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Uptake/efflux transport of tramadol enantiomers and O-desmethyl-tramadol: focus on P-glycoprotein

Kanaan, Mouna
Published in Basic & Clinical Pharmacology & Toxicology. 2009, vol. 105, no. 3, p. 199-206
Abstract The analgesic effect of tramadol (TMD) results from the monoaminergic effect of its two enantiomers, (+)-TMD and (-)-TMD as well as its opioid metabolite (+)-O-desmethyl-tramadol (M1). P-glycoprotein (P-gp) might be of importance in the analgesic and tolerability profile variability of TMD. Our study investigated the involvement of P-gp in the transepithelial transport of (+)-TMD, (-)-TMD and M1, using a Caco-2 cell monolayer model. The bidirectional transport of racemic TMD and M1 (1-100 microM) across the monolayers was investigated at two pH conditions (pH 6.8/7.4 and 7.4/7.4) in the presence and absence of P-gp inhibitor cyclosporine A (10 microM) and assessed with the more potent and specific P-gp inhibitor GF120918 (4 microM). Analytical quantification was performed by liquid chromatography coupled to the fluorescence detector. A net secretion of (+)-TMD, (-)-TMD and M1 was observed when a pH gradient was applied (TR: P(app)(B - A)/P(app)(A - B): 1.8-2.7; P < 0.05). However, the bidirectional transport of all compounds was equal in the non-gradient system. In the presence of P-gp inhibitors, a slight but significant increase of secretory flux was observed (up to 26%; P < 0.05) at both pH conditions. In conclusion, (+)-TMD, (-)-TMD and M1 are not P-gp substrates. However, proton-based efflux pumps may be involved in limiting the gastrointestinal absorption of TMD enantiomers as well as enhancing TMD enantiomers and M1 renal excretion. A possible involvement of uptake carriers in the transepithelial transport of TMD enantiomers and M1 is suggested.
Keywords Analgesics, Opioid/pharmacokineticsBiological TransportCaco-2 CellsElectric ImpedanceHumansHydrogen-Ion ConcentrationP-Glycoprotein/physiologyStereoisomerismTramadol/analogs & derivatives/pharmacokinetics
PMID: 19496778
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Research groups Pharmaco-omiques et médecine de précision (1003)
Groupe Desmeules Jules (pharmacologie/toxicologie) (567)
Groupe Pierre Dayer (pharmacologie/toxicologie) (78)
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KANAAN, Mouna et al. Uptake/efflux transport of tramadol enantiomers and O-desmethyl-tramadol: focus on P-glycoprotein. In: Basic & Clinical Pharmacology & Toxicology, 2009, vol. 105, n° 3, p. 199-206. doi: 10.1111/j.1742-7843.2009.00428.x https://archive-ouverte.unige.ch/unige:5305

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Deposited on : 2010-03-02

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