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Zhang X, Li Q, Ye X, Chen Q, Chen C, Hu G, Zhang L, Chen L. The impacts of natural product miltirone and the CYP2D6 pharmacogenetic phenotype on fluoxetine metabolism. Front Pharmacol 2024; 15:1373048. [PMID: 38741591 PMCID: PMC11089247 DOI: 10.3389/fphar.2024.1373048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction: To study the effects of drug-induced CYP2D6 activity inhibition and genetic polymorphisms on fluoxetine metabolism, rat liver microsomes (RLMs) and SD rats were used to investigate the potential drug‒drug interactions (DDIs), and CYP2D6 http://muchong.com/t-10728934-1 recombinant baculosomes were prepared and subjected to catalytic reactivity studies. Methods and Results: All analytes were detected by ultraperformance liquid chromatography-tandem mass spectrometry (UPLC‒MS/MS). After screening for 27 targeted natural products, miltirone was identified as having obvious inhibitory effect on fluoxetine metabolism in RLMs. In vivo, the concentration of fluoxetine in rat blood increased markedly after miltirone administration. The molecular docking results showed that miltirone bound more strongly to CYP2D6 than fluoxetine, and PHE120 may be the key residue leading to the inhibition of CYP2D6-mediated fluoxetine N-demethylation by miltirone. In terms of the genetic polymorphism of CYP2D6 on fluoxetine metabolism, the intrinsic clearance values of most variants were significantly altered. Among these variants, CYP2D6*92 and CYP2D6*96/Q424X were found to be catalytically inactive for fluoxetine metabolism, five variants (CYP2D6*89/L142S, *97/F457L, *R497, *V342M and *R344Q) exhibited markedly increased clearance values (>125.07%) and seven variants (CYP2D6*2, *10, *87/A5V, *93/T249P, *E215K, *R25Q and *R440C) exhibited significantly decreased clearance values (from 6.62% to 66.79%) compared to those of the wild-type. Conclusion: Our results suggest that more attention should be given to subjects in the clinic who take fluoxetine and also carry one of these infrequent CYP2D6 alleles or are coadministered drugs containing miltirone.
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Affiliation(s)
- Xiaodan Zhang
- Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang, China
- Department of Clinical Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qingqing Li
- Department of Clinical Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Renji College, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinwu Ye
- Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang, China
| | - Qing Chen
- Department of Clinical Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chen Chen
- Department of Clinical Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guoxin Hu
- Renji College, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Likang Zhang
- Renji College, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lianguo Chen
- Department of Clinical Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Jeong HC, Chae YJ, Lee S, Kang W, Yun HY, Shin KH. Prediction of Fluoxetine and Norfluoxetine Pharmacokinetic Profiles Using Physiologically Based Pharmacokinetic Modeling. J Clin Pharmacol 2021; 61:1505-1513. [PMID: 34118174 DOI: 10.1002/jcph.1927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/10/2021] [Indexed: 11/06/2022]
Abstract
Fluoxetine is a selective serotonin reuptake inhibitor that is metabolized to norfluoxetine by cytochrome P450 (CYP) 2D6, CYP2C19, and CYP3A4. A physiologically based pharmacokinetic model for fluoxetine and norfluoxetine metabolism was developed to predict and investigate changes in concentration-time profiles according to fluoxetine dosage in the Korean population. The model was developed based on the Certara repository model and information gleaned from the literature. Digitally extracted clinical study data were used to develop and verify the model. Simulations for plasma concentrations of fluoxetine and norfluoxetine after a single dose of 60 or 80 mg fluoxetine were made based on 1000 virtual healthy Korean individuals using the SimCYP version 19 simulator. The mean ratios (simulated/observed) after a single administration of 80 mg fluoxetine for maximum plasma concentration, area under the plasma concentration-time curve, and apparent clearance were 1.12, 1.08, and 0.93 for fluoxetine; the ratios of maximum plasma concentration and area under the plasma concentration-time curve were 1.08 and 1.08, respectively, for norfluoxetine, indicating that the simulated concentration-time profiles of fluoxetine and norfluoxetine fitted the observed profiles well. The developed model was used to predict plasma fluoxetine and norfluoxetine concentration-time profiles after repeated administrations of fluoxetine in Korean volunteers. This physiologically based pharmacokinetic model could provide basic understanding of the pharmacokinetic profiles of fluoxetine and its metabolite under various situations.
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Affiliation(s)
- Hyeon-Cheol Jeong
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea
| | - Yoon-Jee Chae
- College of Pharmacy, Woosuk University, Jeonbuk, Republic of Korea
| | - Sooyeun Lee
- College of Pharmacy, Keimyung University, Daegu, Republic of Korea
| | - Wonku Kang
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Hwi-Yeol Yun
- College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Kwang-Hee Shin
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea
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Deodhar M, Rihani SBA, Darakjian L, Turgeon J, Michaud V. Assessing the Mechanism of Fluoxetine-Mediated CYP2D6 Inhibition. Pharmaceutics 2021; 13:pharmaceutics13020148. [PMID: 33498694 PMCID: PMC7912198 DOI: 10.3390/pharmaceutics13020148] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 12/27/2022] Open
Abstract
Fluoxetine is still one of the most widely used antidepressants in the world. The drug is extensively metabolized by several cytochrome P450 (CYP450) enzymes and subjected to a myriad of CYP450-mediated drug interactions. In a multidrug regimen, preemptive mitigation of drug-drug interactions requires knowledge of fluoxetine actions on these CYP450 enzymes. The major metabolic pathway of fluoxetine leading to the formation of its active metabolite, norfluoxetine, is mediated by CYP2D6. Fluoxetine and norfluoxetine are strong affinity substrates of CYP2D6 and can inhibit, potentially through various mechanisms, the metabolism of other sensitive CYP2D6 substrates. Remarkably, fluoxetine-mediated CYP2D6 inhibition subsides long after fluoxetine first passes through the liver and even remains long after the discontinuation of the drug. Herein, we review pharmacokinetic and pharmacogenetic information to help us understand the mechanisms underlying the prolonged inhibition of CYP2D6 following fluoxetine administration. We propose that long-term inhibition of CYP2D6 is likely a result of competitive inhibition. This is due to strong affinity binding of fluoxetine and norfluoxetine to the enzyme and unbound fluoxetine and norfluoxetine levels circulating in the blood for a long period of time because of their long elimination half-life. Additionally, we describe that fluoxetine is a CYP2C9 substrate and a mechanism-based inhibitor of CYP2C19.
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Affiliation(s)
- Malavika Deodhar
- Precision Pharmacotherapy Research and Development Institute, Tabula Rasa Health Care, Lake Nona, Orlando, FL 32827, USA; (M.D.); (S.B.A.R.); (L.D.); (J.T.)
| | - Sweilem B. Al Rihani
- Precision Pharmacotherapy Research and Development Institute, Tabula Rasa Health Care, Lake Nona, Orlando, FL 32827, USA; (M.D.); (S.B.A.R.); (L.D.); (J.T.)
| | - Lucy Darakjian
- Precision Pharmacotherapy Research and Development Institute, Tabula Rasa Health Care, Lake Nona, Orlando, FL 32827, USA; (M.D.); (S.B.A.R.); (L.D.); (J.T.)
| | - Jacques Turgeon
- Precision Pharmacotherapy Research and Development Institute, Tabula Rasa Health Care, Lake Nona, Orlando, FL 32827, USA; (M.D.); (S.B.A.R.); (L.D.); (J.T.)
- Faculty of pharmacy, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Veronique Michaud
- Precision Pharmacotherapy Research and Development Institute, Tabula Rasa Health Care, Lake Nona, Orlando, FL 32827, USA; (M.D.); (S.B.A.R.); (L.D.); (J.T.)
- Faculty of pharmacy, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Correspondence: or
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Atypical Michaelis-Menten kinetics in cytochrome P450 enzymes: A focus on substrate inhibition. Biochem Pharmacol 2019; 169:113615. [DOI: 10.1016/j.bcp.2019.08.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 12/18/2022]
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Zastrozhin MS, Skryabin VY, Smirnov VV, Grishina EA, Ryzhikova KA, Chumakov EM, Bryun EA, Sychev DA. Effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder. Can J Physiol Pharmacol 2019; 97:781-785. [PMID: 31100205 DOI: 10.1139/cjpp-2019-0177] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of the study was to investigate the effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder who received mirtazapine. The study included 109 Russian patients who received mirtazapine at a dose of 30.0 [15.0; 45.0] mg per day. Genotyping of CYP2D6*4 (1846G > A, rs3892097) was performed using real-time polymerase chain reaction with allele-specific hybridization. The activity of CYP2D6 was evaluated by determining the concentration of endogenous substrate of the enzyme and its urinary metabolite - pinoline to 6-hydroxy-1,2,3,4-tetrahydro-beta-carboline ratio, using high-performance liquid chromatography - mass spectrometry. The statistically significant differences between the scores on the Hamilton Depression Rating Scale (HAMD) in patients with different genotypes were revealed by day 16: (GG) 5.0 [3.0; 6.0], (GA) 1.5 [1.0; 3.2] (p < 0.001), and for the The UKU Side Effects Rating Scale (UKU): (GG) 6.0 [6.0; 7.0], (GA) 8.5 [8.0; 10.0] (p < 0.001). The calculation of correlation coefficients between the differences in scale scores and metabolic rate showed the presence of statistically significant weak inverse correlation with the efficacy indicator evaluated by HAMD (r = -0.278, p < 0.05), but not by UKU (r = 0.274, p > 0.05). This study demonstrated that an increased CYP2D6 activity reduces the efficacy of treatment with mirtazapine.
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Affiliation(s)
- M S Zastrozhin
- a Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Moscow 109390, Russia.,b Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow 123995, Russia
| | - V Y Skryabin
- a Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Moscow 109390, Russia
| | - V V Smirnov
- c NRC Institute of Immunology FMBA of Russia, Moscow 115478, Russia.,d I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow 119991, Russia
| | - E A Grishina
- b Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow 123995, Russia
| | - K A Ryzhikova
- b Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow 123995, Russia
| | - E M Chumakov
- e Department of Psychiatry and Addictions, Saint-Petersburg State University, 13B Universitetskaya Emb., Saint-Petersburg 199034, Russia.,f Day In-patient Department, Saint-Petersburg Psychiatric Hospital No. 1 named after P.P. Kashchenko, Saint-Petersburg 190121, Russia
| | - E A Bryun
- a Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Moscow 109390, Russia.,b Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow 123995, Russia
| | - D A Sychev
- b Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow 123995, Russia
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Pharmacogenomics in Papua New Guineans: unique profiles and implications for enhancing drug efficacy while improving drug safety. Pharmacogenet Genomics 2019; 28:153-164. [PMID: 29768302 DOI: 10.1097/fpc.0000000000000335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Papua New Guinea (PNG) can be roughly divided into highland, coastal and island peoples with significant mitochondrial DNA differentiation reflecting early and recent distinct migrations from Africa and East Asia, respectively. Infectious diseases such as tuberculosis, malaria and HIV severely impact on the health of its peoples for which drug therapy is the major treatment and pharmacogenetics has clinical relevance for many of these drugs. Although there is generally little information about known single nucleotide polymorphisms in the population, in some instances, their frequencies have been shown to be higher than anywhere worldwide. For example, CYP2B6*6 is over 50%, and CYP2C19*2 and *3 are over 40 and 25%, respectively. Conversely, CYP2A6*9, 2B6*2, *3, *4 and *18, and 2C8*3 appear to be much lower than in Whites. CYP2D6 known variants are unclear, and for phase II enzymes, only UGT2B7 and UGT1A9 data are available, with variant frequencies either slightly lower than or similar to Whites. Although almost all PNG people tested are rapid acetylators, but which variant(s) define this phenotype is not known. For HLA-B*13:01, HLA-B*35:05 and HLA-C*04:01, the frequencies show some regioselectivity, but the clinical implications with respect to adverse drug reactions are not known. There are minimal phenotype data for the CYPs and nothing is known about drug transporter or receptor genetics. Determination of genetic variants that are rare in Whites or Asians but common in PNG people is a topic of both scientific and clinical importance, and further research needs to be carried out. Optimizing the safety and efficacy of infectious disease drug therapy through pharmacogenetic studies that have translation potential is a priority.
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Zastrozhin MS, Grishina EA, Denisenko NP, Skryabin VY, Markov DD, Savchenko LM, Bryun EA, Sychev DA. Effects of CYP2D6 genetic polymorphisms on the efficacy and safety of fluvoxamine in patients with depressive disorder and comorbid alcohol use disorder. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2018; 11:113-119. [PMID: 29988737 PMCID: PMC6029588 DOI: 10.2147/pgpm.s160763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Fluvoxamine therapy is used for treatment of patients with depressive disorder, but it is often ineffective, and some patients suffer from dose-dependent undesirable side effects such as vertigo, headache, indigestion, xerostomia, increased anxiety, etc. CYP2D6 is involved in the biotransformation of fluvoxamine. Meanwhile, the genes encoding these isoenzymes have a high level of polymorphism, which may affect the protein synthesis. Objective The primary objective of our study was to investigate the effects of CYP2D6 genetic polymorphisms on the efficacy and safety of fluvoxamine in patients with depressive disorder and comorbid alcohol use disorder, in order to develop the algorithms of optimization of fluvoxamine therapy for reducing the risk of dose-dependent undesirable side effects and pharmacoresistance. Methods The study involved 45 male patients (average age: 36.44±9.96 years) with depressive disorder and comorbid alcohol use disorder. A series of psychometric scales was used in the research. Genotyping of CYP2D6 (1846G>A) was performed using real-time polymerase chain reaction. Results According to results of Mann–Whitney U-test, statistically significant differences between the efficacy and safety of fluvoxamine were obtained on 9th and 16th days of therapy in patients with GG and GA genotypes (The Hamilton Rating Scale for Depression: 10.0 [10.0; 23.0] vs 25.0 [24.0; 16.0] (P<0.001) on the 9th day and 4.0 [2.0; 5.0] vs 6.0 [6.0; 7.0] on the 16th day; The UKU Side Effect Rating Scale: 6.0 [4.0; 6.0] vs 9.0 [9.0; 10.0] (P<0.001) on the 9th day and 5.0 [1.0; 9.0] vs 19.0 [18.0; 22.0] on the 16th day). Conclusion This study demonstrated the lower efficacy and safety of fluvoxamine in patients with depressive disorder and comorbid alcohol use disorders with GA genotype in CYP2D6 1846G>A polymorphic marker.
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Affiliation(s)
- Mikhail Sergeevich Zastrozhin
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia,.,Department of Addictology, Moscow Research and Practical Center on Addictions, Moscow, Russia,
| | - Elena Anatolievna Grishina
- Research Centre, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | - Nataliya Petrovna Denisenko
- Research Centre, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | | | - Dmitry Dmitrievich Markov
- Research Centre, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | - Ludmila Mikhailovna Savchenko
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia,
| | - Evgeny Alekseevich Bryun
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia,.,Department of Addictology, Moscow Research and Practical Center on Addictions, Moscow, Russia,
| | - Dmitry Alekseevich Sychev
- Department of Clinical Pharmacology and Therapy, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia
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Wang Y, Wang L, Chen X, Sun C, Zhu Y, Kang Y, Zeng S. Chiral detection of entecavir stereoisomeric impurities through coordination with R-besivance and Zn II using mass spectrometry. JOURNAL OF MASS SPECTROMETRY : JMS 2018; 53:247-256. [PMID: 29314359 DOI: 10.1002/jms.4060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 12/11/2017] [Accepted: 12/19/2017] [Indexed: 06/07/2023]
Abstract
In this study, a mass spectrometry (MS)-based kinetic method (KM) is shown to be successful at analyzing a multichiral center drug stereoisomer, entecavir (ETV), both qualitatively and quantitatively. On the basis of the KM, the bivalent complex ion [MII (A)(ref*)2 ]2+ (MII = divalent metal ion, A = analyte, and ref* = chiral reference) was set as precursor ion in MS/MS. The experiment results suggest strong chiral selectivity between ETV and its isomers when using ZnII coordinated with the chiral reference R-besivance (R-B). The logarithm of the fragment ion abundance ratio and the enantiomeric percentage (%) exhibits a strong linear relation because of the competitive loss of the reference and analyte. The product ion pair [ZnII (R-B)A-H]+ (m/z 733) and [ZnII (R-B)2 -H]+ (m/z 849), together with [R-B + H]+ (m/z 394) and [A + H]+ (m/z 278), can realize the identification of ETV and all of its chiral isomers. Theoretical calculation were also performed using the B3LYP functional with the 6-31G* and LanL2DZ basis set to clarify the mechanism of structural difference of these bivalent complex ions. The results reveal that MS-KM can be used to detect optical impurities without a chiral chromatographic column and fussy sample pretreatment. The established method has been used to determine stereoisomeric impurities of less than 0.1% in ETV crude drug, a demonstration of its simple and effective nature for rapid detection of stereoisomeric impurities.
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Affiliation(s)
- Yali Wang
- Institute of Drug Metabolism and Drug Analysis, College of Pharmaceutical Sciences, Hangzhou, 310058, Zhejiang, China
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Lu Wang
- Institute of Drug Metabolism and Drug Analysis, College of Pharmaceutical Sciences, Hangzhou, 310058, Zhejiang, China
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Xiaolei Chen
- Institute of Drug Metabolism and Drug Analysis, College of Pharmaceutical Sciences, Hangzhou, 310058, Zhejiang, China
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Cuirong Sun
- Institute of Drug Metabolism and Drug Analysis, College of Pharmaceutical Sciences, Hangzhou, 310058, Zhejiang, China
| | - Yixin Zhu
- Zhejiang Haochuang Biotech Co, Ltd, Hangzhou, 311121, Zhejiang, China
| | - Yu Kang
- Institute of Drug Metabolism and Drug Analysis, College of Pharmaceutical Sciences, Hangzhou, 310058, Zhejiang, China
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Su Zeng
- Institute of Drug Metabolism and Drug Analysis, College of Pharmaceutical Sciences, Hangzhou, 310058, Zhejiang, China
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Zhejiang University, Hangzhou, 310058, Zhejiang, China
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Hancu G, Cârcu-Dobrin M, Budău M, Rusu A. Analytical methodologies for the stereoselective determination of fluoxetine: An overview. Biomed Chromatogr 2017; 32. [DOI: 10.1002/bmc.4040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/14/2017] [Accepted: 06/27/2017] [Indexed: 01/14/2023]
Affiliation(s)
- Gabriel Hancu
- Faculty of Pharmacy, Department of Pharmaceutical Chemistry; University of Medicine and Pharmacy; Tîrgu Mureş Romania
| | - Melania Cârcu-Dobrin
- Faculty of Pharmacy, Department of Pharmaceutical Chemistry; University of Medicine and Pharmacy; Tîrgu Mureş Romania
| | | | - Aura Rusu
- Faculty of Pharmacy, Department of Pharmaceutical Chemistry; University of Medicine and Pharmacy; Tîrgu Mureş Romania
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Barratt DT, Cox HK, Menelaou A, Yeung DT, White DL, Hughes TP, Somogyi AA. CYP2C8 Genotype Significantly Alters Imatinib Metabolism in Chronic Myeloid Leukaemia Patients. Clin Pharmacokinet 2016; 56:977-985. [DOI: 10.1007/s40262-016-0494-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Backman JT, Filppula AM, Niemi M, Neuvonen PJ. Role of Cytochrome P450 2C8 in Drug Metabolism and Interactions. Pharmacol Rev 2016; 68:168-241. [PMID: 26721703 DOI: 10.1124/pr.115.011411] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
During the last 10-15 years, cytochrome P450 (CYP) 2C8 has emerged as an important drug-metabolizing enzyme. CYP2C8 is highly expressed in human liver and is known to metabolize more than 100 drugs. CYP2C8 substrate drugs include amodiaquine, cerivastatin, dasabuvir, enzalutamide, imatinib, loperamide, montelukast, paclitaxel, pioglitazone, repaglinide, and rosiglitazone, and the number is increasing. Similarly, many drugs have been identified as CYP2C8 inhibitors or inducers. In vivo, already a small dose of gemfibrozil, i.e., 10% of its therapeutic dose, is a strong, irreversible inhibitor of CYP2C8. Interestingly, recent findings indicate that the acyl-β-glucuronides of gemfibrozil and clopidogrel cause metabolism-dependent inactivation of CYP2C8, leading to a strong potential for drug interactions. Also several other glucuronide metabolites interact with CYP2C8 as substrates or inhibitors, suggesting that an interplay between CYP2C8 and glucuronides is common. Lack of fully selective and safe probe substrates, inhibitors, and inducers challenges execution and interpretation of drug-drug interaction studies in humans. Apart from drug-drug interactions, some CYP2C8 genetic variants are associated with altered CYP2C8 activity and exhibit significant interethnic frequency differences. Herein, we review the current knowledge on substrates, inhibitors, inducers, and pharmacogenetics of CYP2C8, as well as its role in clinically relevant drug interactions. In addition, implications for selection of CYP2C8 marker and perpetrator drugs to investigate CYP2C8-mediated drug metabolism and interactions in preclinical and clinical studies are discussed.
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Affiliation(s)
- Janne T Backman
- Department of Clinical Pharmacology, University of Helsinki (J.T.B., A.M.F., M.N., P.J.N.), and Helsinki University Hospital, Helsinki, Finland (J.T.B., M.N., P.J.N.)
| | - Anne M Filppula
- Department of Clinical Pharmacology, University of Helsinki (J.T.B., A.M.F., M.N., P.J.N.), and Helsinki University Hospital, Helsinki, Finland (J.T.B., M.N., P.J.N.)
| | - Mikko Niemi
- Department of Clinical Pharmacology, University of Helsinki (J.T.B., A.M.F., M.N., P.J.N.), and Helsinki University Hospital, Helsinki, Finland (J.T.B., M.N., P.J.N.)
| | - Pertti J Neuvonen
- Department of Clinical Pharmacology, University of Helsinki (J.T.B., A.M.F., M.N., P.J.N.), and Helsinki University Hospital, Helsinki, Finland (J.T.B., M.N., P.J.N.)
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12
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Ji Y, Chen S, Zhao L, Pan P, Wang L, Cai J, Dai D, Hu G, Cai JP, Huang H. In vitro
assessment of 39 CYP2C9
variants found in the Chinese population on the metabolism of the model substrate fluoxetine and a summary of their effects on other substrates. J Clin Pharm Ther 2015; 40:320-7. [PMID: 25884291 DOI: 10.1111/jcpt.12267] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 03/04/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Y. Ji
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Wenzhou Medical University; Wenzhou Zhejiang China
| | - S. Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Wenzhou Medical University; Wenzhou Zhejiang China
| | - L. Zhao
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Wenzhou Medical University; Wenzhou Zhejiang China
| | - P. Pan
- Department of Pharmacology; Wenzhou Medical University; Wenzhou Zhejiang China
| | - L. Wang
- Department of Pharmacology; Wenzhou Medical University; Wenzhou Zhejiang China
| | - J. Cai
- Department of Pharmacology; Wenzhou Medical University; Wenzhou Zhejiang China
| | - D. Dai
- The Key Laboratory of Geriatrics; Beijing Hospital and Beijing Institute of Geriatrics; Ministry of Health; Beijing China
| | - G. Hu
- Department of Pharmacology; Wenzhou Medical University; Wenzhou Zhejiang China
| | - J. P. Cai
- The Key Laboratory of Geriatrics; Beijing Hospital and Beijing Institute of Geriatrics; Ministry of Health; Beijing China
| | - H. Huang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University; Wenzhou Medical University; Wenzhou Zhejiang China
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13
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Demethylation of neferine in human liver microsomes and formation of quinone methide metabolites mediated by CYP3A4 accentuates its cytotoxicity. Chem Biol Interact 2014; 224:89-99. [DOI: 10.1016/j.cbi.2014.10.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/07/2014] [Accepted: 10/13/2014] [Indexed: 12/19/2022]
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