Effect of hypouricaemic and hyperuricaemic drugs on the renal urate efflux transporter, multidrug resistance protein 4
AAK El‐Sheikh, JJMW Van Den Heuvel… - British journal of …, 2008 - Wiley Online Library
AAK El‐Sheikh, JJMW Van Den Heuvel, JB Koenderink, FGM Russel
British journal of pharmacology, 2008•Wiley Online LibraryBackground and purpose: The xanthine oxidase inhibitors allopurinol and oxypurinol are
used to treat hyperuricaemia, whereas loop and thiazide diuretics can cause iatrogenic
hyperuricaemia. Some uricosuric drugs and salicylate have a bimodal action on urate renal
excretion. The mechanisms of action of these hypo‐and hyperuricaemic drugs on the
handling of urate in renal tubules have not been fully elucidated. Recently, we identified the
multidrug resistance protein (MRP) 4 as a luminal efflux transporter for urate in the proximal …
used to treat hyperuricaemia, whereas loop and thiazide diuretics can cause iatrogenic
hyperuricaemia. Some uricosuric drugs and salicylate have a bimodal action on urate renal
excretion. The mechanisms of action of these hypo‐and hyperuricaemic drugs on the
handling of urate in renal tubules have not been fully elucidated. Recently, we identified the
multidrug resistance protein (MRP) 4 as a luminal efflux transporter for urate in the proximal …
Background and purpose
The xanthine oxidase inhibitors allopurinol and oxypurinol are used to treat hyperuricaemia, whereas loop and thiazide diuretics can cause iatrogenic hyperuricaemia. Some uricosuric drugs and salicylate have a bimodal action on urate renal excretion. The mechanisms of action of these hypo‐ and hyperuricaemic drugs on the handling of urate in renal tubules have not been fully elucidated. Recently, we identified the multidrug resistance protein (MRP) 4 as a luminal efflux transporter for urate in the proximal tubule.
Experimental approach
Here, we studied the effect of these drugs on [14C]urate transport using human embryonic kidney 293 cells overexpressing human MRP4 and in membrane vesicles isolated from these cells.
Key results
Allopurinol stimulated MRP4‐mediated cellular urate efflux and allopurinol and oxypurinol both markedly stimulated urate transport by MRP4 in membrane vesicles. Bumetanide and torasemide had no effect, whereas furosemide, chlorothiazide, hydrochlorothiazide, salicylate, benzbromarone and sulfinpyrazone inhibited urate transport, at concentrations ranging from nanomolar up to millimolar. Probenecid stimulated urate transport at 0.1 μM and inhibited transport at higher concentrations.
Conclusions and implications
These data suggest that inhibition of MRP4‐mediated urate efflux by furosemide and thiazide diuretics could have an important function in their hyperuricaemic mechanisms. Furthermore, stimulation of MRP4‐mediated renal urate efflux could be a new mechanism in the hypouricaemic action of allopurinol and oxypurinol. In conclusion, MRP4 may provide a potential target for drugs affecting urate homoeostasis, which needs to be further evaluated in vivo.
British Journal of Pharmacology (2008) 155, 1066–1075; doi:10.1038/bjp.2008.343; published online 25 August 2008
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