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Effect of paracellular permeation enhancers on intestinal permeability of two peptide drugs, enalaprilat and hexarelin, in rats

Study · Acta pharmaceutica Sinica. B · 2021 · DOI 10.1016/j.apsb.2020.12.019 · PMID 34221875

Plain-language summary

Paraphrased from the published abstract below — not a verdict on whether anything works.

In this rat study using a single-pass intestinal perfusion model with concomitant blood sampling, researchers investigated whether paracellular permeation enhancers affect intestinal absorption of two peptide drugs, enalaprilat (349 Da) and hexarelin (887 Da). Luminal compositions tested included chitosan (5 mg/mL) and ethylenediaminetetraacetate (EDTA, 1 and 5 mg/mL), plus low luminal tonicity (100 mOsm) with or without lidocaine. Effects were measured via lumen-to-blood permeability of hexarelin and enalaprilat and blood-to-lumen clearance of 51chromium-labeled EDTA, a marker of mucosal barrier integrity. Both paracellular enhancers increased mucosal permeability of both peptides similarly and increased blood-to-lumen flux of 51Cr-EDTA, as did luminal hypotonicity; hypotonicity, however, did not affect lumen-to-blood transport of enalaprilat and hexarelin. The authors suggest hypotonicity affects paracellular transport mainly in the mucosal crypt region.

Abstract

Transcellular permeation enhancers are known to increase the intestinal permeability of enalaprilat, a 349 Da peptide, but not hexarelin (887 Da). The primary aim of this paper was to investigate if paracellular permeability enhancers affected the intestinal permeation of the two peptides. This was investigated using the rat single-pass intestinal perfusion model with concomitant blood sampling. These luminal compositions included two paracellular permeation enhancers, chitosan (5 mg/mL) and ethylenediaminetetraacetate (EDTA, 1 and 5 mg/mL), as well as low luminal tonicity (100 mOsm) with or without lidocaine. Effects were evaluated by the change in lumen-to-blood permeability of hexarelin and enalaprilat, and the blood-to-lumen clearance of 51chromium-labeled EDTA (CLCr-EDTA), a clinical marker for mucosal barrier integrity. The two paracellular permeation enhancers increased the mucosal permeability of both peptide drugs to a similar extent. The data in this study suggests that the potential for paracellular permeability enhancers to increase intestinal absorption of hydrophilic peptides with low molecular mass is greater than for those with transcellular mechanism-of-action. Further, the mucosal blood-to-lumen flux of 51Cr-EDTA was increased by the two paracellular permeation enhancers and by luminal hypotonicity. In contrast, luminal hypotonicity did not affect the lumen-to-blood transport of enalaprilat and hexarelin. This suggests that hypotonicity affects paracellular solute transport primarily in the mucosal crypt region, as this area is protected from luminal contents by a constant water flow from the crypts.

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