Pharmacokinetics of intravenous theophylline in mutant Nagase analbuminemic rats

Article abstract of DOI:10.1016/S0024-3205(02)02373-1

It was obtained from our laboratories that the expression of hepatic microsomal cytochrome P450 (CYP) 1A2 increased approximately 3.5 times in mutant Nagase analbuminemic rats (NARs, an animal model for human familial analbuminemia), and theophylline was reported to be metabolized to 1,3-dimethyluric acid (1,3-DMU) and 1-methylxanthine (which was further metabolized to 1-methyluric acid, 1-MU, via xanthine oxidase) via CYP1A2 in rats. Hence, the pharmacokinetic parameters of theophylline, 1,3-DMU and 1-MU were compared after intravenous administration of aminophylline, 5 mg/kg as theophylline, to control Sprague-Dawley rats and NARs. In NARs, the total area under the plasma concentration-time curve from time zero to time infinity (AUC) of theophylline was significantly smaller (1040 versus 1750 μg min/ml) than that in control rats and this could be due to significantly faster renal clearance (CL_R, 1.39 versus 0.571 ml/min/kg, due to inhibition of renal reabsorption of unchanged theophylline) and nonrenal clearance (CL_NR, 3.36 versus 2.25 ml/min/kg, due to 3.5-fold increase in CYP1A2) than those in control rats. Based on in vitro hepatic microsomal studies, the intrinsic 1,3-DMU formation clearance was significantly faster in NARs than that in control rats (267 versus 180 × 10^-6 ml/min). After intravenous administration of 1,3-DMU, the renal secretion of 1,3-DMU was inhibited in NARs. Inhibition of renal secretion or reabsorption of various compounds in NARs was also discussed.

Full text of DOI:10.1016/S0024-3205(02)02373-1

Life Sciences 72 (2003) 1231–1245
www.elsevier.com/locate/lifescie
Pharmacokinetics of intravenous theophylline in mutant
Nagase analbuminemic rats
*
Eun Jung Kim, Ok Kyung Suh, Myung Gull Lee
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University,
San 56-1, Shinlim-Dong, Kwanak-Gu, Seoul 151-742, South Korea
Received 15 February 2002; accepted 6 September 2002
Abstract
It was obtained from our laboratories that the expression of hepatic microsomal cytochrome P450 (CYP) 1A2
increased approximately 3.5 times in mutant Nagase analbuminemic rats (NARs, an animal model for human
familial analbuminemia), and theophylline was reported to be metabolized to 1,3-dimethyluric acid (1,3-DMU)
and 1-methylxanthine (which was further metabolized to 1-methyluric acid, 1-MU, via xanthine oxidase) via
CYP1A2 in rats. Hence, the pharmacokinetic parameters of theophylline, 1,3-DMU and 1-MU were compared
after intravenous administration of aminophylline, 5 mg/kg as theophylline, to control Sprague-Dawley rats and
NARs. In NARs, the total area under the plasma concentration-time curve from time zero to time infinity (AUC) of
theophylline was significantly smaller (1040 versus 1750 Ag min/ml) than that in control rats and this could be due
to significantly faster renal clearance (CLR, 1.39 versus 0.571 ml/min/kg, due to inhibition of renal reabsorption of
unchanged theophylline) and nonrenal clearance (CLNR, 3.36 versus 2.25 ml/min/kg, due to 3.5-fold increase in
CYP1A2) than those in control rats. Based on in vitro hepatic microsomal studies, the intrinsic 1,3-DMU
ꢀ
formation clearance was significantly faster in NARs than that in control rats (267 versus 180
10ꢁ 6 ml/min).
After intravenous administration of 1,3-DMU, the renal secretion of 1,3-DMU was inhibited in NARs. Inhibition
of renal secretion or reabsorption of various compounds in NARs was also discussed.
D 2002 Elsevier Science Inc. All rights reserved.
Keywords: Theophylline; 1,3-DMU; Pharmacokinetics; Mutant Nagase analbuminemic rats; CYP1A2
* Corresponding author. Tel.: +82-2-880-7855; fax: +82-2-889-8693.
E-mail address: leemg@snu.ac.kr (M.G. Lee).
0024-3205/02/$ - see front matter D 2002 Elsevier Science Inc. All rights reserved.
PII: S0024-3205(02)02373-1

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Introduction
Role of plasma protein binding in circulating blood in renal excretion of compounds (or drugs) such
as mercapturic acid, phenolsulfonphthalein, and furosemide in mutant Nagase analbuminemic rats
(NARs, an animal model for human familial analbuminemia, [1]) was reported [2–5]. In NARs, the
percentages of intravenous dose excreted in urine as unchanged compounds (Ae) were significantly
smaller and this could be due to significantly smaller plasma protein binding values than those in
control rats [2–5]. For example, after 5-s intravenous administration of mercapturic acid, 10 Amol/kg,
to NARs, the plasma protein binding value was 18.4% at mercapturic acid concentration of 50 AM (the
value in control Sprague-Dawley rats was 80.1%) using an ultrafiltration method, and Ae, 0 ! 20 min was
25.6% of intravenous dose of the compound (the value in control rats was 57.6%) [2]. After 5-s
intravenous administration of phenolsulfonphthalein, 10 Amol/kg, to NARs, the serum protein binding
value was 32.0% at phenolsulfonphthalein concentration of 0.1 mmol/l (the value in control rats was
94.4%) using an ultrafiltration method, and Ae, 0 ! 6 hr was 22.4% of intravenous dose of the compound
(the value in control rats was 49.2%) [3]. Similar results were also obtained from other phenolsul-
fonphthalein studies [4]. After 10-s intravenous administration of furosemide, 0.5 mg/kg, to NARs, the
plasma protein binding value was 12.0% at furosemide concentration of 20 Ag/ml (the value in control
rats was 98.9%), and Ae, 0 ! 30 min was 7% of intravenous dose of the diuretic (the value in control rats
was 26%) [5].
However, in NARs, the Ae values of warfarin, bumetanide, and salicylic acid were significantly or
tended to be greater than those in control rats [6–8]. For example, after intravenous bolus injection of
[14C]warfarin, 1 mg/kg, to NARs, the plasma protein binding value was 63.6% (the value in control rats
was 98.9%) when the blood was collected at 30 min after intravenous administration of [14C]warfarin
using an ultrafiltration method, and Ae, 0 ! 24 hr was 4.6% of intravenous dose of the anticoagulant (the
value in control rat was 1.6%) [6]. After 1-min intravenous administration of bumetanide, 10 mg/kg, to
NARs, the plasma protein binding value was 36.8% at bumetanide concentration of 10 Ag/ml (the value
in control rats was 97.6%) using an equilibrium dialysis method, and Ae, 0 ! 24 hr was 16.0% of
intravenous dose of the diuretic (the value in control rats was 7.96%) [7]. After intravenous bolus
injection of [14C]salicylic acid, 10 mg/kg, to NARs, the plasma protein binding value was 10.9% (the
value in control rats was 93.7%) when the blood was collected at 30 min after intravenous
administration of the drug using an ultrafiltration method, and Ae was 59.9 F 9.8% (the value in
control rats was 45.7 F 10.1%; they were not significantly different and this may be due to limited
numbers of rats used, n = 3) [8].
It was obtained recently from our laboratories (our unpublished data) that the expression of hepatic
microsomal cytochrome P450 (CYP) 1A2 was approximately 3.5-fold increased in NARs compared to
control rats based on Western blot analysis. The mRNA level of CYP1A2 was also 3.5- to 4-fold
increased in NARs compared to control rats based on Northern blot analysis. However, the expression of
CYP2E1 and CYP3A23 was not changed in NARs. It was also reported [9] that theophylline was
metabolized to 1,3-dimethyluric acid (1,3-DMU) via CYP1A2 and CYP2E1 and to 1-methylxanthine via
CYP1A2 which was further metabolized to 1-methyluric acid (1-MU) via xanthine oxidase in rats.
Hence, it could be expected that the pharmacokinetic parameters of theophylline and its metabolites, 1,3-
DMU and 1-MU, could be changed in NARs.
The above mentioned six compounds have high plasma protein binding values in control rats:
80.1% for mercapturic acid [2], 94.4% for phenolsulfonphthalein [3], 98.9% for furosemide [5] and

E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
1233
warfarin [6], 97.6% for bumetanide [7] and 93.7% for salicylic acid [8]. However, the role of
plasma protein binding in circulating blood in renal excretion of compounds having low plasma
protein binding values in NARs has not been published to date. The plasma protein binding values
of theophylline and 1,3-DMU in control rats were 26.9 and 20.7%, respectively, using an
equilibrium dialysis technique. Although the above mentioned compounds are secreted [2–4] or
reabsorbed [6] in rat renal tubules, the changes in renal excretion of compounds which are secreted
or reabsorbed from renal tubules have not been thoroughly studied in NARs. The pharmacokinetic
parameters of the compounds were reported to be changed in NARs [2–8], however, such changes
could not be explained by the changes in CYP isozymes in rats. The purpose of this study was to
report the pharmacokinetic changes of theophylline and its metabolites, 1,3-DMU and 1-MU, after
intravenous administration of theophylline to NARs with respect to changes in CYP1A2 in rats. The
inhibition of renal tubular secretion or renal tubular reabsorption of the compounds in NARs was
also discussed.
Materials and methods
Chemicals
Aminophylline intravenous solution (250 mg/10 ml ampoule) was a product from Daewon
Pharmaceutical Company (Seoul, Korea). 1,3-DMU, 1-MU, h-hydroxyethyltheophylline [the internal
standard of high-performance liquid chromatographic (HPLC) assay] and reduced form of nicotinamide
adenine dinucleotide phosphate (NADPH) were supplied by Sigma Chemical Company (St. Louis, MO).
Other chemicals were of reagent grade or HPLC grade and, therefore, were used without further
purification.
Rats
Male Sprague-Dawley rats (control rats, weighing 290 ꢁ 320 g) and NARs (weighing 280 ꢁ 320 g)
of 9 weeks of age were purchased from Japan SLC Inc. (Hamamatsu, Japan). The protocol of animal
study was approved by Animal Care and Use Committee of College of Pharmacy, Seoul National
University (Seoul, Korea). Animals were maintained in a clean room (Animal Center for Pharmaceutical
Research, College of Pharmacy, Seoul National University) at temperature between 20 and 23jC with
12 hr light and dark cycles and a relative humidity of 50%. Animals were individually housed in
metabolic cages (Tecniplast, Varese, Italy) under the supply of filtered pathogen-free air and water ad
libitum.
Isolation of hepatic microsomal protein
Hepatic microsomal fractions of control rats (n = 6) and NARs (n = 6) were prepared by differential
centrifugation, washed in pyrophosphate buffer (pH 7.4) and stored in 100 mM Tris-acetate buffer (pH
7.4) containing 1 mM sodium ethylenediamine tetraacetate (EDTA). Microsomal preparations were
stored in a ꢁ 70jC freezer until use. Protein content was determined according to the reported methods
[10].

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Measurement of Vmax, Km and CLint for the formation of 1,3-DMU from theophylline in hepatic
microsomal fractions
The Vmax (the maximum velocity) and Km (the Michaelis-Menten constant, the concentration at
which the rate is one-half of Vmax) for the formation of 1,3-DMU from theophylline were determined
after incubating the above microsomal fraction (equivalent to 1 mg protein) in 100 mM phosphate buffer
(pH 7.4). Theophylline was added to the microsomal fraction having theophylline concentrations of 0.5,
1, 2, 5, 7.5 and 10 mM. The reaction was initiated by adding 1.2 mM NADPH and was conducted in a
water-bath shaker kept at 37jC and at a rate of 50 oscillations per min (opm) for 30 min. The reaction
was terminated by adding 0.1 ml of ice-cold 8% ZnSO4. The precipitated proteins were removed by
centrifugation at 15000 g for 10 min and the supernatant was stored in a ꢁ 70jC freezer until HPLC
analysis of 1,3-DMU [11]. The kinetic constants (Km and Vmax) for the formation of 1,3-DMU from
theophylline were calculated using the Lineweaver-Burk plot [12] by linear regression and the method of
least squares. Intrinsic 1,3-DMU formation clearance (CLint) was calculated by dividing Vmax by Km.
The same experiment was again performed (n = 5 for each rat).
Pretreatment of rats
In the early morning, the carotid artery and the jugular vein of each control rat and NAR were
cannulated with polyethylene tubing (Clay Adams, Parsippany, NJ) while the animals were under light
ether anesthesia. Both cannulas were exteriorized to the dorsal side of the neck and terminated with long
silastic tubing (Dow Corning, Midland, MI). Both silastic tubings were inserted into a wire sheath to
allow free movement of the rat. The exposed areas were surgically sutured. Each rat was housed
individually in a rat metabolic cage (Daejong Scientific Company, Seoul, Korea) and was allowed to
recover from the anesthesia for 4 ꢁ 5 hr before commencement of the experiment. They were not
restrained during the study. Heparinized 0.9% NaCl-injectable solution (20 units/ml), 0.3 ml, was used to
flush each cannula to prevent blood from clotting.
Intravenous study
Aminophylline, 5 mg/kg as theophylline diluted in 0.9% NaCl-injectable solution, was infused over
1-min via the jugular vein of control rats (n = 13) and NARs (n = 13). The injection volume was
approximately 1 ml. Approximately, a 0.12-ml aliquot of blood was collected via the carotid artery at 0
(to serve as a control), 1 (at the end of the infusion), 5, 15, 30, 45, 60, 90, 120, 180, 240 and 300 min
after intravenous administration. The blood samples were centrifuged immediately and a 50-Al aliquot of
each plasma sample was stored in a ꢁ 70jC freezer until HPLC analysis of theophylline and 1,3-DMU
[13]. The heparinized 0.9% NaCl-injectable solution, 0.3 ml, was used to flush the cannula immediately
after each blood sampling. At the end of 24 hr, as much blood as possible was collected and plasma was
stored in a ꢁ 70jC freezer until the measurement of protein binding. Each rat was exsanguinated and
sacrificed by cervical dislocation. At the same time, the metabolic cage was rinsed with 10 ml of distilled
water. The rinsings were combined with the 24-hr urine sample. After measuring the exact volume of
combined urine, an aliquot of each urine sample was stored in a ꢁ 70jC freezer until the analysis of
theophylline, 1,3-DMU and 1-MU [13]. Similar experiment was also performed with 1,3-DMU. 1,3-
DMU (the 1,3-DMU powder was dissolved in distilled water with minimum amount of NaOH), 5 mg/

E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
1235
kg, was infused over 1-min to control rats (n = 5) and NARs (n = 3). Total injection volume was
approximately 1 ml.
Plasma protein binding study
The binding of theophylline to plasma protein was determined using an equilibrium dialysis
technique [14]. One ml of plasma was dialyzed against 1 ml of isotonic Sørensen phosphate buffer
(pH 7.4) containing 3.0% dextran (‘the buffer’) to minimize volume shift with a 1 ml dialysis cell
(Fisher Scientific, Fair Lawn, NJ) and Spectral/Por 4 membrane (molecular weight cutoff of
12000 ꢁ 14000; Spectrum Medical Industries Inc., Los Angeles, CA). Theophylline was spiked into
the plasma side at theophylline concentration of 5 Ag/ml. The spiked dialysis cell was incubated for
24-hr in a water-bath shaker kept at 37jC and at a rate of 50 opm [14]. Similar experiment was also
performed with 1,3-DMU at 1,3-DMU concentration of 1 Ag/ml. Equilibrium of theophylline between
rat plasma and ‘the buffer’ in the dialysis cell was found to be established after 4 hr incubation and
the binding value was not influenced for up to 24 hr incubation at an initial theophylline concentration
of 5 Ag/ml.
Biliary excretion study
In the early morning, the jugular vein and the bile duct of each control rat and NAR were catheterized
with polyethylene tubing (Clay Adams) while each rat was lightly anesthetized with ether. Aminophyl-
line, 5 mg/kg as theophylline diluted in 0.9% NaCl-injectable solution, was infused over 1-min via the
jugular vein of control rats (n = 4) and NARs (n = 4). The injection volume was approximately 1 ml.
Each rat was kept in supine position during the entire experiment by tying four feet on a plate. Bile juice
was collected between 0–8 hr. After measuring the exact volume of bile juice, an aliquot of bile sample
was stored in a ꢁ 70jC freezer until HPLC analysis of theophylline and 1,3-DMU [13].
HPLC analysis of theophylline, 1,3-DMU and/or 1-MU
The concentrations of theophylline and its metabolites in the above biological samples were analyzed
by the reported HPLC method [13]; a 300-Al aliquot of acetonitrile (containing 2 Ag/ml of the internal
standard, h-hydroxyethyl theophylline) was added to a 50-Al aliquot of biological sample. After vortex-
mixing and centrifugation, a 300-Al aliquot of supernatant was evaporated under N2 gas. The residue was
reconstituted with a 100-Al aliquot of the mobile phase and a 50-Al aliquot of the supernatant was
injected directly onto the HPLC column. The mobile phase, 10 mM acetate buffer (pH 5.0): acetonitrile :
tetrahydrofuran (94:5:1, v/v/v), was run at a flow rate of 1.0 ml/min and the column effluent was
monitered by a UV detector set at 280 nm. The detection limits of theophylline and 1,3-DMU in rat
plasma were 100 and 50 ng/ml, respectively, and the detection limits of theophylline, 1,3-DMU and 1-
MU in rat urine were 100, 100 and 200 ng/ml, respectively. The coefficients of variation of the assay
(within- and between-day) were generally low (below 8.90%).
The concentrations of 1.3-DMU in the microsomal samples (for the measurement of Vmax, Km and
CLint) were analyzed by a slight modification of the reported method [11]; a 50-Al aliquot of the
ꢀ
supernatant was injected directly onto a reversed-phase (C18) column (4.6 mm, i.d.
150 mm, l.;
particle size, 5 Am; YMC, Kyoto, Japan). The mobile phase, 10 mM acetate buffer (pH 4.5): acetonitrile

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E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
(95:5, v/v), was run at a flow rate of 1.0 ml/min and the column effluent was monitered by a UV detector
set at 280 nm. The detection limit of 1,3-DMU was 100 ng/ml. The coefficients of variation of the assay
(within-day) were generally low (below 3.56%).
Pharmacokinetic analysis
The total area under the plasma concentration-time curve from time zero to time infinity (AUC) was
calculated using the trapezoidal rule-extrapolation method; this method employed the logarithmic
trapezoidal rule [15] for the calculation of area during the declining plasma-level phase and the linear
trapezoidal rule for the rising plasma-level phase. The area from the last data point to time infinity was
estimated by dividing the last measured concentration by the terminal rate constant.
Standard methods [16] were used to calculate the following pharmacokinetic parameters: the time-
averaged total body clearance (CL), area under the first moment of plasma concentration-time curve
(AUMC), mean residence time (MRT), apparent volume of distribution at steady-state (Vss), and time-
averaged renal (CLR) and nonrenal (CLNR) clearances [17];
CL ¼ Dose=AUC
ð1Þ
ð2Þ
Z
l
AUMC ¼
t ꢀ Cpdt
0
MRT ¼ AUMC=AUC
VSS¼ CL ꢀ MRT
ð3Þ
ð4Þ
ð5Þ
ð6Þ
CLR ¼ Ae0!24 hr=AUC
CLNR ¼ CL ꢁ CLR
where Cp is the plasma concentration of theophylline or 1,3-DMU at time t and Ae0 ! 24 hr is the total
amount of unchanged theophylline or 1,3-DMU excreted in urine for up to 24 hr. The AUC instead of
AUC0 ! 24
was employed in the calculation of CLR of theophylline or 1,3-DMU, since, the
hr
contribution of AUC24 hr ! l to AUC were less than 0.191% for both theophylline and 1,3-DMU in
both rats.
The mean values of each clearance [18], Vss [19] and terminal half-life [20] were calculated using the
harmonic mean method.
Statistical analysis
The differences between the two means for unpaired data were assessed by t-test. A P value of less
than 0.05 was considered to be statistically significant. All results are expressed as mean F SD.

E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
1237
Results
Measurement of Vmax, Km and CLint for the formation of 1,3-DMU from theophylline in hepatic
microsomal fraction
The Vmax, Km and CLint for the formation of 1,3-DMU from theophylline in hepatic microsomal
fraction in control rats and NARs are listed in Table 1. The Vmax values were not significantly different
between two groups of rats; however, the Km in NARs was significantly lower (23.4% decrease) than
that in control rats. Hence, the CLint in NARs was significantly faster (48.3% increase) than that in
control rats suggesting that the clearance of theophylline to form 1,3-DMU could be faster in NARs than
that in control rats. This experiment was performed again (n = 5 for each rat) and the results were very
similar to those in Table 1. The Vmax, Km and CLint values were 450 F 24.9 versus 473 F 14.3 pmol/
mg/min (P = 0.116429), 3.21 F 0.702 versus 2.52 F 0.301 mM (P = 0.077264) and 144 F 23.0
versus 190 F 18.9 10ꢁ 6 ml/min (P = 0.009229), respectively. The above data indicated that the affinity
of theophylline for the enzyme could increase in NARs.
Intravenous study
Many investigators have reported the dose-dependent metabolic disposition of theophylline in
humans [21,22] and in rats [9]. Therefore, theophylline dose, 5 mg/kg, which has been reported to be
in the dosing range demonstrating linear pharmacokinetics in rats [9], was administered intravenously to
rats. The mean arterial plasma concentration-time profiles of theophylline and 1,3-DMU after intra-
venous administration of theophylline, 5 mg/kg, to control rats (n = 13) and NARs (n = 13) are shown in
Fig. 1, and relevant pharmacokinetic parameters are listed in Table 2. After intravenous administration of
theophylline, the plasma concentrations of theophylline declined in a polyexponential fashion for both
groups of rats (Fig. 1) with mean terminal half-lives of 140 min for control rats and 153 min for NARs
(Table 2). The half-lives were not significantly different between two groups of rats. The MRTs were
also not significantly different between two groups of rats (Table 2). However, the AUC of theophylline
in NARs was significantly smaller (40.6% decrease) than that in control rats due to significantly faster
CL of theophylline (68.2% increase) in the rats (Table 2). The faster CL of theophylline in NARs was
due to significantly faster CLR (143% increase) and CLNR (49.3% increase) of theophylline than those in
control rats (Table 2).
The faster CLR in NARs could be due to significantly greater 24-hr urinary excretion of unchanged
theophylline (Ae, Theo, 0 ! 24 hr, 36.2% increase) and significantly smaller AUC of theophylline than
Table 1
Mean ( F SD) Vmax, Km and CLint for the formation of 1,3-DMU from theophylline in hepatic microsomes of control rats and
NARs
Parameters
Control rats (n = 6)
NARs (n = 6)
Vmax (pmol/mg/min)
Km (mM)
CLint (10ꢁ 6 ml/min)
610 F 142
3.37 F 0.571
180 F 22.2
688 F 84.2
2.58 F 0.190*
267 F 37.5**
* P < 0.01.
** P < 0.001 compared with control.

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E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
Fig. 1. Mean arterial plasma concentration-time profiles of theophylline (circle) or 1,3-DMU (rectangle) after 1-min intravenous
infusion of aminophylline, 5 mg/kg as theophylline, to control rats (closed symbol, n = 13) and mutant Nagase analbuminemic
rats (open symbol, n = 13). Vertical bars represent SD.
those in control rats (Table 2). The role of protein binding in circulating blood in renal excretion of
compound having low plasma protein binding, theophylline, in NARs was also observed. Considering
the plasma protein binding and CLR of theophylline (Table 2), the estimated CLR values for unbound
(free in plasma) theophylline were 0.781 and 1.58 ml/min/kg for control rats and NARs, respectively; the
values were considerably smaller than the reported glomerular filtration rate (GFR), 5.24 ml/min/kg, in
rats [23]. The above data indicated that theophylline was reabsorbed in the renal tubules for both groups
of rats. The estimated CLR value for unbound theophylline in NARs was considerably faster (102%
increase) than that in control rats suggesting that the renal reabsorption of theophylline was inhibited in
NARs. Renal tubular reabsorption of theophylline was also reported in other rat studies [24].
Considering CLR of theophylline based on plasma data (Table 2) and reported kidney blood flow of
36.8 ml/min/kg [23] and hematocrit of approximately 45% [25] in rats, the estimated renal extraction
ratios (CLR/renal plasma flow, only for urinary excretion of unchanged drug) of theophylline were 2.82
and 6.87% for control rats and NARs, respectively. The above data indicated that theophylline was
extracted poorly via the kidney for both groups of rats and renal extraction of unchanged theophylline
increased in NARs. Therefore, the faster CLR of theophylline in NARs could be due to increase in renal
extraction ratio of theophylline mainly because of decrease in renal reabsorption of theophylline. In
NARs, the significantly greater Ae, Theo, 0 ! 24 hr (% of dose) could be at least partly due to significant
increase in free fraction of theophylline in plasma (Table 2).
The CLNR of theophylline was also significantly faster in NARs than that in control rats (Table 2).
This could be due to 3.5- to 4-fold increase in CYP1A2 in NARs since theophylline was metabolized

E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
1239
Table 2
Mean ( F SD) pharmacokinetic parameters of theophylline and its metabolites after 1-min intravenous infusion of
aminophylline, 5 mg/kg as theophylline, to control rats and NARs
Parameters
Control rats (n = 13)
NARs (n = 13)
Theophylline
Terminal half-life (min)
AUC (Ag min/ml)
MRT (min)
140 F 20.3
1750 F 251
183 F 25.6
2.86 F 0.546
0.571 F 0.343
2.25 F 0.351
523 F 60.5
337 F 111
153 F 17.8
1040 F 128***
182 F 26.0
4.81 F 0.596***
1.39 F 0.399***
3.36 F 0.363***
860 F 152***
444 F 78.2**
30.1 F 5.28**
12.0 F 1.83***
CL (ml/min/kg)
CLR (ml/min/kg)
CLNR (ml/min/kg)
VSS (ml/kg)
Ae, Theo, 0 ! 24 hr (Ag)
Ae, Theo, 0 ! 24 hr (% of dose)
Protein binding (%)
22.1 F 7.09
26.9 F 5.24
1,3-DMU
Terminal half-life (min)
AUC (Ag min/ml)
144 F 48.5
152 F 71.9
324 F 87.4
21.2 F 5.73
174 F 33.9
66.1 F 8.84**
228 F 94.8*
15.5 F 6.76*
Ae, 1,3-DMU, 0 ! 24 hr (Ag)a
Ae, 1,3-DMU, 0 ! 24 hr (% of dose)a
1-MU
Ae, 1-MU, 0 ! 24 hr (Ag)a
226 F 59.3
14.8 F 3.95
125 F 48.0***
8.47 F 3.36***
Ae, 1-MU, 0 ! 24 hr (% of dose)a
a
Expressed in terms of theophylline.
* P < 0.05.
** P < 0.01.
*** P < 0.001 compared with control.
to 1,3-DMU via CYP1A2 and CYP2E1 and to 1-MU via CYP1A2 in rats [9]. CYP2E1 was not
changed in NARs. The contribution of biliary excretion of unchanged theophylline to CLNR of
theophylline was almost negligible; the percentages of intravenous dose of theophylline excreted in 8-
hr bile juice as unchanged theophylline were 2.29 F 0.292 and 2.77 F 1.13% for control rats and
NARs, respectively (the corresponding values for 1,3-DMU were 7.42 F 3.44 and 7.78 F 2.65%).
The above data suggested that the CLNR values of theophylline listed in Table 2 could represent
metabolic clearances of theophylline. Hence, it could be concluded that the nonrenal metabolism of
theophylline was faster in NARs than that in control rats. The faster CLNR of theophylline in NARs
could be supported by significantly faster intrinsic 1,3-DMU formation clearance (CLint) in NARs
(Table 1). The contributions of CLR to CL of theophylline were 20.0 and 28.9% for control rats and
NARs, respectively (Table 2).
In NARs, the AUC of theophylline was significantly smaller (40.6% decrease) and hence the CL of
theophylline was significantly faster (68.2% increase) than those in control rats (Table 2). Similar results
were also reported [26] in spontaneously hyperlipidemic rats with hypoalbuminemia (HLRs, which had
approximately one half the serum albumin concentration of control Sprague-Dawley rats). After
administration of theophylline, 10 mg/kg, to HLRs, the AUC of theophylline was significantly smaller
(36.0% decrease) and the CL of theophylline was significantly faster (57.1% increase) than those in

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control rats [26]. Although the changes in AUC and CL of theophylline were similar between HLRs [26]
and NARs (Table 2), the explanation for the difference was not the same. In HLRs, the enzymatic
activities and apoprotein expression levels of CYP1A2 decreased significantly compared with the
control [26]. Hence, the changes of AUC and CL of theophylline in HLRs were explained by
significantly larger volume of distribution of theopylline due to significant increase in unbound fraction
of theophylline in HLRs [26].
The VSS of theophylline was significantly larger (64.4% increase) in NARs and this could be due to
significant increase in unbound fraction of theophylline in NARs (Table 2). It was also reported that in
NARs, tissue distribution (volume of distribution) of mercapturic acid [2], phenolsulfonphthalein [3,4],
furosemide [5], salicylic acid [8], taurocholic acid (plasma protein binding values were 76 and 24% for
control rats and NARs, respectively) [27], phenytoin (plasma protein binding values were 92.8 and
60.3% for control rats and NARs, respectively) [28] and warfarin [6] increased significantly compared
with those in control rats due to significant increase in unbound fraction in the rats. However, tissue
distribution of bumetanide was comparable between two groups of rats although the unbound fraction
increased significantly in NARs [7]. The tissue distribution and protein binding of cisplatin were
reported to be comparable between two groups of rats [29].
The mean arterial plasma concentration-time profiles of 1,3-DMU after intravenous administration of
1,3-DMU, 5 mg/kg, to control rats (n = 5) and NARs (n = 3) are shown in Fig. 2, and relevant
pharmacokinetic parameters are listed in Table 3. After intravenous administration of 1,3-DMU, the
plasma concentrations of 1,3-DMU declined in a polyexponential fashion for both groups of rats (Fig.
Fig. 2. Mean arterial plasma concentration-time profiles of 1,3-DMU after 1-min intravenous infusion of 1,3-DMU, 5 mg/kg, to
control rats (closed symbol, n = 5) and mutant Nagase analbuminemic rats (open symbol, n = 3). Vertical bars represent SD.

E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
1241
Table 3
Mean ( F SD) pharmacokinetic parameters of 1,3-DMU after 1-min intravenous infusion of 1,3-DMU, 5 mg/kg, to control rats
and NARs
Parameters
Control rats (n = 5)
NARs (n = 3)
Terminal half-life (min)
AUC (Ag min/ml)
MRT (min)
10.5 F 3.83
329 F 23.2
5.15 F 1.47
15.2 F 1.08
12.9 F 1.38
1.95 F 0.969
75.0 F 16.9
1330 F 115
77.6 F 5.19
20.7 F 6.03
12.8 F 0.656
301 F 36.6
7.38 F 2.11
16.6 F 1.90
9.89 F 2.89
5.16 F 4.05
116 F 46.3
802 F 257**
57.7 F 17.6*
21.0 F 1.61
CL (ml/min/kg)
CLR (ml/min/kg)
CLNR (ml/min/kg)
VSS (ml/kg)
Ae, 1,3-DMU, 0 ! 24 hr (Ag)a
Ae, 1,3-DMU, 0 ! 24 hr (% of dose)a
Protein binding (%)
a
Expressed in terms of theophylline.
* P < 0.05.
** P < 0.01 compared with control.
2). The terminal half-lives of 1,3-DMU were very short; the mean values were 10.5 min for control rats
and 12.8 min for NARs (Table 3). As expected from very short terminal half-life, 1,3-DMU was
eliminated fast from rats; the CLs of 1,3-DMU were 5.31 and 3.45 times faster (Table 3) than those of
theophylline (Table 2) in control rats and NARs, respectively. Considering the plasma protein binding
and CLR of 1,3-DMU (Table 3), the estimated CLR values for unbound 1,3-DMU were 16.3 and 12.5
ml/min/kg for control rats and NARs, respectively; the values were considerably greater than the
reported GFR, 5.24 ml/min/kg, in rats [23]. The above data indicated that 1,3-DMU was secreted in the
renal tubules for both groups of rats, but the renal secretion of 1,3-DMU was inhibited in NARs. Renal
tubular secretion of 1,3-DMU was also reported in other rat studies [24]. Considering the CLR of 1,3-
DMU based on plasma data (Table 3) and reported kidney blood flow of 36.8 ml/min/kg [23] and
hematocrit of approximately 45% [25] in rats, the estimated renal extraction ratios (only for urinary
excretion of unchanged drug) of 1,3-DMU were 63.7 and 48.9% for control rats and NARs,
respectively. The values were considerably greater than those of theophylline as mentioned earlier.
The above data indicated that 1,3-DMU was extracted considerably via kidney for both groups of rats.
In NARs, Ae, 1,3-DMU, 0 ! 24 hr was significantly smaller (25.6% decrease) and this could be due to
inhibition of renal tubular secretion and decrease in renal extraction ratio of 1,3-DMU. In NARs, the
significant decrease in Ae, 1,3-DMU, 0 ! 24 hr (% of dose) was not due to decrease in free fraction of 1,3-
DMU in plasma; the unbound fractions in plasma were 79.3 and 79.0% for control rats and NARs,
respectively (Table 3).
Unexpectedly, the AUCs of 1,3-DMU were comparable between control rats and NARs after
intravenous administration of 1,3-DMU (Table 3). Similar results were also reported for cisplatin
(protein binding values were 52.9–59.6 and 56.8–68.0% for control rats and NARs, respectively) [29],
bilirubin [30], inulin (negligible protein binding) [2] and [14C]antipyrine (negligible protein binding) and
[14C]urea [8]. However, in NARs, the AUC (or AUC0-t) values of mercapturic acid (44.9% decrease) [2],
phenolsulfonphthalein (91.3% decrease [3] and 81.4% decrease [4]), sulfobromophthalein (40.6%
decrease) [31], taurocholic acid (56.4% decrease) [27], furosemide (61.5% decrease) [5], warfarin
(98.4 and 95.4% decrease at warfarin doses of 1 and 40 mg/kg, respectively) [6], bumetanide (59.1%

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decrease) [7], phenytoin (50% decrease) [28], salicylic acid (83.0 and 17.6% decrease at salicylic acid
doses of 10 and 173 mg/kg, respectively [8], and 68.9% decrease at salicylic acid dose of 100 ACi/kg
[32]), azosemide (81.9% decrease, the protein binding values were 97.9 and 84.6% for control rats and
NARs, respectively) (our unpublished data) and torasemide (88.8% decrease, the protein binding values
were 94.1 and 23.3% for control rats and NARs, respectively) [33] decreased significantly compared
with those in control rats. Although the exact reasons are not clear, the differences in AUC (or CL) of
compounds between control rats and NARs could not be due to the differences in acidity or basicity of
compounds or in pharmacokinetic parameters (such as volume of distribution, fraction of dose excreted
via kidney, protein binding, etc). The AUC differences could depend on compounds and at least partly
due to doses of compounds; the AUC difference increased with decreasing doses. For example, the
AUCs of bilirubin were not significantly different between two groups of rats at trace amount, but were
significantly different at loading amount [30]. The AUC differences of warfarin [6] and salicylic acid [8]
were greater at 1 mg/kg than those at 40 mg/kg [6] and at 10 mg/kg than those at 173 mg/kg [8],
respectively. The contributions of CLR to CL of 1,3-DMU were 84.9 and 59.6% for control rats and
NARs, respectively (Table 3).
The mean arterial plasma concentration-time profiles of 1,3-DMU after intravenous administration of
theophylline, 5 mg/kg, to control rat and NARs are also shown in Fig. 1 and the relevant
pharmacokinetic parameters are also listed in Table 2. After intravenous administration of theophylline,
the formation of 1,3-DMU was fast; 1,3-DMU was detected in plasma from the first blood sampling time
(1 min) as shown in Fig. 1. After intravenous administration of 1,3-DMU to both groups of rats, the
plasma concentrations of 1,3-DMU declined fast (due to fast CL) with mean terminal half life of 10.5–
12.8 min (Table 3) and 1,3-DMU were detected in plasma only up to 60 min (Fig. 2). However, after
intravenous administration of theophylline, plasma concentrations of 1,3-DMU were ‘almost’ constant
during 30–300 min (Fig. 1) and mean terminal half-lives were 140–153 min (Table 2). The above data
indicated that 1,3-DMU was continuously formed from theophylline after intravenous administration of
theophylline for both groups of rats. After intravenous administration of theophylline to NARs, the AUC
of 1,3-DMU (56.5% decrease) and Ae, 1,3-DMU, 0 ! 24 hr (26.9% decrease) were significantly smaller than
those in control rats (Table 2). The Ae, 1-MU, 0 ! 24 hr was also significantly smaller (42.8% decrease) in
NARs (Table 2).
Discussion
It has been reported that the expression of CYP1A2 was decreased in HLRs, which had approximately
one half the serum albumin concentration of the Sprague-Dawley rats [26]. In the present study,
CYP1A2 was induced in NARs. The plasma albumin level in NARs used in the present study is
approximately one thousandth of control animals [34]. Hence, CYP1A2 expression in NARs appeared to
be completely different from that in HLRs presumably because of the difference in pathophysiology (e.g.
metabolic function).
After intravenous administration of theophylline to NARs, the pharmacokinetic parameters of
theophylline were changed compared with control rats; while the AUC was significantly smaller, CL,
CLR and CLNR were significantly faster and VSS and Ae, Theo, 0 ! 24 hr (amount and percentages of
intravenous dose) were significantly greater than those in control rats (Table 2). In NARs, significantly
faster CLR of theophylline was due to inhibition of renal tubular reabsorption and significantly faster

E.J. Kim et al. / Life Sciences 72 (2003) 1231–1245
1243
CLNR of theophylline was due to 3.5- to 4-fold increase in CYP1A2 in the rats. In NARs, the AUC of
1,3-DMU, Ae, 1,3-DMU, 0 ! 24 hr and Ae, 1-MU, 0 ! 24 hr were significantly smaller than those in control rats
(Table 2).
In the present study, the renal reabsorption of theophylline and renal secretion of 1,3-DMU were
inhibited in NARs. This provoked us to elucidate the renal excretion mechanism of compounds (or
drugs) in NARs and the following results were obtained. The renal secretion of the following
compounds was inhibited in NARs. First, the estimated renal clearances of mercapturic acid based
on unbound (free) fraction in plasma were 72.9 and 14.3 ml/min/kg for control rats and NARs,
respectively [2]. The values for both control rats and NARs were greater than the reported GFR value,
5.24 ml/min/kg, in control rats [23], indicating that mercapturic acid is secreted in the renal tubule for
both groups of rats. However, the value in NARs was considerably slower (80.4% decrease) than that in
control rats. Second, the estimated unbound renal clearances of phenolsulfonphthalein were 41.3 and
17.8 ml/min/kg for control rats and NARs, respectively, using protein binding value at phenolsulfonph-
thalein concentration of 0.1 mmol/l [3]. The values in both control rats and NARs were also greater than
the reported GFR value [23], indicating that phenolsulfonphthalein is secreted in the renal tubule for
both groups of rats. However, the value in NARs was considerably slower (56.9% decrease) than that in
control rats. Third, the estimated unbound renal clearances of furosemde were 222 and 1.94 ml/min/kg
for control rats and NARs, respectively [5]. The value in NARs was considerably slower (99.1%
decrease) than that in control rats. Above data indicated that furosemide is mainly secreted in renal
tubule for control rats and reabsorbed in the renal tubule for NARs. It was reported [35] that furosemide
is reabsorbed at distal tubule and collecting duct in rats. Fourth, the estimated unbound renal clearance
values of bumetanide were 11.5 and 2.36 ml/min/kg for control rats and NARs, respectively [7]. The
value in NARs was considerably slower (79.5% decrease) in control rats. Above data indicated that
bumetanide is mainly secreted in renal tubule for control rats and reabsorbed in renal tubule for NARs.
It was reported [36] that bumetanide was reabsorbed in renal tubule in the rabbits, and the renal
clearance of bumetanide was dependent on urine flow rate. Fifth, the estimated unbound renal
clearances of salicylic acid were 8.70 and 4.73 ml/min/kg for control rats and NARs, respectively
[8]. The value in NARs was considerably slower (45.6% decrease) than that in control rats. Above data
indicated that salicylic acid is mainly secreted for control rats and filtered by glomerulus for NARs.
Finally, in the present 1,3-DMU study (Table 3), the renal secretion of 1,3-DMU was inhibited in NARs
as mentioned earlier.
Interestingly, the renal reabsorption of the following compounds was also inhibited in NARs. First,
the estimated unbound renal clearance values of warfarin were 0.308 and 1.63 ml/min/kg for control rats
and NARs, respectively [6]. The above data indicated that warfarin is reabsorbed in renal tubule for both
groups of rats. However, the value in NARs was considerably faster (429% increase) than that in control
rats indicating that reabsorption of warfarin was inhibited in NARs. Second, in the present study, the
renal reabsorption of theophylline was inhibited in NARs as mentioned earlier. More studies are required
which renal transport system(s) could be inhibited in NARs.
Acknowledgements
This study was supported in part by a grant from the Korea Ministry of Health & Welfare (01-PJ1-
PG3-21700-0003), 2001-2003.

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