Microdialysis study of zidovudine (AZT) transport in rat brain.

The concentration profiles of [14C]3'-azido-3'-deoxythymidine (AZT) emanating from an acutely implanted microdialysis probe were measured in rat caudate putamen by quantitative autoradiography for infusions of 14 min and 1 and 2 h. A mathematical model which simulated diffusive solute transport, unaffected by the processes of microvascular exchange or tissue metabolism, did not fit the observed concentration profiles. Chromatographic analysis of brain homogenates for metabolites of AZT showed that the rate of metabolic transformation was not large enough to affect transport of the drug through the brain tissue. A model simulating the effect of microvascular exchange on the diffusion profiles fit the observed concentration profiles and the transient change in the dialysate extraction fraction. This analysis yielded an estimated tissue elimination rate constant for microvascular exchange of Kel = 0.013 ml/(g.min) and an intra- to extracellular partition coefficient of K pi = 1.04. Inclusion of probenecid in the dialysate, together with an i.p. injection, led to a substantial increase in the diffusion distance of the labeled AZT from the microdialysis probe, suggesting at least a 4-fold decrease in the microvascular exchange rate constant. These results imply that AZT is actively transported out of the brain parenchyma to the microvasculature and that this active transport mechanism is responsible for the limited central nervous system penetration of systemically administered AZT, in spite of its high lipid solubility.