Blood–Brain Barrier Transporters: Opportunities for Therapeutic Development in Ischemic Stroke

Globally, stroke is a leading cause of death and long-term disability. Over the past decades, several efforts have attempted to discover new drugs or repurpose existing therapeutics to promote post-stroke neurological recovery. Preclinical stroke studies have reported successes in identifying novel...

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Published inInternational journal of molecular sciences Vol. 23; no. 3; p. 1898
Main Authors Nilles, Kelsy L., Williams, Erica I., Betterton, Robert D., Davis, Thomas P., Ronaldson, Patrick T.
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 08.02.2022
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Abstract Globally, stroke is a leading cause of death and long-term disability. Over the past decades, several efforts have attempted to discover new drugs or repurpose existing therapeutics to promote post-stroke neurological recovery. Preclinical stroke studies have reported successes in identifying novel neuroprotective agents; however, none of these compounds have advanced beyond a phase III clinical trial. One reason for these failures is the lack of consideration of blood–brain barrier (BBB) transport mechanisms that can enable these drugs to achieve efficacious concentrations in ischemic brain tissue. Despite the knowledge that drugs with neuroprotective properties (i.e., statins, memantine, metformin) are substrates for endogenous BBB transporters, preclinical stroke research has not extensively studied the role of transporters in central nervous system (CNS) drug delivery. Here, we review current knowledge on specific BBB uptake transporters (i.e., organic anion transporting polypeptides (OATPs in humans; Oatps in rodents); organic cation transporters (OCTs in humans; Octs in rodents) that can be targeted for improved neuroprotective drug delivery. Additionally, we provide state-of-the-art perspectives on how transporter pharmacology can be integrated into preclinical stroke research. Specifically, we discuss the utility of in vivo stroke models to transporter studies and considerations (i.e., species selection, co-morbid conditions) that will optimize the translational success of stroke pharmacotherapeutic experiments.
AbstractList Globally, stroke is a leading cause of death and long-term disability. Over the past decades, several efforts have attempted to discover new drugs or repurpose existing therapeutics to promote post-stroke neurological recovery. Preclinical stroke studies have reported successes in identifying novel neuroprotective agents; however, none of these compounds have advanced beyond a phase III clinical trial. One reason for these failures is the lack of consideration of blood-brain barrier (BBB) transport mechanisms that can enable these drugs to achieve efficacious concentrations in ischemic brain tissue. Despite the knowledge that drugs with neuroprotective properties (i.e., statins, memantine, metformin) are substrates for endogenous BBB transporters, preclinical stroke research has not extensively studied the role of transporters in central nervous system (CNS) drug delivery. Here, we review current knowledge on specific BBB uptake transporters (i.e., organic anion transporting polypeptides (OATPs in humans; Oatps in rodents); organic cation transporters (OCTs in humans; Octs in rodents) that can be targeted for improved neuroprotective drug delivery. Additionally, we provide state-of-the-art perspectives on how transporter pharmacology can be integrated into preclinical stroke research. Specifically, we discuss the utility of in vivo stroke models to transporter studies and considerations (i.e., species selection, co-morbid conditions) that will optimize the translational success of stroke pharmacotherapeutic experiments.
Globally, stroke is a leading cause of death and long-term disability. Over the past decades, several efforts have attempted to discover new drugs or repurpose existing therapeutics to promote post-stroke neurological recovery. Preclinical stroke studies have reported successes in identifying novel neuroprotective agents; however, none of these compounds have advanced beyond a phase III clinical trial. One reason for these failures is the lack of consideration of blood-brain barrier (BBB) transport mechanisms that can enable these drugs to achieve efficacious concentrations in ischemic brain tissue. Despite the knowledge that drugs with neuroprotective properties (i.e., statins, memantine, metformin) are substrates for endogenous BBB transporters, preclinical stroke research has not extensively studied the role of transporters in central nervous system (CNS) drug delivery. Here, we review current knowledge on specific BBB uptake transporters (i.e., organic anion transporting polypeptides (OATPs in humans; Oatps in rodents); organic cation transporters (OCTs in humans; Octs in rodents) that can be targeted for improved neuroprotective drug delivery. Additionally, we provide state-of-the-art perspectives on how transporter pharmacology can be integrated into preclinical stroke research. Specifically, we discuss the utility of in vivo stroke models to transporter studies and considerations (i.e., species selection, co-morbid conditions) that will optimize the translational success of stroke pharmacotherapeutic experiments.Globally, stroke is a leading cause of death and long-term disability. Over the past decades, several efforts have attempted to discover new drugs or repurpose existing therapeutics to promote post-stroke neurological recovery. Preclinical stroke studies have reported successes in identifying novel neuroprotective agents; however, none of these compounds have advanced beyond a phase III clinical trial. One reason for these failures is the lack of consideration of blood-brain barrier (BBB) transport mechanisms that can enable these drugs to achieve efficacious concentrations in ischemic brain tissue. Despite the knowledge that drugs with neuroprotective properties (i.e., statins, memantine, metformin) are substrates for endogenous BBB transporters, preclinical stroke research has not extensively studied the role of transporters in central nervous system (CNS) drug delivery. Here, we review current knowledge on specific BBB uptake transporters (i.e., organic anion transporting polypeptides (OATPs in humans; Oatps in rodents); organic cation transporters (OCTs in humans; Octs in rodents) that can be targeted for improved neuroprotective drug delivery. Additionally, we provide state-of-the-art perspectives on how transporter pharmacology can be integrated into preclinical stroke research. Specifically, we discuss the utility of in vivo stroke models to transporter studies and considerations (i.e., species selection, co-morbid conditions) that will optimize the translational success of stroke pharmacotherapeutic experiments.
Author Davis, Thomas P.
Nilles, Kelsy L.
Betterton, Robert D.
Ronaldson, Patrick T.
Williams, Erica I.
AuthorAffiliation Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ 85724-5050, USA; knilles@email.arizona.edu (K.L.N.); eiwilliams@email.arizona.edu (E.I.W.); rdbetter@email.arizona.edu (R.D.B.); davistp@email.arizona.edu (T.P.D.)
AuthorAffiliation_xml – name: Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ 85724-5050, USA; knilles@email.arizona.edu (K.L.N.); eiwilliams@email.arizona.edu (E.I.W.); rdbetter@email.arizona.edu (R.D.B.); davistp@email.arizona.edu (T.P.D.)
Author_xml – sequence: 1
  givenname: Kelsy L.
  orcidid: 0000-0002-2866-5878
  surname: Nilles
  fullname: Nilles, Kelsy L.
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  surname: Williams
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  orcidid: 0000-0001-9877-5370
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/35163820$$D View this record in MEDLINE/PubMed
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Issue 3
Keywords blood–brain barrier
transporters
organic anion transporting polypeptides
endothelial cell
neuroprotection
statins
organic cation transporters
ischemic stroke
Language English
License https://creativecommons.org/licenses/by/4.0
Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Snippet Globally, stroke is a leading cause of death and long-term disability. Over the past decades, several efforts have attempted to discover new drugs or repurpose...
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SubjectTerms Animals
Blood-Brain Barrier - metabolism
Comorbidity
Disease Models, Animal
Drug therapy
Edema
Endothelium
Extracellular matrix
Gene Expression Regulation - drug effects
Glucose
Human subjects
Humans
Ischemic Stroke - drug therapy
Ischemic Stroke - metabolism
Molecular Targeted Therapy
Neuroprotective Agents - pharmacokinetics
Neuroprotective Agents - therapeutic use
Organic Anion Transporters - metabolism
Organic Cation Transport Proteins - metabolism
Permeability
Proteins
Review
Sodium
Solute movement
Stroke
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Title Blood–Brain Barrier Transporters: Opportunities for Therapeutic Development in Ischemic Stroke
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