Publication

Maternal use of drug substrates of placental transporters and the effect of transporter-mediated drug interactions on the risk of congenital anomalies

Daud, A. N. A., Bergman, J. E. H., Oktora, M. P., Kerstjens-Frederikse, W. S., Groen, H., Bos, J. H., Hak, E. & Wilffert, B., 13-Mar-2017, In : PLoS ONE. 12, 3, 14 p., e0173530.

Research output: Contribution to journalArticleAcademicpeer-review

Background

A number of transporter proteins are expressed in the placenta, and they facilitate the placental transfer of drugs. The inhibition of P-glycoprotein (P-gp) was previously found to be associated with an increase in the risk of congenital anomalies caused by drug substrates of this transporter. We now explore the role of other placental transporter proteins.

Methods

A population-based case-referent study was performed using cases with congenital anomalies (N = 5,131) from EUROCAT Northern Netherlands, a registry of congenital anomalies. The referent population (N = 31,055) was selected from the pregnancy IADB. nl, a pharmacy prescription database.

Results

Ten placental transporters known to have comparable expression levels in the placenta to that of P-gp, were selected in this study. In total, 147 drugs were identified to be substrates, inhibitors or inducers, of these transporters. Fifty-eight of these drugs were used by at least one mother in our cases or referent population, and 28 were used in both. The highest user rate was observed for the substrates of multidrug resistance-associated protein 1, mainly folic acid (6% of cases, 8% of referents), and breast cancer resistance protein, mainly nitrofurantoin (2.3% of cases, 2.9% of referents). In contrast to P-gp, drug interactions involving substrates of these transporters did not have a significant effect on the risk of congenital anomalies.

Conclusions

Some of the drugs which are substrates or inhibitors of placental transporters were commonly used during pregnancy. No significant effect of transporter inhibition was found on fetal drug exposure, possibly due to a limited number of exposures.

Original languageEnglish
Article numbere0173530
Number of pages14
JournalPLoS ONE
Volume12
Issue number3
Publication statusPublished - 13-Mar-2017

    Keywords

  • RESISTANCE PROTEIN BCRP/ABCG2, RNA EXPRESSION PROFILES, P-GLYCOPROTEIN, MESSENGER-RNA, MEMBRANE TRANSPORTERS, PREGNANCY, EXPOSURE, PHARMACOKINETICS, DISPOSITION, METABOLISM

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