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Mahajan P, Palkar M, Pingili RB. Drug reactive metabolite-induced hepatotoxicity: a comprehensive review. Toxicol Mech Methods 2024; 34:607-627. [PMID: 38504503 DOI: 10.1080/15376516.2024.2332613] [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: 08/18/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024]
Abstract
Nowadays, drug-induced liver toxicity (DILT) is one of the main contributing factors to severe liver disease. In the United States (US) alone, DILT is the cause of more than 50% of instances of acute liver failure. Prescription or over-the-counter drugs, xenobiotics, and herbal and nutritional supplements can cause DILT and could produce anomalies in hepatic function tests. Some drugs induce hepatotoxicity directly, and others induce it indirectly (i. e. through their toxic or reactive metabolites). Currently, the United States Food and Drug Administration (US FDA) has issued black box warnings for about 1279 drugs due to their hepatotoxicity. When we analyzed their mechanism in inducing hepatotoxicity, we found nearly 18 drugs causing hepatotoxicity by their toxic metabolites. In this review, we attempted to highlight the well-known drugs that induce hepatotoxicity indirectly through their toxic metabolites including the enzymes involved in the formation of these metabolites. The Cytochrome P-450 (CYP), Hypoxanthine phosphoribosyltransferase 1, Alcohol oxidase, Uridine diphosphate (UDP)-glucuronosyltransferases, Xanthine dehydrogenase, Purine-nucleoside phosphorylase, Xanthine oxidase, Thiopurine S-methyltransferase, Inosine-5'-monophosphate dehydrogenase, and aldehyde dehydrogenase are involving in the formation of toxic metabolites. The metabolic reactions and enzymes discussed in this review help toxicologists, pharmacologists, and chemists to design and develop hepatotoxicity-free pharmaceutical products containing the inhibitors of these enzymes to reduce hepatotoxicity and improve human health.
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Affiliation(s)
- Piyush Mahajan
- Department of Pharmaceutical Quality Assurance, SVKM's NMIMS School of Pharmacy and Technology Management, Shirpur, Maharashtra, India
| | - Mahesh Palkar
- Department of Pharmaceutical Chemistry, SVKM's NMIMS Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, Mumbai, Maharashtra, India
| | - Ravindra Babu Pingili
- Department of Pharmacology, SVKM's NMIMS School of Pharmacy and Technology Management, Shirpur, Maharashtra, India
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2
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Munzen ME, Goncalves Garcia AD, Martinez LR. An update on the global treatment of invasive fungal infections. Future Microbiol 2023; 18:1095-1117. [PMID: 37750748 DOI: 10.2217/fmb-2022-0269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
Fungal infections are a serious problem affecting many people worldwide, creating critical economic and medical consequences. Fungi are ubiquitous and can cause invasive diseases in individuals mostly living in developing countries or with weakened immune systems, and antifungal drugs currently available have important limitations in tolerability and efficacy. In an effort to counteract the high morbidity and mortality rates associated with invasive fungal infections, various approaches are being utilized to discover and develop new antifungal agents. This review discusses the challenges posed by fungal infections, outlines different methods for developing antifungal drugs and reports on the status of drugs currently in clinical trials, which offer hope for combating this serious global problem.
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Affiliation(s)
- Melissa E Munzen
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL 32610, USA
| | | | - Luis R Martinez
- Department of Oral Biology, University of Florida College of Dentistry, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
- Center for Immunology and Transplantation, University of Florida, Gainesville, FL 32610, USA
- Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL 32610, USA
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3
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Visvanathan N, Lim JYA, Chng HT, Xie S. A Critical Review on the Dosing and Safety of Antifungals Used in Exotic Avian and Reptile Species. J Fungi (Basel) 2023; 9:810. [PMID: 37623581 PMCID: PMC10455840 DOI: 10.3390/jof9080810] [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: 05/31/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Antifungals are used in exotic avian and reptile species for the treatment of fungal diseases. Dose extrapolations across species are common due to lack of species-specific pharmacological data. This may not be ideal because interspecies physiological differences may result in subtherapeutic dosing or toxicity. This critical review aims to collate existing pharmacological data to identify antifungals with the most evidence to support their safe and effective use. In the process, significant trends and gaps are also identified and discussed. An extensive search was conducted on PubMed and JSTOR, and relevant data were critically appraised. Itraconazole or voriconazole showed promising results in Japanese quails, racing pigeons and inland bearded dragons for the treatment of aspergillosis and CANV-related infections. Voriconazole neurotoxicity manifested as seizures in multiple penguins, but as lethargy or torticollis in cottonmouths. Itraconazole toxicity was predominantly hepatotoxicity, observed as liver abnormalities in inland bearded dragons and a Parson's chameleon. Differences in formulations of itraconazole affected various absorption parameters. Non-linearities in voriconazole due to saturable metabolism and autoinduction showed opposing effects on clearance, especially in multiple-dosing regimens. These differences in pharmacokinetic parameters across species resulted in varying elimination half-lives. Terbinafine has been used in dermatomycoses, especially in reptiles, due to its keratinophilic nature, and no significant adverse events were observed. The use of fluconazole has declined due to resistance or its narrow spectrum of activity.
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Affiliation(s)
- Naresh Visvanathan
- Department of Pharmacy, National University of Singapore, Singapore 117559, Singapore
| | - Jolise Yi An Lim
- Department of Pharmacy, National University of Singapore, Singapore 117559, Singapore
| | - Hui Ting Chng
- Department of Pharmacy, National University of Singapore, Singapore 117559, Singapore
| | - Shangzhe Xie
- Mandai Wildlife Group, 80 Mandai Lake Road, Singapore 729826, Singapore
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4
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Farghali H, Kutinová Canová N, Arora M. The potential applications of artificial intelligence in drug discovery and development. Physiol Res 2021. [DOI: 10.33549//physiolres.934765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Development of a new dug is a very lengthy and highly expensive process since only preclinical, pharmacokinetic, pharmacodynamic and toxicological studies include a multiple of in silico, in vitro, in vivo experimentations that traditionally last several years. In the present review, we briefly report some examples that demonstrate the power of the computer-assisted drug discovery process with some examples that are published and revealing the successful applications of artificial intelligence (AI) technology on this vivid area. Besides, we address the situation of drug repositioning (repurposing) in clinical applications. Yet few success stories in this regard that provide us with a clear evidence that AI will reveal its great potential in accelerating effective new drug finding. AI accelerates drug repurposing and AI approaches are altogether necessary and inevitable tools in new medicine development. In spite of the fact that AI in drug development is still in its infancy, the advancements in AI and machine-learning (ML) algorithms have an unprecedented potential. The AI/ML solutions driven by pharmaceutical scientists, computer scientists, statisticians, physicians and others are increasingly working together in the processes of drug development and are adopting AI-based technologies for the rapid discovery of medicines. AI approaches, coupled with big data, are expected to substantially improve the effectiveness of drug repurposing and finding new drugs for various complex human diseases.
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Affiliation(s)
| | - N Kutinová Canová
- Institute of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
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5
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Schleiff MA, Payakachat S, Schleiff BM, Swamidass SJ, Boysen G, Miller GP. Impacts of diphenylamine NSAID halogenation on bioactivation risks. Toxicology 2021; 458:152832. [PMID: 34107285 DOI: 10.1016/j.tox.2021.152832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 12/14/2022]
Abstract
Diphenylamine NSAIDs are highly prescribed therapeutics for chronic pain despite causing symptomatic hepatotoxicity through mitochondrial damage in five percent of patients taking them. Differences in toxicity are attributed to structural modifications to the diphenylamine scaffold rather than its inherent toxicity. We hypothesize that marketed diphenylamine NSAID substituents affect preference and efficiency of bioactivation pathways and clearance. We parsed the FDA DILIrank hepatotoxicity database and modeled marketed drug bioactivation into quinone-species metabolites to identify a family of seven clinically relevant diphenylamine NSAIDs. These drugs fell into two subgroups, i.e., acetic acid and propionic acid diphenylamines, varying in hepatotoxicity risks and modeled bioactivation propensities. We carried out steady-state kinetic studies to assess bioactivation pathways by trapping quinone-species metabolites with dansyl glutathione. Analysis of the glutathione adducts by mass spectrometry characterized structures while dansyl fluorescence provided quantitative yields for their formation. Resulting kinetics identified four possible bioactivation pathways among the drugs, but reaction preference and efficiency depended upon structural modifications to the diphenylamine scaffold. Strikingly, diphenylamine dihalogenation promotes formation of quinone metabolites through four distinct metabolic pathways with high efficiency, whereas those without aromatic halogen atoms were metabolized less efficiently through two or fewer metabolic pathways. Overall metabolism of the drugs was comparable with bioactivation accounting for 4-13% of clearance. Lastly, we calculated daily bioload exposure of quinone-species metabolites based on bioactivation efficiency, bioavailability, and maximal daily dose. The results revealed stratification into the two subgroups; propionic acid diphenylamines had an average four-fold greater daily bioload compared to acetic acid diphenylamines. However, the lack of sufficient study on the hepatotoxicity for all drugs prevents further correlative analyses. These findings provide critical insights on the impact of diphenylamine bioactivation as a precursor to hepatotoxicity and thus, provide a foundation for better risk assessment in drug discovery and development.
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Affiliation(s)
- Mary Alexandra Schleiff
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Sasin Payakachat
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | | | - S Joshua Swamidass
- Department of Pathology and Immunology, Washington University, St. Louis, MO 63130, United States
| | - Gunnar Boysen
- Department of Environmental and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Grover Paul Miller
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.
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6
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Shibazaki C, Ohe T, Takahashi K, Nakamura S, Mashino T. Development of fluorescent-labeled trapping reagents based on cysteine to detect soft and hard electrophilic reactive metabolites. Drug Metab Pharmacokinet 2021; 39:100386. [PMID: 34091122 DOI: 10.1016/j.dmpk.2021.100386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/27/2021] [Accepted: 02/12/2021] [Indexed: 12/18/2022]
Abstract
Trapping assays are conducted at lead optimization stages to detect reactive metabolites (RMs) that can contribute to drug toxicity. The commonly used dansyl glutathione (dGSH) provides a sensitive analysis owing to the fluorescent label, however, it captures only soft electrophilic RMs. TRs for hard electrophilic RMs, few of which are labeled fluorescently, can detect hard electrophilic aldehydes only by forming unstable imine derivatives. In this study, we aimed to develop novel fluorescently labeled TRs that detect both soft and hard electrophilic RMs and form stable ring structures with aldehydes. We designed four dansylated TRs based on cysteine, which has both soft and hard nucleophilic groups. To evaluate the reactivity of the TRs, we incubated them with several substrates and found that one of the TRs (CysGlu-Dan) detected all the soft and hard electrophilic RMs. We also examined the inhibition potential of each TR for seven major CYPs involved in drug metabolism and found that CysGlu-Dan showed an inhibitory profile similar to that of dGSH. In conclusion, CysGlu-Dan can be used to evaluate the risk of RMs in drug discovery.
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Affiliation(s)
- Chikako Shibazaki
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, Japan
| | - Tomoyuki Ohe
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, Japan.
| | - Kyoko Takahashi
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, Japan
| | - Shigeo Nakamura
- Department of Chemistry, Nippon Medical School, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, Japan
| | - Tadahiko Mashino
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, Japan.
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Schleiff MA, Flynn NR, Payakachat S, Schleiff BM, Pinson AO, Province DW, Swamidass SJ, Boysen G, Miller GP. Significance of Multiple Bioactivation Pathways for Meclofenamate as Revealed through Modeling and Reaction Kinetics. Drug Metab Dispos 2020; 49:133-141. [PMID: 33239334 PMCID: PMC7841419 DOI: 10.1124/dmd.120.000254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/05/2020] [Indexed: 12/20/2022] Open
Abstract
Meclofenamate is a nonsteroidal anti-inflammatory drug used in the treatment of mild-to-moderate pain yet poses a rare risk of hepatotoxicity through an unknown mechanism. Nonsteroidal anti-inflammatory drug (NSAID) bioactivation is a common molecular initiating event for hepatotoxicity. Thus, we hypothesized a similar mechanism for meclofenamate and leveraged computational and experimental approaches to identify and characterize its bioactivation. Analyses employing our XenoNet model indicated possible pathways to meclofenamate bioactivation into 19 reactive metabolites subsequently trapped into glutathione adducts. We describe the first reported bioactivation kinetics for meclofenamate and relative importance of those pathways using human liver microsomes. The findings validated only four of the many bioactivation pathways predicted by modeling. For experimental studies, dansyl glutathione was a critical trap for reactive quinone metabolites and provided a way to characterize adduct structures by mass spectrometry and quantitate yields during reactions. Of the four quinone adducts, we were able to characterize structures for three of them. Based on kinetics, the most efficient bioactivation pathway led to the monohydroxy para-quinone-imine followed by the dechloro-ortho-quinone-imine. Two very inefficient pathways led to the dihydroxy ortho-quinone and a likely multiply adducted quinone. When taken together, bioactivation pathways for meclofenamate accounted for approximately 13% of total metabolism. In sum, XenoNet facilitated prediction of reactive metabolite structures, whereas quantitative experimental studies provided a tractable approach to validate actual bioactivation pathways for meclofenamate. Our results provide a foundation for assessing reactive metabolite load more accurately for future comparative studies with other NSAIDs and drugs in general.
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Affiliation(s)
- Mary Alexandra Schleiff
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - Noah R Flynn
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - Sasin Payakachat
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - Benjamin Mark Schleiff
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - Anna O Pinson
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - Dennis W Province
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - S Joshua Swamidass
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - Gunnar Boysen
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
| | - Grover P Miller
- Departments of Biochemistry and Molecular Biology (M.A.S, G.P.M.) and Environmental and Occupational Health (G.B.), University of Arkansas for Medical Sciences, Little Rock, Arizona (M.A.S.); Department of Pathology and Immunology, Washington University, St. Louis, Missouri (N.R.F., S.J.S.); Department of Chemistry, Hendrix College, Conway, Arizona (S.P.); and Independent Researcher (B.M.S.) and Department of Chemistry and Biochemistry (A.O.P., D.W.P.), Harding University, Searcy, Arkansas
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Flynn NR, Dang NL, Ward MD, Swamidass SJ. XenoNet: Inference and Likelihood of Intermediate Metabolite Formation. J Chem Inf Model 2020; 60:3431-3449. [PMID: 32525671 PMCID: PMC8716322 DOI: 10.1021/acs.jcim.0c00361] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Drug metabolism is a common cause of adverse drug reactions. Drug molecules can be metabolized into reactive metabolites, which can conjugate to biomolecules, like protein and DNA, in a process termed bioactivation. To mitigate adverse reactions caused by bioactivation, both experimental and computational screening assays are utilized. Experimental assays for assessing the formation of reactive metabolites are low throughput and expensive to perform, so they are often reserved until later stages of the drug development pipeline when the drug candidate pools are already significantly narrowed. In contrast, computational methods are high throughput and cheap to perform to screen thousands to millions of compounds for potentially toxic molecules during the early stages of the drug development pipeline. Commonly used computational methods focus on detecting and structurally characterizing reactive metabolite-biomolecule adducts or predicting sites on a drug molecule that are liable to form reactive metabolites. However, such methods are often only concerned with the structure of the initial drug molecule or of the adduct formed when a biomolecule conjugates to a reactive metabolite. Thus, these methods are likely to miss intermediate metabolites that may lead to subsequent reactive metabolite formation. To address these shortcomings, we create XenoNet, a metabolic network predictor, that can take a pair of a substrate and a target product as input and (1) enumerate pathways, or sequences of intermediate metabolite structures, between the pair, and (2) compute the likelihood of those pathways and intermediate metabolites. We validate XenoNet on a large, chemically diverse data set of 17 054 metabolic networks built from a literature-derived reaction database. Each metabolic network has a defined substrate molecule that has been experimentally observed to undergo metabolism into a defined product metabolite. XenoNet can predict experimentally observed pathways and intermediate metabolites linking the input substrate and product pair with a recall of 88 and 46%, respectively. Using likelihood scoring, XenoNet also achieves a top-one pathway and intermediate metabolite accuracy of 93.6 and 51.9%, respectively. We further validate XenoNet against prior methods for metabolite prediction. XenoNet significantly outperforms all prior methods across multiple metrics. XenoNet is available at https://swami.wustl.edu/xenonet.
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Affiliation(s)
- Noah R Flynn
- Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 S. Euclid Ave., St. Louis, Missouri 63110, United States
| | - Na Le Dang
- Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 S. Euclid Ave., St. Louis, Missouri 63110, United States
| | - Michael D Ward
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, Missouri 63110, United States
| | - S Joshua Swamidass
- Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 S. Euclid Ave., St. Louis, Missouri 63110, United States
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9
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Barnette DA, Davis MA, Flynn N, Pidugu AS, Swamidass SJ, Miller GP. Comprehensive kinetic and modeling analyses revealed CYP2C9 and 3A4 determine terbinafine metabolic clearance and bioactivation. Biochem Pharmacol 2019; 170:113661. [PMID: 31605674 PMCID: PMC6905088 DOI: 10.1016/j.bcp.2019.113661] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 10/07/2019] [Indexed: 01/27/2023]
Abstract
Terbinafine N-dealkylation pathways result in formation of 6,6-dimethyl-2-hepten-4-ynal (TBF-A), a reactive allylic aldehyde, that may initiate idiosyncratic drug-induced liver toxicity. Previously, we reported on the importance of CYP2C19 and 3A4 as major contributors to TBF-A formation. In this study, we expanded on those efforts to assess individual contributions of CYP1A2, 2B6, 2C8, 2C9, and 2D6 in terbinafine metabolism. The combined knowledge gained from these studies allowed us to scale the relative roles of the P450 isozymes in hepatic clearance of terbinafine including pathways leading to TBF-A, and hence, provide a foundation for assessing their significance in terbinafine-induced hepatotoxicity. We used in vitro terbinafine reactions with recombinant P450s to measure kinetics for multiple metabolic pathways and calculated contributions of all individual P450 isozymes to in vivo hepatic clearance for the average human adult. The findings confirmed that CYP3A4 was a major contributor (at least 30% total metabolism) to all three of the possible N-dealkylation pathways; however, CYP2C9, and not CYP2C19, played a critical role in terbinafine metabolism and even exceeded CYP3A4 contributions for terbinafine N-demethylation. A combination of their metabolic capacities accounted for at least 80% of the conversion of terbinafine to TBF-A, while CYP1A2, 2B6, 2C8, and 2D6 made minor contributions. Computational approaches provide a more rapid, less resource-intensive strategy for assessing metabolism, and thus, we additionally predicted terbinafine metabolism using deep neural network models for individual P450 isozymes. Cytochrome P450 isozyme models accurately predicted the likelihood for terbinafine N-demethylation, but overestimated the likelihood for a minor N-denaphthylation pathway. Moreover, the models were not able to differentiate the varying roles of the individual P450 isozymes for specific reactions with this particular drug. Taken together, the significance of CYP2C9 and 3A4 and to a lesser extent, CYP2C19, in terbinafine metabolism is consistent with reported drug interactions. This finding suggests that variations in individual P450 contributions due to other factors like polymorphisms may similarly contribute to terbinafine-related adverse health outcomes. Nevertheless, the impact of their metabolic capacities on formation of reactive TBF-A and consequent idiosyncratic hepatotoxicity will be mitigated by competing detoxification pathways, TBF-A decay, and TBF-A adduction to glutathione that remain understudied.
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Affiliation(s)
- Dustyn A Barnette
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Mary A Davis
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Noah Flynn
- Department of Pathology and Immunology, Washington University, St. Louis, MO 63130, United States
| | - Anirudh S Pidugu
- Department of Chemistry, Emory University, Atlanta, GA 30322, Georgia
| | - S Joshua Swamidass
- Department of Pathology and Immunology, Washington University, St. Louis, MO 63130, United States
| | - Grover P Miller
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.
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10
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Mendez KM, Broadhurst DI, Reinke SN. The application of artificial neural networks in metabolomics: a historical perspective. Metabolomics 2019; 15:142. [PMID: 31628551 DOI: 10.1007/s11306-019-1608-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/11/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Metabolomics data, with its complex covariance structure, is typically modelled by projection-based machine learning (ML) methods such as partial least squares (PLS) regression, which project data into a latent structure. Biological data are often non-linear, so it is reasonable to hypothesize that metabolomics data may also have a non-linear latent structure, which in turn would be best modelled using non-linear equations. A non-linear ML method with a similar projection equation structure to PLS is artificial neural networks (ANNs). While ANNs were first applied to metabolic profiling data in the 1990s, the lack of community acceptance combined with limitations in computational capacity and the lack of volume of data for robust non-linear model optimisation inhibited their widespread use. Due to recent advances in computational power, modelling improvements, community acceptance, and the more demanding needs for data science, ANNs have made a recent resurgence in interest across research communities, including a small yet growing usage in metabolomics. As metabolomics experiments become more complex and start to be integrated with other omics data, there is potential for ANNs to become a viable alternative to linear projection methods. AIM OF REVIEW We aim to first describe ANNs and their structural equivalence to linear projection-based methods, including PLS regression. We then review the historical, current, and future uses of ANNs in the field of metabolomics. KEY SCIENTIFIC CONCEPT OF REVIEW Is metabolomics ready for the return of artificial neural networks?
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Affiliation(s)
- Kevin M Mendez
- Centre for Integrative Metabolomics & Computational Biology, School of Science, Edith Cowan University, Joondalup, 6027, Australia
| | - David I Broadhurst
- Centre for Integrative Metabolomics & Computational Biology, School of Science, Edith Cowan University, Joondalup, 6027, Australia.
| | - Stacey N Reinke
- Centre for Integrative Metabolomics & Computational Biology, School of Science, Edith Cowan University, Joondalup, 6027, Australia.
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11
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Davis MA, Barnette DA, Flynn NR, Pidugu AS, Swamidass SJ, Boysen G, Miller GP. CYP2C19 and 3A4 Dominate Metabolic Clearance and Bioactivation of Terbinafine Based on Computational and Experimental Approaches. Chem Res Toxicol 2019; 32:1151-1164. [PMID: 30925039 DOI: 10.1021/acs.chemrestox.9b00006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Lamisil (terbinafine) is an effective, widely prescribed antifungal drug that causes rare idiosyncratic hepatotoxicity. The proposed toxic mechanism involves a reactive metabolite, 6,6-dimethyl-2-hepten-4-ynal (TBF-A), formed through three N-dealkylation pathways. We were the first to characterize them using in vitro studies with human liver microsomes and modeling approaches, yet knowledge of the individual enzymes catalyzing reactions remained unknown. Herein, we employed experimental and computational tools to assess terbinafine metabolism by specific cytochrome P450 isozymes. In vitro inhibitor phenotyping studies revealed six isozymes were involved in one or more N-dealkylation pathways. CYP2C19 and 3A4 contributed to all pathways, and so, we targeted them for steady-state analyses with recombinant isozymes. N-Dealkylation yielding TBF-A directly was catalyzed by CYP2C19 and 3A4 similarly. Nevertheless, CYP2C19 was more efficient than CYP3A4 at N-demethylation and other steps leading to TBF-A. Unlike microsomal reactions, N-denaphthylation was surprisingly efficient for CYP2C19 and 3A4, which was validated by controls. CYP2C19 was the most efficient among all reactions. Nonetheless, CYP3A4 was more selective at steps leading to TBF-A, making it more effective in terbinafine bioactivation based on metabolic split ratios for competing pathways. Model predictions did not extrapolate to quantitative kinetic constants, yet some results for CYP3A4 and CYP2C19 agreed qualitatively with preferred reaction steps and pathways. Clinical data on drug interactions support the CYP3A4 role in terbinafine metabolism, while CYP2C19 remains understudied. Taken together, knowledge of P450s responsible for terbinafine metabolism and TBF-A formation provides a foundation for investigating and mitigating the impact of P450 variations in toxic risks posed to patients.
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Affiliation(s)
- Mary A Davis
- Department of Biochemistry and Molecular Biology , University of Arkansas for Medical Sciences , Little Rock , Arkansas 72205 , United States
| | - Dustyn A Barnette
- Department of Biochemistry and Molecular Biology , University of Arkansas for Medical Sciences , Little Rock , Arkansas 72205 , United States
| | - Noah R Flynn
- Department of Pathology and Immunology , Washington University , St. Louis , Missouri 63130 , United States
| | - Anirudh S Pidugu
- Department of Neuroscience and Behavioral Biology , Emory University , Atlanta , Georgia 30322 , United States
| | - S Joshua Swamidass
- Department of Pathology and Immunology , Washington University , St. Louis , Missouri 63130 , United States
| | - Gunnar Boysen
- Department of Environmental and Occupational Health , University of Arkansas for Medical Sciences , Little Rock , Arkansas 72205 , United States
| | - Grover P Miller
- Department of Biochemistry and Molecular Biology , University of Arkansas for Medical Sciences , Little Rock , Arkansas 72205 , United States
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Liu Y, Vu V, Sweeney G. Examining the Potential of Developing and Implementing Use of Adiponectin-Targeted Therapeutics for Metabolic and Cardiovascular Diseases. Front Endocrinol (Lausanne) 2019; 10:842. [PMID: 31920962 PMCID: PMC6918867 DOI: 10.3389/fendo.2019.00842] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 11/19/2019] [Indexed: 02/06/2023] Open
Abstract
Cardiometabolic diseases encompass those affecting the heart and vasculature as well as other metabolic problems, such as insulin resistance, diabetes, and non-alcoholic fatty liver disease. These diseases tend to have common risk factors, one of which is impaired adiponectin action. This may be due to reduced bioavailability of the hormone or resistance to its effects on target tissues. A strong negative correlation between adiponectin levels and cardiometabolic diseases has been well-documented and research shown that adiponectin has cardioprotective, insulin sensitizing and direct beneficial metabolic effects. Thus, therapeutic approaches to enhance adiponectin action are widely considered to be desirable. The complexity of adiponectin structure and function has so far made progress in this area less than ideal. In this article we will review the effects and mechanism of action of adiponectin on cardiometabolic tissues, identify scenarios where enhancing adiponectin action would be of clinical value and finally discuss approaches via which this can be achieved.
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Affiliation(s)
- Ying Liu
- Metabolic Disease Research Division, iCarbonX Co. Ltd., Shenzhen, China
- *Correspondence: Ying Liu
| | - Vivian Vu
- Department of Biology, York University, Toronto, ON, Canada
| | - Gary Sweeney
- Department of Biology, York University, Toronto, ON, Canada
- Gary Sweeney
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