Indocyanine Green biliary excretion

SKF 525-A did, however, depress the rate of biliary excretion of indocyanine green. This dye has a complex chemical structure, with one eat ionic and two anionic centers (see structure XXXIII). The liver seems to have independent mechanisms for the secretion of organic cations and anions (Schanker and Solomon, 1963). Thus it i.s possible that indocyanine green is excreted by both pathways, while succinylsulfathiazole and phenolphthalein glucuronide can be secreted only by the anionic route. SKF 525-A does not affect the biliarv excretion of these two anions,... 

Huang L, Vore M. Multi drug resistance p-glycoprotein 2 is essential for the biliary excretion of indocyanine green. Dmg Metab Dispos 2001 29(5) 634-637. 

Source From Refs. 14 and 15. Table 5.8 Biliary Excretion of Indocyanine Green in Various Species ... 

The species pattern of the rabbit and the guinea pig being poor biliary excretors and the rat being an extensive biliary excretor is maintained with many other compounds. With compounds of higher molecular weight, however, species differences are less, as illustrated by the compound indocyanine green (Table 5.8). The metabolism of a compound obviously influences the extent of biliary excretion, and therefore species differences in metabolism may also be a factor. 

The dye removed from the plasma by the hepatic cells may be metabolized before excretion into bile as in the case of BSP, or it may be excreted without metabolism, as in the case of rose bengal and indocyanine green. When BSP is injected intravenously there is a time lapse before it reaches maximum concentration in the bile (C2, C7, C8, C34, RIO). This has been attributed to storage of BSP in the liver and possibly to its conjugation, although some of the delay is due to the dead space of the biliary system in analogy to the delay time of the urinary tract (C18, M23). 

Chlorpromazine decreases BSP excretion in rats (C22) and in man (D8). However, in mice, the biliary excretion of BSP is not reduced by this drug (El). Chlorpromazine does not inhibit the clearance of either bilirubin or indocyanine green (H5), but its action and that of other phenothiazines (e.g., promazine, trifluoroperazine, prochlorperazine, and pecazine) is complex. These drugs, cause a cholestatic reaction with a transient cholestatic hepatitis (PIO, W4, Zl), with an incidence of approximately 1%. Thus, the effect on BSP retention may be a reflection of the cholestasis induced by these drugs. Their action may also be due to increased membrane permeability (H5). 

TABLE 5.8 Biliary excretion of indocyanine green in various speccies... 

FIGURE 8.4 Indocyanine green excretion rate (a) and Biliary acid output (b) as a function of liver ATP content (Chijiiwa et al. (2002), figures 1 and 2. Reproduced with permission of Springer). 

Chijiiwa K, Miznta A, Ueda J, Takamatsu Y, Nakamura K, Watanahe M, Kuroki S, Tanaka M (2002) Relation of biliary bile acid output to hepatic adenosine triphosphate level and biliary indocyanine green excretion in humans. World J Surg 26,457-61. 

Uesaka K,Nimura Y.Nagino M (1996) Changes in hepaticlobar function after right portal vein embolization. An appraisal by biliary indocyanine green excretion. Ann Surg 223 77-83... 

Treatment of mice or rats with phenobarbital significantly increases the rate of disappearance of exogenous bilirubin from the plasma which is accompanied by an increase in bile volume but no alteration in the concentration of bilirubin in the bile suggesting that the accelerated clearance results primarily from enhanced bile flow. However, there does not appear to be a direct relationship between increased biliary flow and microsomal enzyme induction because other enzyme inducers such as chlordane, nikethamide, phenylbutazone, 3-methylcholanthrene. 3,4-benzpyrene, or chlorcyclizine have no effect on bile flow. Other compounds whose rate of clearance from the plasma is accelerated by phenobarbital treatment are bromosulphophthalein (BSP), chlorothiazide, indocyanine green, probenecid, and chloramphenicol Enhanced clearance of the two latter compounds is associated with significant increases in the excretion of glucuronide conjugates. 

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