Probenecid-associated alterations in valproate glucuronide hepatobiliary disposition: mechanistic assessment using mathematical modeling.

The complexity of processes associated with the hepatobiliary disposition of xenobiotics may require a multiexperimental approach, including pharmacokinetic modeling, to assess mechanisms of drug interactions. The objective of this study was to examine the disposition of valproate glucuronide (VG) in the rat isolated perfused liver (IPL), and to determine the mechanisms of interaction with probenecid (PRB). Livers were isolated and perfused with standard techniques, and valproate (VPA) (20 mg) was administered in the absence and presence of PRB (approximately 75 microg/ml). Concentrations of VPA and VG in perfusate and bile were determined at timed intervals. In the absence of PRB, total recovery of VPA and VG in perfusate and bile was approximately 80%; PRB significantly increased this recovery to approximately 100%, suggesting a decrease in oxidative VPA metabolism. Similarly, pharmacokinetic modeling of the IPL data indicated that PRB competitively inhibited formation of oxidative VPA metabolites. PRB also significantly inhibited formation, biliary excretion, and sinusoidal egress of VG. These observations suggest a competitive interaction between PRB and VG for transport across the canalicular and sinusoidal membranes. Despite PRB-associated impairment of VG formation, mathematical modeling of the data revealed that hepatocyte VG concentrations were increased by PRB, presumably due to simultaneous inhibition of VG biliary excretion and sinusoidal egress by PRB. These results demonstrate the utility of pharmacokinetic modeling in elucidating the mechanisms of alteration in the hepatobiliary disposition of xenobiotics.

Assessment of ascorbate ocular disposition in the conscious rabbit: an approach using the microdialysis technique.

PURPOSE: This study was performed to evaluate the transport kinetics of ascorbate in aqueous humor of conscious rabbits. METHODS: Following the development of a spectrophotometric assay for ascorbate in serum, aqueous humor and microdialysate, and preliminary studies of ascorbate systemic disposition in the rabbit, microdialysis probes were placed into the anterior chamber of one eye, and the posterior chamber of the contralateral eye, of four New Zealand white rabbits. After a one-month recovery period, conscious rabbits were placed in restraining devices, and marginal ear veins were cannulated for repeat blood sampling and ascorbate administration. A tracer i.v. bolus of (14)C-ascorbate, followed by stepwise increasing i.v. infusions of unlabelled ascorbate, was administered. Estimates of basal ascorbate transport into aqueous were determined by analysis of tracer ( 14)C-ascorbate in microdialysis probe effluent and serum. Kinetic modeling was employed to assess ascorbate disposition during infusion. RESULTS: Systemic disposition of exogenously administered ascorbate was well characterized by a two-compartment model. Kinetic modeling returned physiologically realistic volumes for the posterior chamber, and reliable estimates governing ascorbate flux into, between, and from the posterior and anterior chambers. CONCLUSIONS: In vivo assessment of ascorbate kinetics in aqueous humor and blood of the rabbit was facilitated by the microdialysis technique. Contrary to reports in the literature, ascorbate saturable uptake from blood to aqueous was not observed at physiologic blood concentrations ( approximately 11 to 30 mg/L).

Assessment of valproic acid serum-cerebrospinal fluid transport by microdialysis.

The systemic disposition and serum-cerebrospinal fluid (CSF) translocation of valproic acid (VPA) were examined in rats after administration of VPA as a bolus, as a continuous infusion, or with probenecid. VPA in CSF was monitored continuously by in vivo microdialysis. Both prolonged VPA infusion and probenecid pretreatment increased the Km for saturable VPA elimination and decreased intrinsic hepatic clearance, perhaps due to competition of probenecid or accumulated VPA metabolites for glucuronidation or depletion of hepatic UDP-glucuronic acid. The CSF/serum VPA ratio increased rapidly initially, then decreased with time throughout the remainder of the experiment in all three groups. This time- and/or concentration-dependent behavior suggested that the rate of CSF penetration increased disproportionately with increasing serum VPA and could be described by a kinetic model incorporating a concentration-dependent first-order rate constant for VPA influx into CSF. Under all experimental conditions, the VPA efflux from CSF appeared to be saturable; an increase in the Michaelis constant for efflux was observed following probenecid pretreatment and during VPA infusion, suggesting competitive inhibition of transport by probenecid and derived metabolites of VPA, respectively. The mechanisms responsible for asymmetric VPA transport between serum and CSF, in particular the apparent concentration-dependent change in the rate constant governing CSF penetration, remain to be elucidated.

Determination of hepatic blood flow in the rat using sequential infusions of indocyanine green or galactose.

A method was developed for the estimation of hepatic blood flow in the rat using sequential infusions of one of two model substrates, indocyanine green or galactose. Either substrate was infused to steady state (achieved within 6 min of the start of indocyanine green infusion and within 40 min of the start of galactose infusion) through either the femoral or portal vein, and three steady state blood samples were obtained. Following a 30-min washout period, the same substrate was infused a second time through the alternate blood vessel. Using a pharmacokinetic approach, hepatic blood flow was estimated from the mean steady state concentrations during the two infusions and the infusion rate. The present method yielded hepatic blood flow estimates of 2.03 +/- 0.13 ml/min/g of liver (indocyanine green) and 2.28 +/- 0.49 ml/min/g of liver (galactose) in two groups of four adult male rats. A Monte-Carlo simulation experiment was conducted to assess the potential error introduced into the blood flow calculation by the moderate transhepatic extraction ratio of the two model substrates (0.386 +/- 0.049 for indocyanine green; 0.439 +/- 0.139 for galactose). The simulation experiment predicted calculational errors between 7.4% (indocyanine green) and 19.5% (galactose), based on the hepatic extraction ratio and the precision of the analytical method for the two compounds. The predicted errors were in good agreement with the variability in blood flow estimates observed experimentally (6.5% for indocyanine green; 21.4% for galactose). The steady state approach employed appears to be associated with superior reproducibility as compared to previously reported methods utilizing bolus dose administration of marker compounds and calculations based upon AUC estimates.