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Gjestad C, Huynh DK, Haslemo T, Molden E. 4β-hydroxycholesterol correlates with dose but not steady-state concentration of carbamazepine: indication of intestinal CYP3A in biomarker formation? Br J Clin Pharmacol 2015; 81:269-76. [PMID: 26574235 DOI: 10.1111/bcp.12833] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 11/11/2015] [Accepted: 11/13/2015] [Indexed: 11/30/2022] Open
Abstract
AIM 4β-hydroxycholesterol (4βOHC) is an endogenous CYP3A(4) biomarker, which is elevated by use of the CYP3A4 inducer carbamazepine. Our aim was to compare to what extent serum concentration of 4βOHC correlates with dose (presystemic exposure) and steady-state concentration (systemic exposure) of carbamazepine. METHODS The study was based on a therapeutic drug monitoring material, including information about daily doses and steady-state concentrations (Css ) of carbamazepine. 4βOHC concentrations were determined in residual serum samples of 55 randomly selected carbamazepine-treated patients and 54 levetiracetam-treated patients (negative controls) by UPLC-APCI-MS/MS after liquid-liquid extraction. Correlation analyses between 4βOHC concentration and daily dose and Css of carbamazepine, respectively, were performed by Spearman's tests. In addition, 4βOHC concentrations in females vs. males were compared in induced and non-induced patients. RESULTS Median 4βOHC concentration was ~10-fold higher in carbamazepine- vs. levetiracetam-treated patients (650 vs. 54 nmol l(-1) , P < 0.0001). There was a significant, positive correlation between carbamazepine dose and 4βOHC concentration (Spearman r = 0.53, 95% confidence interval [CI] 0.27, 0.72, P < 0.001). No significant correlation between carbamazepine Css and 4βOHC concentration was found (Spearman r = 0.14; 95% CI -0.14, 0.40, P = 0.3). Enzyme-induced females had significantly higher 4βOHC concentrations than males (P < 0.001), while no significant gender difference was found in non-induced patients (P = 0.52). CONCLUSION Serum concentrations of 4βOHC correlate with presystemic, but not systemic exposure of the CYP3A4 inducer carbamazepine. This suggests a stronger inductive effect of carbamazepine on presystemic than systemic CYP3A4 phenotype and might indicate a role of the intestine in 4βOHC formation. Moreover, CYP3A4 inducibility seems to be higher in females than males.
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Affiliation(s)
| | - Duy Khanh Huynh
- Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Norway
| | - Tore Haslemo
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo
| | - Espen Molden
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo.,Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Norway
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Ekström L, Skilving I, Ovesjö ML, Aklillu E, Nylén H, Rane A, Diczfalusy U, Björkhem-Bergman L. miRNA-27b levels are associated with CYP3A activity in vitro and in vivo. Pharmacol Res Perspect 2015; 3:e00192. [PMID: 27022466 PMCID: PMC4777245 DOI: 10.1002/prp2.192] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/17/2015] [Indexed: 01/21/2023] Open
Abstract
Previous in vitro studies have shown that microRNA‐27b (miR‐27b) may regulate mRNA levels of CYP3A4, vitamin D receptor (VDR), and Peroxisome proliferator‐activated receptor α (PPARα) as well as CYP3A4 protein expression and activity. In vitro studies have also shown that vitamin D may affect the expression of CYP3A4. The primary aim of this pilot study was to investigate the association between miR‐27b and CYP3A expression and activity. The secondary aim was to investigate the association between 25‐hydroxy vitamin D in serum and CYP3A activity. Mi‐RNA‐27b was quantified using real‐time PCR in serum samples (n = 28) and 25‐hydroxyvitamin D was measured and correlated with the levels of the endogenous CYP3A activity marker 4β‐hydroxycholesterol. In addition, the correlation between miR‐27b and CYP3A activity, measured by dextromethorphan N‐demethylation and 6β‐hydroxylation of testosterone and the gene expression of CYP3A4, VDR and PPARα were assessed in 20 human liver samples. A significant association between circulatory miR‐27b levels and 4β‐hydroxycholesterol ratio was found; P = 0.04, and between hepatic miR‐27b levels and CYP3A activity, measured by dextromethorphan N‐demethylation in human liver (P = 0.04). There was no association between hepatic miR‐27b and mRNA levels of CYP3A4, VDR or PPARα. There was a significant association between serum 25‐hydroxyvitamin D levels and 4β‐hydroxycholesterol ratio, P = 0.002. In conclusion, this pilot‐study supports the hypothesis that miR‐27b levels as well as 25‐hydroxyvitamin D may affect CYP3A activity in vivo. The results indicate that miR‐27b exerts its inhibitory effect on a translational level rather than affecting mRNA levels.
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Affiliation(s)
- Lena Ekström
- Division of Clinical Pharmacology Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden
| | - Ilona Skilving
- Division of Clinical Pharmacology Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden
| | - Marie-Louise Ovesjö
- Division of Clinical Pharmacology Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden
| | - Eleni Aklillu
- Division of Clinical Pharmacology Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden
| | - Hanna Nylén
- Division of Clinical Chemistry Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden
| | - Anders Rane
- Division of Clinical Pharmacology Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden
| | - Ulf Diczfalusy
- Division of Clinical Chemistry Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden
| | - Linda Björkhem-Bergman
- Division of Clinical Microbiology Department of Laboratory Medicine Karolinska Institutet Karolinska University Hospital, Huddinge SE-141 86 Stockholm Sweden; Palliative Home Care and Hospice Ward ASIH Stockholm Södra Långbro Park Bergtallsvägen 12SE-125 59 Älvsjö Sweden
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Woolsey SJ, Beaton MD, Choi YH, Dresser GK, Gryn SE, Kim RB, Tirona RG. Relationships between Endogenous Plasma Biomarkers of Constitutive Cytochrome P450 3A Activity and Single-Time-Point Oral Midazolam Microdose Phenotype in Healthy Subjects. Basic Clin Pharmacol Toxicol 2015; 118:284-91. [DOI: 10.1111/bcpt.12492] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/02/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Sarah J. Woolsey
- Department of Physiology & Pharmacology; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
- Division of Clinical Pharmacology; Department of Medicine; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
| | - Melanie D. Beaton
- Division of Gastroenterology; Department of Medicine; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
| | - Yun-Hee Choi
- Department of Epidemiology & Biostatistics; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
| | - George K. Dresser
- Division of Clinical Pharmacology; Department of Medicine; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
| | - Steven E. Gryn
- Division of Clinical Pharmacology; Department of Medicine; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
| | - Richard B. Kim
- Department of Physiology & Pharmacology; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
- Division of Clinical Pharmacology; Department of Medicine; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
| | - Rommel G. Tirona
- Department of Physiology & Pharmacology; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
- Division of Clinical Pharmacology; Department of Medicine; Schulich School of Medicine and Dentistry; The University of Western Ontario; London ON Canada
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Kasichayanula S, Boulton DW, Luo WL, Rodrigues AD, Yang Z, Goodenough A, Lee M, Jemal M, LaCreta F. Validation of 4β-hydroxycholesterol and evaluation of other endogenous biomarkers for the assessment of CYP3A activity in healthy subjects. Br J Clin Pharmacol 2015; 78:1122-34. [PMID: 24837659 DOI: 10.1111/bcp.12425] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 05/12/2014] [Indexed: 11/29/2022] Open
Abstract
AIMS This study aimed to assess changes in the plasma concentrationss of 4β-hydroxycholesterol (4βHC) against intravenous (i.v.) and oral midazolam (MDZ) pharmacokinetics (PK) after administration of a potent CYP3A inhibitor [ketoconazole (KETO)] and inducer [rifampicin (RIF)]. METHODS Thirty-two healthy subjects (HS) were allocated into three groups of 12 each in KETO and RIF and 10 in a placebo group (PLB). All HS were randomized to receive oral and i.v. MDZ on day 1 or 2 and on day 15 or 16 after receiving RIF (600 mg once daily), KETO (400 mg once daily) or PLB for 2 weeks. Subjects were followed until day 30. The effect of treatments on 4βHC was assessed by analyzing % change from baseline using a linear spline mixed effects model. RESULTS Compared with PLB, KETO decreased 4βHC mean values up to 13% (P = 0.003) and RIF increased 4βHC mean values up to 220% (P < 0.001). Within 14 days of stopping KETO and RIF, 4βHC had either returned to baseline (KETO) or was still returning to baseline (RIF). Compared with baseline, mean oral MDZ AUC increased by 11-fold (90% CI ranging from 9-fold to 13-fold increase) and decreased by 92% (90% CI ranging from 90% to 95% decrease) after KETO and RIF, respectively. Similar trends were observed for 6β-hydroxycortisol : cortisol (6βHCL : CL) urinary ratios. CONCLUSIONS Changes in plasma 4βHC can be utilized as a surrogate for MDZ PK after multiple doses of potent CYP3A inducers. There is a more limited dynamic range for 4βHC for assessment of potential CYP3A inhibitors. 4βHC is a valuable tool for the assessment of potential CYP3A inducers in early drug development.
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de Jong J, Skee D, Murphy J, Sukbuntherng J, Hellemans P, Smit J, de Vries R, Jiao JJ, Snoeys J, Mannaert E. Effect of CYP3A perpetrators on ibrutinib exposure in healthy participants. Pharmacol Res Perspect 2015; 3:e00156. [PMID: 26171235 PMCID: PMC4492731 DOI: 10.1002/prp2.156] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 05/24/2015] [Indexed: 12/11/2022] Open
Abstract
Ibrutinib (PCI-32765), a potent covalent inhibitor of Bruton’s tyrosine kinase, has shown efficacy against a variety of B-cell malignancies. Given the prominent role of CYP3A in ibrutinib metabolism, effect of coadministration of CYP3A perpetrators with ibrutinib was evaluated in healthy adults. Ibrutinib (120 mg [Study 1, fasted], 560 mg [studies 2 (fasted), and 3 (nonfasted)]) was given alone and with ketoconazole [Study 1; 400 mg q.d.], rifampin [Study 2; 600 mg q.d.], and grapefruit juice [GFJ, Study 3]. Lower doses of ibrutinib were used together with CYP3A inhibitors [Study 1: 40 mg; Study 3: 140 mg], as safety precaution. Under fasted condition, ketoconazole increased ibrutinib dose-normalized (DN) exposure [DN-AUClast: 24-fold; DN-Cmax: 29-fold], rifampin decreased ibrutinib exposure [Cmax: 13-fold; AUClast: 10-fold]. Under nonfasted condition, GFJ caused a moderate increase [DN-Cmax: 3.5-fold; DN-AUC: 2.2-fold], most likely through inhibition of intestinal CYP3A. Half-life was not affected by CYP perpetrators indicating the interaction was mainly on first-pass extraction. All treatments were well-tolerated.
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Affiliation(s)
- Jan de Jong
- Janssen Research & Development San Diego, California
| | - Donna Skee
- Janssen Research & Development Raritan, New Jersey
| | - Joe Murphy
- Janssen Research & Development Raritan, New Jersey
| | | | | | - Johan Smit
- Janssen Research & Development Beerse, Belgium
| | | | | | - Jan Snoeys
- Janssen Research & Development Beerse, Belgium
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Ngaimisi E, Minzi O, Mugusi S, Sasi P, Riedel KD, Suda A, Ueda N, Bakari M, Janabi M, Mugusi F, Bertilsson L, Burhenne J, Aklillu E, Diczfalusy U. Pharmacokinetic and pharmacogenomic modelling of the CYP3A activity marker 4β-hydroxycholesterol during efavirenz treatment and efavirenz/rifampicin co-treatment. J Antimicrob Chemother 2014; 69:3311-9. [PMID: 25096076 DOI: 10.1093/jac/dku286] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To assess the effect of the major efavirenz metabolizing enzyme (CYP2B6) genotype and the effects of rifampicin co-treatment on induction of CYP3A by efavirenz. PATIENTS AND METHODS Two study arms (arm 1, n = 41 and arm 2, n = 21) were recruited into this study. In arm 1, cholesterol and 4β-hydroxycholesterol were measured in HIV treatment-naive patients at baseline and then at 4 and 16 weeks after initiation of efavirenz-based antiretroviral therapy. In arm 2, cholesterol and 4β-hydroxycholesterol were measured among patients taking efavirenz during rifampicin-based tuberculosis (TB) treatment (efavirenz/rifampicin) just before completion of TB treatment and then serially following completion of TB treatment (efavirenz alone). Non-linear mixed-effect modelling was performed. RESULTS A one-compartment, enzyme turnover model described 4β-hydroxycholesterol kinetics adequately. Efavirenz treatment in arm 1 resulted in 1.74 (relative standard error = 15%), 3.3 (relative standard error = 33.1%) and 4.0 (relative standard error = 37.1%) average fold induction of CYP3A for extensive (CYP2B6*1/*1), intermediate (CYP2B6*1/*6) and slow (CYP2B6*6/*6) efavirenz metabolizers, respectively. The rate constant of 4β-hydroxycholesterol formation [mean (95% CI)] just before completion of TB treatment [efavirenz/rifampicin co-treatment, 7.40 × 10(-7) h(-1) (5.5 × 10(-7)-1.0 × 10(-6))] was significantly higher than that calculated 8 weeks after completion [efavirenz alone, 4.50 × 10(-7) h(-1) (4.40 × 10(-7)-4.52 × 10(-7))]. The CYP3A induction dropped to 62% of its maximum by week 8 of completion. CONCLUSIONS Our results indicate that efavirenz induction of CYP3A is influenced by CYP2B6 genetic polymorphisms and that efavirenz/rifampicin co-treatment results in higher induction than efavirenz alone.
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Affiliation(s)
- E Ngaimisi
- Department of Pharmacognosy, Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - O Minzi
- Department of Pharmacognosy, Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - S Mugusi
- Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
| | - P Sasi
- Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
| | - K-D Riedel
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - A Suda
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - N Ueda
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - M Bakari
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
| | - M Janabi
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
| | - F Mugusi
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, PO Box 65001, Dar es Salaam, Tanzania
| | - L Bertilsson
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - J Burhenne
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - E Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - U Diczfalusy
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, C1: 74, SE-141 86 Stockholm, Sweden
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Evaluation of 4β-Hydroxycholesterol as a Clinical Biomarker of CYP3A4 Drug Interactions Using a Bayesian Mechanism-Based Pharmacometric Model. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2014; 3:e120. [PMID: 24964282 PMCID: PMC4076805 DOI: 10.1038/psp.2014.18] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 04/09/2014] [Indexed: 11/08/2022]
Abstract
A Bayesian mechanism–based pharmacokinetic/pharmacodynamic model of cytochrome P450 3A4 (CYP3A4) activity was developed based on a clinical study of the effects of ketoconazole and rifampin on midazolam exposure and plasma 4β-hydroxycholesterol (4βHC) concentrations. Simulations from the model demonstrated that the dynamic range of 4βHC as a biomarker of CYP3A4 induction or inhibition was narrower than that of midazolam; an inhibitor that increases midazolam area under the curve by 20-fold may only result in a 20% decrease in 4βHC after 14 days of dosing. Likewise, an inducer that elevates CYP3A4 activity by 1.2-fold would reduce the area under the curve of midazolam by 50% but would only increase 4βHC levels by 20% after 14 days of dosing. Elevation in 4βHC could be reliably detected with a twofold induction in CYP3A4 activity with study sample sizes (N ~ 6–20) typically used in early clinical development. Only a strong CYP3A4 inhibitor (e.g., ketoconazole) could be detected with similar sample sizes.
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Huang MQ, Lin W, Wang W, Zhang W, Lin ZJ, Weng N. Quantitation of P450 3A4 endogenous biomarker - 4β-hydroxycholesterol - in human plasma using LC/ESI-MS/MS. Biomed Chromatogr 2014; 28:794-801. [DOI: 10.1002/bmc.3131] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Mike-Qingtao Huang
- Janssen Research and Development LLC; Pharmaceutical Companies of Johnson & Johnson; 1400 McKean Road Spring House PA 19477 USA
| | - Weisheng Lin
- Frontage Laboratories Inc.; 700 Pennsylvania Drive Exton PA 19341 USA
| | - Weimin Wang
- Frontage Laboratories Inc.; 700 Pennsylvania Drive Exton PA 19341 USA
| | - Wei Zhang
- Frontage Laboratories Inc.; 700 Pennsylvania Drive Exton PA 19341 USA
| | | | - Naidong Weng
- Janssen Research and Development LLC; Pharmaceutical Companies of Johnson & Johnson; 1400 McKean Road Spring House PA 19477 USA
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Dutreix C, Lorenzo S, Wang Y. Comparison of two endogenous biomarkers of CYP3A4 activity in a drug-drug interaction study between midostaurin and rifampicin. Eur J Clin Pharmacol 2014; 70:915-20. [PMID: 24839948 PMCID: PMC4088993 DOI: 10.1007/s00228-014-1675-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 03/27/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Midostaurin, a multitargeted tyrosine kinase inhibitor, is primarily metabolized by CYP3A4. This midostaurin drug-drug interaction study assessed the dynamic response and clinical usefulness of urinary 6β-hydroxycortisol to cortisol ratio (6βCR) and plasma 4β-hydroxycholesterol (4βHC) for monitoring CYP3A4 activity in the presence or absence of rifampicin, a strong CYP3A4 inducer. METHODS Forty healthy adults were randomized into groups for either placebo or treatment with rifampicin 600 mg QD for 14 days. All participants received midostaurin 50 mg on day 9. Midostaurin plasma pharmacokinetic parameters were assessed. Urinary 6βCR and plasma 4βHC levels were measured on days 1, 9, 11, and 15. RESULTS Both markers remained stable over time in the control group and increased significantly in the rifampicin group. In the rifampicin group, the median increases (vs day 1) on days 9, 11, and 15 were 4.1-, 5.2-, and 4.7-fold, respectively, for 6βCR and 3.4-, 4.1-, and 4.7-fold, respectively, for 4βHC. Inter- and intrasubject variabilities in the control group were 45.6 % and 30.5 %, respectively, for 6βCR, and 33.8 % and 7.5 %, respectively, for 4βHC. Baseline midostaurin area under the concentration-time curve (AUC) correlated with 4βHC levels (ρ = -0.72; P = .003), but not with 6βCR (ρ = 0.0925; P = .6981). CONCLUSIONS Both 6βCR and 4βHC levels showed a good dynamic response range upon strong CYP3A4 induction with rifampicin. Because of lower inter- and intrasubject variability, 4βHC appeared more reliable and better predictive of CYP3A4 activity compared with 6βCR. The data from our study further support the clinical utility of these biomarkers.
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Nylén H, Björkhem-Bergman L, Ekström L, Roh HK, Bertilsson L, Eliasson E, Lindh JD, Diczfalusy U. Plasma levels of 25-hydroxyvitamin D3 and in vivo markers of cytochrome P450 3A activity in Swedes and Koreans: effects of a genetic polymorphism and oral contraceptives. Basic Clin Pharmacol Toxicol 2014; 115:366-71. [PMID: 24655660 DOI: 10.1111/bcpt.12230] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 02/26/2014] [Indexed: 01/21/2023]
Abstract
In vitro studies have shown that vitamin D may induce several cytochrome P450 (CYP) enzymes in general and CYP3A4 in particular. The primary aim of this study was to investigate the relationship between plasma levels of 25-hydroxyvitamin D3 and suggested in vivo markers of CYP3A activity in healthy volunteers from Sweden and Korea. Plasma concentrations of 25-hydroxyvitamin D3 were analysed in samples from three previously performed studies, and the correlation between these levels and suggested in vivo markers of CYP3A activity was investigated by means of nonparametric correlation. In addition, we studied the modulating effects of three vitamin D receptor promoter polymorphisms on the association between 25-hydroxyvitamin D3 and CYP3A enzyme activity in Swedish subjects. The plasma levels of 25-hydroxyvitamin D3 were not significantly associated with CYP3A phenotypes in any of the three studies, but after accounting for the vitamin D receptor polymorphism rs4516035, there was a significant positive association between 25-hydroxyvitamin D3 and CYP3A activity (p = 0.004). Swedes (n = 65) had significantly higher 25-hydroxyvitamin D3 levels than Koreans (n = 67), 75 nM compared with 31 nM (p < 0.001). Swedish women taking oral contraceptives (OC) (n = 19) had somewhat higher plasma levels of 25-hydroxyvitamin D3 compared with Swedish women not taking oral contraceptives (n = 21), 89 and 72 nM, respectively (p = 0.02). In conclusion, our results suggest that the overall influence on the CYP3A activity by 25-hydroxyvitamin D3 is of marginal importance.
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Affiliation(s)
- Hanna Nylén
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Björkhem-Bergman L, Bäckström T, Nylén H, Rönquist-Nii Y, Bredberg E, Andersson TB, Bertilsson L, Diczfalusy U. Quinine Compared to 4β-Hydroxycholesterol and Midazolam as Markers for CYP3A Induction by Rifampicin. Drug Metab Pharmacokinet 2014; 29:352-5. [DOI: 10.2133/dmpk.dmpk-13-sh-138] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ma JD, Nafziger AN, Bertino JS. Endogenous 4β-Hydroxycholesterol-to-Cholesterol Ratio Is Not a Validated Biomarker for the Assessment of CYP3A Activity. Drug Metab Dispos 2013; 41:1972. [DOI: 10.1124/dmd.113.054361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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