In vitro metabolism of zolmitriptan in rat cytochromes induced with β-naphthoflavone and the interaction between six drugs and zolmitriptan

Metabolic activation of zolmitriptan mediated by CYP2D6

Zolmitriptan (ZOL), a member of triptans, has been used for the treatment of migraine with definite therapeutic effects. However, several cases of liver injury associated with ZOL have been reported and the underlying mechanisms remain unclear.The present study aimed to investigate the metabolic activation of ZOL in vitro and in vivo. ZOL-derived glutathione (GSH) and N-acetyl cysteine (NAC) conjugates were detected in rat liver microsomal incubations. In addition, the GSH and NAC conjugates were also found in bile and urine of rats given ZOL, respectively.ZOL-derived GSH conjugate M1 was also observed in ZOL-treated rat primary hepatocytes, and the formation of M1 was inhibited by pre-cultured with quinidine (a selective inhibitor of CYP2D6). Combining with recombinant P450 enzymes incubations, we found that CYP2D6 was the predominant enzyme responsible for the metabolic activation of ZOL.ZOL can be metabolized to an α,β-unsaturated imine intermediate by CYP2D6. Pre-treatment of primary hepatocytes with quinidine was able to reverse ZOL-induced cytotoxicity. The finding facilitates the understanding of the mechanisms involved in ZOL-associated liver adverse reactions.

Considering CYP1A2 phenotype and genotype for optimizing the dose of olanzapine in the management of schizophrenia

INTRODUCTION

Schizophrenia, a mental disorder, is a debilitating condition which typically strikes young people in their early 20's. Antipsychotic medications are widely prescribed for the treatment of schizophrenia however a balancing act is necessary to provide the correct dose to each patient. It is suggested that a large number of patients discontinue antipsychotic pharmacotherapy because the treatments provided do not always reduce the positive symptoms of the disease, while many have adverse effects on the patients. This implies that neither the incorrect drug nor the optimal dosage for that patient is achieved.

AREAS COVERED

The current review investigates variability in response to olanzapine with a specific focus on the common intrinsic and extrinsic factors that influence both olanzapine and CYP1A2 activity. Furthermore, the authors discuss the utilization of phenotyping and genotyping of CYP1A2 and their potential utility in clinical practice for olanzapine dosing regimens. The authors also consider the potential of pharmacometrics compared to pharmacogenomics as a tool to personalize medicine.

EXPERT OPINION

Careful consideration must be given to the impact of a genetic variant on the disposition of a drug prior to implementing genetic 'tests' to determine response. CYP1A2 phenotypic assessment can yield important information regarding the disposition of olanzapine; however, it relies on the accuracy of the metric and the minimal impact of other metabolic pathways. The application of pharmacometrics provides an effective method to establish covariates that significantly influence olanzapine disposition which can incorporate phenotype and/or genotype.

Male-specific induction of CYP3A2 in rats by zolmitriptan

We report here a novel observation that zolmitriptan induced CYP3A2 in male but not female rats. As part of our research programme to evaluate sex differences in the response to zolmitriptan, we studied the effects of zolmitriptan on CYP3A activity, protein and gene expression in male and female rats. Zolmitriptan was found to induce CYP3A activity, measured as testosterone and diazepam metabolism in-vitro, as well as midazolam pharmacokinetics in-vivo, in male but not female rats. The sex difference in response to zolmitriptan was further evaluated by analysis of CYP3A1/2 mRNA levels using real-time PCR, and CYP3A1/2 protein levels using immunoblotting. Zolmitriptan preferentially induced CYP3A2 in male but not female rats. No obvious effects on CYP3A1 were observed at any dose in either sex. Thus, we concluded that the observed sex-dependent induction of CYP3A by zolmitriptan was largely due to induction of CYP3A2 in male rats.

Transport characteristics of zolmitriptan in a human intestinal epithelial cell line Caco-2

The intestinal absorption characteristics and the efflux mechanisms of zolmitriptan, a new generation and highly selective 5-HT1B/1D receptor agonist used in the acute oral treatment of migraine, were investigated. A human intestinal cell line, Caco-2, was used as an in-vitro model of the intestinal mucosa to assess transepithelial transport of zolmitriptan. In the Caco-2 cells, the absorptive transport of zolmitriptan was pH dependent and the transport was enhanced at weakly alkali pH on the apical side. No concentration dependence and saturation were observed for the apical-to-basolateral and basolateral-to-apical transport of zolmitriptan at a concentration of 0.1–10 mM. The permeability ratio value was about 1.5-2.6 at a concentration of 0.1–2.0 mM. Inhibition experiments using verapamil, nifedipine and nimodipine as inhibitors were studied and indicated that P-glycoprotein participated in the transport of zolmitriptan. Inhibition of the Na+-H+ exchanger with amiloride resulted in a significant increase in absorption and a slight inhibition in secretion. This suggests that the Na+-H+ exchanger may be involved in the transport of zolmitriptan. The results indicated that the transport of zolmitriptan was mediated by both passive diffusion and active transport. A series of drug-drug interaction experiments were carried out between zolmitriptan and some drugs that may be co-administrated with zolmitriptan in the clinic. The results indicated that flunarizine, cetirizine, propranolol and atenolol potently decreased both the apical-to-basolateral and basolateral-to-apical transport rate of zolmitriptan. Cimetidine and aspirin slightly inhibited the apical-to-basolateral transport of zolmitriptan, but significantly decreased the basolateral-to-apical transport of zolmitriptan. Thus, the absorption drug-drug interactions should be considered when these drugs are co-administrated with zolmitriptan in the clinic.

Structural elucidation of metabolites of ginkgolic acid in rat liver microsomes by ultra-performance liquid chromatography/electrospray ionization tandem mass spectrometry and hydrogen/deuterium exchange

Ginkgolic acids have been shown to possess allergenic as well as genotoxic and cytotoxic properties. The question arises whether the metabolism of ginkgolic acids in the liver could decrease or increase their toxicity. In this study, the in vitro metabolism of ginkgolic acid (15:1, GA), one component of ginkgo acids, was investigated as a model compound in Sprague-Dawley rat liver microsomes. The metabolites were analyzed by ultra-performance liquid chromatography coupled with photodiode array detector/negative-ion electrospray ionization tandem mass spectrometry (UPLC-PDA/ESI-MS/MS) and hydrogen/deuterium (H/D) exchange. The result showed that the benzene ring remained unchanged and the oxidations occurred at the side alkyl chain in rat liver microsomes. At least eight metabolites were found. Among them, six phase I metabolites were tentatively identified. This study might be useful for the investigation of toxicological mechanism of ginkgolic acids.

Carboxyl-glucuronidation of mitiglinide by human UDP-glucuronosyltransferases

Mitiglinide (MGN) is a new potassium channel antagonist for the treatment of type 2 diabetes mellitus. In the present study, a potential metabolic pathway of MGN, via carboxyl-linked glucuronic acid conjugation, was found. MGN carboxyl-glucuronide was isolated from a reaction mixture consisting of MGN and human liver microsomes fortified with UDP-glucuronic acid (UDPGA) and identified by a hydrolysis reaction with beta-glucuronidase and HPLC-MS/MS. Kinetic analysis indicated that MGN from four species had the highest affinity for the rabbit liver microsomal enzyme (K(m)=0.202 mM) and the lowest affinity for the dog liver microsomal enzyme (K(m)=1.164 mM). The metabolic activity (V(max)/K(m)) of MGN to the carboxyl-glucuronidation was in the following order: rabbit>dog>rat>human. With the assessment of MGN glucuronide formation across a panel of recombinant UDP-glucuronosyltransferase (UGT) isoforms (UGT1A3, UGT1A4, UGT1A6, UGT1A9, and UGT2B7), only UGT1A3 and UGT2B7 exhibited high MGN glucuronosyltransferase activity. The K(m) values of MGN glucuronidation in recombinant UGT1A3 and UGT2B7 microsomes were close to those in human liver microsomes. The formation of MGN glucuronidation by human liver microsomes was effectively inhibited by quercetin (substrate for UGT1A3) and diclofenac (substrate for UGT2B7), respectively. The MGN glucuronidation activities in 15 human liver microsomes were significantly correlated with quercetin (r(2)=0.806) and diclofenac glucuronidation activities (r(2)=0.704), respectively. These results demonstrate that UGT1A3 and UGT2B7 are catalytic enzymes in MGN carboxyl-glucuronidation in human liver.

Determination of zolmitriptan enantiomers in rat liver microsomes by chiral high performance liquid chromatography with ?uorescence detection

A selective chiral high performance liquid chromatographic method was developed and validated to separate and quantify the enantiomers of a new potent selective 5-HT(1B/1D) receptor partial agonist, S-zolmitriptan, and its antipode in rat liver microsomes induced with beta-naphtho flavone. S- and R-zolmitriptan were extracted from rat hepatic microsomal incubates with chloroform/isopropanol (75:25, v/v), and were separated on a narrow-bore enantioselective normal phase Chiralpak AD-H column (250 x 0.46 mm) with hexane-isopropanol-triethylamine (72/28/0.25, v/v/v) as mobile phase and fluorescence detection with emission at 350 nm and excitation at 291 nm. The calibration curves were linear for R- and S-zolmitriptan concentration over the range 0.1-5.0 microg/mL (r = 0.9996 and 0.9999), and the limits of quantitation were 0.1 microg/mL. The metabolism and interaction of the enantiomers of zolmitriptan in treated hepatic microsomes were investigated using chiral HPLC. There was significant difference between the disposition of the S- and R-zolmitriptan when racemic zolmitriptan or single enantiomers of zolmitriptan were incubated for 5, 10 and 20 min, suggesting that the metabolism of zolmitriptan in rat liver microsomes is enantioselective. In addition, there was also a significant difference between the IC(50) of R- to S-zolmitriptan and S- to R-zolmitriptan (IC(50S/R)/IC(50R/S) = 45.2). This indicated that the disposition process favored the S-form of zolmitriptan.