Human Ontogeny of Drug Transporters: Review and Recommendations of the Pediatric Transporter Working Group

K L R Brouwer1, L M Aleksunes2, B Brandys3

  • 1Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Insights

Drug transporter activity in children is poorly understood, impacting pediatric pharmacotherapy. This review examines transporter development in children, highlighting knowledge gaps and recommending future research directions.

Area of Science:

  • Pharmacology
  • Pediatrics
  • Molecular Biology

Background:

  • Membrane-bound transporters are crucial for drug efficacy and safety.
  • Limited data exists on drug transporter ontogeny and function in pediatric populations.
  • Understanding transporter development is vital for optimizing pediatric pharmacotherapy.

Purpose of the Study:

  • To systematically review the ontogeny of clinically relevant membrane transporters in pediatric patients.
  • To identify knowledge gaps in pediatric drug transporter activity.
  • To provide recommendations for future research in pediatric pharmacotherapy.

Main Methods:

  • Systematic review of literature on membrane transporter ontogeny (SLC, ABC superfamilies).
  • Focus on transporters in the intestine, liver, and kidney.
  • Analysis of developmental patterns of individual transporters.

Main Results:

  • Significant variability in the developmental patterns of different drug transporters was observed.
  • Substantial knowledge gaps remain regarding transporter expression and function in children.
  • Specific transporters show distinct ontogenic trajectories in pediatric organs.

Conclusions:

  • Further research is essential to elucidate drug transporter ontogeny in children.
  • Addressing these knowledge gaps will improve the safety and efficacy of pharmacotherapy in pediatric patients.
  • Recommendations are provided to guide future investigations into pediatric transporter biology.

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