Purpose
Several in vivo studies have found that the 5-HT1A PET radioligand 18F-MPPF is a substrate of rodent P-glycoprotein (P-gp). However, in vitro assays suggest that MPPF is not a substrate of human P-gp. We have now tested the influence of inhibiting P-gp on the brain kinetics of 18F-MPPF in mice and non-human primates.
Methods
We measured the peripheral kinetics (arterial input function, metabolism, free fraction in plasma (fP)) during 18F-MPPF brain PET scanning in baboons with or without cyclosporine A (CsA) infusion. We measured 3H-MPPF transport at the mouse BBB using in situ brain perfusion in P-gp/Bcrp deficient mice and after inhibiting P-gp with PSC833.
Results
There was an unexpected 1.9-fold increase in brain area under the curve in CsA-treated baboons (n = 4), with no change in radiometabolite-corrected arterial input. However, total volume of distribution corrected for fP (VT/fP) remained unchanged. In situ brain perfusion showed that P-gp restricted the permeability of the mouse BBB to 3H-MPPF while Bcrp did not.
Conclusion
These and previous in vitro results suggest that P-gp may not influence the permeability of human BBB to 18F-MPPF. However, CsA treatment increased 18F-MPPF free fraction, which is responsible for a misleading, P-gp unrelated enhanced brain uptake.