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Yumoto Y, Endo T, Harada H, Kobayashi K, Nakabayashi T, Abe Y. High-throughput assay to simultaneously evaluate activation of CYP3A and the direct and time-dependent inhibition of CYP3A, CYP2C9, and CYP2D6 using liquid chromatography-tandem mass spectrometry. Xenobiotica 2024; 54:45-56. [PMID: 38265764 DOI: 10.1080/00498254.2024.2308818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/18/2024] [Indexed: 01/25/2024]
Abstract
In the early stages of drug discovery, adequate evaluation of the potential drug-drug interactions (DDIs) of drug candidates is important. Several CYP3A activators are known to lead to underestimation of DDIs. These compounds affect midazolam 1'-hydroxylation but not midazolam 4-hydroxylation.We used both metabolic reactions of midazolam to evaluate the activation and inhibition of CYP3A activators simultaneously. For our CYP inhibition assay using cocktail probe substrates, simultaneous liquid chromatography-tandem mass spectrometry monitoring of 1'-hydroxymidazolam and 4-hydroxymidazolam for CYP3A was established in addition to monitoring of 4-hydroxydiclofenac and 1'-hydroxybufuralol for CYP2C9 and CYP2D6.The results of our cocktail inhibition assay were well correlated with those of a single inhibition assay, as were the estimated inhibition parameters for typical CYP3A inhibitors. In our assay, a proprietary compound that activated midazolam 1'-hydroxylation and tended to inhibit 4-hydroxylation was evaluated along with known CYP3A activators. All compounds were well characterised by comparison of the results of midazolam 1'- and 4-hydroxylation.In conclusion, our CYP cocktail inhibition assay can detect CYP3A activation and assess the direct and time-dependent inhibition potentials for CYP3A, CYP2C9, and CYP2D6. This method is expected to be very efficient in the early stages of drug discovery.
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Affiliation(s)
- Yu Yumoto
- Central Research Laboratories, Kissei Pharmaceutical Co., Ltd, Azumino, Nagano, Japan
| | - Takuro Endo
- Central Research Laboratories, Kissei Pharmaceutical Co., Ltd, Azumino, Nagano, Japan
| | - Hiroshi Harada
- Central Research Laboratories, Kissei Pharmaceutical Co., Ltd, Azumino, Nagano, Japan
| | - Kaoru Kobayashi
- Central Research Laboratories, Kissei Pharmaceutical Co., Ltd, Azumino, Nagano, Japan
| | - Takeshi Nakabayashi
- Central Research Laboratories, Kissei Pharmaceutical Co., Ltd, Azumino, Nagano, Japan
| | - Yoshikazu Abe
- Central Research Laboratories, Kissei Pharmaceutical Co., Ltd, Azumino, Nagano, Japan
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Wang LC, Tsai HP, Chen SH, Wang SM. Therapeutics for fulminant hepatitis caused by enteroviruses in neonates. Front Pharmacol 2022; 13:1014823. [DOI: 10.3389/fphar.2022.1014823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022] Open
Abstract
Neonatal infection with nonpolio enteroviruses (EVs) causes nonspecific febrile illnesses and even life-threatening multiorgan failure. Hepatitis, which often results in hepatic necrosis followed by disseminated intravascular coagulopathy, is one of the most severe and frequent fatal neonatal EV infection complications. Coxsackievirus B (CVB) 1–5 and many echoviruses have been most commonly identified. Neonatal EV infection treatment has usually involved initial supportive care. Studies for CVB and echovirus infection treatments were developed for more than thirty years. Intravenous immunoglobulin and pleconaril therapy was performed in some clinical trials. Additionally, other studies demonstrated antiviral and/or anti-inflammatory pathogenesis mechanisms of neonatal EV hepatitis in in vitro or in vivo models. These treatments represented promising options for the clinical practice of neonatal EV hepatitis. However, further investigation is needed to elucidate the whole therapeutic potential and safety problems.
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Yang J, Nikanjam M, Capparelli EV, Tsunoda SM, Greenberg HE, Penzak SR, Stoch SA, Bertino JS, Nafziger AN, Ma JD. Midazolam Limited Sampling Strategy With a Population Pharmacokinetic Approach to Simultaneously Estimate Cytochrome P450 (CYP) 3A Constitutive, Inhibition, and Induction/Activation Conditions in Healthy Adults. J Clin Pharmacol 2019; 59:1495-1504. [DOI: 10.1002/jcph.1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 04/18/2019] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Joseph D. Ma
- University of California San Diego La Jolla CA USA
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Egorova A, Ekins S, Schmidtke M, Makarov V. Back to the future: Advances in development of broad-spectrum capsid-binding inhibitors of enteroviruses. Eur J Med Chem 2019; 178:606-622. [PMID: 31226653 PMCID: PMC8194503 DOI: 10.1016/j.ejmech.2019.06.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 01/16/2023]
Abstract
The hydrophobic pocket within viral capsid protein 1 is a target to combat the rhino- and enteroviruses (RV and EV) using small molecules. The highly conserved amino acids lining this pocket enable the development of antivirals with broad-spectrum of activity against numerous RVs and EVs. Inhibitor binding blocks: the attachment of the virion to the host cell membrane, viral uncoating, and/or production of infectious virus particles. Syntheses and biological studies of the most well-known antipicornaviral capsid binders have been reviewed and we propose next steps in this research.
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Affiliation(s)
- Anna Egorova
- Bach Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Leninsky prospekt 33-2, Moscow, 119071, Russia
| | - Sean Ekins
- Collaborations Pharmaceuticals, Inc., 840 Main Campus Drive, Lab 3510, Raleigh, NC27606, USA
| | - Michaela Schmidtke
- Jena University Hospital, Department of Medical Microbiology, Section Experimental Virology, Hans-Knöll-Str. 2, 07745, Jena, Germany
| | - Vadim Makarov
- Bach Institute of Biochemistry, Research Center of Biotechnology of the Russian Academy of Sciences, Leninsky prospekt 33-2, Moscow, 119071, Russia.
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Yang J, Patel M, Nikanjam M, Capparelli EV, Tsunoda SM, Greenberg HE, Penzak SR, Aubrey Stoch S, Bertino JS, Nafziger AN, Ma JD. Midazolam Single Time Point Concentrations to Estimate Exposure and Cytochrome P450 (CYP) 3A Constitutive Activity Utilizing Limited Sampling Strategy With a Population Pharmacokinetic Approach. J Clin Pharmacol 2018; 58:1205-1213. [DOI: 10.1002/jcph.1125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 02/27/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Jincheng Yang
- University of California (UC); San Diego La Jolla CA USA
| | - Maulik Patel
- University of California (UC); San Diego La Jolla CA USA
| | - Mina Nikanjam
- University of California (UC); San Diego La Jolla CA USA
| | | | | | | | | | | | | | | | - Joseph D. Ma
- University of California (UC); San Diego La Jolla CA USA
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Mikus G, Heinrich T, Bödigheimer J, Röder C, Matthee AK, Weiss J, Burhenne J, Haefeli WE. Semisimultaneous Midazolam Administration to Evaluate the Time Course of CYP3A Activation by a Single Oral Dose of Efavirenz. J Clin Pharmacol 2017; 57:899-905. [DOI: 10.1002/jcph.879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/09/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Gerd Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
| | - Tilman Heinrich
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
| | - Julia Bödigheimer
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
| | - Claudia Röder
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
| | - Anne-Kathrin Matthee
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
| | - Johanna Weiss
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
| | - Jürgen Burhenne
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
| | - Walter E. Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology; University of Heidelberg; Heidelberg Germany
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Abzug MJ, Michaels MG, Wald E, Jacobs RF, Romero JR, Sánchez PJ, Wilson G, Krogstad P, Storch GA, Lawrence R, Shelton M, Palmer A, Robinson J, Dennehy P, Sood SK, Cloud G, Jester P, Acosta EP, Whitley R, Kimberlin D. A Randomized, Double-Blind, Placebo-Controlled Trial of Pleconaril for the Treatment of Neonates With Enterovirus Sepsis. J Pediatric Infect Dis Soc 2016; 5:53-62. [PMID: 26407253 PMCID: PMC4765488 DOI: 10.1093/jpids/piv015] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/24/2015] [Indexed: 11/13/2022]
Abstract
BACKGROUND Neonatal enterovirus sepsis has high mortality. Antiviral therapy is not available. METHODS Neonates with suspected enterovirus sepsis (hepatitis, coagulopathy, and/or myocarditis) with onset at ≤15 days of life were randomized 2:1 to receive oral pleconaril or placebo for 7 days. Serial virologic (oropharynx, rectum, urine, serum), clinical, pharmacokinetic, and safety evaluations were performed. RESULTS Sixty-one subjects were enrolled (43 treatment, 18 placebo), of whom 43 were confirmed enterovirus infected (31 treatment, 12 placebo). There was no difference in day 5 oropharyngeal culture positivity (primary endpoint; 0% in both groups). However, enterovirus-infected subjects in the treatment group became culture negative from all anatomic sites combined faster than placebo group subjects (median 4.0 versus 7.0 days, P = .08), and fewer subjects in the treatment group remained polymerase chain reaction (PCR)-positive from the oropharynx when last sampled (23% versus 58%, P = .02; median, 14.0 days). By intent to treat, 10/43 (23%) subjects in the treatment group and 8/18 (44%) in the placebo group died (P = .02 for 2-month survival difference); among enterovirus-confirmed subjects, 7/31 (23%) in the treatment group died versus 5/12 (42%) in the placebo group (P = .26). All pleconaril recipients attained concentrations greater than the IC90 after the first study day, but 38% were less than the IC90 during the first day of treatment. One subject in the treatment group and three in the placebo group had treatment-related adverse events. CONCLUSIONS Shorter times to culture and PCR negativity and greater survival among pleconaril recipients support potential efficacy and warrant further evaluation.
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Affiliation(s)
- Mark J. Abzug
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora
| | - Marian G. Michaels
- Children's Hospital, Pittsburgh of University of Pittsburgh Medical Center
| | | | | | - José R. Romero
- University of Nebraska School of Medicine, Omaha, and University of Arkansas for Medical Sciences, Little Rock
| | - Pablo J. Sánchez
- University of Texas Southwestern, Dallas, and Nationwide Children's Hospital—The Ohio State University, Columbus
| | | | | | | | | | | | - April Palmer
- University of Mississippi Medical Center, Jackson
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Benschop KSM, van der Avoort HGAM, Duizer E, Koopmans MPG. Antivirals against enteroviruses: a critical review from a public-health perspective. Antivir Ther 2015; 20:121-30. [PMID: 25643052 DOI: 10.3851/imp2939] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2014] [Indexed: 10/24/2022]
Abstract
The enteroviruses (EVs) of the Picornaviridae family are the most common viral pathogens known. Most EV infections are mild and self-limiting but manifestations can be severe in children and immunodeficient individuals. Antiviral development is actively pursued to benefit these high-risk patients and, given the alarming problem of antimicrobial drug resistance, antiviral drug resistance is a public-health concern. Picornavirus antivirals can be used off-label or as part of outbreak control measures. They may be used in the final stages of poliovirus eradication and to mitigate EV-A71 outbreaks. We review the potential emergence of drug-resistant strains and their impact on EV transmission and endemic circulation. We include non-picornavirus antivirals that inhibit EV replication, for example, ribavirin, a treatment for infection with HCV, and amantadine, a treatment for influenza A. They may have spurred resistance emergence in HCV or influenza A patients who are unknowingly coinfected with EV. The public-health challenge is always to find a balance between individual benefit and the long-term health of the larger population.
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Affiliation(s)
- Kimberley S M Benschop
- Centre for Infectious Diseases Research, Diagnostics and Screening, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
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Zhang JG, Ho T, Callendrello AL, Clark RJ, Santone EA, Kinsman S, Xiao D, Fox LG, Einolf HJ, Stresser DM. Evaluation of Calibration Curve–Based Approaches to Predict Clinical Inducers and Noninducers of CYP3A4 with Plated Human Hepatocytes. Drug Metab Dispos 2014; 42:1379-91. [DOI: 10.1124/dmd.114.058602] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Einolf HJ, Chen L, Fahmi OA, Gibson CR, Obach RS, Shebley M, Silva J, Sinz MW, Unadkat JD, Zhang L, Zhao P. Evaluation of Various Static and Dynamic Modeling Methods to Predict Clinical CYP3A Induction Using In Vitro CYP3A4 mRNA Induction Data. Clin Pharmacol Ther 2013; 95:179-88. [DOI: 10.1038/clpt.2013.170] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 08/20/2013] [Indexed: 01/06/2023]
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Avoiding PXR and CAR Activation and CYP3A4 Enzyme Induction. TOPICS IN MEDICINAL CHEMISTRY 2013. [DOI: 10.1007/7355_2013_24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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Morley A, Tomkinson N, Cook A, MacDonald C, Weaver R, King S, Jenkinson L, Unitt J, McCrae C, Phillips T. Effect of lipophilicity modulation on inhibition of human rhinovirus capsid binders. Bioorg Med Chem Lett 2011; 21:6031-5. [DOI: 10.1016/j.bmcl.2011.08.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 08/15/2011] [Accepted: 08/17/2011] [Indexed: 02/03/2023]
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13
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Fahmi OA, Ripp SL. Evaluation of models for predicting drug–drug interactions due to induction. Expert Opin Drug Metab Toxicol 2010; 6:1399-416. [DOI: 10.1517/17425255.2010.516251] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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14
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Fahmi OA, Boldt S, Kish M, Obach RS, Tremaine LM. PREDICTION OF DRUG-DRUG INTERACTIONS FROM IN VITRO INDUCTION DATA. Drug Metab Dispos 2008; 36:1971-4. [DOI: 10.1124/dmd.108.021907] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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15
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Abstract
The evolution of antiviral therapy began with developments in the management of influenza and herpes simplex keratitis in the 1960s and early 1970s. However, the field exploded with the successful treatment of herpes simplex encephalitis, herpes zoster and genital herpes simplex virus infections, all occurring in the late 1970s and early 1980s. These advances have contributed to the development of therapies for HIV that have transformed the lives of infected patients in recent years. The clinical fruit of all of these research advances has been an armamentarium of drugs that can be used to successfully treat a variety of viral illnesses. In addition to HIV/AIDS, current antiviral therapy focuses primarily on herpesviruses, hepatitis viruses and influenza. Notably, considerable progress remains to be made in these areas. Moreover, a variety of additional viral diseases currently require the development of specific therapies.
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Affiliation(s)
- Scott T Rottinghaus
- Infectious Diseases, The University of Alabama at Birmingham, Department of Medicine, 1530 Third Avenue South, Birmingham, AL 35294-0006, USA.
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