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Liu J, Kandel SE, Lampe JN, Scott EE. Human cytochrome P450 3A7 binding four copies of its native substrate dehydroepiandrosterone 3-sulfate. J Biol Chem 2023; 299:104993. [PMID: 37392852 PMCID: PMC10388207 DOI: 10.1016/j.jbc.2023.104993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/26/2023] [Indexed: 07/03/2023] Open
Abstract
Human fetal cytochrome P450 3A7 (CYP3A7) is involved in both xenobiotic metabolism and the estriol biosynthetic pathway. Although much is understood about cytochrome P450 3A4 and its role in adult drug metabolism, CYP3A7 is poorly characterized in terms of its interactions with both categories of substrates. Herein, a crystallizable mutated form of CYP3A7 was saturated with its primary endogenous substrate dehydroepiandrosterone 3-sulfate (DHEA-S) to yield a 2.6 Å X-ray structure revealing the unexpected capacity to simultaneously bind four copies of DHEA-S. Two DHEA-S molecules are located in the active site proper, one in a ligand access channel, and one on the hydrophobic F'-G' surface normally embedded in the membrane. While neither DHEA-S binding nor metabolism exhibit cooperative kinetics, the current structure is consistent with cooperativity common to CYP3A enzymes. Overall, this information suggests that mechanism(s) of CYP3A7 interactions with steroidal substrates are complex.
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Affiliation(s)
- Jinghan Liu
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Sylvie E Kandel
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado, USA
| | - Jed N Lampe
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado, USA
| | - Emily E Scott
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, Michigan, USA; Departments of Pharmacology, Biological Chemistry and Programs in Chemical Biology and Biophysics, University of Michigan, Ann Arbor, Michigan, USA.
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2
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Muccee F, Bijou O, Harakeh S, Adawiyah R, Sayyed RZ, Haghshenas L, Alshehri D, Ansari MJ, Ghazanfar S. In-Silico Investigation of Effects of Single-Nucleotide Polymorphisms in PCOS-Associated CYP11A1 Gene on Mutated Proteins. Genes (Basel) 2022; 13:genes13071231. [PMID: 35886014 PMCID: PMC9317558 DOI: 10.3390/genes13071231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a reproductive disorder with multiple etiologies, mainly characterized by the excess production of androgens. It is equally contributed to by genes and environment. The CYP11A1 gene is imperative for steroidogenesis, so any dysregulation or mutation in this gene can lead to PCOS pathogenesis. Therefore, nucleotide diversity in this gene can be helpful in spotting the likelihood of developing PCOS. The present study was initiated to investigate the effect of single nucleotide polymorphisms in human CYP11A1 gene on different attributes of encoded mutated proteins, i.e., sub-cellular localization, ontology, half-life, isoelectric point, instability index, aliphatic index, extinction coefficient, 3-D and 2-D structures, and transmembrane topology. For this purpose, initially coding sequence (CDS) and single nucleotide polymorphisms (SNPs) were retrieved for the desired gene from Ensembl followed by translation of CDS using EXPASY tool. The protein sequence obtained was subjected to different tools including CELLO2GO, ProtParam, PHYRE2, I-Mutant, SIFT, and PolyPhen. It was found that out of seventy-eight SNPs analyzed in this project, seventeen mutations, i.e., rs750026801 in exon 1, rs776056840, rs779154292 and rs1217014229 in exon 2, rs549043326 in exon 3, rs755186597 in exon 4, rs1224774813, rs757299093 and rs1555425667 in exon 5, rs1454328072 in exon 7, rs762412759 and rs755975808 in exon 8, and rs754610565, rs779413653, rs765916701, rs1368450780, and rs747901197 in exon 9 considerably altered the structure, sub-cellular localization, and physicochemical characteristics of mutated proteins. Among the fifty-nine missense SNPs documented in present study, fifty-five and fifty-three were found to be deleterious according to SIFT and PolyPhen tools, respectively. Forty-nine missense mutations were analyzed to have a decreasing effect on the stability of mutant proteins. Hence, these genetic variants can serve as potential biomarkers in human females for determining the probability of being predisposed to PCOS.
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Affiliation(s)
- Fatima Muccee
- School of Biochemistry and Biotechnology, University of Punjab, Lahore 52254, Pakistan
- Correspondence: ; Tel.: +92-0331-4767254
| | - Osama Bijou
- Obstetrics and Gynaecology Department, Faculty of Medicine (FM), King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Steve Harakeh
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Yousef Abdul Latif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine (FM), King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rabi’atul Adawiyah
- Faculty of Health and Life Sciences, INTI International University, Nilai 71800, Negeri Sembilan, Malaysia;
| | - R. Z. Sayyed
- Department of Microbiology, P.S.G.V.P. Mandal’s S I Patil Arts, G B Patel Science and S.T.K.V.S. Sangh Commerce College, Shahada 425409, India;
| | - Leila Haghshenas
- Department of Molecular Genetics, Postdoc Association Member of Harvard Medical School, Boston, MA 02138, USA;
| | - Dikhnah Alshehri
- Department of Biology, Faculty of Science, Tabuk University, Tabuk 71491, Saudi Arabia;
| | - Mohammad Javed Ansari
- Department of Botany, Hindu College Moradabad, Mahatma Jyotiba Phule Rohilkhand University, Bareilly 244001, India;
| | - Shakira Ghazanfar
- National Institute for Genomics Advanced Biotechnology (NIGAB), National Agricultural Research Centre (NARC), Islamabad 45500, Pakistan;
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Lin YS, Thummel KE, Thompson BD, Totah RA, Cho CW. Sources of Interindividual Variability. Methods Mol Biol 2021; 2342:481-550. [PMID: 34272705 DOI: 10.1007/978-1-0716-1554-6_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The efficacy, safety, and tolerability of drugs are dependent on numerous factors that influence their disposition. A dose that is efficacious and safe for one individual may result in sub-therapeutic or toxic blood concentrations in others. A significant source of this variability in drug response is drug metabolism, where differences in presystemic and systemic biotransformation efficiency result in variable degrees of systemic exposure (e.g., AUC, Cmax, and/or Cmin) following administration of a fixed dose.Interindividual differences in drug biotransformation have been studied extensively. It is recognized that both intrinsic factors (e.g., genetics, age, sex, and disease states) and extrinsic factors (e.g., diet , chemical exposures from the environment, and the microbiome) play a significant role. For drug-metabolizing enzymes, genetic variation can result in the complete absence or enhanced expression of a functional enzyme. In addition, upregulation and downregulation of gene expression, in response to an altered cellular environment, can achieve the same range of metabolic function (phenotype), but often in a less predictable and time-dependent manner. Understanding the mechanistic basis for variability in drug disposition and response is essential if we are to move beyond the era of empirical, trial-and-error dose selection and into an age of personalized medicine that will improve outcomes in maintaining health and treating disease.
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Affiliation(s)
- Yvonne S Lin
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA.
| | - Kenneth E Thummel
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA
| | - Brice D Thompson
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA
| | - Rheem A Totah
- Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA
| | - Christi W Cho
- Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA
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Carvalho Henriques B, Yang EH, Lapetina D, Carr MS, Yavorskyy V, Hague J, Aitchison KJ. How Can Drug Metabolism and Transporter Genetics Inform Psychotropic Prescribing? Front Genet 2020; 11:491895. [PMID: 33363564 PMCID: PMC7753050 DOI: 10.3389/fgene.2020.491895] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/25/2020] [Indexed: 12/11/2022] Open
Abstract
Many genetic variants in drug metabolizing enzymes and transporters have been shown to be relevant for treating psychiatric disorders. Associations are strong enough to feature on drug labels and for prescribing guidelines based on such data. A range of commercial tests are available; however, there is variability in included genetic variants, methodology, and interpretation. We herein provide relevant background for understanding clinical associations with specific variants, other factors that are relevant to consider when interpreting such data (such as age, gender, drug-drug interactions), and summarize the data relevant to clinical utility of pharmacogenetic testing in psychiatry and the available prescribing guidelines. We also highlight areas for future research focus in this field.
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Affiliation(s)
| | - Esther H. Yang
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Diego Lapetina
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Michael S. Carr
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Vasyl Yavorskyy
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Joshua Hague
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Katherine J. Aitchison
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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Li H, Lampe JN. Neonatal cytochrome P450 CYP3A7: A comprehensive review of its role in development, disease, and xenobiotic metabolism. Arch Biochem Biophys 2019; 673:108078. [PMID: 31445893 DOI: 10.1016/j.abb.2019.108078] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/17/2019] [Accepted: 08/18/2019] [Indexed: 12/14/2022]
Abstract
The human cytochrome P450 CYP3A7, once thought to be an enzyme exclusive to fetal livers, has more recently been identified in neonates and developing infants as old as 24 months post-gestational age. CYP3A7 has been demonstrated to metabolize two endogenous compounds that are known to be important in the growth and development of the fetus and neonate, namely dehydroepiandrosterone sulfate (DHEA-S) and all-trans retinoic acid (atRA). In addition, it is also known to metabolize a variety of drugs and xenobiotics, albeit generally to a lesser extent relative to CYP3A4/5. CYP3A7 is an important component in the development and protection of the fetal liver and additionally plays a role in certain disease states, such as cancer and adrenal hyperplasia. Ultimately, a full understanding of the expression, regulation, and metabolic properties of CYP3A7 is needed to provide neonates with appropriate individualized pharmacotherapy. This article summarizes the current state of knowledge of CYP3A7, including its discovery, distribution, alleles, RNA splicing, expression and regulation, metabolic properties, substrates, and inhibitors.
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Affiliation(s)
- Haixing Li
- Sino-German Joint Research Institute Nanchang University, 235 East Nanjing Road, Nanchang, 330047, Jiangxi, PR China
| | - Jed N Lampe
- University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Mail Stop C238, 12850 E. Montview Blvd., Aurora, CO, 80045, USA.
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Ajmal N, Khan SZ, Shaikh R. Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. Eur J Obstet Gynecol Reprod Biol X 2019; 3:100060. [PMID: 31403134 PMCID: PMC6687436 DOI: 10.1016/j.eurox.2019.100060] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/27/2019] [Accepted: 05/30/2019] [Indexed: 01/16/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous condition which is related to an endocrine reproductive disorder of females. It affects females of 18-44 age. The persistent hormonal disbalance leads to the complexities such as numerous cysts, an irregular menstrual cycle that ultimately leads to infertility among females. Many candidate genes have been identified to be one of the causes of PCOS. Different studies have been carried out to find the genetic correlation of PCOS. It is essential to carry out such studies that identify the clear cause of PCOS and its genetic association and hormonal disbalance. This review has highlighted different genes and their correlation with PCOS that leads to hormonal disbalance. Yet not in-depth but an attempt to study the genetic predisposition of PCOS.
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Affiliation(s)
| | | | - Rozeena Shaikh
- Department of Biotechnology, Faculty of Life Sciences and Informatics, Balochistan University of Information Technology, Engineering and Management Sciences (BUITEMS), Quetta, Balochistan, Pakistan
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7
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Chen YJ, Zhang J, Zhu PP, Tan XW, Lin QH, Wang WX, Yin SS, Gao LZ, Su MM, Liu CX, Xu L, Jia W, Sevrioukova IF, Lan K. Stereoselective Oxidation Kinetics of Deoxycholate in Recombinant and Microsomal CYP3A Enzymes: Deoxycholate 19-Hydroxylation Is an In Vitro Marker of CYP3A7 Activity. Drug Metab Dispos 2019; 47:574-581. [PMID: 30918015 DOI: 10.1124/dmd.119.086637] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 03/25/2019] [Indexed: 12/30/2022] Open
Abstract
The primary bile acids (BAs) synthesized from cholesterol in the liver are converted to secondary BAs by gut microbiota. It was recently disclosed that the major secondary BA, deoxycholate (DCA) species, is stereoselectively oxidized to tertiary BAs exclusively by CYP3A enzymes. This work subsequently investigated the in vitro oxidation kinetics of DCA at C-1β, C-3β, C-4β, C-5β, C-6α, C-6β, and C-19 in recombinant CYP3A enzymes and naive enzymes in human liver microsomes (HLMs). The stereoselective oxidation of DCA fit well with Hill kinetics at 1-300 μM in both recombinant CYP3A enzymes and pooled HLMs. With no contributions or trace contributions from CYP3A5, CYP3A7 favors oxidation at C-19, C-4β, C-6α, C-3β, and C-1β, whereas CYP3A4 favors the oxidation at C-5β and C-6β compared with each other. Correlation between DCA oxidation and testosterone 6β-hydroxylation in 14 adult single-donor HLMs provided proof-of-concept evidence that DCA 19-hydroxylation is an in vitro marker reaction for CYP3A7 activity, whereas oxidation at other sites represents mixed indicators for CYP3A4 and CYP3A7 activities. Deactivation caused by DCA-induced cytochrome P450-cytochrome P420 conversion, as shown by the spectral titrations of isolated CYP3A proteins, was observed when DCA levels were near or higher than the critical micelle concentration (about 1500 μM). Unlike CYP3A4, CYP3A7 showed abnormally elevated activities at 500 and 750 μM, which might be associated with an altered affinity for DCA multimers. The disclosed kinetic and functional roles of CYP3A isoforms in disposing of the gut bacteria-derived DCA may help in understanding the structural and functional mechanisms of CYP3A.
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Affiliation(s)
- Yu-Jie Chen
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Jian Zhang
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Ping-Ping Zhu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Xian-Wen Tan
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Qiu-Hong Lin
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Wen-Xia Wang
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Shan-Shan Yin
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Ling-Zhi Gao
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Ming-Ming Su
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Chang-Xiao Liu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Liang Xu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Wei Jia
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Irina F Sevrioukova
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
| | - Ke Lan
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, People's Republic of China (Y.-J.C., J.Z., P.-P.Z., X.-W.T., Q.-H.L., W.W., S.-S.Y., L.-Z.G., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.-M.S., W.J.); Department of Molecular Biology and Biochemistry, University of California, Irvine, California (I.F.S.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, People's Republic of China (C.-X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, People's Republic of China (S.-S.Y., K.L.)
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8
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Zhang J, Gao LZ, Chen YJ, Zhu PP, Yin SS, Su MM, Ni Y, Miao J, Wu WL, Chen H, Brouwer KLR, Liu CX, Xu L, Jia W, Lan K. Continuum of Host-Gut Microbial Co-metabolism: Host CYP3A4/3A7 are Responsible for Tertiary Oxidations of Deoxycholate Species. Drug Metab Dispos 2019; 47:283-294. [PMID: 30606729 PMCID: PMC6378331 DOI: 10.1124/dmd.118.085670] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/31/2018] [Indexed: 02/05/2023] Open
Abstract
The gut microbiota modifies endogenous primary bile acids (BAs) to produce exogenous secondary BAs, which may be further metabolized by cytochrome P450 enzymes (P450s). Our primary aim was to examine how the host adapts to the stress of microbe-derived secondary BAs by P450-mediated oxidative modifications on the steroid nucleus. Five unconjugated tri-hydroxyl BAs that were structurally and/or biologically associated with deoxycholate (DCA) were determined in human biologic samples by liquid chromatography-tandem mass spectrometry in combination with enzyme-digestion techniques. They were identified as DCA-19-ol, DCA-6β-ol, DCA-5β-ol, DCA-6α-ol, DCA-1β-ol, and DCA-4β-ol based on matching in-laboratory synthesized standards. Metabolic inhibition assays in human liver microsomes and recombinant P450 assays revealed that CYP3A4 and CYP3A7 were responsible for the regioselective oxidations of both DCA and its conjugated forms, glycodeoxycholate (GDCA) and taurodeoxycholate (TDCA). The modification of secondary BAs to tertiary BAs defines a host liver (primary BAs)-gut microbiota (secondary BAs)-host liver (tertiary BAs) axis. The regioselective oxidations of DCA, GDCA, and TDCA by CYP3A4 and CYP3A7 may help eliminate host-toxic DCA species. The 19- and 4β-hydroxylation of DCA species demonstrated outstanding CYP3A7 selectivity and may be useful as indicators of CYP3A7 activity.
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Affiliation(s)
- Jian Zhang
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Ling-Zhi Gao
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Yu-Jie Chen
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Ping-Ping Zhu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Shan-Shan Yin
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Ming-Ming Su
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Yan Ni
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Jia Miao
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Wen-Lin Wu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Hong Chen
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Kim L R Brouwer
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Chang-Xiao Liu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Liang Xu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Wei Jia
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
| | - Ke Lan
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, West China School of Pharmacy, Sichuan University, Chengdu, China (J.Z., L.Z.G., Y.J.C., P.P.Z., S.S.Y., L.X., K.L.); Metabolomics Shared Resource, University of Hawaii Cancer Center, Honolulu, Hawaii (M.M.S., Y.N., W.J.); Institute of Clinical Pharmacology, West China Hospital, Sichuan University, Chengdu, China (J.M.); Chengdu Institutes for Food and Drug Control, Chengdu, China (W.L.W., H.C.); UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina (K.L.R.B.); State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin, China (C.X.L.); and Chengdu Health-Balance Medical Technology Co., Ltd., Chengdu, China (S.S.Y.)
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9
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Dadachanji R, Shaikh N, Patil A, Shah N, Mukherjee S. PON1 promoter polymorphisms contribute to PCOS susceptibility and phenotypic outcomes in Indian women. Gene 2018; 661:34-44. [DOI: 10.1016/j.gene.2018.03.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/09/2018] [Accepted: 03/26/2018] [Indexed: 12/28/2022]
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10
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Goodarzi MO, Carmina E, Azziz R. DHEA, DHEAS and PCOS. J Steroid Biochem Mol Biol 2015; 145:213-25. [PMID: 25008465 DOI: 10.1016/j.jsbmb.2014.06.003] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/16/2014] [Accepted: 06/05/2014] [Indexed: 11/17/2022]
Abstract
Approximately 20-30% of PCOS women demonstrate excess adrenal precursor androgen (APA) production, primarily using DHEAS as a marker of APA in general and more specifically DHEA, synthesis. The role of APA excess in determining or causing PCOS is unclear, although observations in patients with inherited APA excess (e.g., patients with 21-hydroxylase deficient congenital classic or non-classic adrenal hyperplasia) demonstrate that APA excess can result in a PCOS-like phenotype. Inherited defects of the enzymes responsible for steroid biosynthesis, or defects in cortisol metabolism, account for only a very small fraction of women suffering from hyperandrogenism or APA excess. Rather, women with PCOS and APA excess appear to have a generalized exaggeration in adrenal steroidogenesis in response to ACTH stimulation, although they do not have an overt hypothalamic-pituitary-adrenal axis dysfunction. In general, extra-adrenal factors, including obesity, insulin and glucose levels, and ovarian secretions, play a limited role in the increased APA production observed in PCOS. Substantial heritabilities of APAs, particularly DHEAS, have been found in the general population and in women with PCOS; however, the handful of SNPs discovered to date account only for a small portion of the inheritance of these traits. Paradoxically, and as in men, elevated levels of DHEAS appear to be protective against cardiovascular risk in women, although the role of DHEAS in modulating this risk in women with PCOS remains unknown. In summary, the exact cause of APA excess in PCOS remains unclear, although it may reflect a generalized and inherited exaggeration in androgen biosynthesis of an inherited nature.
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Affiliation(s)
| | | | - Ricardo Azziz
- Georgia Regents University, Office of the President, 120 15th St., AA 311, Augusta, GA 30912, USA.
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11
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Abstract
The efficacy, safety, and tolerability of drugs are dependent on numerous factors that influence their disposition. A dose that is efficacious and safe for one individual may result in sub-therapeutic or toxic blood concentrations in other individuals. A major source of this variability in drug response is drug metabolism, where differences in pre-systemic and systemic biotransformation efficiency result in variable degrees of systemic exposure (e.g., AUC, C max, and/or C min) following administration of a fixed dose.Interindividual differences in drug biotransformation have been studied extensively. It is well recognized that both intrinsic (such as genetics, age, sex, and disease states) and extrinsic (such as diet, chemical exposures from the environment, and even sunlight) factors play a significant role. For the family of cytochrome P450 enzymes, the most critical of the drug metabolizing enzymes, genetic variation can result in the complete absence or enhanced expression of a functional enzyme. In addition, up- and down-regulation of gene expression, in response to an altered cellular environment, can achieve the same range of metabolic function (phenotype), but often in a less reliably predictable and time-dependent manner. Understanding the mechanistic basis for drug disposition and response variability is essential if we are to move beyond the era of empirical, trial-and-error dose selection and into an age of personalized medicine that brings with it true improvements in health outcomes in the therapeutic treatment of disease.
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Affiliation(s)
- Kenneth E Thummel
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA
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12
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Louwers YV, de Jong FH, van Herwaarden NAA, Stolk L, Fauser BCJM, Uitterlinden AG, Laven JSE. Variants in SULT2A1 affect the DHEA sulphate to DHEA ratio in patients with polycystic ovary syndrome but not the hyperandrogenic phenotype. J Clin Endocrinol Metab 2013; 98:3848-55. [PMID: 23861462 DOI: 10.1210/jc.2013-1976] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT Because of the elevated dehydroepiandrosterone sulfate (DHEAS) levels in polycystic ovary syndrome (PCOS) and the heritability of DHEAS serum levels, genes encoding the enzymes that control the sulfation of dehydroepiandrosterone (DHEA) to DHEAS and vice versa are obvious candidate genes to explain part of the heritability of PCOS. OBJECTIVE The objective of the study was to determine the role of genetic variants in sulfotransferase (SULT2A1), 3-phosphoadenosine 5-phosphosulfate synthase isoform 2 (PAPSS2), and steroid sulfatase (STS) in PCOS and in hormone levels related to the hyperandrogenic phenotype of PCOS. DESIGN This was a candidate-gene study. PATIENTS The discovery set consisted of 582 patients and 2017 controls. MAIN OUTCOME MEASURES A pruned subset of 28 single-nucleotide polymorphisms (SNPs) in SULT2A1, PAPSS2, and STS was generated based on pairwise genotypic correlation. Association with PCOS was tested, and we studied whether the SNPs modulate DHEAS levels, DHEA levels, and their ratio in PCOS. Significant SNPs were replicated in an independent sample of patients. RESULTS None of the SNPs in SULT2A1, PAPSS2, and STS constituted risk alleles for PCOS. SNP rs2910397 in SULT2A1 decreased the DHEAS to DHEA ratio in PCOS by 5% in the discovery sample. Meta-analysis of discovery and replication sample resulted in a combined effect of -0.095 (P = .027). However, carrying the minor T allele did not contribute to differences in the hyperandrogenic phenotype, including the levels of T and androstenedione, of PCOS patients. CONCLUSIONS Genetic variants in SULT2A1, PAPSS2, and STS do not predispose to PCOS. Although a variant in SULT2A1 decreased the DHEAS to DHEA ratio, no changes in other androgenic hormone levels were observed.
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Affiliation(s)
- Yvonne V Louwers
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.
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13
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Kaupert LC, Lemos-Marini SHV, De Mello MP, Moreira RP, Brito VN, Jorge AAL, Longui CA, Guerra G, Mendonca BB, Bachega TA. The effect of fetal androgen metabolism-related gene variants on external genitalia virilization in congenital adrenal hyperplasia. Clin Genet 2012; 84:482-8. [DOI: 10.1111/cge.12016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 09/10/2012] [Accepted: 09/10/2012] [Indexed: 12/21/2022]
Affiliation(s)
- LC Kaupert
- Laboratório de Hormônios e Genética Molecular- LIM/42; Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo; São Paulo Brazil
| | - SHV Lemos-Marini
- Unidade de Endocrinologia Pediátrica; Departamento de Pediatria, Faculdade de Ciências Médicas da Universidade Estadual de Campinas; Campinas São Paulo Brazil
| | - MP De Mello
- Centro de Biologia Molecular e Engenharia Genética; Universidade Estadual de Campinas; Campinas São Paulo Brazil
| | - RP Moreira
- Laboratório de Hormônios e Genética Molecular- LIM/42; Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo; São Paulo Brazil
| | - VN Brito
- Laboratório de Hormônios e Genética Molecular- LIM/42; Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo; São Paulo Brazil
| | - AAL Jorge
- Laboratório de Hormônios e Genética Molecular- LIM/42; Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo; São Paulo Brazil
| | - CA Longui
- Unidade de Endocrinologia Pediátrica; Departamento de Pediatria, Irmandade da Santa Casa de Misericórdia de São Paulo; São Paulo Brazil
| | - G Guerra
- Unidade de Endocrinologia Pediátrica; Departamento de Pediatria, Faculdade de Ciências Médicas da Universidade Estadual de Campinas; Campinas São Paulo Brazil
| | - BB Mendonca
- Laboratório de Hormônios e Genética Molecular- LIM/42; Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo; São Paulo Brazil
| | - TA Bachega
- Laboratório de Hormônios e Genética Molecular- LIM/42; Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo; São Paulo Brazil
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14
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Zhai G, Teumer A, Stolk L, Perry JRB, Vandenput L, Coviello AD, Koster A, Bell JT, Bhasin S, Eriksson J, Eriksson A, Ernst F, Ferrucci L, Frayling TM, Glass D, Grundberg E, Haring R, Hedman ÅK, Hofman A, Kiel DP, Kroemer HK, Liu Y, Lunetta KL, Maggio M, Lorentzon M, Mangino M, Melzer D, Miljkovic I, Nica A, Penninx BWJH, Vasan RS, Rivadeneira F, Small KS, Soranzo N, Uitterlinden AG, Völzke H, Wilson SG, Xi L, Zhuang WV, Harris TB, Murabito JM, Ohlsson C, Murray A, de Jong FH, Spector TD, Wallaschofski H. Eight common genetic variants associated with serum DHEAS levels suggest a key role in ageing mechanisms. PLoS Genet 2011; 7:e1002025. [PMID: 21533175 PMCID: PMC3077384 DOI: 10.1371/journal.pgen.1002025] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 01/27/2011] [Indexed: 01/12/2023] Open
Abstract
Dehydroepiandrosterone sulphate (DHEAS) is the most abundant circulating steroid secreted by adrenal glands--yet its function is unknown. Its serum concentration declines significantly with increasing age, which has led to speculation that a relative DHEAS deficiency may contribute to the development of common age-related diseases or diminished longevity. We conducted a meta-analysis of genome-wide association data with 14,846 individuals and identified eight independent common SNPs associated with serum DHEAS concentrations. Genes at or near the identified loci include ZKSCAN5 (rs11761528; p = 3.15 × 10(-36)), SULT2A1 (rs2637125; p = 2.61 × 10(-19)), ARPC1A (rs740160; p = 1.56 × 10(-16)), TRIM4 (rs17277546; p = 4.50 × 10(-11)), BMF (rs7181230; p = 5.44 × 10(-11)), HHEX (rs2497306; p = 4.64 × 10(-9)), BCL2L11 (rs6738028; p = 1.72 × 10(-8)), and CYP2C9 (rs2185570; p = 2.29 × 10(-8)). These genes are associated with type 2 diabetes, lymphoma, actin filament assembly, drug and xenobiotic metabolism, and zinc finger proteins. Several SNPs were associated with changes in gene expression levels, and the related genes are connected to biological pathways linking DHEAS with ageing. This study provides much needed insight into the function of DHEAS.
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Affiliation(s)
- Guangju Zhai
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Alexander Teumer
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - Lisette Stolk
- Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands
- Netherlands Consortium of Healthy Ageing, Rotterdam, The Netherlands
| | - John R. B. Perry
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Liesbeth Vandenput
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrea D. Coviello
- Sections of General Internal Medicine, Preventive Medicine, Cardiology and Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Annemarie Koster
- Laboratory for Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, United States of America
| | - Jordana T. Bell
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Shalender Bhasin
- Section of Endocrinology, Diabetes, and Nutrition, Claude D. Pepper Older Americans Independence Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Joel Eriksson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Eriksson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Florian Ernst
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Timothy M. Frayling
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
| | - Daniel Glass
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Elin Grundberg
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Wellcome Trust Sanger Institute, Hixton, United Kingdom
| | - Robin Haring
- Institute for Clinical Chemistry and Laboratory Medicine, University of Greifswald, Greifswald, Germany
| | - Åsa K. Hedman
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Albert Hofman
- Netherlands Consortium of Healthy Ageing, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Douglas P. Kiel
- Hebrew Senior Life Institute for Aging Research and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Heyo K. Kroemer
- Center of Pharmacology and Experimental Therapeutics, Department of Pharmacology, University of Greifswald, Greifswald, Germany
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States of America
| | - Kathryn L. Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Marcello Maggio
- Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Parma, Italy
| | - Mattias Lorentzon
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - David Melzer
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
| | - Iva Miljkovic
- Department of Epidemiology, University of Pittsburgh, Pittsburg, Pennsylvania, United States of America
| | | | - Alexandra Nica
- Wellcome Trust Sanger Institute, Hixton, United Kingdom
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | | | - Ramachandran S. Vasan
- Sections of General Internal Medicine, Preventive Medicine, Cardiology and Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- The National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands
- Netherlands Consortium of Healthy Ageing, Rotterdam, The Netherlands
| | - Kerrin S. Small
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Wellcome Trust Sanger Institute, Hixton, United Kingdom
| | - Nicole Soranzo
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Wellcome Trust Sanger Institute, Hixton, United Kingdom
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands
- Netherlands Consortium of Healthy Ageing, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Henry Völzke
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - Scott G. Wilson
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia
- School of Medicine and Pharmacology, University of Western Australia, Nedlands, Australia
| | - Li Xi
- Molecular Medicine – Computational Biology, Pfizer Worldwide R&D, Groton, Connecticut, United States of America
| | - Wei Vivian Zhuang
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Tamara B. Harris
- Laboratory for Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, United States of America
| | - Joanne M. Murabito
- Sections of General Internal Medicine, Preventive Medicine, Cardiology and Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- The National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - Claes Ohlsson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Murray
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
| | - Frank H. de Jong
- Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Henri Wallaschofski
- Institute for Clinical Chemistry and Laboratory Medicine, University of Greifswald, Greifswald, Germany
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Moreira RPP, Jorge AAL, Gomes LG, Kaupert LC, Massud Filho J, Mendonca BB, Bachega TASS. Pharmacogenetics of glucocorticoid replacement could optimize the treatment of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Clinics (Sao Paulo) 2011; 66:1361-6. [PMID: 21915484 PMCID: PMC3161212 DOI: 10.1590/s1807-59322011000800009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 05/02/2011] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION 21-hydroxylase deficiency is an autosomal recessive disorder that causes glucocorticoid deficiency and increased androgen production. Treatment is based on glucocorticoid replacement; however, interindividual variability in the glucocorticoid dose required to achieve adequate hormonal control has been observed. OBJECTIVE The present study aimed to evaluate the association between polymorphic variants involved inglucocorticoid action and/or metabolism and the mean daily glucocorticoid dose in 21-hydroxylase deficiency patients. METHODS We evaluated 53 patients with classical forms of 21-hydroxylase deficiency who were receiving cortisone acetate. All patients were between four and six years of age and had normal androgen levels. RESULTS The P450 oxidoreductase A503V, HSD11B1 rs12086634, and CYP3A7*1C variants were found in 19%, 11.3% and 3.8% of the patients, respectively. The mean ± SD glucocorticoid dose in patients with the CYP3A7*1C and wild-type alleles was 13.9 ± 0.8 and 19.5 ± 3.2 mg/m²/d, respectively. We did not identify an association between the P450 oxidoreductase or HSD11B1 allelic variants and the mean glucocorticoid dose. CONCLUSION Patients carrying the CYP3A7*1C variant required a significantly lower mean glucocorticoid dose. Indeed, the CYP3A7*1C allele accounted for 20% of the variability in the cortisone acetate dose. The analysis of genes involved in glucocorticoid metabolism may be useful in the optimization of treatment of 21-hydroxylase deficiency.
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Affiliation(s)
- Ricardo P P Moreira
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM 42, Disciplina de Endocrinologia da Faculdade de Medicina da Universidad, Universidade de São Paulo, São Paulo, SP, Brazil
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16
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Neunzig I, Drăgan CA, Widjaja M, Schwaninger AE, Peters FT, Maurer HH, Bureik M. Whole-cell biotransformation assay for investigation of the human drug metabolizing enzyme CYP3A7. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2011; 1814:161-7. [DOI: 10.1016/j.bbapap.2010.07.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 06/28/2010] [Accepted: 07/07/2010] [Indexed: 11/17/2022]
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17
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Sloboda DM, Hickey M, Hart R. Reproduction in females: the role of the early life environment. Hum Reprod Update 2010; 17:210-27. [DOI: 10.1093/humupd/dmq048] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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18
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Perera MA. The missing linkage: what pharmacogenetic associations are left to find in CYP3A? Expert Opin Drug Metab Toxicol 2010; 6:17-28. [PMID: 19968573 DOI: 10.1517/17425250903379546] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
IMPORTANCE OF THE FIELD An enormous amount of drugs and endogenous substrates are metabolized by the enzymes encoded in the CYP3A gene cluster, making variation at this locus of utmost importance in the field of pharmacogenetics. However, the identification of genetic variation that contributes to the wide phenotypic variability at this locus has been elusive. While dozens of studies have investigated the effects of coding variants, none have found the definitive answer to what variant or variants explain the distribution of enzyme activity and clinical effects seen with the drug metabolized by these genes. AREAS COVERED IN THIS REVIEW This review highlights the recent pharmacogenetic work at the CYP3A locus, in particular studies on known functional variants in CYP3A4 and CYP3A5. In addition, common pharmacogenetic strategies as well as considerations specific to the CYP3A locus are discussed. WHAT THE READER WILL GAIN The reader will gain a greater understanding of the complexities involved in studying the CYP3A locus, population differences that may affect pharmacogenetic studies at this locus and the importance of variation that affect gene regulation. TAKE HOME MESSAGE More innovative and comprehensive methods to assay this region are needed, with particular attention paid to the role of gene regulation and non-coding sequence.
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Affiliation(s)
- Minoli A Perera
- University of Chicago, Section of Genetic Medicine and Committee on Clinical Pharmacology and Pharmacogenomics, Division of Biological Sciences, Department of Medicine, Chicago, IL 60637, USA.
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19
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Maliqueo M, Sir-Petermann T, Pérez V, Echiburú B, de Guevara AL, Gálvez C, Crisosto N, Azziz R. Adrenal function during childhood and puberty in daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2009; 94:3282-8. [PMID: 19567527 DOI: 10.1210/jc.2009-0427] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT In some patients, PCOS may develop as a consequence of an exaggerated adrenarche during pubertal development. OBJECTIVE The aim of the study was to assess adrenal function during childhood and pubertal development in daughters of women with PCOS (PCOSd). DESIGN We included 98 PCOSd [64 during childhood (ages 4-8 yr) and 34 during the peripubertal period (ages 9-13 yr)] and 51 daughters of control women (Cd) [30 during childhood and 21 during the peripubertal period]. In both groups, an acute ACTH-(1-24) stimulation test (0.25 mg) and an oral glucose tolerance test were performed. Bone age and serum concentrations of cortisol, androstenedione, 17-hydroxyprogesterone, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), glucose, and insulin were determined. RESULTS PCOSd and Cd were similar in age and body mass index. During the peripubertal period, basal and poststimulated DHEAS concentrations were higher in PCOSd compared to Cd. Among PCOSd, 12.5% of girls in childhood and 32.4% in peripuberty presented biochemical evidence of exaggerated adrenarche. Stimulated insulin was higher in PCOSd compared to Cd during childhood (P = 0.03) and peripuberty (P = 0.03). An advancement of 8 months between bone and chronological age was observed in peripubertal PCOSd compared to Cd. CONCLUSIONS In PCOSd, basal and stimulated DHEAS concentrations were higher during the onset of puberty. Around 30% of the PCOSd demonstrated an exacerbated adrenarche, which may reflect increased P450c17 activity. In addition, a modest advance in bone age was observed, probably secondary to the hyperinsulinemia and/or adrenal hyperandrogenism.
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Affiliation(s)
- Manuel Maliqueo
- Laboratory of Endocrinology, Department of Medicine, West Division, School of Medicine, Las Palmeras 299, Interior Quinta Normal, Casilla 33052, Correo 33, Santiago, Chile
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20
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2009; 16:260-77. [PMID: 19390324 DOI: 10.1097/med.0b013e32832c937e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS) is a common complex endocrine genetic disorder, which involves overproduction of androgens, leading to heterogeneous range of symptoms and associated with increased metabolic and cardiovascular morbidity. This review focuses on androgen biosynthesis, use, metabolism in PCOS and clinical consequences of hyperandrogenism. RECENT FINDINGS Controversial definition of the disorder and different phenotypic subgroups present a challenge for clinical and basic research. Further investigation of different phenotypes highlights the fact that PCOS probably represents a group of disorders with different etiologies. Prenatal androgen exposure and adolescent studies suggest early in life androgen excess as initiating factor of PCOS, but insufficient evidence available to confirm this hypothesis. Various intracellular signaling pathways implicated in PCOS steroidogenesis and in androgen action have been studied, however, PCOS pathogenesis remains obscure. Growing evidence links androgens with pathophysiology of PCOS and metabolic derangements. SUMMARY Despite intensive investigation, etiology and underlying mechanisms of PCOS remain unclear, warranting further investigation. Better understanding of molecular and genetic basis might lead to invention of novel therapeutic approaches. Long-term interventional studies that lower androgen levels in women with hyperandrogenism might protect against metabolic and cardiovascular comorbidities are needed.
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Affiliation(s)
- Vicki Nisenblat
- Robinson Institute, School of Pediatrics and Reproductive Health, University of Adelaide, South Australia, Australia
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