPI + OATP1B1 Transporter Transfections Are Stable Our cell lines are stably, not transiently, transfected. All cells lines exhibit robust expression, both molecularly and functionally, over several passages, ensuring consistency and reproducibility between data sets. Additionally, HEK293 parental cell lines show little to no expression of other uptake transporters; therefore, the uptake due to transporter interactions is a result of the specific transporter being expressed. Uptake of Fluorescent Probes in Transfected Cell Lines Uptake (µM) 0.20 0.15 OATP1B1 14-fold increase in FMTX uptake compared to HEK293 control cells 0.10 0.05 0.00 HEK293 OATP1B1 0.25 Uptake (µM) 0.20 OATP1B3 16-fold increase in FMTX uptake compared to HEK293 control cells 0.15 0.10 0.05 0.00 HEK293 OATP1B3 1.8 1.6 Uptake (µM) 1.4 OCT1 16-fold increase in ASP uptake compared to HEK293 control cells 1.2 1.0 0.8 0.6 0.4 0.2 0.0 HEK293 OCT1 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 51 Substrate Assessment All of our HEK hepatic transporter systems have been subjected to a rigorous panel of experiments to confirm their suitability for substrate and inhibitor assessments. The Km values determined with our systems for known and confirmed substrates are comparable to values reported in the literature. Net Influx Rate (pmol/mg/min) Determination of Km and Vmax 20 15 OATP1B1 10 Km = 0.304 µM Vmax = 18.9 pmol/mg/min 5 0 0 1 2 3 4 5 6 Net Influx Rate (pmol/mg/min) Atorvastatin Concentration (µM) 10 8 OATP1B3 6 Km = 2.01 µM Vmax = 11.7 pmol/mg/min 4 4 0.0 0 1 2 3 4 5 5 6 Net Influx Rate (pmol/mg/min) Atorvastatin Concentration (µM) 4000 3000 OCT1 Km = 56.6 µM Vmax = 4616 pmol/mg/min 2000 1000 0 0 50 100 150 200 250 MPP+ Concentration (µM) Not all compounds interact in the same way with uptake transporters. We determine the optimal concentration and time for all related substrate assessment studies using a 3 time point/3 concentration matrix (9 conditions total). This initial study helps us to determine the optimal assay conditions for any test compound. 52 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Inhibition Assessment Using a panel of known inhibitors, we demonstrated that our hepatic transporter systems exhibit inhibition of substrate uptake. Additionally, we further characterized these inhibitors and established IC50 data for strong and moderate inhibitors (based on our initial inhibitor panels). Determination of IC50 % Activity Remaining 120 100 80 OATP1B1 60 l Rifamycin SV IC50=0.407 40 n Rifampicin IC50=5.28 20 0 -10 -9 -8 -7 -6 -5 -4 Log Concentration (M) % Activity Remaining 120 100 80 OATP1B3 60 l Rifamycin SV IC50=0.244 40 n Rifampicin IC50=3.56 20 0 -10 -9 -8 -7 -6 -5 -4 Log Concentration (M) % Activity Remaining 120 100 80 OCT1 60 l Repaglinide IC50=116 40 n Quinine IC50=109 20 0 -10 -9 -8 -7 -6 -5 -4 -3 Log Concentration (M) absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 53 Transporter Reference Card: OATP1B1 Transporter: OATP1B1 (SLCO1B1) Key Facts: Suggested for evaluation by FDA and EMA; Solute-linked carrier organic anion transporter Localization: Sinusoidal (basolateral) membrane of liver CellPort Advantage: • HEK293 is a human cell line; no interference from animal transporters • Prevalent OATP1B1*1B variant available. •Clinically relevant probe substrate. •Provides definitive inhibitor assessment required for all NCEs. Substrate Evaluation Substrate Evaluation Recommended if hepatic or biliary excretion is major (≥25% total clearance) Test Systems Available OATP1B1-HEK293 vs. control Assay Type Uptake of test compound in OATP-transfected cells vs. control Positive Control Substrate LC-MS/MS: Atorvastatin Radioactive: 3H-atorvastatin Fluorescent: FMTX Chemical Inhibitor Rifamycin SV Inhibitor Evaluation Inhibitor Evaluation Recommended for all NCEs Test Systems Available OATP1B1-HEK293 vs. control Assay Type Uptake of probe substrate +/- test compound in OATPtransfected cells vs. control; single concentration or IC50 Probe Substrate LC-MS/MS: Atorvastatin Radioactive: 3H-atorvastatin Fluorescent: FMTX Positive Control Inhibitor Rifamycin SV 54 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Reference Card: OATP1B3 Transporter: OATP1B3 (SLCO1B3) Key Facts: Suggested for evaluation by FDA and EMA; Solute-linked carrier organic anion transporter Localization: Sinusoidal (basolateral) membrane of liver CellPort Advantage: •HEK293 is a human cell line; no interference from animal transporters. •Prevalent OATP1B3*2 variant available. •Clinically relevant probe substrate. •Provides definitive inhibitor assessment required for all NCEs. Substrate Evaluation Substrate Evaluation Recommended if hepatic or biliary excretion is major (≥25% total clearance) Test Systems Available OATP1B3-HEK293 vs. control Assay Type Uptake of test compound in OATP-transfected cells vs. control Positive Control Substrate LC-MS/MS: Atorvastatin Radioactive: 3H-atorvastatin Fluorescent: FMTX Chemical Inhibitor Rifamycin SV Inhibitor Evaluation Inhibitor Evaluation Recommended for all NCEs Test Systems Available OATP1B3-HEK293 vs. control Assay Type Uptake of probe substrate +/- test compound in OATPtransfected cells vs. control; single concentration or IC50 Probe Substrate LC-MS/MS: Atorvastatin Radioactive: 3H-atorvastatin Fluorescent: FMTX Positive Control Inhibitor Rifamycin SV absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 55 Transporter Reference Card: OCT1 Transporter: OCT1 (SLC22A1) Key Facts: Suggested for evalutation by EMA when appropriate; organic cation uptake transporters; pump substrates from blood to liver for hepatic extraction Localization: Liver, intestines, kidney CellPort Advantage: •HEK293 is a human cell line; no interference from animal transporters. •Use stable transfection rather than transient for consistent gene expression in the same cell line over time, avoiding the caveats associated with repetitive transient transfection. Substrate Evaluation Substrate Evaluation Recommended when appropriate Test Systems Available OCT1-HEK293 vs. control Assay Type Uptake of test compound in OCT1-transfected cells vs. control LC-MS/MS: MPP+ (1 methyl-4-phenylpyridinium iodide) Positive Control Substrate Radioactive: 3H-metformin Fluorescent: ASP Chemical Inhibitor Repaglinide Inhibitor Evaluation 56 Inhibitor Evaluation Recommended when appropriate Test Systems Available OCT1-HEK293 vs. control Assay Type Uptake of probe substrate +/- test compound in OCT1transfected cells vs. control; single concentration or IC50 Probe Substrate LC-MS/MS: MPP+ (1 methyl-4-phenylpyridinium iodide) Radioactive: 3H-metformin Fluorescent: ASP Positive Control Inhibitor Repaglinide absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Reference Card: BSEP Transporter: BSEP (ABCB11) Key Facts: Suggested for evaluation by EMA, and also by FDA when appropriate; ABC efflux transporter Localization: Canalicular (apical) membrane of liver CellPort Advantage: • Robust expression of the transporter in vesicles from over-expressing cells • Inside-out vesicles increase sensitivity of the test system through direct access to the transporter • Validated using clinically relevant inhibitors Substrate Evaluation Substrate Evaluation Recommended when appropriate Test Systems Available hBSEP-expressing vesicles Assay Type Uptake of test compound in hBSEP-expressing vesicles in presence of ATP vs. AMP Positive Control Substrate 3 Chemical Inhibitors CsA H-taurocholic acid Inhibitor Evaluation Inhibitor Evaluation Recommended for all NCEs (EMA) or when appropriate (FDA) Test Systems Available hBSEP-expressing vesicles Assay Type Uptake of probe substrate +/- test compound in hBSEP-expressing vesicles in presence of ATP vs. AMP; single concentration or IC50 Probe Substrate 3 Positive Control Inhibitors CsA H-taurocholic acid absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 57 Renal Transporters Overview Renal Transporters According to the FDA and EMA guidelines, all NCEs should be evaluated for inhibition of OAT1 (SLC22A6), OAT3 (SLC22A8), and OCT2 (SLC22A2). Additional transporters, such as MATE1 and MATE2, should also be assessed when appropriate. Depending on the extent of renal clearance, substrate evaluation should also be considered. Blood Urine OAT4 OATP4C1 URATI OCT2 PepT1, PepT2 OAT1 MRP2, MRP4 OAT2 OAT3 MATE1, MATE2 P-gp OCTN1, OCTN2 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 59 Test Systems for Renal Uptake Inhibitors We have created cell lines which over-express renal OAT1, OAT3, or OCT2 in HEK293 human embryonic kidney cells. We use these models to predict substrate and inhibitor potential with regard to specific uptake transporters. Nuclei are stained blue with DAPI. OCT2 on the surface of the cells is stained green with a fluorescent antibody. There is no green fluorescence in the HEK293 control cells, whereas the transfected cells show robust OCT2 expression. OCT2-transfected HEK Cells DAPI HEK-OCT2 DAPI+HEK-OCT2 HEK293 DAPI+HEK293 Mock-transfected DAPI 60 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Transfection Is Stable These cells were transfected stably, rather than transiently, and show robust expression, both molecularly and functionally, over several passages, ensuring consistency and reproducibility between data sets. Additionally, HEK293 parental cell lines show little to no expression of other uptake transporters; therefore, the uptake due to transporter interactions is a result of the specific transporter being expressed. Uptake of Fluorescent Probes in Transfected Cell Lines 1.5 Uptake (µM) 1.2 OCT2 14-fold increase in ASP uptake compared to HEK293 control cells 0.9 0.6 0.3 0.0 HEK293 OCT2 .80 Uptake (µM) .70 .60 OAT1 263-fold increase in 6CF uptake compared to HEK293 control cells .50 .40 .30 .20 .10 .00 HEK293 OAT1 .12 Uptake (µM) .10 OAT3 .08 29-fold increase in 5CF uptake compared to HEK293 control cells .06 .04 .02 0.0 HEK293 OAT3 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 61 Substrate Assessment All HEK transporter systems have been subjected to a rigorous panel of experiments to confirm their suitability for substrate and inhibitor assessments. Using known and confirmed substrates, we were able to determine Km values in our systems that are comparable to values reported in the literature. Net Influx Rate (pmol/mg/min) Determination of Km and Vmax 4000 OCT2 3000 Km = 27.1 µM Vmax = 3202 pmol/mg/min 2000 1000 0 0 50 100 150 200 250 Net Influx Rate (pmol/mg/min) MPP+ Concentration (µM) 200 150 OAT1 Km = 23.73 µM Vmax = 230.2 pmol/mg/min 100 50 0 0 20 40 80 6 60 Net Influx Rate (pmol/mg/min) PAH Concentration (µM) 750 500 OAT3 250 Km = 22 µM Vmax = 823 pmol/mg/min 0 0 25 50 75 100 125 Furosemide Concentration (µM) Due to the fact that not all compounds interact in the same way with uptake transporters, we determine the optimal concentration and time for all related substrate assessment studies using a 3 time point/3 concentration matrix (9 conditions total). These more rigorous initial studies help us to determine the time and concentration to use for subsequent studies. 62 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Inhibitor Assessment We used a panel of known inhibitors for each transporter to demonstrate inhibition. Additionally, we further characterized these inhibitors and determined IC50 values for strong and moderate inhibitors (based on the data from our inhibitor panels). Determination of IC50 % Activity Remaining 120 100 80 60 OCT2 40 l Imipramine IC50=51.8 20 n Quinidine IC50=276 0 -10 -9 -8 -7 -6 -5 -4 -3 -2 Log Concentration (M) % Activity Remaining 150 OAT1 100 l Probenecid IC50= 4.14 50 n Bumetanide IC50=6.08 20 -50 -4 -2 0 2 4 Log Concentration (µM) % Activity Remaining 125 100 OAT3 75 l Probenecid IC50=9.3 50 n Rosuvastatin IC50=21.7 25 0 -1 0 1 2 3 Log Concentration (µM) absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 63 Transporter Reference Card: OAT1 Transporter: OAT1 (SLC22A6) Key Facts: Suggested for evaluation by FDA and EMA; solute-linked carrier organic anion transporter Localization: Basolateral membrane of kidney proximal tubule cells; also found in brain, placenta, eyes, and smooth muscle CellPort Advantage: •HEK293 is a human cell line; no interference from animal transporters. •Use stable transfection rather than transient for consistent gene expression in the same cell line over time, avoiding the caveats associated with repetitive transient transfection. Substrate Evaluation Substrate Evaluation Recommended if renal secretion is major (≥25% total clearance) Test Systems Available OAT1-HEK293 vs. control Assay Type Uptake of test compound in OAT1-transfected cells vs. control Positive Control Substrate LC-MS/MS: para-Aminohippurate (PAH) Fluorescent: 6-Carboxyfluorescein Chemical Inhibitor Probenecid Inhibitor Evaluation 64 Inhibitor Evaluation Recommended for all NCEs Test Systems Available OAT1-HEK293 vs. control Assay Type Uptake of probe substrate +/- test compound in OAT1transfected cells vs. control; single concentration or IC50 Probe Substrate LC-MS/MS: para-Aminohippurate (PAH) Radioactive: 3H-PAH Fluorescent: 6-Carboxyfluorescein Positive Control Inhibitor Probenecid absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Reference Card: OAT3 Transporter: OAT3 (SLC22A8) Key Facts: Suggested for evaluation by FDA and EMA; solute-linked carrier organic anion transporter Localization: Basolateral membrane of kidney proximal tubule cells CellPort Advantage: •HEK293 is a human cell line; no interference from animal transporters. •Use stable transfection rather than transient for consistent gene expression in the same cell line over time, avoiding the caveats associated with repetitive transient transfection. Substrate Evaluation Substrate Evaluation Recommended if renal secretion is major (≥25% total clearance) Test Systems Available OAT3-HEK293 vs. control Assay Type Uptake of test compound in OAT3-transfected cells vs. control Positive Control Substrate LC-MS/MS: Furosemide Radioactive: 3H-E3S Fluorescent: 5-Carboxyfluorescein Chemical Inhibitor Probenecid Inhibitor Evaluation Inhibitor Evaluation Recommended for all NCEs Test Systems Available OAT3-HEK293 vs. control Assay Type Uptake of probe substrate +/- test compound in OAT3transfected cells vs. control; single concentration or IC50 Probe Substrate LC-MS/MS: Furosemide Radioactive: 3H-E3S Fluorescent: 5-Carboxyfluorescein Positive Control Inhibitor Probenecid absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 65 Transporter Reference Card: OCT2 Transporter: OCT2 (SLC22A2) Key Facts: Suggested for evaluation by FDA and EMA; solute-linked carrier cation transporter Localization: Primarily in kidney, also in liver, brain, lungs, etc. CellPort Advantage: •HEK293 is a human cell line; no interference from animal transporters. •Use stable transfection rather than transient for consistent gene expression in the same cell line over time, avoiding the caveats associated with repetitive transient transfection. Substrate Evaluation Substrate Evaluation Recommended if renal secretion is major (≥25% total clearance) Test Systems Available OCT2-HEK293 vs. control Assay Type Uptake of test compound in OCT2-transfected cells vs. control Positive Control Substrate LC-MS/MS: MPP+ (1 methyl-4-phenylpyridinium iodide) Radioactive: 3H-metformin Fluorescent: ASP Chemical Inhibitor Imipramine Inhibitor Evaluation 66 Inhibitor Evaluation Recommended for all NCEs Test Systems Available OCT2-HEK293 vs. control Assay Type Uptake of probe substrate +/- test compound in OCT2transfected cells vs. control; single concentration or IC50 Probe Substrate LC-MS/MS: MPP+ (1 methyl-4-phenylpyridinium iodide) Radioactive: 3H-metformin Fluorescent: ASP Positive Control Inhibitor Imipramine absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Transporter Reference Card: MATE1/2K Transporter: MATE1/2K (SLC47A1/SLC47A2) Key Facts: Suggested for evaluation by FDA and EMA, when appropriate; SLC transporter Localization: Kidney; Liver (MATE1) CellPort Advantage: • HEK293 is a human cell line; no interference from animal transporters. • Clinically relevant probe substrate. • Provides definitive inhibitor assessment required for all NCEs. Substrate Evaluation Substrate Evaluation Recommended when appropriate Test Systems Available MATE1-HEK293 vs. control; MATE2K-HEK293 vs. control Assay Type Uptake of test compound in MATE-transfected cells vs. control Positive Control Substrate Metformin Chemical Inhibitor Cimetidine Inhibitor Evaluation Inhibitor Evaluation Recommended when appropriate Test Systems Available MATE1-HEK293 vs. control; MATE2K-HEK293 vs. control Assay Type Uptake of probe substrate +/- test compound in MATEtransfected cells vs. control; single concentration or IC50 Probe Substrate Metformin Positive Control Inhibitor Cimetidine absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 67 Concentration Selection Overview Concentration Selection for Transporter Evaluations Important Considerations for In Vitro Transporter Assays: • The choice of concentration(s) • Sampling time points (linear range, appropriate signal to noise ratio) • Calculation methods suitable for the test system • Choice of probe substrates or inhibitors that allow for extrapolation to the clinical situation Concentration Selection for Substrate Assessment Concentrations selected for substrate assessment should be based around the plasma Cmax of the test compound to ensure that results are clinically relevant. If three concentrations are evaluated, then typically 0.5, 2 and 10 µM would be chosen. Concentration Selection for Inhibitor Assessment Concentrations selected for inhibitor assessment are based on the physiological site of interaction. FDA EMA Intestinal Efflux 0.1x [I]2 0.1x [I]2 Hepatic Uptake 10x total Cmax 25x [I]u,inlet,max (administered orally) or 50x unbound Cmax (administered i.v.) Renal Uptake 10x unbound Cmax 50x unbound Cmax Hepatic Efflux 10x total Cmax 50x unbound Cmax [I]2 : the concentration of drug in the intestinal lumen, defined as the highest dose divided by 250 mL [I] u,inlet,max : the unbound hepatic inlet concentration of drug Other factors to consider in selecting concentrations: • Sensitivity of analytical method • Solubility of the test compound • Tolerability of the test compound in the test system If solubility is a limitation for testing relevant concentrations of your test compound, consider the use of protein or excipients. Absorption Systems has evaluated the impact of bovine serum albumen (BSA) on known probe substrates and optimized experimental conditions to ensure proper classification during inhibition assays. We have also confirmed that the following excipients have no influence on monolayer integrity, P-gp function, or BCRP function at specific concentrations: • PEG-400 • Tween 80 • DMSO • HP-β-CD • NMP • Methanol A regulatory viewpoint on transporter-based drug interactions L. Zhang, Y. (D.) Zhang, J. M. Strong, K. S. Reynolds, S.-M. Huang Xenobiotica, 2008, Vol. 38, No. 7-8, 709-724 1 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 69 FAQs Overview Frequently Asked Questions (FAQs) Q–– When will the FDA draft guidance on drug interactions be finalized? A–– A “new draft guidance,” was published in February 2012; it is unclear when a finalized guidance will be issued. Q–– How does the FDA draft guidance compare to the EMA transporter guidelines? A–– There are some different expectations regarding the transporters to be evaluated, as highlighted below: FDA Guidance 2012 EMA Guideline 2012 a a a a* a a a a* a a a a* P-gp BCRP MRP BSEP OATP1B1 OATP1B3 a a a* a* a a OCT1 OCT2 OAT1 OAT3 MATE1/2 a a *When appropriate Q–– When CLH and CLR are not available, can I use preclinical data to determine them? A–– You can, but you should certainly be cautious of species differences. Human results would be best. Q–– If CLR is <1% of total clearance, do I still need to perform an inhibition assessment with renal transporters? A–– Yes. Although the compound may not be a substrate of OATs or OCTs, it could be an inhibitor and thereby interfere with the renal clearance of other drugs. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 71 Q–– [I]2 doesn’t take into account solubility. How do we overcome solubility problems? A–– Protein (BSA) or appropriate excipients can be used to enhance solubility so that a broader range of concentrations may be tested. Absorption Systems has evaluated a number of excipients that are ideal for in vitro drug transporter studies: they do not alter monolayer integrity or affect transporter function. We can check if these excipients improve solubility of your test compound(s). Q–– If in vitro experiments for determination of P-gp/BCRP substrate interactions result in an efflux ratio ≥ 2, do I need to always perform an in vivo DDI study? A–– No, this may not be necessary if is determined that efflux is not rate limiting because the compound has favorable drug specific-factors, such as high permeability and high solubility. You can determine if your compound has good intestinal absorption using a validated in vitro test system such as Absorption Systems’ Caco-2 monolayer system. See section on waiving clinical studies (under intestinal transporters). Q–– Why should I run these studies at Absorption Systems? A–– Absorption Systems has: • • • • Innovative, proprietary technology funded by the FDA Extensively validated test systems Ability to waive clinical DDI and/or BA/BE studies Experience and expertise in drug permeability and transporters Q–– Is it possible to evaluate “sticky” compounds with low recovery using an in vitro test system? A–– Yes, various techniques may be implemented to alleviate non-specific binding (NSB). As a diagnostic measure, the NSB of the test compound to the experimental apparatus is assessed prior to any permeability experiment. If the recovery is low, then a pre-incubation step is included to saturate binding sites. For vectorial assays, 1% BSA is included in the receiver compartment to improve recovery. At the end of a permeability experiment, donor and receiver compartments may be rinsed with organic solvent to collect residual test compound. Cellular accumulation may also be measured. Q–– What are the timelines and prices for these transporter assays? A–– For more information about our study design, prices, and timelines visit us online at www.absorption.com/assays or call us at 610-280-7300. 72 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Drug Transporter Scientific Publications The Role of a Basolateral Transporter in Rosuvastatin Transport and its Interplay with Apical BCRP in Polarized Cell Monolayer Systems Jibin Li, Ying Wang, Wei Zhang, Yuehua Huang, Kristin Hein, and Ismael J Hidalgo Drug Metab. Dispos. published ahead of print August 1, 2012, dmd.112.045666 Models to Predict Unbound Intracellular Drug Concentrations in the Presence of Transporters Ken R. Korzekwa1, Swati Nagar1, Jalia Tucker1, Erica A. Weiskircher 2, Sid Bhoopathy2, and Ismael J. Hidalgo2 1 Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, Pennsylvania 2 Absorption Systems, Exton, Pennsylvania Drug Metab. Dispos. 2012; 40 865-876 Use of Transporter Knockdown Caco-2 Cells to Investigate the In Vitro Efflux of Statins Jibin Li1, Donna A. Volpe2, Ying Wang1, Wei Zhang1, Chris Bode1, Albert Owen1, and Ismael J. Hidalgo1 1 Absorption Systems, Exton, Pennsylvania 2 Food and Drug Administration, Laboratory of Clinical Pharmacology, Silver Spring, Maryland Drug Metab. Dispos. 2011; 39 1196-1202 Silencing the Breast Cancer Resistance Protein Expression and Function in Caco-2 Cells Using Lentiviral Vector-Based Short Hairpin RNA Zhang W, Li J, Allen SM, Weiskircher EA, Huang Y, George RA, Fong RG, Owen A and Hidalgo IJ. Absorption Systems, Exton, Pennsylvania Drug Metab. Dispos. 2009 Apr; 37(4):737-44. Investigation of the Involvement of P-glycoprotein and Multidrug ResistanceAssociated Protein 2 in the Efflux of Ximelagatran and Its Metabolites by Using Short Hairpin RNA Knockdown in Caco-2 Cells Darnell M1, Karlsson JE1, Owen A 2, Hidalgo IJ2, Li J2, Zhang W2, Andersson TB2 1 Clinical Pharmacology and DMPK, AstraZeneca R&D, Mölndal, Sweden. 2 Absorption Systems, Exton, Pennsylvania Drug Metab. Dispos. 2010 Mar;38(3):491-7. Epub 2009 Dec 18. Stably Transfected HEK293 Cell Assays for Assessing Drug Interaction with the Human Hepatic Transporters OATP1B1 and OATP1B3 Jibin Li, Samantha Allen, Ying Wang, Abby Herberger, Yuehua Huang, Alison Rush, Albert Owen, Per Artursson, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Drug Transporters Workshop Mar. 2011, Poster W3011 Development of Cell-based Assays for Assessing Drug Interactions with Human Renal Transporters Jibin Li, Ying Wang, Abby Herberger, Samantha Allen, Libin Li, Yuehua Huang, Alison Rush, Wei Zhang, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Drug Transporters Workshop Mar. 2011, Poster W3012 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 73 Establishment and Characterization of a HEK293 Cell Line with Stable Expression of Human Organic Cation Transporter Wei Zhang, Erica A. Weiskircher, Rebecca A. George, Samantha M. Allen, Yuehua Huang, Jibin Li, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Drug Transporters Workshop Mar. 2011, Poster T2024 Applications of CellPort CPT-P1 Cells in Identifying P-gp Substrates In Vitro Ying Wang, Abby Herberger, Jibin Li, Wei Zhang, Paula Kardos, Alison Rush, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Drug Transporters Workshop Mar. 2011, Poster W3023 Development of a Human Cell-based BCRP Inhibition Assay using CellPort CPT-P1 Cell Monolayers and Cladribine as the Probe Substrate Libin Li, Justin Wright, Amanda Budow, Sid Bhoopathy, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Drug Transporters Workshop Mar. 2011, Poster W3008 Development of Transfected HEK293 Cell Lines Stably Expressing Individual Human Organic Anion Transporters (OATs) Wei Zhang, Samantha M. Allen, Erica A. Weiskircher, Abby L. Herberger, Yuehua Huang, Rebecca A. George, Jibin Li, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Drug Transporters Workshop Mar. 2011, Poster T2025 Mass Action Kinetic Model for P-gp Mediated Transport across Confluent Cell Monolayers: A Sensitive Tool to Facilitate Mechanistic Understanding of DDIs Annie Albin Lumen1,3 Libin Li2, Jibin Li2, Albert Owen2, Ismael J. Hidalgo2, Harma Ellens3, Joe Bentz1 1 Drexel University, Philadelphia Pennsylvania, 2 Absorption Systems, Exton, Pennsylvania 3 GlaxoSmithKline, King of Prussia, Pennsylvania AAPS Drug Transporters Workshop Mar. 2011 Poster M1013 Use of Caco-2 Knockdown Cells to Investigate Transporter-Mediated Efflux of Statin Drugs Donna Volpe1, Jibin Li2, Ying Wang2, Wei Zhang2, Chris Bode2, Albert Owen2, Ismael J. Hidalgo2 1 Food and Drug Administration, Silver Spring, Maryland 2 Absorption Systems, Exton, Pennsylvania AAPS/PSWC Nov. 2010, Poster T3371 Induction of Breast Cancer Resistance Protein (BCRP) and Enhanced Transport of Estrone-3-sulfate and Pheophorbide A Across Caco-2 Cell Monolayers Wei Zhang, Samantha M. Allen, Yuehua Huang, Erica A. Weiskircher, Rebecca A. George, Jibin Li, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS/PSWC Nov. 2010, Poster T3408 Determination of Substrate Specificity and Relative Activity of Uptake and Efflux Transporters in a New Cell Line: OATP1B1-Transfected MDR1-MDCK Cells Wei Zhang, Erica A. Weiskircher, Samantha M. Allen, Yuehua Huang, Rebecca A. George, Jibin Li, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS/PSWC Nov. 2010, Poster T3407 74 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Determination of BCRP Activity and Evaluation of Potential BCRP-Mediated Drug-Drug Interactions in Caco-2 Cells Using the Fluorescent Substrate Pheophorbide A Ying Wang, Abby Herberger, Jibin Li, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS/PSWC Nov. 2010, Poster T2392 Fluorescence Assay for Evaluation of MRP2 Based Drug Interactions Fany B. Guerra, Jibin Li, Albert Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania ISSX Sept. 2010 In Vitro Permeability Systems to Assess P-gp Substrate Potential Qing Wang, Yuehua Huang, Blair DeFulvio, Allison McLaughlin, Paula Kardos, Susan Rawa, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Annual Meeting November 2011 Poster M1296 Cell-based Radioactive Assays for Assessing Drug Interactions with Human Renal Uptake Transporters Jibin Li, Wei Zhang, Ying Wang, Samantha M. Allen, Abby L. Herberger, Albert J. Owen, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Annual Meeting November 2011 Poster M1285 Drug Transporters: ‘Not as Easy as ABC’ A case study demonstrating benefits and limitations of test systems and experimental designs when elucidating complex transporter interactions Libin Li, Ying Wang, Erica A. Weiskircher, Samantha M. Allen, Yuehua Huang, Vatsala Naageshwaran, Sid Bhoopathy, Albert J. Owen, and Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Annual Meeting November 2011 Poster M1280 Rapid Screening of Human OATP1B1- and OATP1B3-Mediated Drug Interactions in Stably Transfected Human Embryonic Kidney HEK293 Cell Lines Using Flow Cytometry and Fluorescence Microplate Methods Steve Wright1, Ying Wang2, Jibin Li2, Albert Owen2, Ismael J. Hidalgo2 1 Department of Biology, Carson-Newman College, Jefferson City, Tennessee 2 Absorption Systems, Exton, Pennsylvania ISSX 17th North American Meeting November 2011 Poster P347 Using Lentiviral Vector-Based shRNA to Silence the Expression and Function of ABC Transporter(s) in Caco-2 Cells Chris Bode, Sid Bhoopathy, Ismael Hidalgo Absorption Systems, Exton, Pennsylvania ISSX 17th North American Meeting November 2011 Poster P352 Development of a Rapid Cell-based Assay using Flow Cytometry for Assessing Drug Interactions with Human Sodium-dependent Taurocholate Cotransporting Polypeptide (NTCP) Steve Wright1, Matt Wilkerson1, Jibin Li2, Ying Wang2, Albert Owen2, Ismael J. Hidalgo2 1 Department of Biology, Carson-Newman College, Jefferson City, Tennessee 2Absorption Systems, Exton, Pennsylvania ISSX 17th North American Meeting November 2011 Poster P114 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 75 Identification of OCT1-mediated interaction of antimicrobial drugs with metformin using stably transfected OCT1 HEK293 cells Wei Zhang, Samantha M. Allen, Jibin Li, Erica A. Weiskircher, Yuehua Huang, Ying Wang, Albert Owen and Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Annual Meeting October 2012 Poster M1322 In Vitro Systems to Assess the Potency of Selected Uptake Transporter Inhibitors Blair Meziewieski, Joseph Rager, Libin Li, Jessica Helwig, Sid Bhoopathy, Ismael J. Hidalgo, and Qing Wang Absorption Systems, Exton, Pennsylvania AAPS Annual Meeting October 2012 Poster M1321 Ex Vivo Evaluation of Regional Differences in the Expression and Function of Active Drug Transporters and Metabolic Enzymes in Rat and Human Intestine Xuexuan Wang, Fany Guerra, Jerline Joseph, Yuehua Huang, Jennifer Winans, Sid Bhoopathy and Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Annual Meeting October 2012 Poster T2298 In Vitro Assays for Assessing Drug Interactions with Human Bile Salt Export Pump Jibin Li, Steve Wright, Wei Zhang, Ying Wang, Yuehua Huang, Ismael J. Hidalgo Absorption Systems, Exton, Pennsylvania AAPS Annual Meeting October 2012 Poster M1312 Determination of Efflux Transporter Membrane Location using Caco-2 Knockdown Cells Erica Weiskircher1, Allison McLaughlin1, Jessica Helwig1, Sid Bhoopathy1, Swati Nagar 2, Ken Korzekwa2, and Ismael Hidalgo1 1 Absorption Systems, Exton, Pennsylvania 2 Temple University, Philadelphia, Pennsylvania DVDMDG The Rozman Symposium June 2012 76 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Glossary Overview Glossary of Terms ABC: ATP-binding cassette, a term referring to a common feature of one of the two superfamilies (the other is the SLC superfamily) of drug transporters. Members of the ABC superfamily, including P-gp, BCRP and the MRP family, are responsible for active efflux of drugs, other xenobiotics, and endogenous substances from cells throughout the body. The extrusion of substrates is driven by hydrolysis of ATP by the transporter itself. Absorption: Before a drug can exert a pharmacological effect in tissues, it generally has to reach the systemic circulation—often via a mucous surface such as that in the digestive tract (intestinal absorption). Factors such as poor solubility, chemical instability in the stomach, and inability to permeate the intestinal wall can all limit the extent to which a drug is absorbed after oral administration. Absorption critically determines a drug’s bioavailability. ADME: An acronym for Absorption, Distribution, Metabolism, and Excretion (or Elimination). Apparent Permeability: The apparent permeability coefficient (also known as Papp) is a parameter that is determined in an in vitro or ex vivo transport assay system. It is referred to as apparent permeability because its value represents the composite effects of traversing all permeation pathways across the test system and does not represent the permeability across any single barrier, such as the unstirred water layer, the cell membrane or the tight junctions between epithelial cells. It is equal to (dQr/dt)/(A x C0), where dQr/dt is the cumulative amount of test compound appearing in the receiver compartment of the assay system vs. time, A is the area of absorption (cell monolayer or tissue), and C0 is the initial concentration of the test compound in the donor compartment of the assay system. Papp can be determined in either or both directions across an assay system. For cell monolayer assay systems the directions are referred to as apical to basolateral (A¨B) and vice versa. For ex vivo tissue systems the directions are typically referred to as mucosal to serosal and vice versa. A significant directional dependence in Papp values suggests that active absorption or efflux mechanisms mediate compound transport across the assay system. When determined in an appropriate assay system, such as Caco-2 cell monolayers or human intestinal tissue strips, the rank order of a compound’s Papp value as compared to control reference compounds of known human absorption potential has been demonstrated to be predictive of the in vivo absorption classification of the same compound in humans. BCRP: An acronym for breast cancer resistance protein, product of the human ABCG2 gene and a member of the ABC (ATP-binding cassette) transporter superfamily. BCRP is expressed in the apical membrane of epithelial and endothelial cells in many tissues of the body, including intestine, liver, kidney, central nervous system (blood-brain barrier) and placenta. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 77 It was originally characterized as one of the gene products mediating resistance to cancer chemotherapeutic drugs; its involvement in drug disposition and drug-drug interactions was recognized more recently. BCS: See Biopharmaceutics Classification System Bioavailability: (also known as %F) The fraction of administered drug that reaches the systemic circulation after enteral administration. Absolute bioavailability is the ratio of the area under the curve (AUC) of the blood (or plasma) concentration versus time curve after enteral administration divided by the AUC after intravenous administration, appropriately adjusted for differences in dose. Relative bioavailability is the AUC ratio after dosing by two different enteral dose routes or two different dosing formulations, etc. Bioavailability is affected by various barriers to enteral drug absorption, including solubility, stability, permeability, active efflux and metabolism. Bioavailability may be expressed as a fraction or as a percent of the administered dose. Biopharmaceutics: The study of the effect of a drug’s formulation and physicochemical properties on its absorption and disposition. Biopharmaceutics Classification System: The Biopharmaceutical Classification System (BCS) was developed in the 1990s by a collaboration of academic, industrial and US FDA scientists in order to provide guidelines for the development of oral dosage forms. It was formalized in the US in 2000, when the FDA published the Guidance for Industry, Waiver of In Vivo Bioavailablity and Bioequivalence Studies for Immediate-Release Solid Oral Dosage Forms Based on a Biopharmaceutics Classification System. The European Medicines Agency (EMA) and the World Health Organization (WHO) have since adopted the BCS in whole or in part. The basic principle behind the classification system is that the absorption of immediate-release, orally administered drugs is driven by two properties, the solubility of the drug in the gastrointestinal tract and the permeability of the drug across the intestinal epithelial cell barrier. Proper in vitro surrogates for these two properties should allow prediction of a drug’s absorption in vivo from in vitro assays. A drug’s solubility classification in the BCS is a function of the intended human dose. Drugs whose solubility under appropriate conditions exceeds the highest dose strength dissolved in 250 mL of aqueous medium are classified as highly soluble, i.e., Class I or III according to the BCS scheme. Drugs not meeting these criteria are classified as Class II or IV. Class I and Class II drugs have high permeability in an appropriate permeability assay system that has been validated with compounds of known in vivo human fractional absorption after oral administration. Drugs not meeting these criteria are class III, if they have high solubility, or class IV, if their solubility is low. 78 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Biotransformation: See Metabolism Biowaiver: An exemption granted by the US FDA from conducting human bioequivalence studies when the active pharmaceutical ingredient(s) meet certain solubility and permeability criteria in vitro and when the dissolution profile of the dose form meets the requirements for an “immediate” release dose form. Biowaivers are based on the Biopharmaceutics Classification System (BCS) category of the active ingredient. Currently BCS class I and some class III compounds are eligible for biowaivers. BSEP: An acronym for bile salt export pump, product of the human ABCB11 gene and a member of the ABC (ATP-binding cassette) transporter superfamily. BSEP is expressed in the canalicular membrane of hepatocytes in the liver, and is involved in the excretion of bile acids into the bile. When inhibited, it induces cholestasis as a result of transcellular accumulation of these bile salts. Buffer: A compound or mixture of compounds which, added to a solution, helps maintain a certain pH. A buffered solution resists changes in pH if either acids or bases are added to the solution or if the solution is diluted. Caco-2: Human colonic carcinoma cells. The Caco-2 cell line is widely used in in vitro assays to predict the absorption of candidate drug compounds across the intestinal epithelial cell barrier. The assay requires that the absorption rate (apparent permeability, or Papp) of a compound be determined approximately 21 days after Caco-2 cell seeding to allow the formation of a confluent monolayer and cell differentiation (appropriate localization of active transporters to the apical or basolateral plasma membrane). Calcein AM: A non-fluorescent compound that is cleaved to a fluorescent compound by non-specific intracellular esterases. Calcein AM (the acetoxymethyl ester of the fluorescent dye, calcein) is a substrate of the drug efflux transporter P-glycoprotein (P-gp). CellPort CPT-B1: the first product in the CellPort Technologies® product line from Absorption Systems. It was created by using RNA interference to achieve stable knockdown of the expression of BCRP in human Caco-2 cells. CellPort Technologies®: Absorption Systems product line, consisting of all products and services related to drug transporters. CL: See Clearance Clearance: Drug elimination from the body, regardless of the route or mechanism. The units are volume per time (L/hr). Therefore, clearance (CL) is defined as the volume of fluid cleared of drug per unit time. CPT-B1: see CellPort CPT-B1 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 79 CYP: Shorthand for cytochrome P450, a family of membrane-bound, heme-containing oxygenases that are active in a range of metabolic and biosynthetic pathways. They are involved in the metabolism (breakdown) of both endogenous and exogenous (xenobiotic) substrates, including drugs and environmental chemicals, and in the synthesis of metabolome components such as leukotrienes, prostacyclins, HETEs, retinoic acids, steroids and bile acids. They are divided into families of structurally related proteins based on their gene sequence. Families are designated by a number, their subfamilies by a letter and their species-specific subfamily by a second number. Thus, CYP 3A4 is a human CYP that is a member of the CYP 3 family and CYP 3A subfamily. The study of CYPs is complicated by the fact that the metabolic products and pathways of individual CYPs overlap and their relative levels of expression differ among species, making interspecies extrapolation of xenobiotic metabolism extremely problematic. In addition, the expression of some CYPs varies greatly among individual human subjects, and some are inducible (expression increased) by drugs, dietary constituents, or environmental chemicals. Within a species, some CYPs are expressed exclusively, or nearly so, in particular tissues, while others are expressed in multiple tissues but at very different levels. In general, hepatic CYPs are the most important drug-metabolizing enzymes, but other (non-CYP) enzymes are important for many drugs, and CYPs in other organs can be significant depending on the route of administration (e.g., intestinal CYPs for oral drugs, dermal CYPs for topical drugs, nasal CYPs for intranasal drugs, etc.). Numerous clinical drug-drug interactions have been reported involving CYPs (e.g., one drug as a substrate, another co-administered drug as an inhibitor) and can result in therapeutic failure or death. CYP450: See CYP Cytochrome P450: See CYP DDI: See Drug-drug Interaction Distribution: The reversible transfer of xenobiotics from one compartment in the body to another compartment, e.g., across the blood-brain barrier from the plasma to the extracellular fluid of the brain. DM: See Metabolism Drug: A chemical substance that can alter or influence the responsiveness of a living organism. A therapeutic chemical substance that is used for the diagnosis, prevention, cure or amelioration of an unwanted health condition (FDA definition). Drugs are usually xenobiotics (i.e., substances chemically foreign to the organism). 80 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Drug-drug Interaction: A pharmacokinetic drug-drug interaction (DDI) involves two (or more) co-administered drugs, often referred to as the perpetrator and the victim: when co-administered with the perpetrator, the systemic exposure (Cmax or AUC), tissue-specific exposure, or side effects (toxicity) of the victim drug are affected to an extent that is clinically significant. This type of DDI typically occurs when the victim drug is a substrate of a drug-metabolizing enzyme or transporter and the perpetrator drug is a substrate or inhibitor of the same enzyme or transporter. Qualitatively, the pharmacokinetic consequences of a metabolism-mediated DDI are fairly straightforward: enzyme inhibition can increase the exposure to a drug that is administered as the active species and can decrease the exposure to the active moiety of a pro-drug. Enzyme induction has the opposite effect. The consequences of transporter-mediated DDIs are much more difficult to predict; in fact, the clinical impact of a transporter-mediated DDI on a particular tissue or organ is often much more significant than the effect on systemic exposure. Whereas the risk of many clinical DDIs can be predicted qualitatively based on in vitro testing, reliable quantitative prediction of the magnitude of a clinical DDI is not yet possible in most cases. Drug Metabolism: See Metabolism Efflux: The process by which molecules (typically, drugs or other xenobiotics) are pumped out of cells. This process is monitored in laboratory assays using polarized epithelial cell lines such as Caco-2, which express several efflux pumps (e.g., P-gp, BCRP and MRP2) in the apical membrane and others in the basolateral membrane. Efflux is catalyzed by such efflux pumps for compounds that are substrates. The cell-based laboratory test systems are models of various cells in the body, which express many of the same efflux transporters as well as others. Efflux Pumps: See Membrane Transport Proteins Efflux Ratio: In in vitro and ex vivo assays, the efflux ratio is defined as the ratio of secretory to absorptive apparent permeability (Papp): (B¨A Papp) / (A¨B Papp). The magnitude of this ratio is used as an indicator of active vs. passive transport through cells. At Absorption Systems, efflux is classified as significant when the efflux ratio is at least 3.0 and the B¨A Papp is at least 1.0 x 10-6 cm/s. HEK293: Continuous cell line derived from human embryonic kidney. HEK293 cells are frequently transfected with a vector containing one or more genes in order to create an in vitro model in which a protein of interest is over-expressed. Hit: A molecule with confirmed pharmacologic activity in a screen for efficacy. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 81 Investigational New Drug (also known as IND): The purpose of an IND application is to provide data showing that it is reasonable to begin tests of a new drug in humans. IND regulations are covered in 21 CFR 312. There are two categories of IND: commercial and research (non-commercial). An IND must contain information in three broad areas: animal pharmacology and toxicology studies; manufacturing information; and clinical protocols and investigator information. Once an IND is submitted, the sponsor must wait thirty calendar days before initiating any clinical trials. During this time, the FDA has an opportunity to review the IND for safety to ensure that research subjects will not be subjected to unreasonable risk. There are four types of IND: • Company- (or institution-) sponsored IND: This is the traditional type of IND. • Investigator IND: Submitted by a physician who both initiates and conducts an investigation, and under whose immediate direction the investigational drug is administered or dispensed. A physician might submit such an IND to propose studying an unapproved drug, or an approved product for a new indication or in a new patient population. • Emergency Use IND: Allows the FDA to authorize use of an experimental drug in an emergency situation that does not allow time for submission of an IND in accordance with the normal process. It is also used for patients who do not meet the criteria of an existing study protocol, or if an approved study protocol does not exist. • Treatment IND: Used to facilitate access by patients to promising new drugs for serious or immediately life-threatening conditions while late-stage clinical trials (in which enrollment may be closed) are conducted and NDA review takes place. ITC White Paper: An authoritative review on drug transporters by the International Transporter Consortium (ITC), a group of experts in the transporter field from the pharmaceutical industry, academia and the FDA. The paper, published in Nature Reviews Drug Discovery in March 2010 (Giacomini KM, et al., Membrane transporters in drug development. Nature Rev Drug Disc 2010 March;9(3):215-36), was immediately recognized as the most relevant reference on the topic to date. In Vitro: Literally, “in glass” (Latin). The term is used to describe a process or reaction that is carried out in an artificial environment such as a test tube, petri dish or 96-well plate. The reaction mixture can include a biologically derived material, such as a tissue extract, cultured cells, or a purified protein. Other in vitro assays, such as physicochemical measurements for solubility or pKa, do not contain any biological matrix. 82 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. LC-MS/MS: Liquid chromatography – tandem mass spectrometry. Mass spectrometry (MS) is an analytical technique to measure the mass-to-charge ratio (m/z) of ions. It is most generally used to find the composition of a physical sample by generating a mass spectrum representing the masses of the components of a sample. In addition to a number of broader applications, in drug development LC-MS/MS is generally used to quantify the amount of a compound in a sample using carefully designed methods (mass spectrometry is not inherently quantitative) and to determine the structure of a compound by analyzing its fragmentation pattern. In LC-MS/MS, molecules are partially resolved by rapid LC, followed by detection via tandem mass spectrometry (MS/MS). This mode of detection is exquisitely sensitive due to the operator’s ability to tune the instrument to a particular m/z value to the exclusion of other molecular species that may be present. Lead Optimization: A portion of the drug discovery continuum, lead optimization is the complex process of refining the chemical structure of a “hit” to improve its drug characteristics, with the goal of producing a pre-clinical drug candidate. Typically, by the lead optimization stage many compounds have been screened and many “hits” discarded for various reasons. At this stage, analogues of a biologically active compound or a series of structurally related compounds are synthesized, the goal being to find a molecule with the most favorable combination of physicochemical (e.g. solubility), pharmacologic (i.e. therapeutic efficacy, potency, and specificity), pharmacokinetic (e.g. metabolic stability), and toxicologic (i.e. safety) properties. Liquid Chromatography: (LC) is the science of separating molecules, applied in a liquid mobile phase, based on differences in affinity for a solid stationary phase relative to the mobile phase, often while varying the composition of the mobile phase. Mass Spectrometer: is a device used for mass spectrometry, and produces a mass spectrum of a sample to find its composition. This is normally achieved by ionizing the sample and separating ions of differing masses and recording their relative abundance by measuring intensities of ion flux. A typical mass spectrometer comprises three parts: an ion source, a mass analyzer, and a detector. MATE: An acronym for Multidrug And Toxin Extrusion transporter, product of the human SLC47 gene and a member of the SLC (solute carriers) transporter superfamily. MATE1 is primarily expressed in the kidney and also in liver. MATE2 and MATE2-K are expressed only in the kidney, and are localized to the brush-border membranes (BBM) of the renal proximal tubules. The MATE family is proposed to play an important role in protecting the kidney from cationic toxins. So far, transport characteristics of the original hMATE2 remain unclear. MATE2-K is currently the only functional isoform in the MATE2 subfamily. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 83 MDR Protein: Multi-drug resistance protein 1 is the protein product of the human MDR1 gene and is a member of the ABC (ATP-binding cassette) superfamily of plasma membrane transporter proteins that pump drugs (such as some anti-cancer drugs) and other xenobiotics out of the cytoplasm of cells. This particular family of transporters is expressed by mammalian cells, but analogous proteins are expressed by bacteria, where they contribute to antibiotic resistance. As the name suggests, the gene encoding the MDR1 protein was discovered in drug-resistant tumors. MDR1 is synonymous with human P-glycoprotein (Pgp), a name that was actually first applied to the bacterial version of the protein. In the context of drug discovery in general, the MDR1 protein can have a major impact on the pharmacokinetic properties of drugs by reducing absorption from the gastrointestinal tract, limiting distribution from the blood into the brain, and/or contributing to biliary excretion from hepatocytes. MDR1 protein can also be a locus of drug-drug interactions in patients taking an inhibitor and a substrate of the transporter at the same time. Because MDR1 protein is expressed in so many locations in the human body that play key roles in pharmacokinetics, the effects of modulation of its activity (induction or inhibition) are complex and difficult to predict. MDR1-MDCK: Madin-Darby Canine Kidney cells transfected with the human multi-drug resistance gene. Confluent monolayers made from these cells can be used to assess a test compound’s potential as a P-gp substrate. Membrane Transport Proteins: Membrane proteins whose primary function is to facilitate the transport of molecules across a biological membrane. Included in this broad category are proteins involved in active transport, facilitated transport and ion channels. They play key roles in drug absorption, distribution and excretion, and are sometimes involved in drug toxicity and drug-drug interactions. They may be indirectly involved in drug metabolism as well, due to their involvement in drug uptake into hepatocytes. Metabolism: Metabolism, one mechanism of clearance of drugs and other xenobiotics, is the irreversible biochemical transformation of a compound to another chemical (metabolite). The metabolite is usually more polar (watersoluble) and, therefore, more readily excreted, than the parent compound; thus, metabolism facilitates drug excretion. Conceptually, metabolism is often divided into Phase I (oxidation or reduction) and Phase II (conjugation with negatively charged functional groups), which are closely coupled in intact cells such that Phase II metabolites are often present at much higher concentrations than Phase I metabolites. In the context of toxicology, metabolism is often referred to as activation; the same enzymes that facilitate excretion of compounds via metabolism can also produce highly reactive metabolites or metabolic intermediates, which bind to cellular proteins or DNA, sometimes 84 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. leading to cell death or cancer. Many drug-drug interactions take place at the level of drug metabolism, via inhibition or induction of drug-metabolizing enzymes, potentially resulting in toxicity or therapeutic failure, respectively. MRP2: Multidrug resistance-associated protein 2, a member of the MRP family of drug transporters and the product of the human ABCC2 gene. Previously known at CMOAT, MRP2 is expressed in the apical membrane of epithelial and endothelial cells in the liver, kidney, placenta, intestine, blood-brain barrier and many other tissues. It is also expressed in the apical membrane of Caco-2 cells. NCE: New chemical entity, a compound not previously described in the scientific literature. New Chemical Entity: See NCE Nonclinical: See Preclinical. The terms are often used interchangeably, but sometimes the term “nonclinical” is preferred because some nonclinical studies are performed in parallel with, not literally prior to, clinical trials of a drug. OATP: An acronym for organic anion transporting polypeptide, a family of solute-linked carrier (SLC) drug transporters. The major human OATPs are OATP1B1 (formerly known as OATP-C or OATP2; product of the SLCO1B1 gene in humans), OATP1B3 (formerly known as OATP8; product of the SLCO1B3 gene) and OATP2B1 (formerly known as OATP-B; product of the SLCO2B1 gene). OATP1B1 and OATP1B3 are expressed in the sinusoidal (basolateral) membrane of hepatocytes in the liver. A number of clinically significant, even fatal, increases in exposure to drugs have been reported involving the hepatic OATPs due to inhibition by co-administered drugs or pharmacogenetics (reduced expression or expression of a less active variant). As a result, drug developers and drug regulatory agencies now pay close attention to new drugs that are substrates of OATP1B1 and/or OATP1B3. Because some of the highly prescribed statin drugs are substrates of OATP1B1 and/or OATP1B3, drug developers and drug regulators also pay close attention to new drugs that are inhibitors of these transporters. The expression of OATP1A2 and OATP2B1 is more diverse, including intestine, kidney and brain in addition to liver. OCT: An acronym for organic cation transporter, a family of solute-linked carrier (SLC) drug transporters including OCT1 (product of the human SLC22A1 gene), OCT2 (SLC22A2) and OCT3 (SLC22A3). Expression of OCT1 is limited to the liver, OCT2 is expressed primarily in kidney (also brain, lungs, testes, etc.), and OCT3 is expressed in many tissues. The involvement of OCT2 in renal drug clearance and the fact that it has been implicated in more than one clinical drug-drug interaction has drawn the attention of drug developers and global drug regulatory authorities. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 85 Papp: See Apparent Permeability P-glycoprotein: See P-gp P-gp: P-gp is short for P-glycoprotein, a 170-kDa integral membrane transport protein present in a variety of types of mammalian cells. P-gp was first identified as a primary cause of multidrug resistance in tumors. Using ATP hydrolysis as an energy source, it transports its substrates, typically sterols or hydrophobic amines, into the gut, out of the brain, into urine, into bile, out of the gonads, or out of other organs. An understanding of P-gp and related transport proteins is key to designing strategies for the improvement of therapeutic efficacy of drugs that are their substrates and to anticipating their role in mediating drug-drug and drug-diet interactions. P-gp Inhibitor: A compound that binds to P-gp and inhibits its transport activity. P-gp inhibitors are useful research tools; their potential clinical applications include reversal of resistance to cancer chemotherapy. Pharmacokinetics: Operationally, the term describes the time course of the variation of a drug’s concentration in various body tissues, as well as blood, blood plasma and urine, following dosing. It is the study of ADME, i.e., the absorption, distribution from plasma into tissues, metabolism and excretion (elimination) of drugs. These factors, combined with dosage, determine the concentration of a drug at its site(s) of action as a function of time. Pharmacokinetics frequently utilizes mathematical equations to describe and model the concentration vs. time profile of a drug in sampled body fluids such as plasma. Compartmental models are widely used to calculate fundamental parameters from preclinical or clinical experimental data. Phase 0: See Preclinical PK: see Pharmacokinetics Preclinical: Literally, “before the clinic”. In drug discovery and development, the term refers to in vitro or in vivo (animal) studies that are performed prior to or concurrent with human clinical trials of a compound. Recovery: The extraction efficiency of an analytical process, reported as a percentage of the known amount of an analyte carried through the sample extraction and processing steps of the method. Recovery is most valid when an internal standard is carried through the process along with the analyte of interest. In some applications, low recovery is not a problem because the observed amount of analyte can simply be normalized to the recovery of the internal standard. In other cases, such as a cell-based permeability study, low recovery is indicative of a high degree of non-specific binding and can confound the interpretation of the observed results. 86 absorption.com/cellport © 2012 Absorption Systems. All rights reserved. Reproducibility: The between-run, or inter-batch, precision of an assay. It typically refers to sets of results obtained with the same test material on different days, by different operators, using different analytical instruments, in different laboratories, etc. It can be viewed as the variation in measurements obtained when two or more people perform the same assay on identical test articles. Ruggedness: The reproducibility of an assay under a variety of normal, but variable, test conditions. Variable conditions might include different instruments, operators, reagent lots, etc. Ruggedness provides an estimate of experimental reproducibility with unavoidable error. In the process of developing an assay, it is necessary to consider the effect of environmental factors on the output of the assay. If these effects are not considered, the results of the assay in actual use may not be as accurate as expected. The purpose of a ruggedness test is to identify the variables (experimental factors) that strongly influence the measurements provided by the assay, and to determine how closely these variables need to be controlled. Ruggedness tests do NOT determine the optimal conditions for the assay. SLC: Solute-linked carrier, a descriptor of one of the two superfamilies (the other is the ABC superfamily) of drug transporters. Members of the SLC superfamily, including the OATP, OAT and OCT families, are responsible for uptake of drugs, other xenobiotics, and endogenous substances by cells throughout the body. The mechanism of transport by these transporters is not well understood; uptake of a drug is coupled to export of another molecule, whose identity is not known. Theoretically, SLC transporters can operate as either uptake or efflux transporters, but physiologically they always mediate uptake of drugs. Substrate: In biochemistry, a substrate is a molecule undergoing a reaction, for which the presence of an enzyme greatly increases the rate by lowering the activation energy when the substrate binds to the enzyme’s active site. In ADME assays, a substrate is a test compound. Transporters: see Membrane Transport Proteins Uptake Pumps: see Membrane Transport Proteins Validated Cell Line: In the context of ADME assays, a validated cell line is a cell line that has been demonstrated to predict the clinical behavior of compounds, e.g., in vivo potency, efficacy or bioavailability. Examples include the rank order of in vitro permeability across Caco-2 cell monolayers vs. human fractional absorption and CYP induction in hepatocytes vs. effect on clinical pharmacokinetics when co-dosed with a sensitive substrate of the same CYP. The rank order responses must be reproducible and rugged with respect to typical changes in assay conditions for the cell line to be considered validated. absorption.com/cellport © 2012 Absorption Systems. All rights reserved. 87 Validation: Method validation is the process of establishing the performance characteristics and limitations of a method and the identification of the influences which may change these characteristics and to what extent. It includes accuracy, precision, specificity, sensitivity, reproducibility, stability, predetermined limits for acceptance of data based on QC standards, and extensive documentation. A related process is verification, the confirmation by examination and provision of objective evidence that specified requirements have been fulfilled. Assay parameter optimization is a separate process that precedes assay validation and/or may be iterative with it. For example, assay validation may identify parameters for which the assay should have been optimized; after further optimization, the assay would need to be re-validated. Xenobiotic: A biologically (pharmacologically, endocrinologically, and/ or toxicologically) active substance that is not produced endogenously and is, therefore, foreign to a living organism. Examples include drugs, dietary components, carcinogens, and chemicals that have been introduced into the environment by artificial means. 88 absorption.com/cellport © 2012 Absorption Systems. All rights reserved.