五味子甲素对大鼠肝微粒体CYP3A活性的影响

目的：通过体外药物代谢实验探讨五味子甲素对CYP3A活性的影响。方法：以大鼠肝微粒体为载体,选取咪达唑仑（MDZ）作为药物“探针”,建立高效液相色谱（HPLC）检测方法,体外给药测定五味子甲素对MDZ的IC50值以及相关酶动力学参数。结果：孵育体系内源性物质不干扰测定,方法快捷、稳定、灵敏度高。在肝微粒中,五味子甲素对MDZ的IC50浓度为6．26μmol／mL,相关酶动力学参数：Km=15．77μmol／L,Ki=5．50μmol／mL。结论：五味子甲素对大鼠肝微粒体CYP3A活性具有抑制作用,其抑制作用为混合型,即：非竞争与反竞争抑制。     

Effects of the CYP3A5 genotype on omeprazole sulfoxidation in CYP2C19 PMs

Objective Omeprazole is metabolized by the two cytochrome P450 isoforms, CYP3A (sulfoxidation) and CYP2C19 (hydroxydation). The aim of this study was to determine whether the CYP3A5 genotype is an important determinant of inter-individual variability of total CYP3A activity in vivo. Methods Plasma levels of omeprazole and omeprazole sulfone were analyzed by high-performance liquid chromatography in blood samples drawn 4–5 h after 43 CYP2C19 poor metabolizers (PMs) had ingested a single oral 40 mg dose of omeprazole. The CYP3A5*3 allele was identified using a PCR-restriction fragment length polymorphism assay. Results Among the 43 CYP2C19 PMs, 24 were CYP3A5*3/*3 carriers and 19 were CYP3A5*1 carriers (CYP3A5*1/*1 in one subject and CYP3A5*1/*3 in 18 subjects). No significant difference was found between the mean log10(metabolic ratio) of the CYP3A5*3/*3 carriers (0.314 ± 0.369) and CYP3A5*1 carriers (0.330 ± 0.313). Conclusions The CYP3A5 genotype was not an important factor underlying the inter-individual variation in the metabolic ratio of omeprazole to omeprazole sulfone in our study cohort, although genotype can be considered to be responsible for the inter-individual variation of many CYP3A substrates in vivo.     

Enzymatic characteristics of CYP3A5 and CYP3A4: A comparison of in vitro kinetic and drug–drug interaction patterns

CYP3A4 and CYP3A5 exhibit significant overlap in substrate specificity, but can differ in catalytic activity and regioselectivity. To investigate their characteristics further, the enzymatic reactions of the two CYP3A enzymes were compared using midazolam, nifedipine, testosterone and terfenadine as substrates. Both CYP3A5 and CYP3A4 showed sigmoid and substrate inhibition patterns for testosterone 6β-hydroxylation and terfenadine t-butylhydroxylation (TFDOH), respectively. In the other reactions, the kinetic model for CYP3A5 was not similar to that for CYP3A4. An inhibition study demonstrated that the interactions between α-naphthoflavone (αNF) and CYP3A substrates were different for the two CYP3A enzymes. αNF stimulated nifedipine oxidation catalysed by CYP3A5, but did not stimulate that catalysed by CYP3A4. αNF at less than 32?µM inhibited TFDOH catalysed by CYP3A5, but did not inhibit that catalysed by CYP3A4. These results indicate that CYP3A5 has different enzymatic characteristics from CYP3A4 in some CYP3A catalysed reactions.     

五味子甲素对大鼠肝微粒体CYP3A活性的影响

目的：通过体外药物代谢实验探讨五味子甲素对CYP3A活性的影响。方法：以大鼠肝微粒体为载体,选取咪达唑仑（MDZ）作为药物“探针”,建立高效液相色谱（HPLC）检测方法,体外给药测定五味子甲素对MDZ的IC50值以及相关酶动力学参数。结果：孵育体系内源性物质不干扰测定,方法快捷、稳定、灵敏度高。在肝微粒中,五味子甲素对MDZ的IC50浓度为6．26μmol／mL,相关酶动力学参数：Km=15．77μmol／L,K1=5．50μmol／mL。结论：五味子甲素对大鼠肝微粒体CYP3A活性具有抑制作用,其抑制作用为混合型,即：非竞争与反竞争抑制。     

CYP3A5基因型的差异对环孢素药代动力学影响的体外研究

目的体外明确CYP3A5基因多态性对CYP3A5蛋白酶表达量的影响;不同的CYP3A5基因型对环孢素体外代谢的影响。方法采用PCR-RFLP方法和测序分析了21份肝脏标本的CYP3A5*3基因型;Western-blot方法对蛋白质进行定量;将CYP3A4特异性抑制剂酮康唑和环孢素一起孵育后,采用LC/MS-MS检测AM9/CsA浓度。结果CYP3A5*1/*1、CYP3A5*1/*3基因型和CYP3A5*3/*3基因型样本的蛋白表达量分别为:260.10±136.89nmol.g-1,85.44±55.22nmol.g-1和19.88±17.33nmol.g-1。各基因型蛋白表达量存在差异的同时,也存在一定程度的性别差异。采用AM9/CsA来评估CYP3A5活性,人肝微粒体孵育环孢素,CYP3A5*1/*1的活性明显强于CYP3A5*3/*3;量化校正CYP3A5后,此活性不存在性别差异。结论CYP3A5基因多态性可引起蛋白酶表达量的差异,因而对携带有CYP3A5*3个体,应用比CYP3A5*1/*1个体更小剂量的环孢素就能达到所需要的治疗血药浓度。     

Urinary metabolic markers reflect on hepatic,not intestinal,CYP3A activity in healthy subjects

Intestinal cytochrome P450 3A (CYP3A) plays an important role in oral drug metabolism, but only endogenous metabolic markers for measuring hepatic CYP3A activity were identified. Our study evaluated whether hepatic CYP3A markers reflected intestinal CYP3A activity. An open-label, three-period, six-treatment, one-sequence clinical trial was performed in 16 healthy Korean males. In the control phase, all subjects received a single dose of intravenous (IV) and oral midazolam (1 mg and 5 mg, respectively). Clarithromycin (500 mg) was administered twice daily for 4 days to inhibit hepatic and intestinal CYP3A, and 500 mL of grapefruit juice was given to inhibit intestinal CYP3A. Clarithromycin significantly inhibited total CYP3A activity, and the clearance of IV and apparent clearance of oral midazolam decreased by 0.15- and 0.32-fold, respectively. Grapefruit juice only reduced the apparent clearance of oral midazolam by 0.84-fold, which indicates a slight inhibition of intestinal CYP3A activity. Urinary markers, including 6β–OH–cortisol/cortisol and 6β–OH–cortisone/cortisone, were significantly decreased 0.5-fold after clarithromycin administration but not after grapefruit juice. The fold changes in 6β–OH–cortisol/cortisol and 6β–OH–cortisone/cortisone did not correlate to changes in intestinal availability but did correlate to hepatic availability. In conclusion, endogenous metabolic markers are only useful to measure hepatic, but not intestinal, CYP3A activity.     

Development of template systems for ligand interactions of CYP3A5 and CYP3A7 and their distinctions from CYP3A4 template

Starting from established CYP3A4 Template (DMPK. 2019, and 2020), CYP3A5 and CYP3A7 Templates have been constructed to be reliable tools for verification of their distinct catalytic properties. A distinct occupancy was observed on CYP3A4-selective ligands, but not on the non-selective ligands, in simulation experiments. These ligands often invade into Bay-1 region during the migration from Entrance to Site of oxidation in simulation experiments. These results offered an idea of the distinct localization of Bay-1 residue on CYP3A5 Template, in which the Bay-1 residue stayed closely to Template border. The idea also accounted for the higher oxidation rates of CYP3A5, than of CYP3A4, of noscapine and schisantherin E through their enhanced sitting-stabilization. Typical CYP3A7 substrates such as zonisamide and retinoic acids took their placements without occupying a left side region of Template for their metabolisms. In turn, the occupancies of the left-side region were inevitably observed among poor ligands of CYP3A7. Altered extent of IJK-Interaction or localization of a specific residue at the left-side would thus explain distinct catalytic properties of CYP3A7 on Template. These data suggest the alteration of each one of Template region, from CYP3A4 Template, led to the distinct catalytic properties of CYP3A5 and CYP3A7 forms.     

五味子甲素对CYP3A活性的影响及其体内外相关性研究

目的:通过"探针"法探讨五味子甲素体内、外对大鼠肝微粒体CYP3A活性的影响及其相关性。方法:选取咪达唑仑作为CYP3A探针,用高效液相色谱法测定五味子甲素体外孵育给药和体内灌胃给药后大鼠肝微粒体酶CYP3A活性,通过药动学参数K_m确定其体内、外作用的相关性。结果:体外试验结果表明,五味子甲素非竞争性抑制咪达唑仑的代谢,其K_i为5.5μmol·L^-1,体内试验亦证实了五味子甲素能显著抑制肝微粒体CYP3A酶活性（P<0.01）并呈剂量依赖性,其体内给药的K_i值为30.67 mg·kg^-1。体内外K_m值十分接近。结论:五味子甲素在体内和体外均可非竞争性抑制大鼠肝微粒体酶CYP3A活性,其对CYP3A影响的体内、体外结果具有良好的相关性。     

灯盏细辛注射液对大鼠肝微粒体CYP3A的抑制作用

目的：研究灯盏细辛注射液对大鼠肝微粒体CYP3A酶活性的抑制作用。方法：在体外大鼠肝微粒体孵育体系中加入底物睾酮和不同体积的灯盏细辛注射液,用高效液相色谱法测定睾酮的羟化代谢产物6β-羟基睾酮的生成量反映CYP3A酶的活性。酮康唑用作阳性对照药。结果：在体外孵育体系中,灯盏细辛注射液对大鼠肝微粒体CYP3A酶活性有抑制作用,IC50和Ki值分别为0.40%和0.24%（V/V）。结论：体外给药灯盏细辛注射液对大鼠肝微粒体CYP3A酶活性有抑制作用,符合混合型抑制模型。     

Pharmacokinetics of midazolam in CYP3A4- and CYP3A5-genotyped subjects

Objective We investigated whether differences in pharmacokinetics of midazolam, a CYP3A probe, could be demonstrated between subjects with different CYP3A4 and CYP3A5 genotypes.Methods Plasma concentrations of midazolam, and of total (conjugated + unconjugated) 1OH-midazolam, and 4OH-midazolam were measured after the oral administration of 7.5 mg or of 75 µg of midazolam in 21 healthy subjects.Results CYP3A5*7, CYP3A4*1E, CYP3A4*2, CYP3A4*4, CYP3A4*5, CYP3A4*6, CYP3A4*8, CYP3A4*11, CYP3A4*12, CYP3A4*13, CYP3A4*17 and CYP3A4*18 alleles were not identified in the 21 subjects. CYP3A5*3, CYP3A5*6, CYP3A4*1B and CYP3A4*1F alleles were identified in 20, 1, 4 and 2 subjects, respectively. No statistically significant differences were observed for the AUC_inf values between the different genotypes after the 75-µg or the 7.5-mg dose.Conclusion Presently, CYP3A4 and CYP3A5 genotyping methods do not sufficiently reflect the inter-individual variability of CYP3A activity.     

CYP3A5~*3和CYP3A4~*18B基因多态性对肾移植患者环孢素药代动力学的影响

目的回顾性研究肾脏移植后1mon,CYP3A5*3和CYP3A4*18B基因多态性对CsA药代动力学参数的影响。方法采用PCR-RFLP方法分析了63名肾脏移植患者CYP3A5*3和CYP3A4*18B基因型;荧光偏正免疫法用于检测肾移植患者静脉全血中的CsA浓度。结果在63名肾移植患者中,CYP3A5*3和CYP3A4*18B突变等位基因发生频率分别为0.770(95CI:0.767～0.773),0.235(95CI:0.235～0.241),而且这些等位基因表现出完全连锁不平衡。在移植术后1mon内,携带CYP3A4*1/*1野生型纯合子患者的C0以及剂量校正谷血浓度(C0/D)均明显高于携带CYP3A4*1/*18B杂合子或CYP3A4*18B/*18B突变型纯合子患者(P<0.05,Mann-WhitneyUtest);CYP3A5*1/*1基因型组的给药剂量明显高于CYP3A5*1/*3或CYP3A5*3/*3基因型组(P=0.004<0.01,Kruakal-Wallistest);CYP34*18B和CYP3A5*3联合考虑,对于CYP3A5表达组,同样发现C0、C0/D在CYP3A4*1/*1组C0以及C0/D均明显高于CYP3A4*1/*18B或CYP3A4*18B/*18B组(P<0.05,Mann-WhitneyUtest);而其他药动学参数在CYP3A5*3及CYP3A4*18B各组间相比差异则没有统计学意义。结论CYP3A5*3和(或)CYP3A4*18B基因多态性对肾移植后1monCsA药代动力学有一定影响,移植前CYP3A5*3基因型的分析仍需进一步研究。     

五味子及木脂素成分对肝CYP3A酶活性的影响

目的研究五味子和五味子科8种木脂素成分对大鼠肝CYP3A1／2活性和人肝CYP3A4活性的影响。方法在体外大鼠及健康人肝微粒体孵育体系中加入底物睾酮和不同浓度的五味子或木脂素成分，甲醇终止反应，用高效液相色谱仪检测睾酮的羟化代谢产物68羟基睾酮的生成量反映CYP3A酶活性。人原代肝细胞和五味子水提物共同培养3d后同法测定CYP3A酶活性的变化。结果大鼠肝微粒体孵育体系中，五味子水提物和醇提物对CYP3A1／2酶活性有浓度依赖性抑制作用，IC50分别为487．8和175．7mg·L^-1，五味子酯甲、南五味子素、异南五味子素、内南五味子素和angeloyl binankadsurina A的IC50分别为3．77、6．18、20．67、16．43和23．07μmol·L^-1；人肝微粒体孵育体系中，五味子水提物抑制CYP3A4酶活性的IC50为317．3mg·L^-1，8种木脂素成分对酶活性的抑制作用与大鼠微粒体结果相似；人原代肝细胞培养中，五味子水提物（1500mg·L^-1）浓度可以抑制50％以上的CYP3A4酶活性。结论体外给药五味子和五种木脂素成分对大鼠肝CYV3A1／2活性和人肝CYP3A4活性有浓度依赖性抑制作用。     

体外探讨五味子乙素对大鼠肝微粒体CYP3A的影响及其作用机制

目的通过体外药物代谢实验探讨五味子乙素对CYP3A活性的影响,并探讨其作用机制。方法以大鼠肝微粒体为载体,选取咪达唑仑为药物"探针",建立高效液相色谱法(HPLC)检测五味子乙素对肝微粒体代谢咪达唑仑的影响,体外给药测定其IC50值以及相关酶动力学参数,并推测其可能的作用机制。结果孵育体系内源性物质不干扰测定,方法快捷、稳定、灵敏度高。结果显示五味子乙素呈剂量依赖性抑制体外肝微粒体咪达唑仑代谢,其IC50为5.50g.L-1,据此计算其Ki为4.32mol·L-1。结论五味子乙素体外抑制大鼠肝微粒体CYP3A活性,其作用机制为可逆性抑制,属于非竞争性抑制类型。     

中药止咳橘红颗粒对CYP3A4和CYP1A2抑制作用的研究

目的：在人体内研究止咳橘红对CYP3A4和CYP1A2的抑制作用，以预测止咳橘红与常用临床药物的相互作用。方法：咪哒唑仑和咖啡因分别作为CYP3A4和A2的探针药物，采取交叉设计，10名受试者在服用3d止咳橘红的前后均服用7.5mg咪哒唑仑和100mg咖啡因，服药后采血测定两者及代谢产物的代谢动力学参数，探讨针药物及代谢物的浓度用HPLC-MS法测定，Cmax,tmax从药时曲线中直接读出，AUC用梯形法计算，Ke用3P87程序进行拟合计算，分析服药前后CYP3A4和CYP1A2被抑制的情况，结果 服用止咳橘红后，咪哒唑仑的代谢受到了轻微的抑制，它的血药浓度，达峰时间和药时曲线下面积都有了升高趋势，但无显著差异。而咖啡因的代谢未受到影响。结论 止咳橘红对CYP3A4的活性有较弱的抑制作用，能够导致CYP3A4底物咪哒唑仑代谢的轻微抑制，而对CYP1A2的活性没有影响。止咳橘红长期使用或超过治疗剂量使用时是否会对CYP3A4产生显著性影响。尚需进一步的研究证明。     

大鼠肝微粒体法测定3种中药对CYP3A4 亚型的作用

［摘要］目的建立肝微粒体测定法,观察中药制剂对CYP3A4 亚型的作用。方法取大鼠肝脏,制备肝微粒体,分别优化肝微粒体体外温孵系统的反应时间、蛋白浓度及探针药物咪达唑仑的浓度;高效液相色谱 质谱联用（HPLC MS MS）法测定大鼠肝微粒体中咪达唑仑的浓度,计算咪达唑仑的活性;在肝微粒体体外温孵系统中分别加入不同浓度的血脂康胶囊、通心络胶囊、枣仁安神胶囊内容物及对照药物酮康唑,测定其半数抑制浓度（IC50）及抑制常数（Ki）。结果肝微粒体体外温孵系统的反应条件为0.4 g&;#8226;L 1大鼠肝微粒体,4 μmol&;#8226;L 1咪达唑仑溶液,37 ℃温育5 min。酮康唑、血脂康胶囊、通心络胶囊的IC50分别为（3.4±0.2）,（25.1±0.3）,（56.2±0.3） mg&;#8226;L 1,枣仁安神胶囊的IC50﹥150 mg&;#8226;L 1;酮康唑、血脂康胶囊、通心络胶囊的Ki分别为（1.7±0.1）,（25.0±0.2）,（50.0±0.3） mg&;#8226;L 1。结论建立了中药制剂对CYP3A4亚型作用的大鼠肝微粒体研究模型。血脂康胶囊和通心络胶囊对大鼠CYP3A4亚型有较弱的抑制作用。     

天然药对CYP3A的影响

天然药在我国及东南亚国家应用相当广泛，在欧洲及美国，天然药正日益受到重视。天然药成分虽复杂，但其单体或有效成分与合成药一样，大多数是通过细胞色素P450酶（CYP450）代谢。CYP3A是很重要的CYP450酶系，临床上一半以上药物由其代谢。目前很多体外、体内实验证明多种天然药及其成分广泛影响CYP3A，从而在合并用药时，导致药物间的相互作用。研究天然药对CYP3A的调控不仅对安全合理用药有指导作用，而且对于新药研发和揭示药物相互作用机制都有指导意义。     

Comparative analysis of substrate and inhibitor interactions with CYP3A4 and CYP3A5

To evaluate the role that cytochrome (CYP) 3A5 plays in hepatic drug metabolism, the substrate selectivity and inhibitory potential of over 60 compounds towards CYP3A4 and CYP3A5 were assessed using Escherichia coli recombinant cell lines. CYP3A4-mediated metabolism predominated for many of the compounds studied. However, a number of drugs gave similar CL_int estimates using CYP3A5 compared with CYP3A4 including midazolam (CL_int?=?3.4 versus 3.3?µl?min^–1?pmol^–1). Significant CYP3A5-mediated metabolism was also observed for several drugs including mifepristone (CL_int?=?10.3 versus 2.4?µl?min^–1?pmol^–1), and ritonavir (CL_int?=?0.76 versus 0.47?µl?min^–1?pmol^–1). The majority of compounds studied showed a greater inhibitory potential (IC₅₀) towards CYP3A4 compared with CYP3A5 (eightfold lower on average). A greater degree of time-dependent inhibition was also observed with CYP3A4 compared with CYP3A5. The range of compounds investigated in the present study extends significantly previous work and suggests that CYP3A5 may have a significant role in drug metabolism particularly in populations expressing high levels of CYP3A5 and/or on co-medications known to inhibit CYP3A4.     

Pioglitazone, an in vitro inhibitor of CYP2C8 and CYP3A4, does not increase the plasma concentrations of the CYP2C8 and CYP3A4 substrate repaglinide

Objective Pioglitazone, a thiazolidinedione antidiabetic, inhibits cytochrome P450 (CYP) 2C8 and CYP3A4 enzymes in vitro. Repaglinide, a meglitinide analogue antidiabetic, is metabolised by CYP2C8 and CYP3A4. In patients with type 2 diabetes, the pioglitazone-repaglinide combination has acted synergistically on glycaemic parameters. Our aim was to determine whether pioglitazone increases the plasma concentrations of repaglinide. Methods In a randomized, 2-phase cross-over study, 12 healthy volunteers received 30 mg pioglitazone or placebo once daily for 5 days. On day 5, they ingested a single 0.25 mg dose of repaglinide 1 h after the last pretreatment dose. Plasma repaglinide and pioglitazone, and blood glucose concentrations were measured for 12 h. Results During the pioglitazone phase, the mean peak plasma repaglinide concentration (C_max) and the total area under the concentration-time curve [AUC(0-∞)] of repaglinide were 100% (range 53–157%, P=0.99) and 90% (range 63–120%, P=0.22), respectively, of those during the placebo phase. Also the half-life of repaglinide was unaffected, but the median peak time of repaglinide was shortened from 40 min to 20 min by pioglitazone (P=0.014). The short-term pioglitazone administration did not modify the blood glucose-lowering effect of a single dose of repaglinide. Conclusions Pioglitazone does not increase the plasma concentrations of repaglinide, indicating that the inhibitory effect of pioglitazone on CYP2C8 and CYP3A4 is very weak in vivo, probably due to its extensive plasma protein binding. The synergistic effect of repaglinide and pioglitazone on the glycaemic parameters, seen in patients with type 2 diabetes during their long-term use, is unlikely to be caused by inhibition of repaglinide metabolism by pioglitazone.     

4种二氢吡啶类钙拮抗药对地塞米松诱导雌性大鼠CYP3A4酶活性的影响

目的：研究二氢吡啶类钙离子拮抗药（DHPs）中非洛地平、尼卡地平、乐卡地平、硝苯地平对CYP3A4酶活性抑制作用大小,为临床了解DHPs发生药物相互作用的几率大小提供理论基础。方法：采用探针药物法,将经80 mg·kg^-1·d^-1地塞米松诱导3 d的SD雌性大鼠分为阴性对照组、阳性对照组、4种DHPs实验组,每组6只。氨苯砜为探针底物,HPLC法为检测手段,数据通过Win Non Lin药动学分析软件进行模型拟合处理,并通过配对t检验进行统计学分析。结果：阴性对照组与四种DHPs组、阳性对照组氨苯砜的AUC0-24、CL/F值比较有统计学意义（P〈0.05）。4种DHPs对氨苯砜的代谢抑制作用大小分别为硝苯地平〉尼卡地平〉乐卡地平〉非洛地平,但差异无统计学意义（P〉0.05）。而统计学结果显示阳性对照组、4种DHPs组与阴性对照组的Cmax比较,差异无统计学意义（P〉0.05）。结论：虽然不同DHPs对CYP3A4存在不同的抑制作用,但差异在体内表现并不显著,对于非主要通过CYP3A4代谢的共服药物不会产生影响。     

CYP3A4,CYP3A5和MDR1基因多态性对环孢素处置的影响

环孢素是一个广泛用于器官移植患者的免疫抑制剂,具有治疗指数窄,不同个体间药代动力学差异较大的特点。它主要通过肝脏和小肠的CYP3A4和CYP3A5代谢;同时它又是药物转运体的底物。不同个体间药物代谢酶和转运体活性的差异可能是造成不同器官移植患者环孢素药代动力学差异的主要原因。而遗传因素即编码药物代谢酶和转运体基因序列的差异可能是其产生活性差异的分子机制。因此,从编码药物代谢酶和转运体的基因入手,可能会为器官移植患者提供最优的治疗方案。