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Kukowka A, Brzuchalski B, Kurzawski M, Malinowski D, Białecka MA. ADH1B, ADH1B/C and CYP2E1 Gene Polymorphism and the Risk of Fetal Alcohol Spectrum Disorder. Genes (Basel) 2023; 14:1392. [PMID: 37510297 PMCID: PMC10379323 DOI: 10.3390/genes14071392] [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: 05/31/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Increasing alcohol consumption by women of childbearing age contributes to more frequent cases of fetal alcohol spectrum disorder. The cause of the syndrome is fetal alcohol exposure, particularly what is referred to as high prenatal alcohol exposure. Low metabolic activity of fetal enzymes shifts the burden of ethanol removal to maternal metabolism. One of the factors influencing the pathogenesis of FASD is the genetic background. It can determine the rate of elimination of ethanol, thus increasing or decreasing the time of fetal exposure to ethanol and also decreasing its concentration. Genetic polymorphisms could potentially play a significant role in these processes. In the present study, we considered three polymorphisms of genes implicated in the synthesis of enzymes involved in ethanol metabolism, i.e., ADH1b (rs1229984), ADH1b/c (rs1789891), and CYP2E1 (rs3813867). The studied group consisted of 303 children and 251 mothers. Both mothers' and children's genotypes were considered in our analysis. There were no statistically significant differences between the respective groups of genotypes of the studied polymorphisms. However, the genetic background of FASD is still elusive.
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Affiliation(s)
- Arnold Kukowka
- Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, Aleja Powstanców Wielkopolskich 72 St., 70-111 Szczecin, Poland (D.M.)
| | - Bogusław Brzuchalski
- Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, Aleja Powstanców Wielkopolskich 72 St., 70-111 Szczecin, Poland (D.M.)
| | - Mateusz Kurzawski
- Department of Experimental and Clinical Pharmacology, Pomeranian Medical University, Aleja Powstanców Wielkopolskich 72 St., 70-111 Szczecin, Poland;
| | - Damian Malinowski
- Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, Aleja Powstanców Wielkopolskich 72 St., 70-111 Szczecin, Poland (D.M.)
| | - Monika Anna Białecka
- Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, Aleja Powstanców Wielkopolskich 72 St., 70-111 Szczecin, Poland (D.M.)
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Physiologically Based Pharmacokinetic Modeling to Characterize Acetaminophen Pharmacokinetics and N-Acetyl-p-Benzoquinone Imine (NAPQI) Formation in Non-Pregnant and Pregnant Women. Clin Pharmacokinet 2021; 59:97-110. [PMID: 31347013 PMCID: PMC6994454 DOI: 10.1007/s40262-019-00799-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background and Objective Little is known about acetaminophen (paracetamol) pharmacokinetics during pregnancy. The aim of this study was to develop a physiologically based pharmacokinetic (PBPK) model to predict acetaminophen pharmacokinetics throughout pregnancy. Methods PBPK models for acetaminophen and its metabolites were developed in non-pregnant and pregnant women. Physiological and enzymatic changes in pregnant women expected to impact acetaminophen pharmacokinetics were considered. Models were evaluated using goodness-of-fit plots and by comparing predicted pharmacokinetic profiles with in vivo pharmacokinetic data. Predictions were performed to illustrate the average concentration at steady state (Css,avg) values, used as an indicator for efficacy, of acetaminophen achieved following administration of 1000 mg every 6 h. Furthermore, as a measurement of potential hepatotoxicity, the molar dose fraction of acetaminophen converted to N-acetyl-p-benzoquinone imine (NAPQI) was estimated. Results PBPK models successfully predicted the pharmacokinetics of acetaminophen and its metabolites in non-pregnant and pregnant women. Predictions resulted in the lowest Css,avg in the third trimester (median [interquartile range]: 4.5 [3.8–5.1] mg/L), while Css,avg was 6.7 [5.9–7.4], 5.6 [4.7–6.3], and 4.9 [4.1–5.5] mg/L in non-pregnant, first trimester, and second trimester populations, respectively. Assuming a constant raised cytochrome P450 2E1 activity throughout pregnancy, the molar dose fraction of acetaminophen converted to NAPQI was highest during the first trimester (median [interquartile range]: 11.0% [9.1–13.4%]), followed by the second (9.0% [7.5–11.0%]) and third trimester (8.2% [6.8–10.1%]), compared with non-pregnant women (7.7% [6.4–9.4%]). Conclusion Acetaminophen exposure is lower in pregnant than in non-pregnant women, and is related to pregnancy duration. Despite these findings, higher dose adjustments cannot be advised yet as it is unknown whether pregnancy affects the toxicodynamics of NAPQI. Information on glutathione abundance during pregnancy and NAPQI in vivo data are required to further refine the presented model. Electronic supplementary material The online version of this article (10.1007/s40262-019-00799-5) contains supplementary material, which is available to authorized users.
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Khatri R, Fallon JK, Sykes C, Kulick N, Rementer RJB, Miner TA, Schauer AP, Kashuba ADM, Boggess KA, Brouwer KLR, Smith PC, Lee CR. Pregnancy-Related Hormones Increase UGT1A1-Mediated Labetalol Metabolism in Human Hepatocytes. Front Pharmacol 2021; 12:655320. [PMID: 33995076 PMCID: PMC8115026 DOI: 10.3389/fphar.2021.655320] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/11/2021] [Indexed: 11/25/2022] Open
Abstract
Pregnancy-related hormones (PRH) are recognized as important regulators of hepatic cytochrome P450 enzyme expression and function. However, the impact of PRH on the hepatic expression and function of uridine diphosphate glucuronosyltransferases (UGTs) remains unclear. Using primary human hepatocytes, we evaluated the effect of PRH exposure on mRNA levels and protein concentrations of UGT1A1, UGT2B7, and other key UGT enzymes, and on the metabolism of labetalol (a UGT1A1 and UGT2B7 substrate commonly prescribed to treat hypertensive disorders of pregnancy). Sandwich-cultured human hepatocytes (SCHH) from female donors were exposed to the PRH estradiol, estriol, estetrol, progesterone, and cortisol individually or in combination. We quantified protein concentrations of UGT1A1, UGT2B7, and four additional UGT1A isoforms in SCHH membrane fractions and evaluated the metabolism of labetalol to its glucuronide metabolites in SCHH. PRH exposure increased mRNA levels and protein concentrations of UGT1A1 and UGT1A4 in SCHH. PRH exposure also significantly increased labetalol metabolism to its UGT1A1-derived glucuronide metabolite in a concentration-dependent manner, which positively correlated with PRH-induced changes in UGT1A1 protein concentrations. In contrast, PRH did not alter UGT2B7 mRNA levels or protein concentrations in SCHH, and formation of the UGT2B7-derived labetalol glucuronide metabolite was decreased following PRH exposure. Our findings demonstrate that PRH alter expression and function of UGT proteins in an isoform-specific manner and increase UGT1A1-mediated labetalol metabolism in human hepatocytes by inducing UGT1A1 protein concentrations. These results provide mechanistic insight into the increases in labetalol clearance observed in pregnant individuals.
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Affiliation(s)
- Raju Khatri
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - John K Fallon
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Craig Sykes
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Natasha Kulick
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rebecca J B Rementer
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Taryn A Miner
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Amanda P Schauer
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angela D M Kashuba
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kim A Boggess
- Department of Obstetrics and Gynecology, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kim L R Brouwer
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Philip C Smith
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Craig R Lee
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Pregnancy-Related Hormones Increase Nifedipine Metabolism in Human Hepatocytes by Inducing CYP3A4 Expression. J Pharm Sci 2020; 110:412-421. [PMID: 32931777 DOI: 10.1016/j.xphs.2020.09.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 12/24/2022]
Abstract
Pregnancy-related hormones (PRH) have emerged as key regulators of hepatic cytochrome P450 (CYP) enzyme expression and function. The impact of PRH on protein levels of CYP3A4 and other key CYP enzymes, and the metabolism of nifedipine (a CYP3A4 substrate commonly prescribed during pregnancy), was evaluated in primary human hepatocytes. Sandwich-cultured human hepatocytes (SCHH) from female donors were exposed to PRH (estradiol, estriol, estetrol, progesterone, and cortisol), individually or in combination as a cocktail. Absolute protein concentrations of twelve CYP isoforms in SCHH membrane fractions were quantified by nanoLC-MS/MS, and metabolism of nifedipine to dehydronifedipine in SCHH was evaluated. PRH significantly increased CYP3A4 protein concentrations and nifedipine metabolism to dehydronifedipine in a concentration-dependent manner. CYP3A4 mRNA levels in hepatocyte-derived exosomes positively correlated with CYP3A4 protein levels and dehydronifedipine formation in SCHH. PRH also increased CYP2B6, CYP2C8 and CYP2A6 levels. Our findings demonstrate that PRH increase nifedipine metabolism in SCHH by inducing CYP3A4 expression and alter expression of other key CYP proteins in an isoform-specific manner, and suggest that hepatocyte-derived exosomes warrant further investigation as biomarkers of hepatic CYP3A4 metabolism. Together, these results offer mechanistic insight into the increases in nifedipine metabolism and clearance observed in pregnant women.
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Guengerich FP. Cytochrome P450 2E1 and its roles in disease. Chem Biol Interact 2020; 322:109056. [PMID: 32198084 PMCID: PMC7217708 DOI: 10.1016/j.cbi.2020.109056] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/12/2019] [Accepted: 03/10/2020] [Indexed: 12/27/2022]
Abstract
Cytochrome P450 (P450) 2E1 is the major P450 enzyme involved in ethanol metabolism. That role is shared with two other enzymes that oxidize ethanol, alcohol dehydrogenase and catalase. P450 2E1 is also involved in the bioactivation of a number of low molecular weight cancer suspects, as validated in vivo in mouse models where cancers could be attenuated by deletion of Cyp2e1. P450 2E1 does not have a role in global production of reactive oxygen species but localized roles are possible, e.g. in mitochondria. The structures, conformations, and catalytic mechanisms of P450 2E1 have some unusual features among P450s. The concentration of hepatic P450 varies ≥10-fold among humans, possibly in part due to single nucleotide variants. The level of P450 2E1 may have relevance in the rates of oxidation of drugs, particularly acetaminophen and anesthetics.
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Affiliation(s)
- F Peter Guengerich
- Department of Biochemistry, Vanderbilt University School of Medicine, 638 Robinson Research Building, 2200 Pierce Avenue, Nashville, TN, 37232-0146, USA.
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Abstract
Hepatic drug metabolism is a major route of drug elimination, mediated by multiple drug-metabolizing enzymes. Any changes in the rate and extent of hepatic drug metabolism can lead to altered drug efficacy or toxicity. Accumulating clinical evidence indicates that pregnancy is accompanied by changes in hepatic drug metabolism. In this article, we discuss in vitro and in vivo tools used to study the mechanisms underlying the altered drug metabolism during pregnancy, focusing on primary hepatocyte culture, transgenic animal models, and use of probe drugs to assess change in enzymatic activity. The information obtained from these studies has enabled prediction of clinical PK changes for a given drug in pregnant women.
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Affiliation(s)
- Hyunyoung Jeong
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, 900 S. Ashland Ave, Chicago, IL 60607, United States.
| | - Catherine S. Stika
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Morgan ET, Dempsey JL, Mimche SM, Lamb TJ, Kulkarni S, Cui JY, Jeong H, Slitt AL. Physiological Regulation of Drug Metabolism and Transport: Pregnancy, Microbiome, Inflammation, Infection, and Fasting. Drug Metab Dispos 2018. [PMID: 29514828 DOI: 10.1124/dmd.117.079905] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This article is a report on a symposium entitled "Physiological Regulation of Drug Metabolism and Transport" sponsored by the American Society for Pharmacology and Experimental Therapeutics and held at the Experimental Biology 2017 meeting in Chicago, IL. The contributions of physiologic and pathophysiological regulation of drug-metabolizing enzymes and transporters to interindividual variability in drug metabolism are increasingly recognized but in many cases are not well understood. The presentations herein discuss the phenomenology, consequences, and mechanism of such regulation. CYP2D6 transgenic mice were used to provide insights into the mechanism of regulation of this enzyme in pregnancy, via hepatocyte nuclear factor 4α, small heterodimer partner, and retinoids. Regulation of intestinal and hepatic drug-processing enzymes by the intestinal microbiota via tryptophan and its metabolites was investigated. The potential impact of parasitic infections on human drug metabolism and clearance was assessed in mice infected with Schistosoma mansoni or Plasmodium chabaudi chabaudi AS, both of which produced widespread and profound effects on murine hepatic drug-metabolizing enzymes. Finally, the induction of Abcc drug efflux transporters by fasting was investigated. This was demonstrated to occur via a cAMP, protein kinase A/nuclear factor-E2-related factor 2/Sirtuin 1 pathway via antioxidant response elements on the Abcc genes.
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Affiliation(s)
- Edward T Morgan
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
| | - Joseph L Dempsey
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
| | - Sylvie M Mimche
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
| | - Tracey J Lamb
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
| | - Supriya Kulkarni
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
| | - Julia Yue Cui
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
| | - Hyunyoung Jeong
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
| | - Angela L Slitt
- Department of Pharmacology, School of Medicine, Emory University, Atlanta, Georgia (E.T.M., S.M.M.); Department of Pathology, University of Utah, Salt Lake City, Utah (T.J.L.); Department of Pharmacy Practice and Department of Biopharmaceutical Sciences, College of Pharmacy, University of Illinois, Chicago, Illinois (H.J., J.L.D.); Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington (J.L.D., J.Y.C.); and Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island (A.L.S., S.K.)
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Sato Y, Kaneko Y, Cho T, Goto K, Otsuka T, Yamamoto S, Goto S, Maruyama H, Narita I. Prolactin Upregulates Female-Predominant P450 Gene Expressions and Downregulates Male-Predominant Gene Expressions in Mouse Liver. Drug Metab Dispos 2017; 45:586-592. [PMID: 28330858 DOI: 10.1124/dmd.116.074658] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/17/2017] [Indexed: 11/22/2022] Open
Abstract
Prolactin is a polypeptide hormone with over 300 separate biologic activities. Its serum level is increased during pregnancy and lactation, and it has been reported that pregnancy and lactation affect drug and steroid metabolism in mice and humans. Several studies reported that pregnancy or lactation influences liver cytochrome P450 (P450) expression and its activity, affecting the biosynthesis of steroids and xenobiotics through growth hormone or sex hormones; however, the role of prolactin as the regulator of liver P450 expression has not been elucidated so far. In the present study, we focused on prolactin as the regulator of expression of liver sex-predominant genes, including P450s. To investigate the role of prolactin in the hepatic gene expressions, pCAGGS expression vector containing mouse prolactin cDNA was transfected by hydrodynamic injection into both male and female mice. Hyperprolactinemia phosphorylated signal transducer and activator of transcription 5 in the liver and augmented female mouse liver mRNA expression of Cyp3a16, Cyp3a41, Cyp3a44, Cyp2b9, and prolactin receptor genes, whose expressions were female-predominant in hepatocytes. Moreover, liver expression of male-predominant genes such as Cyp2d9, Cyp7b1, Mup1, and Alas2 were reduced in male mice with hyperprolactinemia. The serum levels of conventional regulators of hepatic gene expressions, growth hormone, and testosterone were not affected by hyperprolactinemia. We demonstrated that prolactin upregulated female-predominant genes in female mice and downregulated male-predominant genes in male mice. We conjecture that higher concentration of prolactin would alter steroid and xenobiotic metabolisms by modulating hepatic P450 gene expressions during pregnancy and lactation.
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Affiliation(s)
- Yuya Sato
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Yoshikatsu Kaneko
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Takamasa Cho
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Kei Goto
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Tadashi Otsuka
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Suguru Yamamoto
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Shin Goto
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Hiroki Maruyama
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology (Y.S., Y.K., T.C., K.G., T.O., S.Y., S.G., I.N.) and Department of Clinical Nephroscience (H.M.), Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori, Niigata, Japan
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Abstract
BACKGROUND Women are commonly prescribed a variety of medications during pregnancy. As most organ systems are affected by the substantial anatomical and physiological changes that occur during pregnancy, it is expected that pharmacokinetics (PK) (absorption, distribution, metabolism, and excretion of drugs) would also be affected in ways that may necessitate changes in dosing schedules. The objective of this study was to systematically identify existing clinically relevant evidence on PK changes during pregnancy. METHODS AND FINDINGS Systematic searches were conducted in MEDLINE (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Ovid), and Web of Science (Thomson Reuters), from database inception to August 31, 2015. An update of the search from September 1, 2015, to May 20, 2016, was performed, and relevant data were added to the present review. No language or date restrictions were applied. All publications of clinical PK studies involving a group of pregnant women with a comparison to nonpregnant participants or nonpregnant population data were eligible to be included in this review. A total of 198 studies involving 121 different medications fulfilled the inclusion criteria. In these studies, commonly investigated drug classes included antiretrovirals (54 studies), antiepileptic drugs (27 studies), antibiotics (23 studies), antimalarial drugs (22 studies), and cardiovascular drugs (17 studies). Overall, pregnancy-associated changes in PK parameters were often observed as consistent findings among many studies, particularly enhanced drug elimination and decreased exposure to total drugs (bound and unbound to plasma proteins) at a given dose. However, associated alterations in clinical responses and outcomes, or lack thereof, remain largely unknown. CONCLUSION This systematic review of pregnancy-associated PK changes identifies a significant gap between the accumulating knowledge of PK changes in pregnant women and our understanding of their clinical impact for both mother and fetus. It is essential for clinicians to be aware of these unique pregnancy-related changes in PK, and to critically examine their clinical implications.
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10
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Mukai Y, Hoshi F, Sato S. Effect of fructose on the phosphorylation of AMP-activated protein kinase and acetyl-CoA carboxylase in HepG2 cells stimulated with placental lactogen. ACTA ACUST UNITED AC 2016; 107:206-210. [DOI: 10.1002/bdrb.21186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 08/31/2016] [Accepted: 08/31/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Yuuka Mukai
- School of Nutrition and Dietetics, Faculty of Health and Social Work; Kanagawa University of Human Services; Kanagawa Japan
- Division of Health and Social Services, Graduate Course of Health and Social Work; Kanagawa University of Human Services Graduate School; Kanagawa Japan
| | - Fumika Hoshi
- Division of Health and Social Services, Graduate Course of Health and Social Work; Kanagawa University of Human Services Graduate School; Kanagawa Japan
| | - Shin Sato
- Department of Nutrition; Aomori University of Health and Welfare; Aomori Japan
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11
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Tasnif Y, Morado J, Hebert MF. Pregnancy-related pharmacokinetic changes. Clin Pharmacol Ther 2016; 100:53-62. [PMID: 27082931 DOI: 10.1002/cpt.382] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/12/2016] [Indexed: 01/10/2023]
Abstract
The pharmacokinetics of many drugs are altered by pregnancy. Drug distribution and protein binding are changed by pregnancy. While some drug metabolizing enzymes have an apparent increase in activity, others have an apparent decrease in activity. Not only is drug metabolism affected by pregnancy, but renal filtration is also increased. In addition, pregnancy alters the apparent activities of multiple drug transporters resulting in changes in the net renal secretion of drugs.
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Affiliation(s)
- Y Tasnif
- Cooperative Pharmacy Program, University of Texas, Rio Grande Valley TX and Renaissance Transplant Institute, Doctors Hospital at Renaissance, Edinburg, Texas, USA
| | - J Morado
- College of Pharmacy, University of Texas at Austin, Austin, Texas, USA
| | - M F Hebert
- Departments of Pharmacy and Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
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Yu T, Campbell SC, Stockmann C, Tak C, Schoen K, Clark EAS, Varner MW, Spigarelli MG, Sherwin CMT. Pregnancy-induced changes in the pharmacokinetics of caffeine and its metabolites. J Clin Pharmacol 2015; 56:590-6. [PMID: 26358647 DOI: 10.1002/jcph.632] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/08/2015] [Indexed: 01/18/2023]
Abstract
This study sought to assess the pharmacokinetic (PK) changes of caffeine and its CYP1A2 metabolites across the 3 trimesters of pregnancy. A prospective, multicenter PK study was conducted among 59 pregnant women (93.2% white) who were studied once during a trimester. One beverage with 30-95 mg caffeine was consumed, and a blood/urine sample was collected within 1 hour postingestion. Concentrations of caffeine and its primary metabolites were quantified from serum and urine by LC-MS/MS. There was a significant increase in dose-normalized caffeine serum and urine concentrations between the first and third trimesters (P < .05 and P < .01, respectively). Normalized theophylline concentrations also increased significantly in the third trimester in serum (P < .001) and in urine (P < .05). The caffeine urine/serum concentration ratio also increased in the last trimester (P < .05). No significant difference was found in normalized paraxanthine or theobromine concentrations. This study identified decreased caffeine metabolism and an increase in the active metabolite theophylline concentrations during pregnancy, especially in the third trimester, revealing evidence of the large role that pregnancy plays in influencing caffeine metabolism.
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Affiliation(s)
- Tian Yu
- Division of Clinical Pharmacology, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Sarah C Campbell
- Division of Clinical Pharmacology, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Chris Stockmann
- Division of Clinical Pharmacology, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Casey Tak
- Clinical Trials Office, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Katherine Schoen
- Division of Clinical Pharmacology, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Erin A S Clark
- Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Michael W Varner
- Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Intermountain Healthcare, Women and Newborns Clinical Programs, Salt Lake City, Utah, USA
| | - Michael G Spigarelli
- Division of Clinical Pharmacology, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Clinical Trials Office, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Catherine M T Sherwin
- Division of Clinical Pharmacology, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Clinical Trials Office, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT, USA
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Talbot NC, Wang L, Garrett WM, Caperna TJ, Tang Y. Establishment and characterization of feeder cell-dependent bovine fetal liver cell lines. In Vitro Cell Dev Biol Anim 2015; 52:314-326. [DOI: 10.1007/s11626-015-9982-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/16/2015] [Indexed: 12/24/2022]
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