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Sun D, Liu Y, Zhu L, Xu Z, Zhang Y, Li H, Yang H, Cao X, Gu J. Pharmacokinetic/Pharmacodynamic Assessment of the Structural Refinement of Clopidogrel Focusing on the Balance between Bioactivation and Deactivation. Drug Metab Dispos 2024; 52:654-661. [PMID: 38729662 DOI: 10.1124/dmd.124.001699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
The delicate balance between ischemic and bleeding risks is a critical factor in antiplatelet therapy administration. Clopidogrel and prasugrel, belonging to the thienopyridine class of antiplatelet drugs, are known for their variability in individual responsiveness and high incidence of bleeding events, respectively. The present study is centered on the development and assessment of a range of deuterated thienopyridine derivatives, leveraging insights from structure-pharmacokinetic relationships of clopidogrel and prasugrel. Our approaches were grounded in the molecular framework of clopidogrel and incorporated the C2-pharmacophore design from prasugrel. The selection of ester or carbamate substituents at the C2-position facilitated the generation of the 2-oxointermediate through hydrolysis, akin to prasugrel, thereby bypassing the issue of CYP2C19 dependency. The bulky C2-pharmacophore in our approach distinguishes itself from prasugrel's acetyloxy substituent by exhibiting a moderated hydrolysis rate, resulting in a more gradual formation of the active metabolite. Excessive and rapid release of the active metabolite, believed to be linked with an elevated risk of bleeding, is thus mitigated. Our proposed structural modification retains the hydrolysis-sensitive methyl ester of clopidogrel but substitutes it with a deuterated methyl group, shown to effectively reduce metabolic deactivation. Three promising compounds demonstrated a pharmacokinetic profile similar to that of clopidogrel at four times the dose, while also augmenting its antiplatelet activity. SIGNIFICANCE STATEMENT: Inspired by the structure-pharmacokinetic relationship of clopidogrel and prasugrel, a range of clopidogrel derivatives were designed, synthesized, and assessed. Among them, three promising compounds have been identified, striking a delicate balance between efficacy and safety for antiplatelet therapy. Additionally, the ozagrel prodrug conjugate was discovered to exert a synergistic therapeutic effect alongside clopidogrel.
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Affiliation(s)
- Dong Sun
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Yingze Liu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Lin Zhu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Zhiping Xu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Yuyao Zhang
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Haipeng Li
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Huan Yang
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Xia Cao
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
| | - Jingkai Gu
- Research Center for Drug Metabolism, School of Life Science (D.S., L.Z., Y.Z., H.L., H.Y., J.G.), Department of Pharmacology, School of Pharmacy Sciences (Y.L., Z.X., X.C.), and State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry (J.G.), Jilin University, Changchun, China; and Beijing Institute of Drug Metabolism, Beijing, China (J.G.)
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Kuszynski DS, Lauver DA. Pleiotropic effects of clopidogrel. Purinergic Signal 2022; 18:253-265. [PMID: 35678974 DOI: 10.1007/s11302-022-09876-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/26/2022] [Indexed: 01/04/2023] Open
Abstract
Clopidogrel is a widely prescribed prodrug with anti-thrombotic activity through irreversible inhibition of the P2Y12 receptor on platelets. It is FDA-approved for the clinical management of thrombotic diseases like unstable angina, myocardial infarction, stroke, and during percutaneous coronary interventions. Hepatic clopidogrel metabolism generates several distinct metabolites. Only one of these metabolites is responsible for inhibiting the platelet P2Y12 receptor. Importantly, various non-hemostatic effects of clopidogrel therapy have been described. These non-hemostatic effects are perhaps unsurprising, as P2Y12 receptor expression has been reported in multiple tissues, including osteoblasts, leukocytes, as well as vascular endothelium and smooth muscle. While the "inactive" metabolites have been commonly thought to be biologically inert, recent findings have uncovered P2Y12 receptor-independent effects of clopidogrel treatment that may be mediated by understudied metabolites. In this review, we summarize both the P2Y12 receptor-mediated and non-P2Y12 receptor-mediated effects of clopidogrel and its metabolites in various tissues.
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Affiliation(s)
- Dawn S Kuszynski
- Department of Pharmacology and Toxicology, College of Veterinary Medicine, Michigan State University, 1355 Bogue Street, B336 Life Science, East Lansing, MI, USA.,Institute of Integrative Toxicology, Michigan State University, East Lansing, MI, USA
| | - D Adam Lauver
- Department of Pharmacology and Toxicology, College of Veterinary Medicine, Michigan State University, 1355 Bogue Street, B336 Life Science, East Lansing, MI, USA.
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3
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Kaiser RP, Krake EF, Backer L, Urlaub J, Baumann W, Handler N, Buschmann H, Beweries T, Holzgrabe U, Bolm C. Ball milling - a new concept for predicting degradation profiles in active pharmaceutical ingredients. Chem Commun (Camb) 2021; 57:11956-11959. [PMID: 34704567 DOI: 10.1039/d1cc04716g] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A method for forced oxidative mechanochemical degradation of active pharmaceutical ingredients (APIs) using clopidogrel hydrogensulfate as a model compound is presented. Considerable and selective formation of degradants occurs already after very short reaction times of less than 15 minutes and the nature of the products is strongly dependent on the used oxidant.
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Affiliation(s)
- Reinhard P Kaiser
- RWTH Aachen University, Institute of Organic Chemistry, Landoltweg 1, 52074 Aachen, Germany.
| | - Everaldo F Krake
- Leibniz-Institut für Katalyse e.V., Albert-Einstein-Str. 29a, 18059 Rostock, Germany.
| | - Laura Backer
- Institut für Pharmazie und Lebensmittelchemie, Am Hubland, 97074 Würzburg, Germany.
| | - Jonas Urlaub
- Institut für Pharmazie und Lebensmittelchemie, Am Hubland, 97074 Würzburg, Germany.
| | - Wolfgang Baumann
- Leibniz-Institut für Katalyse e.V., Albert-Einstein-Str. 29a, 18059 Rostock, Germany.
| | - Norbert Handler
- RD&C Research, Development & Consulting GmbH, Neuwaldegger Strasse 35/2/3, 1170 Vienna, Austria
| | - Helmut Buschmann
- RD&C Research, Development & Consulting GmbH, Neuwaldegger Strasse 35/2/3, 1170 Vienna, Austria
| | - Torsten Beweries
- Leibniz-Institut für Katalyse e.V., Albert-Einstein-Str. 29a, 18059 Rostock, Germany.
| | - Ulrike Holzgrabe
- Institut für Pharmazie und Lebensmittelchemie, Am Hubland, 97074 Würzburg, Germany.
| | - Carsten Bolm
- RWTH Aachen University, Institute of Organic Chemistry, Landoltweg 1, 52074 Aachen, Germany.
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Wang Q, Sun M, Li D, Li C, Luo C, Wang Z, Zhang W, Yang Z, Feng Y, Wang S, He Z, Zhang H, Kan Q, Sun W, Sun J. Cytochrome P450 enzyme-mediated auto-enhanced photodynamic cancer therapy of co-nanoassembly between clopidogrel and photosensitizer. Theranostics 2020; 10:5550-5564. [PMID: 32373230 PMCID: PMC7196307 DOI: 10.7150/thno.42633] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 02/13/2020] [Indexed: 12/13/2022] Open
Abstract
Reactive oxygen species (ROS)-based photodynamic therapy (PDT) has a widespread application in cancer therapy. Nevertheless, the efficiency of PDT is far from satisfactory. One major impediment is the overexpression of glutathione (GSH) in tumor cells, which could deplete the level of PDT-generated ROS. Herein, we develop a novel type of cytochrome P450 enzyme-mediated auto-enhanced photodynamic co-nanoassembly between clopidogrel (CPG) and photosensitizer pyropheophorbide a (PPa). Methods: In this work, we prepare the co-assembled nanoparticles of CPG and PPa (CPG/PPa NPs) by using one-step precipitation method. The assembly mechanism, drug release behavior, GSH consumption, ROS generation, cellular uptake, cytotoxicity of CPG/PPa NPs are investigated in vitro. The mice bearing 4T1 tumor are employed to evaluate in vivo biodistribution and anti-tumor effect of CPG/PPa NPs. Results: Such CPG/PPa NPs could disrupt the intracellular redox homeostasis, resulting from the elimination of GSH by CPG active metabolite mediated by cytochrome P450 enzyme (CYP2C19). The in vivo assays reveal that CPG/PPa NPs not only increase the drug accumulation in tumor sites but also significantly suppress tumor growth in BALB/c mice bearing 4T1 tumor. With CPG-mediated GSH consumption and PPa-triggered ROS generation, CPG/PPa NPs show the enhanced PDT treatment effect by breaking intracellular redox balance. Conclusion: Our findings provide a valuable knowledge for the rational design of the PDT-based combinational cancer therapy.
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Lauver DA, Kuszynski DS, Christian BD, Bernard MP, Teuber JP, Markham BE, Chen YE, Zhang H. DT-678 inhibits platelet activation with lower tendency for bleeding compared to existing P2Y 12 antagonists. Pharmacol Res Perspect 2019; 7:e00509. [PMID: 31372229 PMCID: PMC6658415 DOI: 10.1002/prp2.509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 12/22/2022] Open
Abstract
The novel clopidogrel conjugate, DT-678, is an effective inhibitor of platelets and thrombosis in preclinical studies. However, a comparison of the bleeding risk with DT-678 and currently approved P2Y12 antagonists has yet to be determined. The objective of this study was to evaluate the bleeding tendency of animals treated with clopidogrel, ticagrelor, and DT-678. Ninety-one New Zealand white rabbits were randomized to one of 13 treatment groups (n = 7). Platelet activation was assessed by flow cytometry and light transmission aggregometry before and after the administration of various doses of DT-678, clopidogrel, and ticagrelor. Tongue template bleeding times were also measured before and after drug treatment. Treatment with P2Y12 receptor antagonists caused a dose-dependent reduction in markers of platelet activation (P-selectin and integrin αIIbβ3) and aggregation in response to adenosine diphosphate stimulation. At the same doses required for platelet inhibition, clopidogrel and ticagrelor significantly prolonged bleeding times, while DT-678 did not. DT-678 and the FDA-approved P2Y12 antagonists clopidogrel and ticagrelor are effective inhibitors of platelet activation and aggregation. However, unlike clopidogrel and ticagrelor, DT-678 did not prolong bleeding times at equally effective antiplatelet doses. The results suggest a more favorable benefit/risk ratio for DT-678 and potential utility as part of a dual antiplatelet therapy regimen.
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Affiliation(s)
- Dale A. Lauver
- Department of Pharmacology and ToxicologyMichigan State UniversityEast LansingMIUSA
| | - Dawn S. Kuszynski
- Department of Pharmacology and ToxicologyMichigan State UniversityEast LansingMIUSA
| | - Barbara D. Christian
- Department of Pharmacology and ToxicologyMichigan State UniversityEast LansingMIUSA
| | - Matthew P. Bernard
- Department of Pharmacology and ToxicologyMichigan State UniversityEast LansingMIUSA
| | - James P. Teuber
- Department of Pharmacology and ToxicologyMichigan State UniversityEast LansingMIUSA
| | | | - Yuqing E. Chen
- Diapin Therapeutics, LLCAnn ArborMIUSA
- Department of PharmacologyUniversity of MichiganAnn ArborMIUSA
| | - Haoming Zhang
- Department of PharmacologyUniversity of MichiganAnn ArborMIUSA
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6
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Lauver DA, Hollenberg P, Zhang H. CYP-independent inhibition of platelet aggregation in rabbits by a mixed disulfide conjugate of clopidogrel. Thromb Haemost 2017; 112:1304-11. [DOI: 10.1160/th14-04-0388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 07/25/2014] [Indexed: 01/27/2023]
Abstract
SummaryDual antiplatelet therapy with clopidogrel and aspirin has been the standard of care in the United States for patients with acute coronary syndromes (ACS) and/or undergoing percutaneous coronary interventions (PCI). However, the effectiveness of clopidogrel varies significantly among different sub-populations due to inter-individual variability. In this study we examined the antiplatelet potential of a novel mixed disulfide conjugate of clopidogrel with the aim to overcome the inter-individual variability. In the metabolic studies using human liver microsomes and cDNA-expressed P450s, we confirmed that multiple P450s are involved in the bioactivation of 2-oxoclopidogrel to H4, one of the diastereomers of the pharmacologically active metabolite (AM) possessing antiplatelet activity. Results from kinetic studies demonstrated that 2C19 is the most active in converting 2-oxoclopidogrel to H4 with a catalytic efficiency of 0.027 µM-1min-1 in the reconstituted system. On the basis of this finding, we were able to biosynthesise the conjugate of clopidogrel with 3-nitropyridine-2-thiol, referred to as clopNPT, and examined its antiplatelet activity in male New Zealand white rabbits. After administration as intravenous bolus at 2 mg/kg, the clopNPT conjugate was rapidly converted to the AM leading to the inhibition of platelet aggregation (IPA). Analyses of the blood samples drawn at various time points showed that intravenous administration of clopNPT led to ~70% IPA within 1 hour and the IPA persisted for more than 3 hours. Since the antiplatelet activity of clopNPT does not require bioactivation by P450s, the mixed disulfide conjugate of clopidogrel has the potential to overcome the inter-individual variability in clopidogrel therapy.
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7
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Zhang H, Lauver DA, Wang H, Sun D, Hollenberg PF, Chen YE, Osawa Y, Eitzman DT. Significant Improvement of Antithrombotic Responses to Clopidogrel by Use of a Novel Conjugate as Revealed in an Arterial Model of Thrombosis. J Pharmacol Exp Ther 2016; 359:11-7. [PMID: 27511819 DOI: 10.1124/jpet.116.236034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/09/2016] [Indexed: 11/22/2022] Open
Abstract
Clopidogrel is a prodrug that requires bioactivation by cytochrome P450 (P450) enzymes to a pharmacologically active metabolite for antiplatelet action. The clinical limitations of clopidogrel are in large part due to its poor pharmacokinetics resulting from inefficient bioactivation by P450s. In this study, we determined the pharmacokinetics and pharmacodynamics of a novel conjugate of clopidogrel, referred to as ClopNPT, in animal models and we evaluated its potential to overcome the limitations of clopidogrel. Results from pharmacokinetic (PK) studies showed that ClopNPT released the active metabolite with a time to maximal plasma concentration of <5 minutes in C57BL/6 mice after either oral or intravenous administration, and plasma concentrations of the active metabolite reached Cmax values of 1242 and 1100 ng/ml after a 10-mg/kg oral dose and a 5-mg/kg intravenous dose, respectively. Furthermore, ClopNPT was highly effective in preventing arterial thrombosis in rabbits and mice after vascular injuries. Formation of occlusive thrombi was prevented by ClopNPT at the 1-mg/kg dose with no significant increase in tongue bleeding time, whereas clopidogrel was ineffective at the same dose. These results suggest that ClopNPT has favorable PK/pharmacodynamic properties that can potentially overcome the attenuated PK properties of clopidogrel and thus significantly improve the efficacy of antiplatelet therapy.
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Affiliation(s)
- Haoming Zhang
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - D Adam Lauver
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - Hui Wang
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - Duxin Sun
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - Paul F Hollenberg
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - Y Eugene Chen
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - Yoichi Osawa
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - Daniel T Eitzman
- Departments of Pharmacology (H.Z., D.A.L., P.F.H., Y.O.) and Internal Medicine (H.W., Y.E.C., D.T.E.), University of Michigan Medical School, Ann Arbor, Michigan; and Department of Pharmaceutical Sciences (D.S.), College of Pharmacy, University of Michigan, Ann Arbor, Michigan
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Ford NF. The Metabolism of Clopidogrel: CYP2C19 Is a Minor Pathway. J Clin Pharmacol 2016; 56:1474-1483. [DOI: 10.1002/jcph.769] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/06/2016] [Accepted: 05/06/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Neville F. Ford
- Woodfield Clinical Consulting LLC; Green Valley AZ USA
- Rutgers-RWJ Medical School; New Brunswick NJ USA
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9
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Cytochrome allelic variants and clopidogrel metabolism in cardiovascular diseases therapy. Mol Biol Rep 2016; 43:473-84. [DOI: 10.1007/s11033-016-3983-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 04/04/2016] [Indexed: 01/18/2023]
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Badri PS, King JR, Polepally AR, McGovern BH, Dutta S, Menon RM. Dosing Recommendations for Concomitant Medications During 3D Anti-HCV Therapy. Clin Pharmacokinet 2016; 55:275-95. [PMID: 26330025 PMCID: PMC4761011 DOI: 10.1007/s40262-015-0317-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The development of direct-acting antiviral (DAA) agents has reinvigorated the treatment of hepatitis C virus infection. The availability of multiple DAA agents and drug combinations has enabled the transition to interferon-free therapy that is applicable to a broad range of patients. However, these DAA combinations are not without drug-drug interactions (DDIs). As every possible DDI permutation cannot be evaluated in a clinical study, guidance is needed for healthcare providers to avoid or minimize drug interaction risk. In this review, we evaluated the DDI potential of the novel three-DAA combination of ombitasvir, paritaprevir, ritonavir, and dasabuvir (the 3D regimen) with more than 200 drugs representing 19 therapeutic drug classes. Outcomes of these DDI studies were compared with the metabolism and elimination routes of prospective concomitant medications to develop mechanism-based and drug-specific guidance on interaction potential. This analysis revealed that the 3D regimen is compatible with many of the drugs that are commonly prescribed to patients with hepatitis C virus infection. Where interaction is possible, risk can be mitigated by paying careful attention to concomitant medications, adjusting drug dosage as needed, and monitoring patient response and/or clinical parameters.
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Affiliation(s)
- Prajakta S Badri
- Clinical Pharmacology and Pharmacometrics (R4PK), AbbVie, Inc., 1 North Waukegan Rd, AP13A-3, North Chicago, IL, 60064, USA.
| | - Jennifer R King
- Clinical Pharmacology and Pharmacometrics (R4PK), AbbVie, Inc., 1 North Waukegan Rd, AP13A-3, North Chicago, IL, 60064, USA
| | - Akshanth R Polepally
- Clinical Pharmacology and Pharmacometrics (R4PK), AbbVie, Inc., 1 North Waukegan Rd, AP13A-3, North Chicago, IL, 60064, USA
| | - Barbara H McGovern
- Clinical Pharmacology and Pharmacometrics (R4PK), AbbVie, Inc., 1 North Waukegan Rd, AP13A-3, North Chicago, IL, 60064, USA
| | - Sandeep Dutta
- Clinical Pharmacology and Pharmacometrics (R4PK), AbbVie, Inc., 1 North Waukegan Rd, AP13A-3, North Chicago, IL, 60064, USA
| | - Rajeev M Menon
- Clinical Pharmacology and Pharmacometrics (R4PK), AbbVie, Inc., 1 North Waukegan Rd, AP13A-3, North Chicago, IL, 60064, USA
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11
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Zhai Y, Wang L, Yang F, Feng G, Feng S, Cui T, An L, He X. The mechanism and risk factors of clopidogrel-induced liver injury. Drug Chem Toxicol 2015; 39:367-74. [PMID: 26654298 DOI: 10.3109/01480545.2015.1122606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT AND OBJECTIVE Clopidogrel (CLP) is a prodrug which is widely used as a platelet aggregation inhibitor. Hepatotoxicity is rare but a potentially serious adverse reaction that is associated with CLP. Thiophene in CLP (the thienopyridine derivative) is a group that is easily oxidated by cytochrome P450 enzymes (CYP450s) to generate reactive metabolites (RMs), it may be implicated in the mechanism of CLP-induced hepatotoxicity. CYP2C19 and CYP2B6 are important CYP450s involved in the metabolism and activation of CLP, and the aim of this study is to investigate whether the metabolites of CYP2C19 and CYP2B6 are associated with the CLP-induced liver injury. METHOD Primary rat hepatocytes are applied to evaluate the hepatotoxicity of CLP. Glutathione-depleted mouse model is used to evaluate whether this toxicity of CLP is metabolized by CYP450s. We also used HepG2 cells co-incubated with recombinant CYP2B6 and CYP2C19 enzymes to further assess whether the metabolites of CYP2C19 and CYP2B6 are associated with the CLP-induced hepatocellular toxicity. RESULT CLP in high dose (100 μM and 300 μM) showed cytotoxicity in primary rat hepatocytes assay. Administration of CLP with l-buthionine-S, R-sulfoxinine (BSO) for seven days enhanced the liver injury of CLP. The level of ALT, AST and TBIL in plasma increased significantly, and the histopathological results showed the obvious liver injury; Pretreatment of 1-aminobenzotriazole, a nonspecific inhibitor of CYP450s, suppressed CLP-induced hepatotoxicity; CLP showed a dose-dependent toxicity in HepG2/CYP2C19 enzyme and HepG2/CYP2B6 enzyme models. CONCLUSION High activities of CYP2C19 and CYP2B6 are the risk factors for hepatocellular toxicity of CLP.
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Affiliation(s)
- Yiran Zhai
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and
| | - Lili Wang
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and.,b Tianjin State Key Laboratory of Modern Chinese Medicine , Tianjin , China
| | - Fan Yang
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and
| | - Guo Feng
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and
| | - Shan Feng
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and
| | - Tianyi Cui
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and
| | - Lijun An
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and
| | - Xin He
- a School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine , Nankai District , Tianjin , China and.,b Tianjin State Key Laboratory of Modern Chinese Medicine , Tianjin , China
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12
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Kallepalli VA, Gore KA, Shi F, Sanchez L, Chotana GA, Miller SL, Maleczka RE, Smith MR. Harnessing C-H Borylation/Deborylation for Selective Deuteration, Synthesis of Boronate Esters, and Late Stage Functionalization. J Org Chem 2015; 80:8341-53. [PMID: 26226056 PMCID: PMC5080619 DOI: 10.1021/acs.joc.5b01588] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ir-catalyzed deborylation can be used to selectively deuterate aromatic and heteroaromatic substrates. Combined with the selectivities of Ir-catalyzed C-H borylations, uniquely labeled compounds can be prepared. In addition, diborylation/deborylation reactions provide monoborylated regioisomers that complement those prepared by C-H borylation. Comparisons between Ir-catalyzed deborylations and Pd-catalyzed deborylations of diborylated indoles described by Movassaghi are made. The Ir-catalyzed process is more effective for deborylating aromatics and is generally more effective in the monodeborylation of diborylated thiophenes. These processes can be applied to complex molecules such as clopidogrel.
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Affiliation(s)
- Venkata A Kallepalli
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
| | - Kristin A. Gore
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
| | - Feng Shi
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
| | - Luis Sanchez
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
| | - Ghayoor A. Chotana
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
| | - Susanne L. Miller
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
| | - Robert E. Maleczka
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
| | - Milton R. Smith
- Department of Chemistry, Michigan State University, 578 South Shaw Lane, East Lansing, Michigan 48824-1322, United States
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13
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Leonard CE, Bilker WB, Brensinger CM, Flockhart DA, Freeman CP, Kasner SE, Kimmel SE, Hennessy S. Comparative risk of ischemic stroke among users of clopidogrel together with individual proton pump inhibitors. Stroke 2015; 46:722-31. [PMID: 25657176 DOI: 10.1161/strokeaha.114.006866] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE There is controversy and little information about whether individual proton pump inhibitors (PPIs) differentially alter the effectiveness of clopidogrel in reducing ischemic stroke risk. We, therefore, aimed to elucidate the risk of ischemic stroke among concomitant users of clopidogrel and individual PPIs. METHODS We conducted a propensity score-adjusted cohort study of adult new users of clopidogrel, using 1999 to 2009 Medicaid claims from 5 large states. Exposures were defined by prescriptions for esomeprazole, lansoprazole, omeprazole, rabeprazole, and pantoprazole-with pantoprazole serving as the referent. The end point was hospitalization for acute ischemic stroke, defined by International Classification of Diseases Ninth Revision Clinical Modification codes in the principal position on inpatient claims, within 180 days of concomitant therapy initiation. RESULTS Among 325 559 concomitant users of clopidogrel and a PPI, we identified 1667 ischemic strokes for an annual incidence of 2.4% (95% confidence interval, 2.3-2.5). Adjusted hazard ratios for ischemic stroke versus pantoprazole were 0.98 (0.82-1.17) for esomeprazole; 1.06 (0.92-1.21) for lansoprazole; 0.98 (0.85-1.15) for omeprazole; and 0.85 (0.63-1.13) for rabeprazole. CONCLUSIONS PPIs of interest did not increase the rate of ischemic stroke among clopidogrel users when compared with pantoprazole, a PPI thought to be devoid of the potential to interact with clopidogrel.
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Affiliation(s)
- Charles E Leonard
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.).
| | - Warren B Bilker
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.)
| | - Colleen M Brensinger
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.)
| | - David A Flockhart
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.)
| | - Cristin P Freeman
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.)
| | - Scott E Kasner
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.)
| | - Stephen E Kimmel
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.)
| | - Sean Hennessy
- From the Center for Clinical Epidemiology and Biostatistics (C.E.L., W.B.B., C.M.B., C.P.F., S.E. Kimmel, S.H.), Center for Pharmacoepidemiology Research and Training (C.E.L., W.B.B., D.A.F., C.P.F., S.E. Kimmel, S.H.), Department of Psychiatry (W.B.B.), Department of Neurology (S.E. Kasner), Division of Cardiovascular Medicine, Department of Medicine (S.E. Kimmel), and Department of Systems Pharmacology and Translational Therapeutics (S.H.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia; and Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis (D.A.F.)
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14
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Dash SP, Panda AK, Pasayat S, Dinda R, Biswas A, Tiekink ERT, Mukhopadhyay S, Bhutia SK, Kaminsky W, Sinn E. Oxidovanadium(v) complexes of aroylhydrazones incorporating heterocycles: synthesis, characterization and study of DNA binding, photo-induced DNA cleavage and cytotoxic activities. RSC Adv 2015. [DOI: 10.1039/c4ra14369h] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The interaction of four neutral oxidovanadium(v) complexes with DNA and their cytotoxic activities have been reported.
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Affiliation(s)
- Subhashree P. Dash
- Department of Chemistry
- National Institute of Technology
- Rourkela 769008
- India
| | - Alok K. Panda
- School of Basic Sciences
- Indian Institute of Technology Bhubaneswar
- Bhubaneswar 751 013
- India
| | - Sagarika Pasayat
- Department of Chemistry
- National Institute of Technology
- Rourkela 769008
- India
| | - Rupam Dinda
- Department of Chemistry
- National Institute of Technology
- Rourkela 769008
- India
| | - Ashis Biswas
- School of Basic Sciences
- Indian Institute of Technology Bhubaneswar
- Bhubaneswar 751 013
- India
| | | | | | - Sujit K. Bhutia
- Department of Life Science
- National Institute of Technology
- Rourkela 769008
- India
| | | | - Ekkehard Sinn
- Department of Chemistry
- Western Michigan University
- Kalamazoo
- USA
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15
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In vitro interaction of clopidogrel and its hydrolysate with OCT1, OCT2 and OAT1. Int J Pharm 2014; 465:5-10. [PMID: 24530383 DOI: 10.1016/j.ijpharm.2014.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 11/26/2013] [Accepted: 02/02/2014] [Indexed: 01/11/2023]
Abstract
Clopidogrel (CP) is metabolized by CYPs to the active metabolite, or hydrolyzed by esterase to clopidogrel carboxylate (CPC) in liver, and CPC is partly excreted from urine. Therefore, the objective of the present study was to evaluate the interactions of CP and CPC with organic cation transporter 1 (OCT1) (in liver), and CPC with organic cation transporter 2 (OCT2) and organic anion transporter 1 (OAT1) (in kidney). Both CP and CPC inhibited the uptake of 1-methyl-4-phenylpyridinium (MPP(+)) and metformin, typical substrates of OCT1, in MDCK-hOCT1 cells with low IC₅₀ (0.307-14.0 μM). CPC (100 μM) reduced the uptake of MPP(+) and metformin mediated by OCT2 in MDCK-hOCT2 cells to 60.8% and 33.6% of the control, CPC (500 μM) decreased the uptake of 6-carboxyfluorescein (6-CFL) and para-aminohippuric acid (PAH), substrates of OAT1, in MDCK-hOAT1 cells to 64.6% and 79.4% of the control. CP and CPC were also found to inhibit other drugs of OCT1 substrates, such as lamivudine and amantadine, in MDCK-hOCT1 cells with the IC₅₀ of 1.97-4.15μM, except CPC on amantadine (IC₅₀>100 μM). The inhibition of CP and CPC on lamivudine uptake in primary rat hepatocytes was also confirmed with the IC₅₀ of 2.91 and 1.25μM, respectively. Additionally, CP and CPC were not substrates of OCT1 and OCT2, whereas CPC was a substrate of OAT1 with the Km of 5.61 μM. In conclusion, CP and CPC are strong inhibitors of OCT1, but weak inhibitors of OCT2 and OAT1, and CPC is a high affinity substrate of OAT1.
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16
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Zahno A, Bouitbir J, Maseneni S, Lindinger PW, Brecht K, Krähenbühl S. Hepatocellular toxicity of clopidogrel: mechanisms and risk factors. Free Radic Biol Med 2013; 65:208-216. [PMID: 23770199 DOI: 10.1016/j.freeradbiomed.2013.06.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 05/11/2013] [Accepted: 06/04/2013] [Indexed: 12/11/2022]
Abstract
Clopidogrel is a prodrug used widely as a platelet aggregation inhibitor. After intestinal absorption, approximately 90% is converted to inactive clopidogrel carboxylate and 10% via a two-step procedure to the active metabolite containing a mercapto group. Hepatotoxicity is a rare but potentially serious adverse reaction associated with clopidogrel. The aim of this study was to find out the mechanisms and susceptibility factors for clopidogrel-associated hepatotoxicity. In primary human hepatocytes, clopidogrel (10 and 100 μM) was cytotoxic only after cytochrome P450 (CYP) induction by rifampicin. Clopidogrel (10 and 100 μM) was also toxic for HepG2 cells expressing human CYP3A4 (HepG2/CYP3A4) and HepG2 cells co-incubated with CYP3A4 supersomes (HepG2/CYP3A4 supersome), but not for wild-type HepG2 cells (HepG2/wt). Clopidogrel (100 μM) decreased the cellular glutathione content in HepG2/CYP3A4 supersome and triggered an oxidative stress reaction (10 and 100 µM) in HepG2/CYP3A4, but not in HepG2/wt. Glutathione depletion significantly increased the cytotoxicity of clopidogrel (10 and 100 µM) in HepG2/CYP3A4 supersome. Co-incubation with 1 μM ketoconazole or 10mM glutathione almost completely prevented the cytotoxic effect of clopidogrel in HepG2/CYP3A4 and HepG2/CYP3A4 supersome. HepG2/CYP3A4 incubated with 100 μM clopidogrel showed mitochondrial damage and cytochrome c release, eventually promoting apoptosis and/or necrosis. In contrast to clopidogrel, clopidogrel carboxylate was not toxic for HepG2/wt or HepG2/CYP3A4 up to 100 µM. In conclusion, clopidogrel incubated with CYP3A4 is associated with the formation of metabolites that are toxic for hepatocytes and can be trapped by glutathione. High CYP3A4 activity and low cellular glutathione stores may be risk factors for clopidogrel-associated hepatocellular toxicity.
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Affiliation(s)
- Anja Zahno
- Division of Clinical Pharmacology & Toxicology and Department of Biomedicine, University Hospital, CH-4031 Basel, Switzerland
| | - Jamal Bouitbir
- Division of Clinical Pharmacology & Toxicology and Department of Biomedicine, University Hospital, CH-4031 Basel, Switzerland
| | - Swarna Maseneni
- Division of Clinical Pharmacology & Toxicology and Department of Biomedicine, University Hospital, CH-4031 Basel, Switzerland
| | - Peter W Lindinger
- Division of Clinical Pharmacology & Toxicology and Department of Biomedicine, University Hospital, CH-4031 Basel, Switzerland
| | - Karin Brecht
- Division of Clinical Pharmacology & Toxicology and Department of Biomedicine, University Hospital, CH-4031 Basel, Switzerland
| | - Stephan Krähenbühl
- Division of Clinical Pharmacology & Toxicology and Department of Biomedicine, University Hospital, CH-4031 Basel, Switzerland.
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17
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Contributions of Intestine and Plasma to the Presystemic Bioconversion of Vicagrel, an Acetate of Clopidogrel. Pharm Res 2013; 31:238-51. [DOI: 10.1007/s11095-013-1158-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 07/22/2013] [Indexed: 02/05/2023]
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18
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Zhu Y, Zhou J, Jiao B. Deuterated clopidogrel analogues as a new generation of antiplatelet agents. ACS Med Chem Lett 2013; 4:349-52. [PMID: 24900671 DOI: 10.1021/ml300460t] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 02/05/2013] [Indexed: 11/28/2022] Open
Abstract
Clopidogrel (CPG) is an antithrombotic prodrug that needs hepatic cytochrome P450 (CYP) enzymes for its bioactivation. The clinical effects of CPG have been associated with high intersubject variability and a certain level of resistance. Recently, comprehensive biotransformation studies of CPG support that the observed clinical uncertainty stems from the low bioactivation efficiency, which is attributed to extensive attritional metabolism (e.g., hydrolysis of the methyl ester functionality and oxidation of the piperidine moiety). With the goal of potentiating the desired thiophene 2-oxidation through minimal structural modification, we have adopted the strategy of targeted metabolism shift and have designed and synthesized deuterated piperidine analogues of CPG. In vitro studies showed that the prodrug activation percentages have been significantly increased for the deuterated analogues as a result of stability enhancement of the piperidine moiety. In a pharmacological study with a rat model, oral administration of the deuterated analogues also demonstrated higher inhibitory activity than that of CPG against adenosine diphosphate (ADP) induced platelet aggregation. These deuterated analogues represent a new generation of antiplatelet agents with the potential to overcome the major clinical drawbacks of CPG.
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Affiliation(s)
- Yaoqiu Zhu
- MetabQuest Research Laboratory, 202 Chengfu Road, Beijing 100871, People’s
Republic of China
| | - Jiang Zhou
- Analytical
Instrumentation Center,
College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, People’s Republic
of China
| | - Bo Jiao
- Department of Pharmacology,
School
of Pharmacy, Shandong University, Jinan,
Shandong 250012, People’s Republic of China
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19
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Zhu Y, Zhou J. In Vitro Biotransformation Studies of 2-Oxo-clopidogrel: Multiple Thiolactone Ring-Opening Pathways Further Attenuate Prodrug Activation. Chem Res Toxicol 2012; 26:179-90. [DOI: 10.1021/tx300460k] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yaoqiu Zhu
- MetabQuest Research Laboratory, 202 Chengfu Road, Beijing 100871, P. R.
China
| | - Jiang Zhou
- Analytical Instrumentation
Center,
College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, P. R. China
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