Effect of 3'-azido-3'-deoxythymidine (AZT) on organic ion transport in rat renal brush border membrane vesicles.

3'-Azido-3'-deoxythymidine (AZT), a nucleoside analog which has potent activity against the acquired immunodeficiency virus, is actively secreted by the mammalian kidney. In order to study the mechanism of renal drug transport, the effect of AZT on the organic cation and organic anion transport systems in rat renal brush border membrane vesicles was examined by using a rapid filtration assay. The following prototypic substrates were used: [3H]N1-methylnicotinamide and [3H]tetraethylammonium for organic cations and p-[3H]aminohippurate for an organic anion. AZT inhibited pH-driven [3H]N'-methylnicotinamide transport (pHi = 6.0, pH0 = 7.5), but not as effectively as mepiperphenidol (MEPI), a known organic cation transport blocker; the corresponding IC50 values for AZT and MEPI were 2500 and 25 microM, respectively. Counterflow studies, which examined the capability of the drug to cross the plasma membrane, indicated that [3H] tetraethylammonium and MEPI trans-stimulated [3H]tetraethyl-ammonium uptake, but AZT did not. To clarify further the actions of AZT on the organic cation transporter, kinetic studies were undertaken. A Hanes-Woolf transformation of the data revealed that both AZT and MEPI inhibited [3H]N'-methylnicotinamide transport in a competitive manner. The specificity of competition was studied by looking at the effect of AZT on the organic anion transporter. Probenecid, a classical inhibitor of organic anion transport, blocked p-[3H]aminohippurate transport, but AZT did not. We conclude that AZT is a weak inhibitor of the renal brush border organic cation transport system.