Aliases: HPECT1, HPEPT1
Gene name: Solute carrier family 15 member 1 (SLC15A1)
Human peptide transporter 1 (PEPT1) is an uptake transporter primarily responsible for the absorption of dietary di- and tripeptides from the small intestinal lumen. It is a high capacity, low affinity (KM of 0.2-10 mM), proton-coupled cotransporter of diverse di- and tripeptides and peptidomimetic substrates , and is primarily expressed on the apical microvilli of enterocytes in the small intestine, with lower expression in epithelial cells in the kidney proximal tubule. In the kidney, PEPT1 reabsorbs peptides from the primary filtrate in the proximal tubule, in conjunction with a similar transporter, PEPT2.
PEPT1 also mediates the active oral absorption of drugs that contain peptide-like structures, most prominently β-lactam antibiotics. This had led to its successful exploitation to improve the systemic exposure of some drugs, notably antivirals and ACE inhibitors; peptide and peptide bond-like prodrugs significantly improved the bioavailability of their active moieties by engaging PEPT1 in the small intestine [2-6]. As DDIs are not reported or anticipated, there are no recommendations for PEPT1 transporter investigation in either the FDA or EMA guidance.
PEPT1 is mainly expressed in the apical plasma membrane of enterocytes in the small intestine, in renal proximal tubular cells of the S1 segment, and in bile duct epithelial cells. Transport activity similar to PEPT1 was also observed in lysosomal membranes of hepatocytes, and immunoreactivity was observed in the nuclei of vascular smooth muscle cells , but the relevance of these findings are largely unexplored.
Function, physiology, and clinically significant polymorphisms
PEPT1 is a high capacity, low affinity, sodium-independent symporter, or cotransporter, which catalyzes the electrogenic uphill transport of L-enantiomers of di- and tri-peptides in a sequence-independent manner. Peptide translocation is coupled with the movement of H+, and the transmembrane electrochemical proton gradient provides the driving force. PEPT1 plays a key role in the supply of nitrogen to the body; it absorbs di- and tripeptides released by the digestion of dietary or endogenous proteins from the small intestine. As a high capacity, low affinity transporter of peptides, PEPT1 is not likely to saturate even at the very high substrate concentrations typically encountered in the intestine.
PEPT1-mediated active absorption is implicated in the high bioavailability of orally active peptide-based drugs (e.g. cephalosporins and penicillins) and ester prodrugs (e.g. ACE inhibitors, protease inhibitors, bestatin, valacyclovir, L-DOPA), as well as artificial di- and tripeptides such as Gly-Sar . Substances without obvious peptide-like bonds may also be substrates (e.g. δ-amino-levulonic acid, ω-amino fatty acids) . The large number of known substrate xenobiotics enables structure-based identification of possible substrates with good confidence .
Several inhibitors of PEPT1 have been identified: sulfonylurea antidiabetic drugs such as nateglinide, glibenclamide, tolbutamide and chlorpropamide, sartans, and the ester prodrugs of ACE inhibitors [10-12].
No reports of clinical DDIs due to PEPT1 inhibition have been posted thus far. Because of this, PEPT1 is not regarded as a likely candidate for DDI liabilities. However, a food-drug interaction between milk and the PEPT1 substrate olsetamavir has been reported . In vitro investigations suggest that quinolone antibiotics such as moxifloxacine may interfere with the absorption of PEPT1 substrates , and a mutual inhibition of PEPT1- and OAT1/3-driven absorption may exist between the protease inhibitor bestatin and cefixime .
Targeting intestinal uptake transporters such as PEPT1 by chemically modifying poorly absorbed drugs is a successful strategy for improving their bioavailability and therapeutic efficacy [16, 17]. Once absorbed, the resulting prodrugs undergo non-specific enzymatic cleavage, releasing the pharmacologically active parent compound. Because PEPT1 has broad substrate specificity for peptides, high capacity, a high level of expression in the intestinal epithelium, and relatively restricted expression elsewhere, it is an attractive target for prodrug strategies. A number of examples where this prodrug approach has been studied are listed below:
• Valacyclovir, the L-valyl ester pro-drug of acyclovir, has 3–5 times higher oral bioavailability than the parent molecule.
• Plasma ganciclovir concentrations are 10-time higher when dosed as the prodrug valganciclovir. [18, 19].
• Enalapril, the ester pro-drug of the ACE-inhibitor enalaprilat, is a substrate for PEPT1. Oral bioavailability of enalaprilat is increased from 3–12% to 60–70% on dosing the prodrug .
• Enhanced permeability over the parent molecule was observed for dipeptidyl derivatives of L-α-methyl-Dopa.
• Talaglumetad (LY544344), an L-alanylamide prodrug of LY354740, had improved oral bioavailability, facilitated by PEPT1 .
Known clinical consequences of PEPT1 genetic variants are scarce, although a number of SNPs have been identified. In a whole-genome analysis study, variation in SLC15A2 was associated with the response of hepatocellular carcinoma to sorafenib treatment: patients with the rs2257212 genotype showed longer progression-free survival .
PEPT1 appears to be upregulated in the colon of inflammatory bowel disease patients compared to healthy individuals. The significance of this finding is not well understood, but a number of studies confirmed PEPT1-mediated transport of peptides of bacterial origin into colonocytes, which may be a pro-inflammatory mechanism .
As DDIs are not reported or anticipated, there are no recommendations for PEPT1 transporter investigation in either the FDA or EMA guidance.
|Location||Endogenous substrates||In vitro substrates used experimentally||Substrate drugs||Inhibitors|
|small intestine, kidney||di- and tripeptides||Gly-Sar,
|cephalosporins and penicillins,
ACE inhibitor prodrugs,
w-amino fatty acids
4 -aminomethylbenzoic acid,
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