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4. Impact of OATP1B1, MDR1, and CYP3A4 expression in liver and intestine on interpatient pharmacokinetic variability of atorvastatin in obese subjects.

Author

Ulvestad M, Skottheim IB, Jakobsen GS, Bremer S, Molden E, Asberg A, Hjelmesæth J, Andersson TB, Sandbu R, and Christensen H

Subjects
ATP Binding Cassette Transporter, Subfamily B, ATP Binding Cassette Transporter, Subfamily B, Member 1 analysis, ATP Binding Cassette Transporter, Subfamily B, Member 1 genetics, Adult, Atorvastatin, Body Mass Index, Cytochrome P-450 CYP3A analysis, Cytochrome P-450 CYP3A genetics, Female, Humans, Liver-Specific Organic Anion Transporter 1, Male, Middle Aged, Organic Anion Transporters analysis, Organic Anion Transporters genetics, ATP Binding Cassette Transporter, Subfamily B, Member 1 physiology, Cytochrome P-450 CYP3A physiology, Heptanoic Acids pharmacokinetics, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacokinetics, Intestinal Mucosa metabolism, Liver metabolism, Obesity metabolism, Organic Anion Transporters physiology, Pyrroles pharmacokinetics
Abstract

Individual variability in expression and function of organic anion-transporting polypeptide 1B1 (OATP1B1), multidrug resistance protein 1 (MDR1), and/or cytochrome P450 3A4 (CYP3A4) may impact the clinical response of many drugs. We investigated the correlation between expression of these proteins and pharmacokinetics of atorvastatin, a substrate of all three, in 21 obese patients with paired biopsies from liver and intestinal segments. The patients were also screened for the SLCO1B1 c.521T→C variant alleles. Approximately 30% (r(2) = 0.28) of the variation in oral clearance (CL/F) of atorvastatin was explained by hepatic OATP1B1 protein expression (P = 0.041). Patients carrying the SLCO1B1 c.521C variant allele (homozygous, n = 4; heterozygous, n = 2) exhibited 45% lower CL/F of atorvastatin than the c.521TT carriers (P = 0.067). No association between hepatic and intestinal expression of MDR1 or CYP3A4 and atorvastatin pharmacokinetics was found (P > 0.149). In conclusion, this study suggests that OATP1B1 phenotype is more important than CYP3A4 and MDR1 phenotypes for the individual pharmacokinetic variability of atorvastatin.

Published
2013
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