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Hirai K, Kimura T, Suzuki Y, Shimoshikiryo T, Shirai T, Itoh K. Gene Polymorphisms of NLRP3 Associated With Plasma Levels of 4β-Hydroxycholesterol, an Endogenous Marker of CYP3A Activity, in Patients With Asthma. Clin Pharmacol Ther 2024; 116:147-154. [PMID: 38482940 DOI: 10.1002/cpt.3254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/02/2024] [Indexed: 06/18/2024]
Abstract
Inflammation decreases the activity of cytochrome P450 3A (CYP3A). Nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domain containing 3 (NLRP3) is responsible for regulating the inflammatory response, and its genetic polymorphisms have been linked to inflammatory diseases such as asthma. However, there have been few studies on the effect of NLRP3 on CYP3A activity. We aimed to investigate the association between polymorphisms in the NLRP3 gene and plasma 4β-hydroxycholesterol (4βOHC), an endogenous marker of CYP3A activity, in patients with asthma. In this observational study including 152 adult asthma patients, we analyzed 10 NLRP3 gene single-nucleotide polymorphisms (SNPs). Plasma 4βOHC levels were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The results showed that five SNPs were associated with significantly lower plasma 4βOHC concentrations. Among these SNPs, rs3806265, rs4612666, rs1539019, and rs10733112 contributed to a significant increase in plasma IL-6 concentrations. Moreover, a multivariate regression model showed that the rs3806265 TT, rs4612666 CC, rs1539019 AA, and rs10733112 TT genotypes were significant factors for decreased plasma 4βOHC, even after including patient background factors and CYP3A5*3 (rs776746) gene polymorphisms as covariates. These results were also observed when plasma 4βOHC concentrations were corrected for cholesterol levels. We conclude that NLRP3 gene polymorphisms are involved in increasing plasma IL-6 concentrations and decreasing plasma 4βOHC concentrations in patients with asthma. Therefore, NLRP3 gene polymorphisms may be a predictive marker of CYP3A activity in inflammatory diseases such as asthma.
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Affiliation(s)
- Keita Hirai
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
- Department of Pharmacy, Shinshu University Hospital, Nagano, Japan
- Department of Clinical Pharmacology and Therapeutics, Shinshu University Graduate School of Medicine, Nagano, Japan
| | - Tomoki Kimura
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Yuya Suzuki
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Takayuki Shimoshikiryo
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Kunihiko Itoh
- Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
- Laboratory of Clinical Pharmacogenomics, Shizuoka General Hospital, Shizuoka, Japan
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2
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Han C, Sun T, Chirumamilla SK, Bois FY, Xu M, Rostami-Hodjegan A. Understanding Discordance between In Vitro Dissolution, Local Gut and Systemic Bioequivalence of Budesonide in Healthy and Crohn's Disease Patients through PBPK Modeling. Pharmaceutics 2023; 15:2237. [PMID: 37765205 PMCID: PMC10535222 DOI: 10.3390/pharmaceutics15092237] [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: 08/01/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
The most common method for establishing bioequivalence (BE) is to demonstrate similarity of concentration-time profiles in the systemic circulation, as a surrogate to the site of action. However, similarity of profiles from two formulations in the systemic circulation does not imply similarity in the gastrointestinal tract (GIT) nor local BE. We have explored the concordance of BE conclusions for a set of hypothetical formulations based on budesonide concentration profiles in various segments of gut vs. those in systemic circulation using virtual trials powered by physiologically based pharmacokinetic (PBPK) models. The impact of Crohn's disease on the BE conclusions was explored by changing physiological and biological GIT attributes. Substantial 'discordance' between local and systemic outcomes of VBE was observed. Upper GIT segments were much more sensitive to formulation changes than systemic circulation, where the latter led to false conclusions for BE. The ileum and colon showed a lower frequency of discordance. In the case of Crohn's disease, a product-specific similarity factor might be needed for products such as Entocort® EC to ensure local BE. Our results are specific to budesonide, but we demonstrate potential discordances between the local gut vs. systemic BE for the first time.
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Affiliation(s)
- Chunyan Han
- Centre for Applied Pharmacokinetic Research (CAPKR), University of Manchester, Manchester M13 9PL, UK
- Pharmaron Inc., Beijing 100176, China; (T.S.); (M.X.)
| | - Tiancheng Sun
- Pharmaron Inc., Beijing 100176, China; (T.S.); (M.X.)
| | | | - Frederic Y. Bois
- Simcyp Division, Certara, Sheffield S1 2BJ, UK; (S.K.C.); (F.Y.B.)
| | - Mandy Xu
- Pharmaron Inc., Beijing 100176, China; (T.S.); (M.X.)
| | - Amin Rostami-Hodjegan
- Centre for Applied Pharmacokinetic Research (CAPKR), University of Manchester, Manchester M13 9PL, UK
- Simcyp Division, Certara, Sheffield S1 2BJ, UK; (S.K.C.); (F.Y.B.)
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3
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Cutts A, Chowdhury S, Ratkay LG, Eyers M, Young C, Namdari R, Cadieux JA, Chahal N, Grimwood M, Zhang Z, Lin S, Tietjen I, Xie Z, Robinette L, Sojo L, Waldbrook M, Hayden M, Mansour T, Pimstone S, Goldberg YP, Webb M, Cohen CJ. Potent, Gut-Restricted Inhibitors of Divalent Metal Transporter 1: Preclinical Efficacy against Iron Overload and Safety Evaluation. J Pharmacol Exp Ther 2023; 386:4-14. [PMID: 36958846 DOI: 10.1124/jpet.122.001435] [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: 09/01/2022] [Revised: 01/26/2023] [Accepted: 02/21/2023] [Indexed: 03/25/2023] Open
Abstract
Divalent metal transporter 1 (DMT1) cotransports ferrous iron and protons and is the primary mechanism for uptake of nonheme iron by enterocytes. Inhibitors are potentially useful as therapeutic agents to treat iron overload disorders such as hereditary hemochromatosis or β-thalassemia intermedia, provided that inhibition can be restricted to the duodenum. We used a calcein quench assay to identify human DMT1 inhibitors. Dimeric compounds were made to generate more potent compounds with low systemic exposure. Direct block of DMT1 was confirmed by voltage clamp measurements. The lead compound, XEN602, strongly inhibits dietary nonheme iron uptake in both rats and pigs yet has negligible systemic exposure. Efficacy is maintained for >2 weeks in a rat subchronic dosing assay. Doses that lowered iron content in the spleen and liver by >50% had no effect on the tissue content of other divalent cations except for cobalt. XEN602 represents a powerful pharmacological tool for understanding the physiologic function of DMT1 in the gut. SIGNIFICANCE STATEMENT: This report introduces methodology to develop potent, gut-restricted inhibitors of divalent metal transporter 1 (DMT1) and identifies XEN602 as a suitable compound for in vivo studies. We also report novel animal models to quantify the inhibition of dietary uptake of iron in both rodents and pigs. This research shows that inhibition of DMT1 is a promising means to treat iron overload disorders.
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Affiliation(s)
- Alison Cutts
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Sultan Chowdhury
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Laszlo G Ratkay
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Maryanne Eyers
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Clint Young
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Rostam Namdari
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Jay A Cadieux
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Navjot Chahal
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Michael Grimwood
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Zaihui Zhang
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Sophia Lin
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Ian Tietjen
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Zhiwei Xie
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Lee Robinette
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Luis Sojo
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Matthew Waldbrook
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Michael Hayden
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Tarek Mansour
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Simon Pimstone
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Y Paul Goldberg
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Michael Webb
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
| | - Charles J Cohen
- Xenon Pharmaceuticals Inc., Burnaby, British Columbia, Canada(A.C., S.C., L.G.R., M.E., C.Y., R.N., J.A.C., N.C., M.G., Z.Z., S.L., I.T., Z.X., L.R., L.S., M.W., M.H., T.M., S.P., Y.P.G., M.W., C.J.C.) and Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada (S.P.)
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4
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Casini R, Vyhlidal CA, Bracken JM, Sherman AK, Ahmed A, Singh V, Williams V, Shakhnovich V. Impact of Duodenal Pathology on Oral Drug Bioavailability and Disease Outcomes in Pediatric Crohn’s Disease. Pharmaceuticals (Basel) 2023; 16:ph16030373. [PMID: 36986472 PMCID: PMC10054108 DOI: 10.3390/ph16030373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/05/2023] Open
Abstract
Background: Crohn’s disease with upper gastrointestinal tract involvement occurs more often in children than adults and has the potential to interfere with oral drug absorption. We aimed to compare disease outcomes in children receiving oral azathioprine for the treatment of Crohn’s disease with (DP) and without (NDP) duodenal pathology at diagnosis. Methods: Duodenal villous length, body mass index (BMI), and laboratory studies were compared in DP vs. NDP during the first year post-diagnosis, using parametric/nonparametric tests and regression analysis (SAS v9.4); the data are reported as the median (interquartile range) or the mean ± standard deviation. Thiopurine metabolite concentration (pmol/8 × 108 erythrocytes) 230–400 was considered therapeutic for 6-thioguanine nucleotides (6-TGN), and >5700 was considered hepatotoxic for 6-methylmercaptopurine (6-MMPN). Results: Twenty-six of the fifty-eight children enrolled (29 DP, 29 NDP) started azathioprine for standard medical care, including nine DP and ten NDP who had normal thiopurine methyltransferase activity. Duodenal villous length was significantly shorter in DP vs. NDP (342 ± 153 vs. 460 ± 85 μm; p < 0.001) at diagnosis; age, sex, hemoglobin, and BMI were comparable between groups. A trend toward lower 6-TGN was observed in the DP vs. NDP subset receiving azathioprine (164 (117, 271) vs. 272 (187, 331); p = 0.15). Compared to NDP, DP received significantly higher azathioprine doses (2.5 (2.3, 2.6) vs. 2.2 (2.0, 2.2) mg/kg/day; p = 0.01) and had an increased relative risk of sub-therapeutic 6-TGN. At 9 months post-diagnosis, children with DP had significantly lower hemoglobin (12.5 (11.7, 12.6) vs. 13.1 (12.7, 13.3) g/dL; p = 0.01) and BMI z-scores (−0.29 (−0.93, −0.11) vs. 0.88 (0.53, 0.99); p = 0.02) than children with NDP. Conclusion: For children with Crohn’s disease, duodenal pathology, marked by villous blunting, increased the risk of sub-therapeutic 6-TGN levels, despite higher azathioprine dosing during the first year post-diagnosis. Lower hemoglobin and BMI z-scores at 9 months post-diagnosis suggest the impaired absorption/bioavailability of nutrients, as well as oral drugs, in children with duodenal disease.
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Affiliation(s)
- Rebecca Casini
- Department of Pediatrics, North Shore University Health System, Skokie, IL 60201, USA
| | | | - Julia M. Bracken
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- Department of Pediatrics, Kansas City School of Medicine, University of Missouri, Kansas City, MO 64018, USA
- Correspondence:
| | | | - Atif Ahmed
- Department of Pathology, Seattle Children’s Hospitals, Seattle, WA 98105, USA
| | - Vivekanand Singh
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | | | - Valentina Shakhnovich
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- Department of Pediatrics, Kansas City School of Medicine, University of Missouri, Kansas City, MO 64018, USA
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Coutant DE, Boulton DW, Dahal UP, Deslandes A, Grimaldi C, Pereira JNS, Säll C, Sarvaiya H, Schiller H, Tai G, Umehara K, Yuan Y, Dallas S. Therapeutic Protein Drug Interactions: A White Paper From the International Consortium for Innovation and Quality in Pharmaceutical Development. Clin Pharmacol Ther 2022; 113:1185-1198. [PMID: 36477720 DOI: 10.1002/cpt.2814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Abstract
Typically, therapeutic proteins (TPs) have a low risk for eliciting meaningful drug interactions (DIs). However, there are select instances where TP drug interactions (TP-DIs) of clinical concern can occur. This white paper discusses the various types of TP-DIs involving mechanisms such as changes in disease state, target-mediated drug disposition, neonatal Fc receptor (FcRn), or antidrug antibodies formation. The nature of TP drug interaction being investigated should determine whether the examination is conducted as a standalone TP-DI study in healthy participants, in patients, or assessed via population pharmacokinetic analysis. DIs involving antibody-drug conjugates are discussed briefly, but the primary focus here will be DIs involving cytokine modulation. Cytokine modulation can occur directly by certain TPs, or indirectly due to moderate to severe inflammation, infection, or injury. Disease states that have been shown to result in indirect disease-DIs that are clinically meaningful have been listed (i.e., typically a twofold change in the systemic exposure of a coadministered sensitive cytochrome P450 substrate drug). Type of disease and severity of inflammation should be the primary drivers for risk assessment for disease-DIs. While more clinical inflammatory marker data needs to be collected, the use of two or more clinical inflammatory markers (such as C-reactive protein, albumin, or interleukin 6) may help broadly categorize whether the predicted magnitude of inflammatory disease-DI risk is negligible, weak, or moderate to strong. Based on current knowledge, clinical DI studies are not necessary for all TPs, and should no longer be conducted in certain disease patient populations such as psoriasis, which do not have sufficient systemic inflammation to cause a meaningful indirect disease-DI.
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Affiliation(s)
- David E Coutant
- Drug Disposition Department, Eli Lilly and Company, Indianapolis, Indiana, USA
| | - David W Boulton
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, Research & Development, AstraZeneca, Gaithersburg, Maryland, USA
| | - Upendra P Dahal
- Pharmacokinetics and Drug Metabolism, Amgen, Inc., South San Francisco, California, USA
| | - Antoine Deslandes
- Translational Medicine and Early Development, Sanofi Research & Development, Chilly-Mazarin, France
| | - Christine Grimaldi
- Formerly of Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut, USA
| | - Joao N S Pereira
- Drug Disposition & Design, Merck Healthcare KGaA, Darmstadt, Germany
| | - Carolina Säll
- Development Absorption, Distribution, Metabolism, and Elimination, Novo Nordisk A/S, Måløv, Denmark
| | - Hetal Sarvaiya
- Drug Metabolism, Pharmacokinetics, and Bioanalytical, AbbVie Inc., California, South San Francisco, USA
| | - Hilmar Schiller
- Pharmacokinetic Sciences, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Guoying Tai
- Department of Metabolism and Pharmacokinetics, GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Kenichi Umehara
- Pharmaceutical Sciences, Roche Pharma Research & Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Yang Yuan
- Formerly of Department of Metabolism and Pharmacokinetics, Bristol Myers Squibb Pharmaceutical Research and Development, Princeton, New Jersey, USA
| | - Shannon Dallas
- Preclinical Sciences & Translational Safety, Janssen Research & Development, Springhouse, Pennsylvania, USA
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6
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Zhao J, Yuan W, Wang S, Zhang H, Chen D, Niu X, Liu X, Liu L, Gao J. Comparative Pharmacokinetics and Tissue Distribution of M10 and Its Metabolite Myricetin in Normal and Dextran-Sodium-Sulfate-Induced Colitis Mice. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27238140. [PMID: 36500233 PMCID: PMC9740244 DOI: 10.3390/molecules27238140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022]
Abstract
M10, a novel myricetin derivative, is an anti-inflammatory agent designed for treatment of colitis. Here, we aim to investigate its pharmacokinetic behavior and tissue distribution in a mouse model with colitis. Pharmacokinetics and tissue distribution of M10 and its metabolite myricetin were compared in normal mice and in dextran-sodium-sulfate (DSS)-induced colitis mice. The role of fecal microbiota was also analyzed during metabolism of M10 in vitro. After oral administration, M10 was very low in the plasma of both normal and diseased mice. However, both M10 and myricetin were mainly distributed in the gastrointestinal tract, including the stomach, colon and small intestine, in physiological and pathological conditions. Significantly, M10 and myricetin were found in higher levels in gastrointestinal tracts with inflamed tissues than in normal tissues of mice. An in vitro assay revealed that 80% of M10 was metabolized to myricetin via fecal microbiota. After oral administration, M10 was not absorbed into circulation but mainly distributed in the inflamed submucosal tissues of colitic mice, where it was metabolized into myricetin to prevent colitis development.
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Affiliation(s)
- Jianchun Zhao
- School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Marine Biomedical Research Institute of Qingdao, Qingdao 266073, China
- Correspondence:
| | - Wenmin Yuan
- Marine Biomedical Research Institute of Qingdao, Qingdao 266073, China
| | - Shixiao Wang
- School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
| | - Hongwei Zhang
- School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
- Marine Biomedical Research Institute of Qingdao, Qingdao 266073, China
| | - Dan Chen
- School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
| | - Xiaochen Niu
- School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
| | - Xiaochun Liu
- Marine Biomedical Research Institute of Qingdao, Qingdao 266073, China
| | - Li Liu
- Marine Biomedical Research Institute of Qingdao, Qingdao 266073, China
| | - Jiangming Gao
- Marine Biomedical Research Institute of Qingdao, Qingdao 266073, China
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7
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Alrubia S, Mao J, Chen Y, Barber J, Rostami-Hodjegan A. Altered Bioavailability and Pharmacokinetics in Crohn's Disease: Capturing Systems Parameters for PBPK to Assist with Predicting the Fate of Orally Administered Drugs. Clin Pharmacokinet 2022; 61:1365-1392. [PMID: 36056298 PMCID: PMC9553790 DOI: 10.1007/s40262-022-01169-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 12/12/2022]
Abstract
Backgrond and Objective Crohn’s disease (CD) is a chronic inflammatory bowel disease that affects a wide age range. Hence, CD patients receive a variety of drugs over their life beyond those used for CD itself. The changes to the integrity of the intestine and its drug metabolising enzymes and transporters (DMETs) can alter the oral bioavailability of drugs. However, there are other changes in systems parameters determining the fate of drugs in CD, and understanding these is essential for dose adjustment in patients with CD. Methods The current analysis gathered all the available clinical data on the kinetics of drugs in CD (by March 2021), focusing on orally administered small molecule drugs. A meta-analysis of the systems parameters affecting oral drug pharmacokinetics was conducted. The systems information gathered on intestine, liver and blood proteins and other physiological parameters was incorporated into a physiologically based pharmacokinetic (PBPK) platform to create a virtual population of CD patients, with a view for guiding dose adjustment in the absence of clinical data in CD. Results There were no uniform trends in the reported changes in reported oral bioavailability. The nature of the drug as well as the formulation affected the direction and magnitude of variation in kinetics in CD patients relative to healthy volunteers. Even for the same drug, the reported changes in exposure varied, possibly due to a lack of distinction between the activity states of CD. The highest alteration was seen with S-verapamil and midazolam, 8.7- and 5.3-fold greater exposure, respectively, in active CD patients relative to healthy volunteers. Only one report was available on liver DMETs in CD, and indicated reduced CYP3A4 activity. In a number of reports, mRNA expression of DMETs in the ileum and colon of CD patients was measured, focussing on P-glycoprotein (p-gp) transporter and CYP3A4 enzyme, and showed contradictory results. No data were available on protein expression in duodenum and jejunum despite their dominant role in oral drug absorption. Conclusion There are currently inadequate dedicated clinical or quantitative proteomic studies in CD to enable predictive PBPK models with high confidence and adequate verification. The PBPK models for CD with the available systems parameters were able to capture the major physiological influencers and the gaps to be filled by future research. Quantification of DMETs in the intestine and the liver in CD is warranted, alongside well-defined clinical drug disposition studies with a number of index drugs as biomarkers of changes in DMETs in these patients, to avoid large-scale dedicated studies for every drug to determine the effects of disease on the drug’s metabolism and disposition and the consequential safety and therapeutic concerns. Supplementary Information The online version contains supplementary material available at 10.1007/s40262-022-01169-4.
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Affiliation(s)
- Sarah Alrubia
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK.,Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Jialin Mao
- Drug Metabolism and Pharmacokinetics, Genentech Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Yuan Chen
- Drug Metabolism and Pharmacokinetics, Genentech Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Jill Barber
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK
| | - Amin Rostami-Hodjegan
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK. .,Certara UK Ltd, Simcyp Division, Level 2-Acero, 1 Concourse Way, Sheffield, UK.
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8
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Alrubia S, Al-Majdoub ZM, Achour B, Rostami-Hodjegan A, Barber J. Quantitative Assessment of the Impact of Crohn's Disease on Protein Abundance of Human Intestinal Drug-Metabolising Enzymes and Transporters. J Pharm Sci 2022; 111:2917-2929. [PMID: 35872023 DOI: 10.1016/j.xphs.2022.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/17/2022] [Accepted: 07/17/2022] [Indexed: 10/17/2022]
Abstract
Crohn's disease affects the mucosal layer of the intestine, predominantly ileum and colon segments, with the potential to affect the expression of intestinal enzymes and transporters, and consequently, oral drug bioavailability. We carried out a quantitative proteomic analysis of inflamed and non-inflamed ileum and colon tissues from Crohn's disease patients and healthy donors. Homogenates from samples in each group were pooled and protein abundance determined by liquid chromatography-mass spectrometry (LC-MS). In inflamed Crohn's ileum, CYP3A4, CYP20A1, CYP51A1, ADH1B, ALPI, FOM1, SULT1A2, SULT1B1 and ABCB7 showed ≥10-fold reduction in abundance compared with healthy baseline. By contrast, only MGST1 showed ≥10 fold reduction in inflamed colon. Ileal UGT1A1, MGST1, MGST2, and MAOA levels increased by ≥2 fold in Crohn's patients, while only ALPI showed ≥2 fold increase in the colon. Counter-intuitively, non-inflamed ileum had a higher magnitude of fold change than inflamed tissue when compared with healthy tissue. Marked but non-uniform alterations were observed in the expression of various enzymes and transporters in ileum and colon compared with healthy samples. Modelling will allow improved understanding of the variable effects of Crohn's disease on bioavailability of orally administered drugs.
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Affiliation(s)
- Sarah Alrubia
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK; Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Zubida M Al-Majdoub
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK
| | - Brahim Achour
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK; Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, the University of Rhode Island, Kingston, Rhode Island, USA
| | - Amin Rostami-Hodjegan
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK; Certara UK Ltd, Simcyp Division, Level 2-Acero, 1 Concourse Way, Sheffield, UK
| | - Jill Barber
- Centre for Applied Pharmacokinetic Research, School of Health Sciences, University of Manchester, Manchester, UK.
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9
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Fujino C, Sanoh S, Katsura T. Variation in Expression of Cytochrome P450 3A Isoforms and Toxicological Effects: Endo- and Exogenous Substances as Regulatory Factors and Substrates. Biol Pharm Bull 2021; 44:1617-1634. [PMID: 34719640 DOI: 10.1248/bpb.b21-00332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The CYP3A subfamily, which includes isoforms CYP3A4, CYP3A5, and CYP3A7 in humans, plays important roles in the metabolism of various endogenous and exogenous substances. Gene and protein expression of CYP3A4, CYP3A5, and CYP3A7 show large inter-individual differences, which are caused by many endogenous and exogenous factors. Inter-individual differences can cause negative outcomes, such as adverse drug events and disease development. Therefore, it is important to understand the variations in CYP3A expression caused by endo- and exogenous factors, as well as the variation in the metabolism and kinetics of endo- and exogenous substrates. In this review, we summarize the factors regulating CYP3A expression, such as bile acids, hormones, microRNA, inflammatory cytokines, drugs, environmental chemicals, and dietary factors. In addition, variations in CYP3A expression under pathological conditions, such as coronavirus disease 2019 and liver diseases, are described as examples of the physiological effects of endogenous factors. We also summarize endogenous and exogenous substrates metabolized by CYP3A isoforms, such as cholesterol, bile acids, hormones, arachidonic acid, vitamin D, and drugs. The relationship between the changes in the kinetics of these substrates and the toxicological effects in our bodies are discussed. The usefulness of these substrates and metabolites as endogenous biomarkers for CYP3A activity is also discussed. Notably, we focused on discrimination between CYP3A4, CYP3A5, and CYP3A7 to understand inter-individual differences in CYP3A expression and function.
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Affiliation(s)
- Chieri Fujino
- Laboratory of Clinical Pharmaceutics and Therapeutics, College of Pharmaceutical Sciences, Ritsumeikan University
| | - Seigo Sanoh
- Graduate School of Biomedical and Health Sciences, Hiroshima University.,School of Pharmaceutical Sciences, Wakayama Medical University
| | - Toshiya Katsura
- Laboratory of Clinical Pharmaceutics and Therapeutics, College of Pharmaceutical Sciences, Ritsumeikan University
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10
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Effinger A, O'Driscoll CM, McAllister M, Fotaki N. Predicting budesonide performance in healthy subjects and patients with Crohn's disease using biorelevant in vitro dissolution testing and PBPK modeling. Eur J Pharm Sci 2021; 157:105617. [PMID: 33164838 DOI: 10.1016/j.ejps.2020.105617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/02/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Drug product performance might be affected in Crohn's disease (CD) patients compared to healthy subjects due to pathophysiological changes. Since a low number of clinical studies is performed in this patient population, physiologically-based pharmacokinetic (PBPK) models with integrated results from biorelevant in vitro dissolution studies could be used to assess differences in the bioavailability of drugs. Using this approach, budesonide was used as model drug and its performance in healthy subjects and CD patients was predicted and compared against observed pharmacokinetic data. The in vitro release tests, under healthy versus CD conditions, revealed a similar extent of drug release from a controlled-release budesonide formulation in the fasted state, whereas in the fed state a lower extent was observed with CD. Differences in the physiology of CD patients were identified in literature and their impact on budesonide performance was investigated with a PBPK model, revealing the highest impact on the simulated bioavailability for the reduced hepatic CYP3A4 enzyme abundance and lower human serum albumin concentration. For CD patients, a higher budesonide exposure compared to healthy subjects was predicted with a PBPK population adapted to CD physiology and in agreement with observed pharmacokinetic data. Budesonide performance in the fasted and fed state was successfully predicted in healthy subjects and CD patients using PBPK modeling and in vitro release testing. Following this approach, predictions of the direction and magnitude of changes in bioavailability due to CD could be made for other drugs and guide prescribers to adjust dosage regimens for CD patients accordingly.
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Affiliation(s)
- Angela Effinger
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | | | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.
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11
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Yang Y, Hu N, Gao XJ, Li T, Yan ZX, Wang PP, Wei B, Li S, Zhang ZJ, Li SL, Yan R. Dextran sulfate sodium-induced colitis and ginseng intervention altered oral pharmacokinetics of cyclosporine A in rats. JOURNAL OF ETHNOPHARMACOLOGY 2021; 265:113251. [PMID: 32810615 DOI: 10.1016/j.jep.2020.113251] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/04/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Application of cyclosporine A (CsA) as a rescue treatment in acute severe ulcerative colitis (UC) is limited by its narrow therapeutic window and great interpatient variability. As a substrate of cytochrome P450 3A enzyme (CYP3A) and P-glycoprotein (P-gp), the oral pharmacokinetics of CsA is susceptible to disease status and concomitant medications. Combined treatment with ginseng, a famous medicinal herb frequently prescribed for ameliorating abnormal immune response in many diseases including UC, showed immunologic safety in CsA-based immunosuppression. AIM OF THE STUDY Since the therapeutic levels of CsA can be achieved within 24 h, this study first assessed the impact of acute colitis and ginseng intervention on the single oral dose pharmacokinetics of CsA and explored the underlying mechanisms in dextran sulfate sodium (DSS)-induced colitis rats and Caco-2 cells. MATERIALS AND METHODS Rats received drinking water (normal group), 5% DSS (UC group), or 5% DSS plus daily oral ginseng extract (GS+UC group). On day 7, GS+UC group only received an oral dose of CsA (5 mg/kg), while animals of normal or UC group received an oral, intravenous (1.25 mg/kg), or intraperitoneal dose of CsA (1.25 mg/kg), respectively. Blood, liver/intestine tissues and fecal samples were collected for determining CsA and main hydroxylated metabolite HO-CsA or measuring hepatic/intestinal CYP3A activity. Caco-2 cells were incubated with gut microbial culture supernatant (CS) of different groups or ginseng (decoction or polysaccharides), and then CYP3A, P-gp and tight junction (TJ) proteins were determined. RESULTS Oral CsA exhibited enhanced absorption, systemic exposure and tissue accumulation, and lower fecal excretion, while intravenous or intraperitoneal CsA showed lower systemic exposure and enhanced distribution, in colitis rats. Diminished intestinal and hepatic P-gp expression well explained the changes with DSS-induced colitis. Moreover, blood exposures of HO-CsA in both normal and colitis after oral dosing were significantly higher than intravenous/intraperitoneal dosing, supporting the dominant role of intestinal first-pass metabolism. Interestingly, colitis reduced CYP3A expression in intestine and liver but only potentiated intestinal CYP3A activity, causing higher oral systemic exposure of HO-CsA. Oral ginseng mitigated colitis-induced down-regulation of CYP3A and P-gp expression, facilitated HO-CsA production, biliary excretion and colonic sequestration of CsA, while not affected CsA oral systemic exposure. In Caco-2 cells, gut microbial CS from both colitis and GS+UC group diminished P-gp function, while ginseng polysaccharides directly affected ZO-1 distribution and suppressed TJ proteins expression, explaining unaltered oral CsA systemic exposure. CONCLUSIONS DSS-induced colitis significantly altered oral CsA disposition through regulating intestinal and hepatic P-gp and CYP3A. One-week ginseng treatment enhanced colonic accumulation while not altered the systemic exposure of CsA after single oral dosing, indicating pharmacokinetic compatibility between the two medications.
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Affiliation(s)
- Ying Yang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Nan Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Xue-Jiao Gao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Ting Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Zhi-Xiang Yan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Pan-Pan Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Bin Wei
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Sai Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China
| | - Zai-Jun Zhang
- Institute of New Drug Research and Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine, Jinan University College of Pharmacy, Guangzhou, 510632, China
| | - Song-Lin Li
- Department of Pharmaceutical Analysis and Metabolomics, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China
| | - Ru Yan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Zhuhai UM Science & Technology Research Institute, Zhuhai, 519080, China.
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12
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Vyhlidal CA, Chapron BD, Ahmed A, Singh V, Casini R, Shakhnovich V. Effect of Crohn's Disease on Villous Length and CYP3A4 Expression in the Pediatric Small Intestine. Clin Transl Sci 2020; 14:729-736. [PMID: 33278326 PMCID: PMC7993283 DOI: 10.1111/cts.12938] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/04/2020] [Indexed: 12/15/2022] Open
Abstract
Changes in absorptive capacity and first‐pass metabolism in the small intestine affect oral drug bioavailability. Characterization of such changes as a consequence of inflammation is important for developing physiologically‐based pharmacokinetic (PBPK) models for inflammatory bowel disease. We sought to elucidate the impact of small intestinal Crohn’s disease (CD) on villous length and CYP3A4 expression in children. Freshly frozen duodenal and terminal ileum (TI) biopsies from 107 children (1–19 years) with and without CD were evaluated for active inflammation. Villous length and CYP3A4 mRNA/protein expression were compared among regions of active and inactive inflammation in CD and controls. A twofold reduction in villous length was observed in inflamed duodena and ilia of children with CD, but in the absence of regional inflammation, villi in CD were comparable in length to controls. Expression of CYP3A4 mRNA correlated significantly with villous length in the TI (P = 0.0003), with a trend observed in the duodenum that did not reach statistical significance. In the presence of active inflammation, a significant decrease in CYP3A protein expression was confirmed in the duodenum, where protein expression also correlated significantly with villous length across diagnoses (P < 0.0001). Our findings suggest that previous observations of decreased CYP3A4 expression and function in inflamed intestine may not be due solely to downregulation by inflammatory cytokines, but also to villous blunting and subsequent loss of surface area for protein expression. This information is relevant for PBPK model development and could aid with dose adjustment decisions for oral CYP3A4 substrates administered during CD flare (e.g., budesonide).
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Affiliation(s)
- Carrie A Vyhlidal
- Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Kansas City, Kansas City, Missouri, USA.,Department of Pediatrics, University of Missouri - Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Brian D Chapron
- Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Atif Ahmed
- Department of Pediatrics, University of Missouri - Kansas City School of Medicine, Kansas City, Missouri, USA.,Division of Pathology, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Vivekanand Singh
- Division of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Rebecca Casini
- NorthShore University Health System, Skokie, Illinois, USA
| | - Valentina Shakhnovich
- Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Kansas City, Kansas City, Missouri, USA.,Department of Pediatrics, University of Missouri - Kansas City School of Medicine, Kansas City, Missouri, USA.,Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, USA
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13
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Liu F, Zhang Q, Lin C, Yao Y, Wang M, Liu C, Zhu C. A comparative study on pharmacokinetics and tissue distribution of 5-hydroxy-4-methoxycanthin-6-one and its metabolite in normal and dextran sodium sulfate-induced colitis rats by HPLC-MS/MS. J Pharm Pharmacol 2020; 72:1761-1770. [PMID: 32363585 DOI: 10.1111/jphp.13285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/04/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This study aimed to investigate the existing form of 5-hydroxy-4-methoxycanthin-6-one (PQ-A) in vivo after oral administration and the effects on its pharmacokinetics and tissue distribution by colitis. METHODS A rapid HPLC-MS/MS method was established to simultaneously determine PQ-A and its main metabolite, 1-methoxicabony-β-carboline (PQ-B), in biological samples acquired from normal and dextran sodium sulfate (DSS)-induced colitic rats administered orally with PQ-A. Then, the pharmacokinetics of both PQ-A and PQ-B, and tissue distribution of PQ-A in the above two states were analysed. KEY FINDINGS The pharmacokinetic results showed that the prototype of PQ-A was the main existing form in both physiological and pathological conditions. And significant difference between the above two status in pharmacokinetics of PQ-A was observed, such as higher exposure and longer elimination in colitis than that in normal rats. It suggested that the pharmacokinetics of medications for colitis was affected by enteritis. The tissue distribution studies displayed that PQ-A mainly accumulated in intestinal tract. Especially, the distribution of PQ-A in intestinal tract was increased obviously in colitic rats. CONCLUSIONS These results contributed to further illuminate the ADME process of PQ-A in different status and were prospected to be the reference to the clinical application of similar medicines in pathological states.
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Affiliation(s)
- Fangle Liu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiuyu Zhang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chaozhan Lin
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yufeng Yao
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Meiqi Wang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Changhui Liu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chenchen Zhu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
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14
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Rosette C, Agan FJ, Rosette N, Moro L, Mazzetti A, Hassan C, Gerloni M. Rifamycin SV exhibits strong anti-inflammatory in vitro activity through pregnane X receptor stimulation and NFκB inhibition. Drug Metab Pharmacokinet 2019; 34:172-180. [DOI: 10.1016/j.dmpk.2019.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/24/2018] [Accepted: 01/08/2019] [Indexed: 02/08/2023]
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15
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Erdmann P, Bruckmueller H, Martin P, Busch D, Haenisch S, Müller J, Wiechowska-Kozlowska A, Partecke LI, Heidecke CD, Cascorbi I, Drozdzik M, Oswald S. Dysregulation of Mucosal Membrane Transporters and Drug-Metabolizing Enzymes in Ulcerative Colitis. J Pharm Sci 2019; 108:1035-1046. [DOI: 10.1016/j.xphs.2018.09.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/17/2018] [Accepted: 09/19/2018] [Indexed: 02/07/2023]
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16
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Effinger A, O'Driscoll CM, McAllister M, Fotaki N. Impact of gastrointestinal disease states on oral drug absorption – implications for formulation design – a PEARRL review. J Pharm Pharmacol 2018; 71:674-698. [DOI: 10.1111/jphp.12928] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/16/2018] [Indexed: 12/18/2022]
Abstract
Abstract
Objectives
Drug product performance in patients with gastrointestinal (GI) diseases can be altered compared to healthy subjects due to pathophysiological changes. In this review, relevant differences in patients with inflammatory bowel diseases, coeliac disease, irritable bowel syndrome and short bowel syndrome are discussed and possible in vitro and in silico tools to predict drug product performance in this patient population are assessed.
Key findings
Drug product performance was altered in patients with GI diseases compared to healthy subjects, as assessed in a limited number of studies for some drugs. Underlying causes can be observed pathophysiological alterations such as the differences in GI transit time, the composition of the GI fluids and GI permeability. Additionally, alterations in the abundance of metabolising enzymes and transporter systems were observed. The effect of the GI diseases on each parameter is not always evident as it may depend on the location and the state of the disease. The impact of the pathophysiological change on drug bioavailability depends on the physicochemical characteristics of the drug, the pharmaceutical formulation and drug metabolism. In vitro and in silico methods to predict drug product performance in patients with GI diseases are currently limited but could be a useful tool to improve drug therapy.
Summary
Development of suitable in vitro dissolution and in silico models for patients with GI diseases can improve their drug therapy. The likeliness of the models to provide accurate predictions depends on the knowledge of pathophysiological alterations, and thus, further assessment of physiological differences is essential.
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Affiliation(s)
- Angela Effinger
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | | | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
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