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Carrera-Pacheco SE, Mueller A, Puente-Pineda JA, Zúñiga-Miranda J, Guamán LP. Designing cytochrome P450 enzymes for use in cancer gene therapy. Front Bioeng Biotechnol 2024; 12:1405466. [PMID: 38860140 PMCID: PMC11164052 DOI: 10.3389/fbioe.2024.1405466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/30/2024] [Indexed: 06/12/2024] Open
Abstract
Cancer is a significant global socioeconomic burden, as millions of new cases and deaths occur annually. In 2020, almost 10 million cancer deaths were recorded worldwide. Advancements in cancer gene therapy have revolutionized the landscape of cancer treatment. An approach with promising potential for cancer gene therapy is introducing genes to cancer cells that encode for chemotherapy prodrug metabolizing enzymes, such as Cytochrome P450 (CYP) enzymes, which can contribute to the effective elimination of cancer cells. This can be achieved through gene-directed enzyme prodrug therapy (GDEPT). CYP enzymes can be genetically engineered to improve anticancer prodrug conversion to its active metabolites and to minimize chemotherapy side effects by reducing the prodrug dosage. Rational design, directed evolution, and phylogenetic methods are some approaches to developing tailored CYP enzymes for cancer therapy. Here, we provide a compilation of genetic modifications performed on CYP enzymes aiming to build highly efficient therapeutic genes capable of bio-activating different chemotherapeutic prodrugs. Additionally, this review summarizes promising preclinical and clinical trials highlighting engineered CYP enzymes' potential in GDEPT. Finally, the challenges, limitations, and future directions of using CYP enzymes for GDEPT in cancer gene therapy are discussed.
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Affiliation(s)
- Saskya E. Carrera-Pacheco
- Centro de Investigación Biomédica (CENBIO), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
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Viviani R, Messina I, Bosch JE, Dommes L, Paul A, Schneider KL, Scholl C, Stingl JC. Effects of genetic variability of CYP2D6 on neural substrates of sustained attention during on-task activity. Transl Psychiatry 2020; 10:338. [PMID: 33024081 PMCID: PMC7539151 DOI: 10.1038/s41398-020-01020-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/01/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022] Open
Abstract
The polymorphic drug-metabolizing enzyme CYP2D6, which is responsible for the metabolism of most psychoactive compounds, is expressed not only in the liver, but also in the brain. The effects of its marked genetic polymorphism on the individual capacity to metabolize drugs are well known, but its role in metabolism of neural substrates affecting behavior personality or cognition, suggested by its CNS expression, is a long-standing unresolved issue. To verify earlier findings suggesting a potential effect on attentional processes, we collected functional imaging data, while N = 415 participants performed a simple task in which the reward for correct responses varied. CYP2D6 allelic variants predicting higher levels of enzymatic activity level were positively associated with cortical activity in occipito-parietal areas as well as in a right lateralized network known to be activated by spatial attentional tasks. Reward-related modulation of activity in cortical areas was more pronounced in poor metabolizers. In conjunction with effects on reaction times, our findings provide evidence for reduced cognitive efficiency in rapid metabolizers compared to poor metabolizers in on-task attentional processes manifested through differential recruitment of a specific neural substrate.
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Affiliation(s)
- Roberto Viviani
- grid.5771.40000 0001 2151 8122Institute of Psychology, University of Innsbruck, Innsbruck, Austria ,grid.6582.90000 0004 1936 9748Department of Psychiatry and Psychotherapy Clinic III, University of Ulm, Ulm, Germany
| | - Irene Messina
- grid.6582.90000 0004 1936 9748Department of Psychiatry and Psychotherapy Clinic III, University of Ulm, Ulm, Germany ,grid.466190.cUniversitas Mercatorum, Rome, Italy
| | - Julia E. Bosch
- grid.6582.90000 0004 1936 9748Department of Psychiatry and Psychotherapy Clinic III, University of Ulm, Ulm, Germany
| | - Lisa Dommes
- grid.6582.90000 0004 1936 9748Department of Psychiatry and Psychotherapy Clinic III, University of Ulm, Ulm, Germany
| | - Anna Paul
- grid.414802.b0000 0000 9599 0422Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany
| | - Katharina L. Schneider
- grid.414802.b0000 0000 9599 0422Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany
| | - Catharina Scholl
- grid.414802.b0000 0000 9599 0422Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany
| | - Julia C. Stingl
- grid.412301.50000 0000 8653 1507Institute of Clinical Pharmacology, University Hospital of RWTH Aachen, Aachen, Germany
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3
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Kaddurah-Daouk R, Hankemeier T, Scholl EH, Baillie R, Harms A, Stage C, Dalhoff KP, Jűrgens G, Taboureau O, Nzabonimpa GS, Motsinger-Reif AA, Thomsen R, Linnet K, Rasmussen HB. Pharmacometabolomics Informs About Pharmacokinetic Profile of Methylphenidate. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2019; 7:525-533. [PMID: 30169917 PMCID: PMC6118295 DOI: 10.1002/psp4.12309] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/17/2018] [Indexed: 12/29/2022]
Abstract
Carboxylesterase 1 (CES1) metabolizes methylphenidate and other drugs. CES1 gene variation only partially explains pharmacokinetic (PK) variability. Biomarkers predicting the PKs of drugs metabolized by CES1 are needed. We identified lipids in plasma from 44 healthy subjects that correlated with CES1 activity as determined by PK parameters of methylphenidate including a ceramide (q value = 0.001) and a phosphatidylcholine (q value = 0.005). Carriers of the CES1 143E allele had decreased methylphenidate metabolism and altered concentration of this phosphatidylcholine (q value = 0.040) and several high polyunsaturated fatty acid lipids (PUFAs). The half‐maximal inhibitory concentration (IC50) values of chenodeoxycholate and taurocholate were 13.55 and 19.51 μM, respectively, consistent with a physiological significance. In silico analysis suggested that bile acid inhibition of CES1 involved both binding to the active and superficial sites of the enzyme. We initiated identification of metabolites predicting PKs of drugs metabolized by CES1 and suggest lipids to regulate or be regulated by this enzyme.
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Affiliation(s)
- Rima Kaddurah-Daouk
- Duke Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.,Duke Institute for Brain Sciences, Duke University, Durham, North Carolina, USA
| | - Thomas Hankemeier
- Division of Analytical Biosciences, Leiden Academic Centre for Drug Research, Leiden, The Netherlands.,Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - Elizabeth H Scholl
- Bioinformatics Research Center, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Amy Harms
- Division of Analytical Biosciences, Leiden Academic Centre for Drug Research, Leiden, The Netherlands.,Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - Claus Stage
- Department of Clinical Pharmacology, Bispebjerg and Frederiksberg University Hospital, Frederiksberg, Denmark
| | - Kim P Dalhoff
- Department of Clinical Pharmacology, Bispebjerg and Frederiksberg University Hospital, Frederiksberg, Denmark
| | - Gesche Jűrgens
- Clinical Pharmacological Unit, Zealand University Hospital, Roskilde, Denmark
| | - Olivier Taboureau
- INSERM, UMRS 973, MTi, Université Paris Diderot, Paris Cedex, France
| | - Grace S Nzabonimpa
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark
| | - Alison A Motsinger-Reif
- Department of Statistics, North Carolina State University, Raleigh, North Carolina, USA.,Bioinformatics Research Center, North Carolina State University, Raleigh, North Carolina, USA
| | - Ragnar Thomsen
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Kristian Linnet
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Henrik B Rasmussen
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Roskilde, Denmark.,Department of Science and Environment, Roskilde University, Roskilde, Denmark
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4
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Schoretsanitis G, de Leon J, Diaz FJ. Prolactin levels: sex differences in the effects of risperidone, 9-hydroxyrisperidone levels, CYP2D6 and ABCB1 variants. Pharmacogenomics 2018; 19:815-823. [PMID: 29914302 DOI: 10.2217/pgs-2018-0053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIM The role of sex on the association of plasma prolactin levels with risperidone (R) and 9-hydroxyrisperidone (9-OHR) concentrations is investigated. METHODS Plasma R and prolactin concentrations, CYP2D6 and exon 21 and 26 ABCB1 gene variants were studied in 110 patients. RESULTS In females, a 1 ng/ml increase in R levels was associated with a significant 1.02% increase in prolactin levels. In males, a 1 ng/ml increase in 9-OHR levels was associated with a significant 1.18% increase in prolactin levels. ABCB1 haplotype 12 had significant but opposite effects in males and females. In the combined sample, 9-OHR, but not R levels had significant effects on prolactin levels. CONCLUSION Genes had sex-specific effects on risperidone-associated prolactin elevations.
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Affiliation(s)
- Georgios Schoretsanitis
- University Hospital of Psychiatry, Bern, Switzerland.,Department of Psychiatry, Psychotherapy & Psychosomatics, RWTH Aachen University, Aachen, Germany, & JARA - Translational Brain Medicine
| | - Jose de Leon
- University of Kentucky Mental Health Research Center at Eastern State Hospital, Lexington, KY 40508, USA.,Psychiatry & Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apostol Hospital, University of the Basque Country, Vitoria, Spain
| | - Francisco J Diaz
- Department of Biostatistics, The University of Kansas Medical Center, Kansas City, KS, USA
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5
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Panza F, Lozupone M, Stella E, Miscio G, La Montagna M, Daniele A, di Mauro L, Bellomo A, Logroscino G, Greco A, Seripa D. The pharmacogenetic road to avoid adverse drug reactions and therapeutic failures in revolving door patients with psychiatric illnesses: focus on the CYP2D6 isoenzymes. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2016. [DOI: 10.1080/23808993.2016.1232148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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6
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Panza F, Lozupone M, Stella E, Lofano L, Gravina C, Urbano M, Daniele A, Bellomo A, Logroscino G, Greco A, Seripa D. Psychiatry meets pharmacogenetics for the treatment of revolving door patients with psychiatric disorders. Expert Rev Neurother 2016; 16:1357-1369. [DOI: 10.1080/14737175.2016.1204913] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Francesco Panza
- a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.,b Neurodegenerative Diseases Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,c Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology , University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico" , Lecce , Italy
| | - Madia Lozupone
- b Neurodegenerative Diseases Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,d Psychiatric Unit, Department of Clinical and Experimental Medicine , University of Foggia , Foggia , Italy
| | - Eleonora Stella
- d Psychiatric Unit, Department of Clinical and Experimental Medicine , University of Foggia , Foggia , Italy
| | - Lucia Lofano
- e Psychiatric Unit, Department of Basic Medicine Sciences, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy
| | - Carolina Gravina
- a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Maria Urbano
- a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Antonio Daniele
- f Institute of Neurology , Catholic University of Sacred Heart , Rome , Italy
| | - Antonello Bellomo
- d Psychiatric Unit, Department of Clinical and Experimental Medicine , University of Foggia , Foggia , Italy
| | - Giancarlo Logroscino
- b Neurodegenerative Diseases Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,c Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology , University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico" , Lecce , Italy
| | - Antonio Greco
- a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Davide Seripa
- a Geriatric Unit and Geriatric Research Laboratory, Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
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7
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Dove ES, Barlas IÖ, Birch K, Boehme C, Borda-Rodriguez A, Byne WM, Chaverneff F, Coşkun Y, Dahl ML, Dereli T, Diwakar S, Elbeyli L, Endrenyi L, Eroğlu-Kesim B, Ferguson LR, Güngör K, Gürsoy U, Hekim N, Huzair F, Kaushik K, Kickbusch I, Kıroğlu O, Kolker E, Könönen E, Lin B, Llerena A, Malhan F, Nair B, Patrinos GP, Şardaş S, Sert Ö, Srivastava S, Steuten LMG, Toraman C, Vayena E, Wang W, Warnich L, Özdemir V. An Appeal to the Global Health Community for a Tripartite Innovation: An "Essential Diagnostics List," "Health in All Policies," and "See-Through 21(st) Century Science and Ethics". OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2015; 19:435-42. [PMID: 26161545 DOI: 10.1089/omi.2015.0075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diagnostics spanning a wide range of new biotechnologies, including proteomics, metabolomics, and nanotechnology, are emerging as companion tests to innovative medicines. In this Opinion, we present the rationale for promulgating an "Essential Diagnostics List." Additionally, we explain the ways in which adopting a vision for "Health in All Policies" could link essential diagnostics with robust and timely societal outcomes such as sustainable development, human rights, gender parity, and alleviation of poverty. We do so in three ways. First, we propose the need for a new, "see through" taxonomy for knowledge-based innovation as we transition from the material industries (e.g., textiles, plastic, cement, glass) dominant in the 20(th) century to the anticipated knowledge industry of the 21st century. If knowledge is the currency of the present century, then it is sensible to adopt an approach that thoroughly examines scientific knowledge, starting with the production aims, methods, quality, distribution, access, and the ends it purports to serve. Second, we explain that this knowledge trajectory focus on innovation is crucial and applicable across all sectors, including public, private, or public-private partnerships, as it underscores the fact that scientific knowledge is a co-product of technology, human values, and social systems. By making the value systems embedded in scientific design and knowledge co-production transparent, we all stand to benefit from sustainable and transparent science. Third, we appeal to the global health community to consider the necessary qualities of good governance for 21st century organizations that will embark on developing essential diagnostics. These have importance not only for science and knowledge-based innovation, but also for the ways in which we can build open, healthy, and peaceful civil societies today and for future generations.
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Affiliation(s)
- Edward S Dove
- 1 J. Kenyon Mason Institute for Medicine, Life Sciences and the Law, University of Edinburgh School of Law , Edinburgh, United Kingdom
| | - I Ömer Barlas
- 2 Faculty of Medicine, Department of Medical Biology and Genetics, Mersin University , Mersin, Turkey
| | - Kean Birch
- 3 Department of Social Science, Faculty of Liberal Arts and Professional Studies, York University , Toronto, Ontario, Canada
| | - Catharina Boehme
- 4 Foundation for Innovative New Diagnostics (FIND) , Campus Biotech, Chemin des Mines, Geneva, Switzerland
| | - Alexander Borda-Rodriguez
- 5 Secretaría Nacional de Educación Superior , Ciencia, Tecnología e Innovación, Quito, Ecuador .,6 Development Policy and Practice Group, The Open University , Milton Keynes, United Kingdom
| | - William M Byne
- 7 Departments of Psychiatry, The Icahn School of Medicine at Mount Sinai, New York, NY and The James J. Peters VA Medical Center , Bronx, New York
| | - Florence Chaverneff
- 8 Department of Neuroscience and Physiology, NYU Langone Medical Center , New York, New York
| | - Yavuz Coşkun
- 9 Office of the President, Gaziantep University , Gaziantep, Turkey
| | - Marja-Liisa Dahl
- 10 Division of Clinical Pharmacology, Karolinska Institute , Stockholm, Sweden
| | - Türkay Dereli
- 11 Department of Industrial Engineering, Faculty of Engineering, Gaziantep University , Gaziantep, Turkey
| | - Shyam Diwakar
- 12 Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham (Amrita University) , Amritapuri, Clappana P.O., Kollam, Kerala, India
| | - Levent Elbeyli
- 13 Faculty of Medicine, Gaziantep University , Gaziantep, Turkey
| | - Laszlo Endrenyi
- 14 Department of Pharmacology, Faculty of Medicine, University of Toronto , Ontario, Canada
| | | | - Lynnette R Ferguson
- 16 Discipline of Nutrition, The University of Auckland , Auckland, New Zealand
| | - Kıvanç Güngör
- 17 Faculty of Health Sciences, Gaziantep University , Gaziantep, Turkey
| | - Ulvi Gürsoy
- 18 Department of Periodontology, Institute of Dentistry, University of Turku , Turku, Finland
| | - Nezih Hekim
- 19 School of Medicine, Beykent University , Istanbul, Turkey
| | - Farah Huzair
- 20 Science, Technology and Innovation Studies, School of Social and Political Science, University of Edinburgh , Edinburgh, United Kingdom
| | | | - Ilona Kickbusch
- 22 Global Health Program, Graduate Institute of International and Development Studies , Geneva, Switzerland
| | - Olcay Kıroğlu
- 23 Department of Pharmacology, Faculty of Medicine, Çukurova University , Adana, Turkey
| | - Eugene Kolker
- 24 Bioinformatics and High-Throughput Analysis Laboratory, Seattle Children's Research Institute and CDO Analytics , Seattle Children's, Seattle, Washington.,25 Departments of Biomedical Informatics and Medical Education and Pediatrics, and University of Washington , Seattle, Washington.,26 Data-Enabled Life Sciences Alliance (DELSA Global) , Seattle, Washington.,27 Department of Chemistry and Chemical Biology, College of Science, Northeastern University , Boston, Massachusetts
| | - Eija Könönen
- 18 Department of Periodontology, Institute of Dentistry, University of Turku , Turku, Finland
| | - Biaoyang Lin
- 28 Department of Urology, University of Washington , Seattle, Washington.,29 Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University , Hangzhou, China
| | - Adrian Llerena
- 30 Extremadura University Hospital and Medical School , Badajoz, Extremadura, Spain
| | - Faruk Malhan
- 31 Istanbul Design Foundation , Istanbul, Turkey
| | - Bipin Nair
- 12 Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham (Amrita University) , Amritapuri, Clappana P.O., Kollam, Kerala, India
| | - George P Patrinos
- 32 Department of Pharmacy, University of Patras School of Health Sciences , Patras, Greece
| | - Semra Şardaş
- 33 Faculty of Pharmacy, Marmara University , Istanbul, Turkey
| | - Özlem Sert
- 34 Urban Studies Center and the Department of History, Hacettepe University , Beytepe, Ankara, Turkey
| | - Sanjeeva Srivastava
- 35 Proteomics Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay , Powai, Mumbai, India
| | - Lotte M G Steuten
- 36 PANAXEA bv , Enschede, The Netherlands .,37 School of Pharmacy, University of Washington , Seattle, Washington
| | - Cengiz Toraman
- 38 Faculty of Communications and Department of Management Sciences, Gaziantep University , Gaziantep, Turkey
| | - Effy Vayena
- 39 Institute of Biomedical Ethics, University of Zurich , Zurich, Switzerland
| | - Wei Wang
- 40 School of Medical Sciences, Edith Cowan University , Perth, Australia .,41 Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University , Beijing, China
| | - Louise Warnich
- 42 Faculty of Science, Stellenbosch University , Stellenbosch, South Africa
| | - Vural Özdemir
- 9 Office of the President, Gaziantep University , Gaziantep, Turkey .,11 Department of Industrial Engineering, Faculty of Engineering, Gaziantep University , Gaziantep, Turkey .,12 Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham (Amrita University) , Amritapuri, Clappana P.O., Kollam, Kerala, India .,26 Data-Enabled Life Sciences Alliance (DELSA Global) , Seattle, Washington.,38 Faculty of Communications and Department of Management Sciences, Gaziantep University , Gaziantep, Turkey
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8
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Peñas-LLedó EM, LLerena A. CYP2D6 variation, behaviour and psychopathology: implications for pharmacogenomics-guided clinical trials. Br J Clin Pharmacol 2014; 77:673-83. [PMID: 24033670 PMCID: PMC3971983 DOI: 10.1111/bcp.12227] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 08/11/2013] [Indexed: 12/16/2022] Open
Abstract
Individual and population differences in polymorphic cytochrome P450 enzyme function have been known for decades. The biological significance of these differences has now been deciphered with regard to drug metabolism, action and toxicity as well as disposition of endogenous substrates, including neuroactive compounds. While the cytochrome P450 enzymes occur abundantly in the liver, they are expressed in most tissues of the body, albeit in varying amounts, including the brain. The latter location of cytochrome P450s is highly pertinent for susceptibility to neuropsychiatric diseases, not to mention local drug metabolism at the site of psychotropic drug action in the brain. In the current era of personality medicine with companion theranostics (i.e. the fusion of therapeutics with diagnostics), this article underscores that such versatile biological roles of cytochrome P450s offer multiple points of entry for personalized medicine and rational therapeutics. We focus our discussion on CYP2D6, one of the most intensively researched drug and endogenous compound metabolism pathways, with a view to relevance for, and optimization of, pharmacogenomic-guided clinical trials. Working on the premise that CYP2D6 is related to human behaviour and certain personality traits such as serotonin and dopamine system function, we further suggest that the motivation of healthy volunteers to participate in clinical trials may in part be influenced by an under- or over-representation of certain CYP2D6 metabolic groups.
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Affiliation(s)
- Eva M Peñas-LLedó
- CICAB Clinical Research Centre, Extremadura University Hospital and Medical SchoolBadajoz
| | - Adrián LLerena
- CICAB Clinical Research Centre, Extremadura University Hospital and Medical SchoolBadajoz
- CIBERSAM, ISCIIIMadrid, Spain
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9
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Genetic variability of drug-metabolizing enzymes: the dual impact on psychiatric therapy and regulation of brain function. Mol Psychiatry 2013; 18:273-87. [PMID: 22565785 DOI: 10.1038/mp.2012.42] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Polymorphic drug-metabolizing enzymes (DMEs) are responsible for the metabolism of the majority of psychotropic drugs. By explaining a large portion of variability in individual drug metabolism, pharmacogenetics offers a diagnostic tool in the burgeoning era of personalized medicine. This review updates existing evidence on the influence of pharmacogenetic variants on drug exposure and discusses the rationale for genetic testing in the clinical context. Dose adjustments based on pharmacogenetic knowledge are the first step to translate pharmacogenetics into clinical practice. However, also clinical factors, such as the consequences on toxicity and therapeutic failure, must be considered to provide clinical recommendations and assess the cost-effectiveness of pharmacogenetic treatment strategies. DME polymorphisms are relevant not only for clinical pharmacology and practice but also for research in psychiatry and neuroscience. Several DMEs, above all the cytochrome P (CYP) enzymes, are expressed in the brain, where they may contribute to the local biochemical homeostasis. Of particular interest is the possibility of DMEs playing a physiological role through their action on endogenous substrates, which may underlie the reported associations between genetic polymorphisms and cognitive function, personality and vulnerability to mental disorders. Neuroimaging studies have recently presented evidence of an effect of the CYP2D6 polymorphism on basic brain function. This review summarizes evidence on the effect of DME polymorphisms on brain function that adds to the well-known effects of DME polymorphisms on pharmacokinetics in explaining the range of phenotypes that are relevant to psychiatric practice.
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10
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Peñas-Lledó EM, Blasco-Fontecilla H, Dorado P, Vaquero-Lorenzo C, Baca-García E, Llerena A. CYP2D6 and the severity of suicide attempts. Pharmacogenomics 2012; 13:179-84. [DOI: 10.2217/pgs.11.146] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Among people who die by suicide, an increased frequency of CYP2D6 active gene multiplication has been described. Therefore, the present study analyzed the relationship between the severity of the suicidal intent and CYP2D6 number of active genes among survivors. Materials & methods: A group of 342 individuals were evaluated with Beck Suicide Intent Scale within 24 h of the failed attempt. ‘Severe’ suicide attempters were classified as those scoring above percentile 75 in the objective circumstances section of the Suicide Intent Scale Scale. A group of 377 healthy controls were also genotyped. Results: A higher number of ‘severe’ suicide attempters carrying ≥2 active CYP2D6 genes as compared with the rest of the patients population (p < 0.01) or the healthy control group (p < 0.01) was found. Conclusion: Considering that ‘severe’ suicide attempters are more likely eventually to die by suicide, CYP2D6 genetic polymorphism might be of use as a biomarker of death by suicide, which is in agreement with previous findings. Original submitted: 17 July 2011; Revision submitted: 21 September 2011
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Affiliation(s)
- Eva M Peñas-Lledó
- CICAB, Clinical Research Centre, Extremadura University Hospital & Medical School, Badajoz, Spain
| | - Hilario Blasco-Fontecilla
- Department of Psychiatry at Fundación Jimenez Diaz Hospital, Autónoma University, Madrid, Spain
- Centro de Investigación Biomedica en Red en el Área de Salud Mental (CIBERSAM), Madrid, Spain
| | - Pedro Dorado
- CICAB, Clinical Research Centre, Extremadura University Hospital & Medical School, Badajoz, Spain
| | - Concepción Vaquero-Lorenzo
- Department of Psychiatry at Fundación Jimenez Diaz Hospital, Autónoma University, Madrid, Spain
- Biology Department, Sciences Faculty-Autónoma University (UAM), Madrid, Spain
| | - Enrique Baca-García
- Department of Psychiatry at Fundación Jimenez Diaz Hospital, Autónoma University, Madrid, Spain
- Centro de Investigación Biomedica en Red en el Área de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry at the New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Adrián Llerena
- CIS Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
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11
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Bijl MJ, Luijendijk HJ, van den Berg JF, Visser LE, van Schaik RHN, Hofman A, Vulto AG, van Gelder T, Tiemeier H, Stricker BHC. Association between the CYP2D6*4 polymorphism and depression or anxiety in the elderly. Pharmacogenomics 2009; 10:541-7. [PMID: 19374513 DOI: 10.2217/pgs.09.9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION 5-methoxytryptamine (5-MT), a precursor of serotonin, is considered to be an endogenous substrate of cytochrome P450 2D6 (CYP2D6). Homozygous carriers of the variant allele CYP2D6*4 lack CYP2D6 enzyme activity. Relative to extensive metabolizers, these poor metabolizers may have lower baseline serotonin concentrations in various brain regions, and may be more prone to depression or anxiety. AIM To test whether the CYP2D6*4/*4 genotype is associated with a predisposition to depression or anxiety disorders in the elderly. MATERIALS & METHODS We conducted a cross-sectional study within the Rotterdam Study, a population-based cohort study, among persons aged 55 years or older, who were screened for depression and anxiety disorders at two consecutive examination rounds. Logistic regression was used to analyze the association between the CYP2D6*4 polymorphism and the risk of depression or anxiety disorders. RESULTS The risk of major depression in CYP2D6*4/*4 was not significantly different from extensive metabolizers (OR = 0.85; 95% CI: 0.36-2.00; p = 0.72). Neither did we find an association between CYP2D6 genotype and minor depression (OR = 1.56; 95% CI: 0.69-3.52; p = 0.28). No increased risk of anxiety disorders was found (OR = 1.19; 95% CI: 0.68-2.09; p = 0.55). CONCLUSION Variation in the CYP2D6 gene is not related to a predisposition to depression or anxiety disorders in the elderly.
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Affiliation(s)
- Monique J Bijl
- Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Dorado P, Peñas-Lledó EM, Llerena A. CYP2D6 polymorphism: implications for antipsychotic drug response, schizophrenia and personality traits. Pharmacogenomics 2008; 8:1597-608. [PMID: 18034624 DOI: 10.2217/14622416.8.11.1597] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The CYP2D6 gene is highly polymorphic, causing absent (poor metabolizers), decreased, normal or increased enzyme activity (extensive and ultrarapid metabolizers). The genetic polymorphism of the CYP2D6 influences plasma concentration of a wide variety of drugs metabolized in the liver by the cytochrome P450 (CYP) 2D6 enzyme, including antipsychotic drugs used for schizophrenia treatment. Additionally, CYP2D6 is involved in the metabolism of endogenous substrates in the brain, and reported to be located in regions such as the cortex, hippocampus and cerebellum, which are impaired in schizophrenia. Moreover, recently we have found that CYP2D6 poor metabolizers are under-represented in a case-control association study of schizophrenia. Furthermore, null CYP2D6 activity in healthy volunteers is associated with personality characteristics of social cognitive anxiety, which may bear some resemblance to milder forms of psychotic-like symptoms. In keeping with this, CYP2D6 may influence, not only variability to drug response, but also vulnerability to disease in schizophrenia patients.
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Affiliation(s)
- Pedro Dorado
- Extremadura University Hospital and Medical School, Clinical Research Center-CICAB, Servicio Extremeño de Salud, Faculty of Medicine, CICAB Hospital Infanta Cristina, Avda. de Elvas s/n. E-06071, Badajoz, Spain.
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Zhang W, He YJ, Gan Z, Fan L, Li Q, Wang A, Liu ZQ, Deng S, Huang YF, Xu LY, Zhou HH. OATP1B1 POLYMORPHISM IS A MAJOR DETERMINANT OF SERUM BILIRUBIN LEVEL BUT NOT ASSOCIATED WITH RIFAMPICIN-MEDIATED BILIRUBIN ELEVATION. Clin Exp Pharmacol Physiol 2007; 34:1240-4. [DOI: 10.1111/j.1440-1681.2007.04798.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ozdemir V, Williams-Jones B, Cooper DM, Someya T, Godard B. Mapping translational research in personalized therapeutics: from molecular markers to health policy. Pharmacogenomics 2007; 8:177-85. [PMID: 17286540 DOI: 10.2217/14622416.8.2.177] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Translational research is frequently used in the bioscience literature to refer to the translation of basic science into practical applications at the point of patient care. With the introduction of theragnostics, a new medical subspecialty that fuses therapeutics and diagnostic medicine with the goal of providing individualized pharmacotherapy, we suggest that the focus of translational research is shifting. We identify two bottlenecks or gaps in translational research for theragnostics: GAP1 translation from basic science to first-in-human proof-of-concept; and GAP2 translation from clinical proof-of-concept to development of evidence-based personalized treatment guidelines. GAP1 translational research in theragnostics is usually performed in traditional craft-based studies with small sample sizes and led by independent academic or industry researchers. In contrast, GAP2 translational investigations typically rely on large research consortiums and population-based biobanks that couple biomarker information with longitudinal ‘real-life’ observational data on a broad range of pharmacological phenotypes. Despite an abundance of research on the use of biobanks in disease gene discovery, there has been little conceptual work on whether and to what extent population biobanks can be utilized for translating genomics discoveries to practical treatment guidelines for theragnostic tests.
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Affiliation(s)
- Vural Ozdemir
- General Clinical Research Center, School of Medicine, University of California, Irvine, CA, USA.
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