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Pharmacokinetic modeling of P-glycoprotein function at the rat and human blood–brain barriers studied with (R)-[11C]verapamil positron emission tomography

Julia Müllauer1, Claudia Kuntner1, Martin Bauer2, Jens P Bankstahl3, Markus Müller2, Rob A Voskuyl45, Oliver Langer12 and Stina Syvänen56*

Author Affiliations

1 Biomedical Systems, Health & Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, 2444, Austria

2 Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria

3 Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625, Germany

4 Epilepsy Institutes of The Netherlands Foundation, Achterweg 5, Heemstede, 2103 SW, The Netherlands

5 Division of Pharmacology, Leiden University, Einsteinweg 55, Leiden, 2333 CC, The Netherlands

6 Department of Public Health and Caring Sciences, Uppsala University, Rudbecklaboratoriet, Uppsala, 751 85, Sweden

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EJNMMI Research 2012, 2:58  doi:10.1186/2191-219X-2-58

Published: 16 October 2012



This study investigated the influence of P-glycoprotein (P-gp) inhibitor tariquidar on the pharmacokinetics of P-gp substrate radiotracer (R)-[11C]verapamil in plasma and brain of rats and humans by means of positron emission tomography (PET).


Data obtained from a preclinical and clinical study, in which paired (R)-[11C]verapamil PET scans were performed before, during, and after tariquidar administration, were analyzed using nonlinear mixed effects (NLME) modeling. Administration of tariquidar was included as a covariate on the influx and efflux parameters (Qin and Qout) in order to investigate if tariquidar increased influx or decreased outflux of radiotracer across the blood–brain barrier (BBB). Additionally, the influence of pilocarpine-induced status epilepticus (SE) was tested on all model parameters, and the brain-to-plasma partition coefficient (VT-NLME) was calculated.


Our model indicated that tariquidar enhances brain uptake of (R)-[11C]verapamil by decreasing Qout. The reduction in Qout in rats during and immediately after tariquidar administration (sevenfold) was more pronounced than in the second PET scan acquired 2 h after tariquidar administration (fivefold). The effect of tariquidar on Qout in humans was apparent during and immediately after tariquidar administration (twofold reduction in Qout) but was negligible in the second PET scan. SE was found to influence the pharmacological volume of distribution of the central brain compartment Vbr1. Tariquidar treatment lead to an increase in VT-NLME, and pilocarpine-induced SE lead to increased (R)-[11C]verapamil distribution to the peripheral brain compartment.


Using NLME modeling, we were able to provide mechanistic insight into the effects of tariquidar and SE on (R)-[11C]verapamil transport across the BBB in control and 48 h post SE rats as well as in humans.

Nonlinear mixed effects modeling; Positron emission tomography; (R)-[11C]verapamil; P-glycoprotein; Tariquidar; Pilocarpine-induced epilepsy; Species differences