Journal
EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY
Volume 8, Issue 8, Pages 943-958Publisher
INFORMA HEALTHCARE
DOI: 10.1517/17425255.2012.691165
Keywords
cationic amphipathic drug (CAD); drug sequestration; drug-drug interaction; hydrophobic amine; ion trapping; lipidosis; lysosomal pH; lysosomal volume; lysosomes; Niemann pick disease (NPC); pH partitioning
Funding
- Biotech Training Grant [T32-GM008359]
- PhRMA Foundation
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Introduction: Many commercially available, weakly basic drugs have been shown to be lysosomotropic, meaning they are subject to extensive sequestration in lysosomes through an ion trapping-type mechanism. The extent of lysosomal trapping of a drug is an important therapeutic consideration because it can influence both activity and pharmacokinetic disposition. The administration of certain drugs can alter lysosomes such that their accumulation capacity for co-administered and/or secondarily administered drugs is altered. Areas covered: In this review the authors explore what is known regarding the mechanistic basis for drug-drug interactions involving lysosomes. Specifically, the authors address the influence of drugs on lysosomal pH, volume and lipid processing. Expert opinion: Many drugs are known to extensively accumulate in lysosomes and significantly alter their structure and function; however, the therapeutic and toxicological implications of this remain controversial. The authors propose that drug-drug interactions involving lysosomes represent an important potential source of variability in drug activity and pharmacokinetics. Most evaluations of drug-drug interactions involving lysosomes have been performed in cultured cells and isolated tissues. More comprehensive in vivo evaluations are needed to fully explore the impact of this drug-drug interaction pathway on therapeutic outcomes.
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