Evidence for CYP2D1-mediated primary and secondary O-dealkylation of ethylmorphine and codeine in rat liver microsomes

Intestinal Absorption Study: Challenges and Absorption Enhancement Strategies in Improving Oral Drug Delivery

The oral route is the most common and practical means of drug administration, particularly from a patient’s perspective. However, the pharmacokinetic profile of oral drugs depends on the rate of drug absorption through the intestinal wall before entering the systemic circulation. However, the enteric epithelium represents one of the major limiting steps for drug absorption, due to the presence of efflux transporters on the intestinal membrane, mucous layer, enzymatic degradation, and the existence of tight junctions along the intestinal linings. These challenges are more noticeable for hydrophilic drugs, high molecular weight drugs, and drugs that are substrates of the efflux transporters. Another challenge faced by oral drug delivery is the presence of first-pass hepatic metabolism that can result in reduced drug bioavailability. Over the years, a wide range of compounds have been investigated for their permeation-enhancing effect in order to circumvent these challenges. There is also a growing interest in developing nanocarrier-based formulation strategies to enhance the drug absorption. Therefore, this review aims to provide an overview of the challenges faced by oral drug delivery and selected strategies to enhance the oral drug absorption, including the application of absorption enhancers and nanocarrier-based formulations based on in vitro, in vivo, and in situ studies.

First demonstration that brain CYP2D-mediated opiate metabolic activation alters analgesia in vivo

The response to centrally acting drugs is highly variable between individuals and does not always correlate with plasma drug levels. Drug-metabolizing CYP enzymes in the brain may contribute to this variability by affecting local drug and metabolite concentrations. CYP2D metabolizes codeine to the active morphine metabolite. We investigated the effect of inhibiting brain, and not liver, CYP2D activity on codeine-induced analgesia. Rats received intracerebroventricular injections of CYP2D inhibitors (20 μg propranolol or 40 μg propafenone) or vehicle controls. Compared to vehicle-pretreated rats, inhibitor-pretreated rats had: (a) lower analgesia in the tail-flick test (p<0.05) and lower areas under the analgesia-time curve (p<0.02) within the first hour after 30 mg/kg subcutaneous codeine, (b) lower morphine concentrations and morphine to codeine ratios in the brain (p<0.02 and p<0.05, respectively), but not in plasma (p>0.6 and p>0.7, respectively), tested at 30 min after 30 mg/kg subcutaneous codeine, and (c) lower morphine formation from codeine ex vivo by brain membranes (p<0.04), but not by liver microsomes (p>0.9). Analgesia trended toward a correlation with brain morphine concentrations (p=0.07) and correlated with brain morphine to codeine ratios (p<0.005), but not with plasma morphine concentrations (p>0.8) or plasma morphine to codeine ratios (p>0.8). Our findings suggest that brain CYP2D affects brain morphine levels after peripheral codeine administration, and may thereby alter codeine's therapeutic efficacy, side-effect profile and abuse liability. Brain CYPs are highly variable due to genetics, environmental factors and age, and may therefore contribute to interindividual variation in the response to centrally acting drugs.

Prosubstrates of CYP3A4, the major human hepatic cytochrome P450: transformation into substrates by other P450 isoforms

This study demonstrates interplay among human hepatic cytochrome P450 (CYP) isoforms in transforming aromatic compounds from being prosubstrates of CYP3A4 into phenolic substrates. Incubation of methoxychlor with CYP2C19 yields the phenolic monodemethylated derivative (mono-OH-M). Additionally, CYP2C19 catalyzes the ortho-hydroxylation of mono-OH-M and of residual methoxychlor. CYP3A4 does not catalyze the O-demethylation or hydroxylation of methoxychlor, but does hydroxylate mono-OH-M (ortho to the phenolic hydroxyl) (Stresser DM and Kupfer D, Biochemistry 36: 2203-2210, 1997). A combination of reconstituted CYP2C19 and 3A4 in the same vessel elicits stimulation of the ortho-hydroxylation of mono-OH-M compared with 2C19 alone. It is unlikely that stimulation of hydroxylation was due to protein-protein interactions, generating more active P450(s), because progression of the stimulation was time-dependent. When reconstituted CYP3A4 was added to an ongoing incubation containing reconstituted 2C19, stimulation of catechol formation occurred. In another experiment, stimulatory activity was similar when 2C19 and 3A4 were reconstituted together in the same vesicles or separately. Cumulative evidence demonstrates that the stimulation of catechol formation resulted from CYP3A4-mediated ortho-hydroxylation of the phenolic metabolite(s) generated by CYP2C19. Similarly, estradiol 3-methyl ether is demethylated by CYP2C19 into estradiol, a CYP3A4 substrate for ortho-hydroxylation; there was significant stimulation of hydroxylation by combined 2C19 and 3A4. These findings demonstrate that pro-phenolic compounds (methoxychlor and estradiol 3-methyl ether) are prosubstrates of CYP3A4. Because catalysis may become evident only after prosubstrate conversion (by a different P450) into a substrate, caution is warranted when concluding a lack of catalytic involvement by a particular P450 isoform, based solely on data from the use of individual cDNA-expressed P450s.

Effects of horminone on liver mixed function mono-oxygenases and glutathione enzyme activities of Wistar rat

The present study reports on the effects of horminone on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, on hepatic cytochrome P450 (P450) and cytochrome b5 (cyt b5) contents and on the activities of NADPH-cytochrome P450 reductase (NR), mixed function mono-oxygenases (MFO), glutathione-S-transferase (GST) and glutathione reductase (GR) of Wistar male rat. Horminone is a diterpenoid quinone (7,12-dihydroxyabiet-8,12-diene-11,14-dione) present in several species of the Labiatae family and used as medicinal plants in folk medicine. In this study, horminone was administered by the intraperitoneal route (i.p.) at a concentration of 1 or 10 mg/kg to each group of six mice, using water as a vehicle. On the one hand, results showed that horminone increased serum ALT and AST levels and cyt b5 content and induced the activities of ethylmorphine N-demethylase (EMD). On the other hand, horminone decreased P450 content and inhibited the activities of 7-ethoxyresorufin O-deethylase (ERD), 7-ethoxycoumarin O-deethylase (ECD), aniline 4-hydroxylase (AH) and NR. Based on these results, the possibility of toxic effects occurring after administration of plant extracts containing horminone must be considered.