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      Effects of ABCB1, UGT1A1, and UGT1A9 Genetic Polymorphisms on the Pharmacokinetics of Sitafloxacin Granules in Healthy Subjects

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          Abstract

          Sitafloxacin, a new fluoroquinolone, has strong antibacterial activity. We evaluated the effects of sitafloxacin granules in single‐dose and multidose cohorts and the effects of ABCB1, UGT1A1, and UGT1A9 genetic polymorphisms on the pharmacokinetics (PK) of sitafloxacin in healthy subjects. The single‐dose study included 3 fasted cohorts receiving 50, 100, and 200 mg of sitafloxacin granules and 1 cohort receiving 50 mg of sitafloxacin granules with a high‐fat meal. The multidose study included 1 cohort receiving 100 mg of sitafloxacin granules once daily for 5 days. PK parameters were calculated using noncompartmental parameters based on concentration‐time data. The genotypes for ABCB1, UGT1A1, and UGT1A9 single‐nucleotide polymorphisms were determined using Sanger sequencing. Subsequently, the association between sitafloxacin PK parameters and target single‐nucleotide polymorphisms was analyzed. Sitafloxacin granules were well tolerated up to 200 and 100 mg in the single‐dose and multidose studies, respectively. Sitafloxacin AUC and C max increased linearly within the detection range, and a steady state was reached within 3 days after the administration of multiple oral doses. Our findings showed that C max was lower in the ABCB1 (rs1045642) mutation group, whereas t 1/2 was longer in the UGT1A1 (rs2741049) and UGT1A9 (rs3832043) mutation groups. In conclusion, sitafloxacin granules were safe at single doses and multiple doses up to 200 and 100 mg/day, respectively, with a linear plasma PK profile. However, ABCB1 (rs1045642), UGT1A1 (rs2741049), and UGT1A9 (rs3832043) genetic polymorphisms are likely to influence the C max or t 1/2 and thereby merit further clinical evaluation.

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          Pharmacogenomics knowledge for personalized medicine.

          The Pharmacogenomics Knowledgebase (PharmGKB) is a resource that collects, curates, and disseminates information about the impact of human genetic variation on drug responses. It provides clinically relevant information, including dosing guidelines, annotated drug labels, and potentially actionable gene-drug associations and genotype-phenotype relationships. Curators assign levels of evidence to variant-drug associations using well-defined criteria based on careful literature review. Thus, PharmGKB is a useful source of high-quality information supporting personalized medicine-implementation projects.
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            Overcoming ABC transporter-mediated multidrug resistance: Molecular mechanisms and novel therapeutic drug strategies.

            Multidrug resistance is a key determinant of cancer chemotherapy failure. One of the major causes of multidrug resistance is the enhanced efflux of drugs by membrane ABC transporters. Targeting ABC transporters projects a promising approach to eliminating or suppressing drug resistance in cancer treatment. To reveal the functional mechanisms of ABC transporters in drug resistance, extensive studies have been conducted from identifying drug binding sites to elucidating structural dynamics. In this review article, we examined the recent crystal structures of ABC proteins to depict the functionally important structural elements, such as domains, conserved motifs, and critical amino acids that are involved in ATP-binding and drug efflux. We inspected the drug-binding sites on ABC proteins and the molecular mechanisms of various substrate interactions with the drug binding pocket. While our continuous battle against drug resistance is far from over, new approaches and technologies have emerged to push forward our frontier. Most recent developments in anti-MDR strategies include P-gp inhibitors, RNA-interference, nano-medicines, and delivering combination strategies. With the advent of the 'Omics' era - genomics, epigenomics, transcriptomics, proteomics, and metabolomics - these disciplines play an important role in fighting the battle against chemoresistance by further unraveling the molecular mechanisms of drug resistance and shed light on medical therapies that specifically target MDR.
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              Very important pharmacogene summary: ABCB1 (MDR1, P-glycoprotein).

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                Author and article information

                Contributors
                wyqjsph@163.com
                Journal
                Clin Pharmacol Drug Dev
                Clin Pharmacol Drug Dev
                10.1002/(ISSN)2160-7648
                CPDD
                Clinical Pharmacology in Drug Development
                John Wiley and Sons Inc. (Hoboken )
                2160-763X
                2160-7648
                20 July 2020
                January 2021
                : 10
                : 1 ( doiID: 10.1002/cpdd.v10.1 )
                : 57-67
                Affiliations
                [ 1 ] Research Division of Clinical Pharmacology First Affiliated Hospital of Nanjing Medical University Nanjing China
                [ 2 ] Department of Pharmacy Affiliated Hospital of Yangzhou University Yangzhou China
                [ 3 ] Department of Pharmacy Jiangsu Shengze Hospital Suzhou China
                Author notes
                [*] [* ] Corresponding Author:

                Yong‐Qing Wang, PhD, Research Division of Clinical Pharmacology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210009, China

                (e‐mail: wyqjsph@ 123456163.com )

                Article
                CPDD848
                10.1002/cpdd.848
                7818398
                32687695
                705e2ad8-e809-46e4-8ed9-779c52a885ab
                © 2020 The Authors. Clinical Pharmacology in Drug Development published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 December 2019
                : 07 June 2020
                Page count
                Figures: 4, Tables: 2, Pages: 11, Words: 5799
                Funding
                Funded by: National Natural Science Foundation of China , open-funder-registry 10.13039/501100001809;
                Award ID: 81673515
                Award ID: 81503160
                Award ID: 81870436
                Funded by: National Science and Technology Major Project
                Award ID: 2018ZX09734007
                Funded by: Natural Science Foundation of Jiangsu Province , open-funder-registry 10.13039/501100004608;
                Award ID: BK20161591
                Funded by: Suzhou Science and Education Youth Project
                Award ID: KJXW2016067
                Funded by: Suzhou Industrial Technology Innovation
                Award ID: SYSD2016046
                Funded by: Jiangsu Provincial Medical Youth Talent , open-funder-registry 10.13039/501100013059;
                Award ID: QNRC2016215
                Categories
                Original Manuscript
                Articles
                Custom metadata
                2.0
                January 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.6 mode:remove_FC converted:21.01.2021

                abcb1,gene polymorphism,pharmacokinetics,safety,sitafloxacin,ugt1a1,ugt1a9

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