Evasion of P-gp mediated cellular efflux and permeability enhancement of HIV-protease inhibitor saquinavir by prodrug modification

Uptake of [3H]erythromycin by MDCKII-MDR1 cells exhibited a four-fold increase in the presence of 75 μM SQV. However, equimolar concentrations of Val-Val-SQV and Gly-Val-SQV showed only 2.5-fold increase in [3H]erythromycin uptake. Concentration dependent inhibition of [3H]glycylsarcosine (Gly-Sar), a model peptide transporter substrate, was observed in the presence of SQV prodrugs. Transepithelial transport studies of Val-Val-SQV and Gly-Val-SQV exhibited an enhanced absorptive flux and reduced secretory flux relative to studies employing SQV. These results are very likely due to decreased efflux of SQV dipeptide prodrugs by P-gp. Peptide prodrug derivatization constitutes an exciting strategy to improve intestinal absorption and oral bioavailability of SQV.