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Cardona P, Dutta S, Houk B. Effect of Strong CYP3A4 Inhibition, CYP3A4 Induction, and OATP1B1/3 Inhibition on the Pharmacokinetics of a Single Oral Dose of Sotorasib. Clin Pharmacol Drug Dev 2024; 13:810-818. [PMID: 38421129 DOI: 10.1002/cpdd.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
Sotorasib is a small molecule that irreversibly inhibits the Kirsten rat sarcoma viral oncogene homolog (KRAS) protein with a G12C amino acid substitution mutant protein. The impact of cytochrome P450 (CYP) 3A4 inhibition and induction on sotorasib pharmacokinetics (PKs) was evaluated in 2 separate studies in healthy volunteers (N = 14/study). The impact of CYP3A4 inhibition was interrogated utilizing repeat doses of 200 mg of itraconazole, a strong CYP3A4 inhibitor, on 360 mg of sotorasib PKs. The impact of CYP3A4 induction was interrogated utilizing multiple doses of 600 mg of rifampin, a strong CYP3A4 inducer. Additionally, the impact of organic anion transporting polypeptide (OATP) 1B1/3 inhibition on 960 mg of sotorasib PKs was interrogated after a single dose of 600 mg of rifampin. CYP3A4 inhibition did not significantly impact sotorasib Cmax but did lead to a 26% increase in sotorasib AUCinf. CYP3A4 induction decreased sotorasib Cmax by 35% and AUCinf by 51%. OATP1B1/3 inhibition decreased sotorasib Cmax and AUCinf by 16% and 23%, respectively. These results support that sotorasib can be given together with strong CYP3A4 and OATP1B1/3 inhibitors but the co-administration of sotorasib and strong CYP3A4 inducers should be avoided.
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Affiliation(s)
- Panli Cardona
- Clinical Pharmacology, Modeling and Simulation, Amgen Inc., Thousand Oaks, CA, USA
| | - Sandeep Dutta
- Clinical Pharmacology, Modeling and Simulation, Amgen Inc., Thousand Oaks, CA, USA
| | - Brett Houk
- Clinical Pharmacology, Modeling and Simulation, Amgen Inc., Thousand Oaks, CA, USA
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Štěpánek O, Čmoková A, Procházková E, Grobárová V, Černý J, Sklapničková M, Zíková AP, Kolařík M, Baszczynski O. Piperazine‐modified ketoconazole derivatives show increased activity against fungal and trypanosomatid pathogens. ChemMedChem 2022; 17:e202200385. [DOI: 10.1002/cmdc.202200385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/14/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Ondřej Štěpánek
- Charles University: Univerzita Karlova Department of Organic Chemistry CZECH REPUBLIC
| | - Adéla Čmoková
- Institute of Microbiology Mikrobiologický ústav AV ČR, v.v.i. CZECH REPUBLIC
| | - Eliška Procházková
- IOCB CAS: Ustav organicke chemie a biochemie Akademie ved Ceske republiky NMR department CZECH REPUBLIC
| | - Valéria Grobárová
- Charles University: Univerzita Karlova Department of Cell Biology CZECH REPUBLIC
| | - Jan Černý
- Charles University: Univerzita Karlova Department of Cell Biology CZECH REPUBLIC
| | - Martina Sklapničková
- Institute of Parasitology Czech Academy of Sciences: Biologicke centrum Akademie ved Ceske republiky Parazitologicky ustav Parazitologicky ustav CZECH REPUBLIC
| | - Alena Panicucci Zíková
- Institute of Parasitology Czech Academy of Sciences: Biologicke centrum Akademie ved Ceske republiky Parazitologicky ustav Parazitologicky ustav CZECH REPUBLIC
| | - Miroslav Kolařík
- Institute of Microbiology Czech Academy of Sciences: Mikrobiologicky ustav Akademie ved Ceske republiky Mikrobiologicky ustav CZECH REPUBLIC
| | - Ondrej Baszczynski
- Univerzita Karlova Prirodovedecka fakulta Department of Organic Chemistry Hlavova 8/2030 12800 Prague CZECH REPUBLIC
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Zhang F, Zhang T, Gong J, Fang Q, Qi S, Li M, Han Y, Liu W, Ge G. The Chinese herb Styrax triggers pharmacokinetic herb-drug interactions via inhibiting intestinal CYP3A. Front Pharmacol 2022; 13:974578. [PMID: 36110541 PMCID: PMC9469097 DOI: 10.3389/fphar.2022.974578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022] Open
Abstract
Human cytochrome P450 3A4 (hCYP3A4) is a predominant enzyme to trigger clinically relevant drug/herb-drug interactions (DDIs or HDIs). Although a number of herbal medicines have been found with strong anti-hCYP3A4 effects in vitro, the in vivo modulatory effects of herbal medicines on hCYP3A4 and their potential risks to trigger HDIs are rarely investigated. Herein, we demonstrate a case study to efficiently find the herbal medicine(s) with potent hCYP3A4 inhibition in vitro and to accurately assess the potential HDIs risk in vivo. Following screening over 100 herbal medicines, the Chinese herb Styrax was found with the most potent hCYP3A4 inhibition in HLMs. In vitro assays demonstrated that Styrax could potently inhibit mammalian CYP3A in liver and intestinal microsomes from both humans and rats. In vivo pharmacokinetic assays showed that Styrax (i.g., 100 mg/kg) significantly elevated the plasma exposure of two CYP3A-substrate drugs (midazolam and felodipine) when midazolam or felodipine was administered orally. By contrast, the plasma exposure of either midazolam or felodipine was hardly affected by Styrax (i.g.) when the victim drug was administered intravenously. Further investigations demonstrated that seven pentacyclic triterpenoid acids (PTAs) in Styrax were key substances responsible for CYP3A inhibition, while these PTAs could be exposed to intestinal tract at relatively high exposure levels but their exposure levels in rat plasma and liver were extremely low. These findings well explained why Styrax (i.g.) could elevate the plasma exposure of victim drugs only when these agents were orally administrated. Collectively, our findings demonstrate that Styrax can modulate the pharmacokinetic behavior of CYP3A-substrate drugs via inhibiting intestinal CYP3A, which is very helpful for the clinical pharmacologists to better assess the HDIs triggered by Styrax or Styrax-related herbal products.
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Affiliation(s)
- Feng Zhang
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tiantian Zhang
- School of Pharmacy, Zunyi Medical University, Zunyi, China
| | - Jiahao Gong
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qinqin Fang
- Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Institute of Liver Diseases, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shenglan Qi
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Institute of Liver Diseases, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengting Li
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Han
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Guangbo Ge, ; Wei Liu, ; Yan Han,
| | - Wei Liu
- Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Institute of Liver Diseases, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Guangbo Ge, ; Wei Liu, ; Yan Han,
| | - Guangbo Ge
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Guangbo Ge, ; Wei Liu, ; Yan Han,
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Chantarasorn Y, Rasmidatta K, Pokawattana I, Silpa-Archa S. Effects of Ketoconazole on the Clinical Recovery in Central Serous Chorioretinopathy. Clin Ophthalmol 2022; 16:1871-1882. [PMID: 35711967 PMCID: PMC9192783 DOI: 10.2147/opth.s368427] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients with hypercortisolism have been associated with a higher prevalence of the pachychoroid spectrum including central serous chorioretinopathy (CSCR), which may explain the inconsistency of therapeutic responses of the mineralocorticoid receptor antagonist because hyperaldosteronism has rarely been detected in patients with CSCR. Therefore, this study aimed to evaluate the effects of ketoconazole, the first-line cortisol inhibitor, on the resolution of subretinal fluid (SRF) in CSCR and to analyze correlations between choroidal thickness and steroid hormones. Patients and Methods This retrospective cohort study included 41 naïve CSCR eyes of 41 patients categorized into control (20 eyes) and treatment (21 eyes) groups. Patients in the treatment group were administered oral ketoconazole at a daily dose of 400 or 600 mg for 3–6 weeks. At week 12, rescue laser therapy was applied to patients exhibiting persistent SRF. Thus, a survival analysis was performed to determine the time interval from presentation to clinical resolution of SRF. Secondary outcomes consisted of eyes with persistent SRF and factors affecting the therapeutic response. Results The mean 24-hour urinary free cortisol (UFC) levels were elevated at 181 ± 70 and 150 ± 68 µg/day (range: 20–150) in the treatment and control groups, respectively (p = 0.21). After controlling for age and gender, baseline UFC levels were significantly associated with choroidal thickness in both eyes (p < 0.05). Ketoconazole significantly increased the CSCR resolution with the median time to resolution of 7 vs 16 weeks (p < 0.01) and decreased the proportion of eyes receiving rescue therapy at 12 weeks (23.8% vs 50%; p = 0.01). Prolonged CSCR durations were likely found in elderly patients with thick choroids in fellow eyes. Conclusion Patients with CSCR showed elevated glucocorticoids, which further correlated with their choroidal thickness. Using cortisol blockers may shorten the duration of existing SRF.
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Affiliation(s)
- Yodpong Chantarasorn
- Department of Ophthalmology, Vajira Hospital, Navamindradhiraj University, Bangkok, 10300, Thailand
| | - Kochapong Rasmidatta
- Department of Ophthalmology, Vajira Hospital, Navamindradhiraj University, Bangkok, 10300, Thailand
| | - Itsara Pokawattana
- Department of Ophthalmology, Vajira Hospital, Navamindradhiraj University, Bangkok, 10300, Thailand.,Department of Ophthalmology, H.R.H Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakhon Nayok, 26120, Thailand
| | - Sukhum Silpa-Archa
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, 10400, Thailand
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Fraxinellone Induces Hepatotoxicity in Zebrafish through Oxidative Stress and the Transporters Pathway. Molecules 2022; 27:molecules27092647. [PMID: 35566003 PMCID: PMC9103149 DOI: 10.3390/molecules27092647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Fraxinellone (FRA), a major active component from Cortex Dictamni, produces hepatotoxicity via the metabolization of furan rings by CYP450. However, the mechanism underlying the hepatotoxicity of FRA remains unclear. Therefore, zebrafish larvae at 72 h post fertilization were used to evaluate the metabolic hepatotoxicity of FRA and to explore the underlying molecular mechanisms. The results showed that FRA (10-30 μM) induced liver injury and obvious alterations in the metabolomics of zebrafish larvae. FRA induces apoptosis by increasing the level of ROS and activating the JNK/P53 pathway. In addition, FRA can induce cholestasis by down-regulating bile acid transporters P-gp, Bsep, and Ntcp. The addition of the CYP3A inhibitor ketoconazole (1 μM) significantly reduced the hepatotoxicity of FRA (30 μM), which indicated that FRA induced hepatotoxicity through CYP3A metabolism. Targeted metabolomics analysis indicates the changes in amino acid levels can be combined with molecular biology to clarify the mechanism of hepatotoxicity induced by FRA, and amino acid metabolism monitoring may provide a new method for the prevention and treatment of DILI from FRA.
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Rohr BS, Mikus G. Proposal of a Safe and Effective Study Design for CYP3A-Mediated Drug-Drug Interactions. J Clin Pharmacol 2020; 60:1294-1303. [PMID: 32437074 DOI: 10.1002/jcph.1622] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 03/25/2020] [Indexed: 12/12/2022]
Abstract
Numerous drug-drug interaction (DDI) trials have to be conducted in healthy volunteers based on current regulatory guidelines. Because the worst-case scenario of strong cytochrome P450 (CYP) inhibitors has to be tested, the results and their validity have to be balanced with the risk to volunteer safety. The use of ketoconazole in clinical DDI studies has been discouraged by regulatory agencies due to an alleged risk of liver injury. In order to reduce the risk to healthy volunteers, we carried out a study with single-day exposure to each of 6 perpetrator azole fungistatic drugs. They were evaluated regarding their CYP3A inhibition using microdosed midazolam and a limited sampling strategy. Ratios of areas under the concentration-time curves ranged from 1.93 with isavuconazole to 8.42 with ketoconazole. The highest number of adverse events occurred with voriconazole, followed by ketoconazole; 2 dropouts occurred due to adverse events following itraconazole administration. Literature data on adverse events of azole fungistatic drugs in DDI trials are rare and inconclusive. Only in recent years with the newer drugs are they more precise and reliable. It can be concluded that the duration of preexposure of perpetrator drugs can be reduced to 1 hour before administration of the victim drug. This still can be sufficient to achieve the scientific objectives of the trial with the lowest possible risk.
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Affiliation(s)
- Brit Silja Rohr
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Gerd Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
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Elgart A, Greenblatt DJ, Loupe PS, Zur AA, Weiss S, Mimrod D, Spiegelstein O. The Effect of CYP3A Induction and Inhibition on the Pharmacokinetics of Laquinimod, a Novel Neuroimmunomodulator. Clin Pharmacol Drug Dev 2020; 9:1015-1024. [PMID: 32237115 DOI: 10.1002/cpdd.785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/02/2020] [Indexed: 11/10/2022]
Abstract
Laquinimod, a neuroimmunomodulator, is extensively metabolized by cytochrome P450 (CYP) 3A4, and modulations of CYP3A4 activity may lead to alterations in the pharmacokinetics and/or clinical effects of laquinimod. To determine the drug-drug interaction potential of laquinimod with CYP3A inhibitors and inducers, interaction assessments were conducted in healthy volunteers using single-dose administration of laquinimod before and after multiple dosing of CYP3A inhibitors (ketoconazole, fluconazole, and cimetidine) or a CYP3A4 inducer (rifampin). For ketoconazole, subjects (n = 14) received laquinimod 0.6 mg following 1 day of ketoconazole (400 mg daily) pretreatment, a single concomitant dose, and 28 additional days. For fluconazole, subjects (n = 14) received laquinimod 0.6 mg after a single fluconazole dose of 400 mg followed by 200-mg daily fluconazole administration for 20 additional days. For cimetidine, subjects (n = 14) received laquinimod 0.6 mg following 1 day of cimetidine (800 mg twice daily) pretreatment, a single concomitant dose, and 21 additional days. For rifampin, subjects (n = 14) received laquinimod 0.6 mg following 9 days of rifampin (600 mg daily) pretreatment, a single concomitant dose, and 12 additional days. Coadministration of laquinimod with CYP3A inhibitors, ketoconazole, fluconazole, and cimetidine increased laquinimod area under the plasma concentration-time curve from time zero to infinity by approximately 3.1-, 2.5-, and 1.1-fold, respectively. Coadministration of laquinimod with rifampin decreased laquinimod area under the plasma concentration-time curve from time zero to infinity by 5-fold. These results indicate that coadministration of laquinimod with moderate to strong inhibitors of CYP3A or strong inducers of CYP3A may give rise to significant pharmacokinetic drug interactions.
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Affiliation(s)
- Anna Elgart
- Teva Pharmaceutical Industries Ltd, Netanya, Israel
| | | | | | - Arik A Zur
- Teva Pharmaceutical Industries Ltd, Netanya, Israel
| | - Sivan Weiss
- Teva Pharmaceutical Industries Ltd, Netanya, Israel
| | - Dorit Mimrod
- Teva Pharmaceutical Industries Ltd, Netanya, Israel
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Martin F, Pop M, Kacso I, Grosu IG, Miclăuş M, Vodnar D, Lung I, Filip GA, Olteanu ED, Moldovan R, Nagy A, Filip X, Bâldea I. Ketoconazole- p-aminobenzoic Acid Cocrystal: Revival of an Old Drug by Crystal Engineering. Mol Pharm 2020; 17:919-932. [PMID: 31986050 DOI: 10.1021/acs.molpharmaceut.9b01178] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The 1:1 cocrystal of the antifungal agent ketoconazole with p-aminobenzoic acid was successfully crystallized and systematically characterized by a physical and pharmacological point of view. Crystal structure determination confirmed the cocrystal identity, giving full insight in its crystal packing and degree of disorder. Powder dissolution measurements revealed a 10-fold aqueous solubility increase that induces a 6.7-fold oral bioavailability improvement compared to ketoconazole. In vitro cell assays showed a good toxicity profile of the cocrystal with lower oxidative stress and inflammation and enhanced antifungal activity against several Candida species. The in vivo study of the cocrystal indicated similar pharmacokinetic profiles and liver toxicity with increased transaminases, as reported for ketoconazole. Notably, besides minor signs of inflammation, no morphological changes in liver parenchyma or signs of fibrosis and necrosis were detected. The enhanced solubility and oral bioavailability of the cocrystal over ketoconazole, together with the improved antifungal activity and good in vitro/in vivo toxicity, indicate its potential use as an alternative antifungal agent to the parent drug. Our results bring evidence of cocrystallization as a successful approach for bioavailability improvement of poorly soluble drugs.
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Affiliation(s)
- Flavia Martin
- Molecular and Biomolecular Physics Department, National Institute for R&D of Isotopic and Molecular Technologies, 67-103 Donat, 400293 Cluj-Napoca, Romania
| | - Mihaela Pop
- TeraCrystal, 67-103 Donat, 400293 Cluj-Napoca, Romania
| | - Irina Kacso
- Molecular and Biomolecular Physics Department, National Institute for R&D of Isotopic and Molecular Technologies, 67-103 Donat, 400293 Cluj-Napoca, Romania
| | - Ioana Georgeta Grosu
- Molecular and Biomolecular Physics Department, National Institute for R&D of Isotopic and Molecular Technologies, 67-103 Donat, 400293 Cluj-Napoca, Romania
| | - Maria Miclăuş
- Molecular and Biomolecular Physics Department, National Institute for R&D of Isotopic and Molecular Technologies, 67-103 Donat, 400293 Cluj-Napoca, Romania
| | - Dan Vodnar
- Department of Food Science, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania
| | - Ildiko Lung
- Physics of Nanostructured Systems, National Institute for R&D of Isotopic and Molecular Technologies, 67-103 Donat, 400293 Cluj-Napoca, Romania
| | - Gabriela Adriana Filip
- Department of Physiology, Iuliu Haţieganu University of Medicine and Pharmacy, Clinicilor 1, 400006 Cluj-Napoca, Romania
| | - Elena Diana Olteanu
- Department of Physiology, Iuliu Haţieganu University of Medicine and Pharmacy, Clinicilor 1, 400006 Cluj-Napoca, Romania
| | - Remus Moldovan
- Department of Physiology, Iuliu Haţieganu University of Medicine and Pharmacy, Clinicilor 1, 400006 Cluj-Napoca, Romania
| | - Andras Nagy
- Department of Toxicology, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, 400372 Cluj-Napoca, Romania
| | - Xenia Filip
- Molecular and Biomolecular Physics Department, National Institute for R&D of Isotopic and Molecular Technologies, 67-103 Donat, 400293 Cluj-Napoca, Romania
| | - Ioana Bâldea
- Department of Physiology, Iuliu Haţieganu University of Medicine and Pharmacy, Clinicilor 1, 400006 Cluj-Napoca, Romania
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Bouchal B, Abrigach F, Takfaoui A, Elidrissi Errahhali M, Elidrissi Errahhali M, Dixneuf PH, Doucet H, Touzani R, Bellaoui M. Identification of novel antifungal agents: antimicrobial evaluation, SAR, ADME-Tox and molecular docking studies of a series of imidazole derivatives. BMC Chem 2019; 13:100. [PMID: 31410411 PMCID: PMC6685181 DOI: 10.1186/s13065-019-0623-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 07/31/2019] [Indexed: 02/07/2023] Open
Abstract
Thirty-four imidazole-based compounds synthesized by one-pot catalytic method were evaluated for their antifungal and antibacterial activities against several fungal and bacterial strains. None of the compounds had antibacterial activity. Interestingly, compounds 1, 2, 3, 10 and 15 displayed a strong antifungal activity against all the tested fungal species, while compounds 5, 7, 9, 11, 21 and 27 showed a moderate antifungal activity. To better understand the biological activity of the most active compounds ADME-Tox and molecular docking studies were carried out. Interestingly, compounds 1, 2, 3, 7, 10 and 15 showed excellent bioavailability. In addition, compounds 1, 2 and 3, exhibited good toxicity profiles. Docking studies of the two most active compounds 2 (IC50 of 95 ± 7.07 μM) and 10 (IC50 of 235 ± 7.07 μM) suggested that they might act by inhibiting the fungal lanosterol 14α-demethylase. Therefore, these novel antifungal agents merit further characterization for the development of new antifungal therapeutics.
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Affiliation(s)
- Btissam Bouchal
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | - Farid Abrigach
- Laboratory of Applied Chemistry & Environment, Faculty of Sciences, University Premier, Oujda, Morocco Mohamed Premier, Oujda, Morocco
| | - Abdelilah Takfaoui
- Laboratory of Applied Chemistry & Environment, Faculty of Sciences, University Premier, Oujda, Morocco Mohamed Premier, Oujda, Morocco
| | - Manal Elidrissi Errahhali
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
| | | | - Pierre H. Dixneuf
- Institut des Sciences Chimiques de Rennes, UMR 6226, CNRS, Université de Rennes, Rennes, France
| | - Henri Doucet
- Institut des Sciences Chimiques de Rennes, UMR 6226, CNRS, Université de Rennes, Rennes, France
| | - Rachid Touzani
- Laboratory of Applied Chemistry & Environment, Faculty of Sciences, University Premier, Oujda, Morocco Mohamed Premier, Oujda, Morocco
| | - Mohammed Bellaoui
- Genetics Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed Premier, Oujda, Morocco
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10
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Greenblatt DJ, Mikus G. Ketoconazole and Liver Injury: A Five-Year Update. Clin Pharmacol Drug Dev 2019; 8:6-8. [DOI: 10.1002/cpdd.652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - Gerd Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
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11
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Periasamy S, Liu CT, Chien SP, Chen YC, Liu MY. Daily sesame oil supplementation mitigates ketoconazole-induced oxidative stress-mediated apoptosis and hepatic injury. J Nutr Biochem 2016; 37:67-75. [PMID: 27619544 DOI: 10.1016/j.jnutbio.2016.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 05/25/2016] [Accepted: 07/28/2016] [Indexed: 12/25/2022]
Abstract
Ketoconazole (KCZ) is the most commonly used systemic antifungal drug. However, long-term treatment of KCZ induces hepatic injury. Oxidative stress is involved in KCZ-induced hepatic injury. Oxidative stress plays an important role in apoptosis-associated hepatic damage. Sesame oil is rich in potent antioxidants and antifungal constituents. It attenuates hepatic injury by inhibiting oxidative stress. Thus, sesame oil may protect against KCZ-induced oxidative stress, apoptosis and hepatic damage. The aim of the present study was to investigate the protective effect of sesame oil as a nutritional supplement on KCZ-induced hepatic injury in mice. KCZ (300 mg/kg/day) was administered by gastric intubation; 30 min later, sesame oil (0, 0.0625, 0.125, 0.25 or 0.5 ml/kg/day; p.o.) was administered to mice for 14 days. Blood and liver tissue were collected. Hepatic injury was evaluated by serum biochemistry and histology. Oxidative stress was evaluated by myeloperoxidase activity, p47-phox, reactive oxygen species generation, lipid peroxidation and glutathione level. Apoptosis was evaluated by p53, caspase-3, Bcl-2, Bax and Cyto-C expression. Osteopontin was measured to assess liver healing. Sesame oil attenuated hepatic injury; it also decreased oxidative stress and apoptosis in KCZ-treated mice. Sesame oil may be used as a nutritional supplement with existing antifungal therapies to neutralize the adverse hepatotoxic nature of antifungal drugs by attenuating hepatic apoptosis through redox system to protect and heal liver injury in KCZ-treated mice.
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Affiliation(s)
- Srinivasan Periasamy
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan
| | - Chuan-Teng Liu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan
| | - Se-Ping Chien
- Department of Food and Beverage Services, Tainan University of Technology, Tainan 71002, Taiwan
| | - Ying-Chien Chen
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan
| | - Ming-Yie Liu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan.
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Outeiro N, Hohmann N, Mikus G. No Increased Risk of Ketoconazole Toxicity in Drug-Drug Interaction Studies. J Clin Pharmacol 2016; 56:1203-11. [PMID: 27406945 DOI: 10.1002/jcph.795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/08/2016] [Accepted: 07/08/2016] [Indexed: 11/08/2022]
Abstract
In July 2013 the U.S. Food and Drug Administration (FDA) released a safety announcement regarding the use of ketoconazole and its adverse drug reactions. The FDA report advised against the use ketoconazole tablets as a first-line treatment for any fungal infections because of the risk of potentially serious drug-drug interactions and liver and adrenal gland complications. The European Medicines Agency (EMA) also proposed to limit the use of oral ketoconazole in fungal infections because of the same risk of harmful effects and interactions. In addition, the FDA also advised against the use of oral ketoconazole in drug interaction studies, in which it has been extensively used as an index inhibitor of drug metabolism. The aim of this investigation was to evaluate the risks of ketoconazole-induced hepatotoxicity described by the FDA and EMA in published drug interaction studies with ketoconazole and compare these data with the toxicity reported for ketoconazole when used as antifungal treatment. In the drug interaction studies (2355 participants; healthy volunteers and patients; median treatment duration, 6 days), only 40 participants were reported to have increased liver transaminase activity (1.7%), and no deaths were reported or associated with ketoconazole. In studies investigating ketoconazole treatment, patients were treated for 276 days (median), and 5.6% of patients had elevated liver enzyme activity. Because of the short treatment period in drug interaction studies the risk of drug-induced hepatic injury is considered very low. As such, we recommend that ketoconazole remain a safe CYP3A index inhibitor for use in drug interaction studies with healthy volunteers.
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Affiliation(s)
- Noémi Outeiro
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Nicolas Hohmann
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Gerd Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.
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