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Tremmel R, Hofmann U, Haag M, Schaeffeler E, Schwab M. Circulating Biomarkers Instead of Genotyping to Establish Metabolizer Phenotypes. Annu Rev Pharmacol Toxicol 2024; 64:65-87. [PMID: 37585662 DOI: 10.1146/annurev-pharmtox-032023-121106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Pharmacogenomics (PGx) enables personalized treatment for the prediction of drug response and to avoid adverse drug reactions. Currently, PGx mainly relies on the genetic information of absorption, distribution, metabolism, and excretion (ADME) targets such as drug-metabolizing enzymes or transporters to predict differences in the patient's phenotype. However, there is evidence that the phenotype-genotype concordance is limited. Thus, we discuss different phenotyping strategies using exogenous xenobiotics (e.g., drug cocktails) or endogenous compounds for phenotype prediction. In particular, minimally invasive approaches focusing on liquid biopsies offer great potential to preemptively determine metabolic and transport capacities. Early studies indicate that ADME phenotyping using exosomes released from the liver is reliable. In addition, pharmacometric modeling and artificial intelligence improve phenotype prediction. However, further prospective studies are needed to demonstrate the clinical utility of individualized treatment based on phenotyping strategies, not only relying on genetics. The present review summarizes current knowledge and limitations.
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Affiliation(s)
- Roman Tremmel
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany;
- University of Tuebingen, Tuebingen, Germany
| | - Ute Hofmann
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany;
- University of Tuebingen, Tuebingen, Germany
| | - Mathias Haag
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany;
- University of Tuebingen, Tuebingen, Germany
| | - Elke Schaeffeler
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany;
- University of Tuebingen, Tuebingen, Germany
- Cluster of Excellence iFIT (EXC2180) "Image-Guided and Functionally Instructed Tumor Therapies," University of Tuebingen, Tuebingen, Germany
| | - Matthias Schwab
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany;
- University of Tuebingen, Tuebingen, Germany
- Cluster of Excellence iFIT (EXC2180) "Image-Guided and Functionally Instructed Tumor Therapies," University of Tuebingen, Tuebingen, Germany
- Departments of Clinical Pharmacology, and Pharmacy and Biochemistry, University of Tuebingen, Tuebingen, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center Heidelberg (DKFZ), Partner Site, Tübingen, Germany
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2
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Cytochromes P450 in biosensing and biosynthesis applications: Recent progress and future perspectives. Trends Analyt Chem 2023. [DOI: 10.1016/j.trac.2022.116791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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3
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Ning J, Tian Z, Wang J, Wang B, Tian X, Yu Z, Huo X, Feng L, Cui J, James TD, Ma X. Rational Design of a Two‐Photon Fluorescent Probe for Human Cytochrome P450 3A and the Visualization of Mechanism‐Based Inactivation. Angew Chem Int Ed Engl 2022. [DOI: 10.1002/ange.202113191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jing Ning
- Second Affiliated Hospital of Dalian Medical University Dalian 116023 China
- College of Integrative Medicine College of Pharmacy Dalian Medical University Dalian 116044 China
| | - Zhenhao Tian
- School of Life Sciences Northwestern Polytechnical University Xi'an 710072 China
| | - Jiayue Wang
- College of Integrative Medicine College of Pharmacy Dalian Medical University Dalian 116044 China
- Department of Pharmacy Peking University Shenzhen Hospital Shenzhen 518036 China
| | - Bo Wang
- School of Medicine & Holistic Integrative Medicine Nanjing University of Chinese Medicine Nanjing China
| | - Xiangge Tian
- College of Integrative Medicine College of Pharmacy Dalian Medical University Dalian 116044 China
| | - Zhenlong Yu
- College of Integrative Medicine College of Pharmacy Dalian Medical University Dalian 116044 China
| | - Xiaokui Huo
- College of Integrative Medicine College of Pharmacy Dalian Medical University Dalian 116044 China
| | - Lei Feng
- Second Affiliated Hospital of Dalian Medical University Dalian 116023 China
- School of Chemistry and Chemical Engineering Henan Normal University Xinxiang 453007 China
| | - Jingnan Cui
- State Key Laboratory of Fine Chemicals Dalian University of Technology Dalian 116024 China
| | - Tony D. James
- School of Chemistry and Chemical Engineering Henan Normal University Xinxiang 453007 China
- Department of Chemistry University of Bath Bath BA2 7AY United Kingdom
| | - Xiaochi Ma
- Second Affiliated Hospital of Dalian Medical University Dalian 116023 China
- College of Integrative Medicine College of Pharmacy Dalian Medical University Dalian 116044 China
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4
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Ning J, Tian Z, Wang J, Wang B, Tian X, Yu Z, Huo X, Feng L, Cui J, James TD, Ma X. Rational Design of a Two-Photon Fluorescent Probe for Human Cytochrome P450 3A and the Visualization of Mechanism-Based Inactivation. Angew Chem Int Ed Engl 2021; 61:e202113191. [PMID: 34851011 DOI: 10.1002/anie.202113191] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Indexed: 12/18/2022]
Abstract
Mechanism-based inactivation (MBI) can mediate adverse reactions and hepatotoxicity from drugs, which is a result of their conversion into highly reactive metabolites catalyzed by enzymes such as cytochrome P450 3A (CYP3A). In the present research, we optimized the key interaction domain of the fluorophore with the target protein to develop a two-photon fluorescent probe for CYP3A that is involved in the metabolism of more than half of all clinical drugs. The developed BN-1 probe exhibited appropriate selectivity and sensitivity for the semi-quantitative detection and imaging of endogenous CYP3A activity in various living systems, thereby providing a high-throughput screening system enabling evaluation of MBI-associated hepatotoxicity by CYP3A. Using BN-1 as a fluorescent molecular tool facilitates the efficient discovery and characterization of CYP3A-induced MBI in natural systems.
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Affiliation(s)
- Jing Ning
- Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, China
- College of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China
| | - Zhenhao Tian
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Jiayue Wang
- College of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China
- Department of Pharmacy, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Bo Wang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiangge Tian
- College of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China
| | - Zhenlong Yu
- College of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China
| | - Xiaokui Huo
- College of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China
| | - Lei Feng
- Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, China
- School of Chemistry and Chemical Engineering, Henan Normal University, Xinxiang, 453007, China
| | - Jingnan Cui
- State Key Laboratory of Fine Chemicals, Dalian University of Technology, Dalian, 116024, China
| | - Tony D James
- School of Chemistry and Chemical Engineering, Henan Normal University, Xinxiang, 453007, China
- Department of Chemistry, University of Bath, Bath, BA2 7AY, United Kingdom
| | - Xiaochi Ma
- Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, China
- College of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China
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5
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Kapetas AJ, Abuhelwa AY, Sorich MJ, McKinnon RA, Rodrigues AD, Rowland A, Hopkins AM. Evidence-Based Guidelines for Drug Interaction Studies: Model-Informed Time Course of Intestinal and Hepatic CYP3A4 Inhibition by Clarithromycin. AAPS JOURNAL 2021; 23:104. [PMID: 34467456 DOI: 10.1208/s12248-021-00632-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/29/2021] [Indexed: 01/10/2023]
Abstract
Drug-drug interaction (DDI) studies are mandated in drug development; however, protocols for evaluating the impact of cytochrome P450 (CYP) inhibition on new molecular entities are currently inconsistent. This study utilised validated physiologically based pharmacokinetic (PBPK) software to define the optimal dose, frequency, and duration of clarithromycin to achieve optimal characterisation of CYP3A4 inhibition in a study population. The Simcyp® Simulator (Version 19.0) was used to simulate clarithromycin-mediated CYP3A4 inhibition in healthy virtual cohorts. Between trial variability in magnitude and time course of CYP3A4 activity was assessed following clarithromycin dosing strategies obtained from the University of Washington Drug Interaction Database. Heterogeneity in CYP3A4 inhibition was evaluated across sex, race, and age. Literature review identified 500 mg twice daily for 5 days as the most common clarithromycin dosing protocol for CYP3A4 inhibition studies. On simulation, clarithromycin 500 mg twice daily resulted in the largest steady-state inhibition of hepatic (percent mean inhibition [95%CI] = 80 [77-83]) and small intestine (94 [94-95]) CYP3A4 activity (as compared to 500 mg once daily, 400 mg once/twice daily, or 250 mg once/twice daily). Additionally, 500 mg twice daily was associated with the shortest time for 90% of individuals to reach 90% of their minimum hepatic (4 days) and small intestine (1 days) CYP3A4 activity. The study presented herein supports that clarithromycin dosing protocol of 500 mg twice daily for 5 days is sufficient to achieve maximal hepatic and small intestine CYP3A4 inhibition. These findings were consistent between sex, race, and age differences.
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Affiliation(s)
- Asha J Kapetas
- College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia
| | - Ahmad Y Abuhelwa
- College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia.
| | - Michael J Sorich
- College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia
| | - Ross A McKinnon
- College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia
| | - A David Rodrigues
- ADME Science, Pfizer Worldwide Research and Development, Groton, CT, USA
| | - Andrew Rowland
- College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia
| | - Ashley M Hopkins
- College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia
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Nassi A, Quintieri L, Merlanti R, Pezzato F, Capolongo F, Pauletto M, Dacasto M, Giantin M. Midazolam oxidation in cattle liver microsomes: The role of cytochrome P450 3A. J Vet Pharmacol Ther 2020; 43:608-613. [PMID: 32893906 DOI: 10.1111/jvp.12906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/24/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022]
Abstract
In humans, the cytochrome P450 3A (CYP3A) subfamily is involved in midazolam (MDZ) biotransformation into 1'- and 4-hydroxy metabolites, and the former serves as a probe for CYP3A catalytic activity. In veterinary species is still crucial to identify enzyme- and species-specific CYP substrates; thus, the aim of this study was to characterize MDZ oxidation in cattle liver. A HPLC-UV method was used to measure 1'- and 4-hydroxy MDZ (1'- and 4-OHMDZ, respectively) formation in cattle liver microsomes and assess the role of CYP3A by an immunoinhibition study. Moreover, MDZ hydroxylation was evaluated in 300 cattle liver samples and results were correlated with testosterone hydroxylation. Formation of both metabolites conformed to a single-enzyme Michaelis-Menten kinetics. Values of Vmax and Km were 0.67 nmol/min/mg protein and 6.16 μM for 4-OHMDZ, and 0.06 nmol/min/mg protein and 10.08 μM for 1'-OHMDZ. An anti-rat CYP3A1 polyclonal antibody inhibited up to 50% and 94% 1'- and 4-OHMDZ formation, respectively. MDZ oxidation in liver microsomes was poorly correlated with testosterone hydroxylation. In conclusion, cattle metabolized MDZ to 1'-OHMDZ and 4-OHMDZ. The immunoinhibition results indicated a major contribution of CYP3As to 4-OHMDZ formation and the involvement of other CYPs in 1'-OHMDZ production, paving the way for further investigations.
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Affiliation(s)
- Alberto Nassi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Luigi Quintieri
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Roberta Merlanti
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
| | - Francesca Pezzato
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
| | - Francesca Capolongo
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
| | - Marianna Pauletto
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
| | - Mauro Dacasto
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
| | - Mery Giantin
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
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