The impact of desorption kinetics from albumin on hepatic extraction efficiency and hepatic clearance: a model study

Until now, the question whether slow desorption of compounds from transport proteins like the plasma protein albumin can affect hepatic uptake and thereby hepatic metabolism of these compounds has not yet been answered conclusively. This work now combines recently published experimental desorption rate constants with a liver model to address this question. For doing so, the used liver model differentiates the bound compound in blood, the unbound compound in blood and the compound within the hepatocytes as three well-stirred compartments. Our calculations show that slow desorption kinetics from albumin can indeed limit hepatic metabolism of a compound by decreasing hepatic extraction efficiency and hepatic clearance. The extent of this decrease, however, depends not only on the value of the desorption rate constant but also on how much of the compound is bound to albumin in blood and how fast intrinsic metabolism of the compound in the hepatocytes is. For strongly sorbing and sufficiently fast metabolized compounds, our calculations revealed a twentyfold lower hepatic extraction efficiency and hepatic clearance for the slowest known desorption rate constant compared to the case when instantaneous equilibrium between bound and unbound compound is assumed. The same desorption rate constant, however, has nearly no effect on hepatic extraction efficiency and hepatic clearance of weakly sorbing and slowly metabolized compounds. This work examines the relevance of desorption kinetics in various example scenarios and provides the general approach needed to quantify the effect of flow limitation, membrane permeability and desorption kinetics on hepatic metabolism at the same time.