Ontogeny of Small Intestinal Drug Transporters and Metabolizing Enzymes Based on Targeted Quantitative Proteomics

Drug Metab Dispos. 2021 Dec;49(12):1038-1046. doi: 10.1124/dmd.121.000559. Epub 2021 Sep 21.


Most drugs are administered to children orally. An information gap remains on the protein abundance of small intestinal drug-metabolizing enzymes (DMEs) and drug transporters (DTs) across the pediatric age range, which hinders precision dosing in children. To explore age-related differences in DMEs and DTs, surgical leftover intestinal tissues from pediatric and adult jejunum and ileum were collected and analyzed by targeted quantitative proteomics for apical sodium-bile acid transporter, breast cancer resistance protein (BCRP), monocarboxylate transporter 1 (MCT1), multidrug resistance protein 1 (MDR1), multidrug resistance-associated protein (MRP) 2, MRP3, organic anion-transporting polypeptide 2B1, organic cation transporter 1, peptide transporter 1 (PEPT1), CYP2C19, CYP3A4, CYP3A5, UDP glucuronosyltransferase (UGT) 1A1, UGT1A10, and UGT2B7. Samples from 58 children (48 ileums, 10 jejunums, age range: 8 weeks to 17 years) and 16 adults (8 ileums, 8 jejunums) were analyzed. When comparing age groups, BCRP, MDR1, PEPT1, and UGT1A1 abundance was significantly higher in adult ileum as compared with the pediatric ileum. Jejunal BCRP, MRP2, UGT1A1, and CYP3A4 abundance was higher in the adults compared with children 0-2 years of age. Examining the data on a continuous age scale showed that PEPT1 and UGT1A1 abundance was significantly higher, whereas MCT1 and UGT2B7 abundance was lower in adult ileum as compared with the pediatric ileum. Our data contribute to the deeper understanding of the ontogeny of small intestinal drug-metabolizing enzymes and drug transporters and shows DME-, DT-, and intestinal location-specific, age-related changes. SIGNIFICANCE STATEMENT: This is the first study that describes the ontogeny of small intestinal DTs and DMEs in human using liquid chromatography with tandem mass spectrometry-based targeted quantitative proteomics. The current analysis provides a detailed picture about the maturation of DT and DME abundances in the human jejunum and ileum. The presented results supply age-related DT and DME abundance data for building more accurate PBPK models that serve to support safer and more efficient drug dosing regimens for the pediatric population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily G, Member 2 / metabolism
  • Adult
  • Age Factors
  • Biological Transport, Active
  • Child
  • Chromatography, Liquid / methods
  • Cytochrome P-450 CYP3A / metabolism
  • Enzyme Assays / methods
  • Gene Ontology
  • Glucuronosyltransferase / metabolism
  • Humans
  • Inactivation, Metabolic / physiology*
  • Intestine, Small* / drug effects
  • Intestine, Small* / enzymology
  • Intestine, Small* / metabolism
  • Membrane Transport Proteins / metabolism*
  • Metabolic Clearance Rate
  • Multidrug Resistance-Associated Protein 2 / metabolism
  • Neoplasm Proteins / metabolism
  • Peptide Transporter 1 / metabolism
  • Tandem Mass Spectrometry / methods


  • ABCC2 protein, human
  • ABCG2 protein, human
  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • Membrane Transport Proteins
  • Multidrug Resistance-Associated Protein 2
  • Neoplasm Proteins
  • Peptide Transporter 1
  • SLC15A1 protein, human
  • Cytochrome P-450 CYP3A
  • UGT1A1 enzyme
  • Glucuronosyltransferase