Bromuconazole-induced hepatotoxicity is accompanied by upregulation of PXR/CYP3A1 and downregulation of CAR/CYP2B1 gene expression

Despite widespread use of bromuconazole as a pesticide for food crops and fruits, limited studies have been done to evaluate its toxic effects. Here, we evaluated the hepatotoxic effect of bromuconazole using classical toxicological (biochemical analysis and histopathological examination) and gene-based molecular methods. Male rats were treated either orally or topically with bromuconazole at doses equal to no observed adverse effect level (NOAEL) and 1/10 LD50 for 90?d. Bromuconazole increased activities of liver enzymes (ALT, AST, ALP, and ACP), and levels of bilirubin. It also induced hepatic oxidative stress as evidenced by significant decrease in the activities of superoxide dismutase (SOD), and significant increase in levels of malondialdehyde (MDA) in liver. In addition, bromuconazole caused an increase in liver weights and necrobiotic changes (vacuolation and hepatocellular hypertrophy). It also strongly induced the expression of PXR and its downstream target CYP3A1 gene as well as the activity of CYP3A1. However, it inhibited the expression of CAR and its downstream target CYP2B1 gene without significant changing in CYP2B1 activity. Overall, the oral route showed higher hepatotoxic effect and molecular changes than the dermal route and all changes were dose dependent. This is the first investigation to report that bromuconazole-induced liver oxidative damage is accompanied by upregulation of PXR/CYP3A1 and downregulation of CAR/CYP2B1.     

孕烷X受体(PXR)对药物代谢途径的调控

目的 从孕烷X受体（PXR）对药物代谢途径的调控入手,在代谢性药物相互作用、PXR在CYP3A4调控中的作用及其调控机制等方面作分析和阐述。方法 结合近年来国内外相关文献进行评述。结果 PXR是CYP3A4的主要转录调控因子,药物通过PXR介导的信号通路调节CYP3A4的表达是影响药物体内代谢变化的重要途径。结论 就临床药物而言,由PXR介导的CYP3A4酶蛋白表达的改变可造成合用药物药效的减弱甚至丧失,因此必须引起广大临床药师的足够重视。     

Sequencing and functional assessment of hPXR (NR1I2) variants in intrahepatic cholestasis of pregnancy

1. The purpose of this study was to evaluate the role of coding variation in hPXR (NR1I2) in intrahepatic cholestasis of pregnancy (ICP) and to functionally asses the response of PXR variants to ligands of interest in ICP.

2. The coding region of hPXR was sequenced in a cohort of 121 Caucasian ICP patients and exon 2 was sequenced in an additional 226 cases. Reporter assays were used to evaluate the function of all known hPXR variants in response to the secondary bile acid lithocholic acid and therapeutic agents rifampicin, ursodeoxycholic acid and dexamethasone.

3. Two coding single nucleotide polymorphisms (C79T and G106A) were detected in the ICP cohort at frequencies consistent with healthy populations. These do not alter hPXR function in response to ligands of interest to ICP. Analysis of all known coding hPXR variants demonstrates that while subtle changes in experimental design mask or may unveil the functional effects of genetic variation, these are not maintained in a standard functional assay.

4. Coding genetic variation in hPXR does not contribute to the aetiology of ICP in Caucasian populations.     

Arsenite and its metabolites, MMA and DMA, modify CYP3A4, PXR and RXR alpha expression in the small intestine of CYP3A4 transgenic mice

Arsenic is an environmental pollutant that has been associated with an increased risk for the development of cancer and several other diseases through alterations of cellular homeostasis and hepatic function. Cytochrome P450 (P450) modification may be one of the factors contributing to these disorders. Several reports have established that exposure to arsenite modifies P450 expression by decreasing or increasing mRNA and protein levels. Cytochrome P450 3A4 (CYP3A4), the predominant P450 expressed in the human liver and intestines, which is regulated mainly by the Pregnane X Receptor-Retinoid X Receptor alpha (PXR-RXR alpha) heterodimer, contributes to the metabolism of approximately half the drugs in clinical use today. The present study investigates the effect of sodium arsenite and its metabolites monomethylarsonous acid (MMA^III) and dimethylarsinous acid (DMA^III) on CYP3A4, PXR, and RXR alpha expression in the small intestine of CYP3A4 transgenic mice. Sodium arsenite treatment increases mRNA, protein and CYP3A4 activity in a dose-dependent manner. However, the increase in protein expression was not as marked as compared to the increase in mRNA levels. Arsenite treatment induces the accumulation of Ub-protein conjugates, indicating that the activation of this mechanism may explain the differences observed between the mRNA and protein expression of CYP3A4 induction. Treatment with 0.05 mg/kg of DMA^III induces CYP3A4 in a similar way, while treatment with 0.05 mg/kg of MMA^III increases mostly mRNA, and to a lesser degree, CYP3A4 activity. Sodium arsenite and both its metabolites increase PXR mRNA, while only DMA^III induces RXR alpha expression. Overall, these results suggest that sodium arsenite and its metabolites induce CYP3A4 expression by increasing PXR expression in the small intestine of CYP3A4 transgenic mice.     

Thiazide-like diuretic drug metolazone activates human pregnane X receptor to induce cytochrome 3A4 and multidrug-resistance protein 1

Human pregnane X receptor (hPXR) regulates the expression of drug-metabolizing enzyme cytochrome P450 3A4 (CYP3A4) and drug transporters such as multidrug-resistance protein 1 (MDR1). PXR can be modulated by small molecules, including Federal Drug Administration (FDA)—approved drugs, thus altering drug metabolism and causing drug–drug interactions. To determine the role of FDA-approved drugs in PXR-mediated regulation of drug metabolism and clearance, we screened 1481 FDA-approved small-molecule drugs by using a luciferase reporter assay in HEK293T cells and identified the diuretic drug metolazone as an activator of hPXR. Our data showed that metolazone activated hPXR-mediated expression of CYP3A4 and MDR1 in human hepatocytes and intestine cells and increased CYP3A4 promoter activity in various cell lines. Mammalian two-hybrid assays showed that hPXR recruits its co-activator SRC-1 upon metolazone binding in HepG2 cells, explaining the mechanism of hPXR activation. To understand the role of other commonly-used diuretics in hPXR activation and the structure–activity relationship of metolazone, thiazide and non-thiazide diuretics drugs were also tested but only metolazone activates hPXR. To understand the molecular mechanism, docking studies and mutational analysis were carried out and showed that metolazone binds in the ligand-binding pocket and interacts with mostly hydrophobic amino acid residues. This is the first report showing that metolazone activates hPXR. Because activation of hPXR might cause drug–drug interactions, metolazone should be used with caution for drug treatment in patients undergoing combination therapy.     

Population pharmacokinetic approach to evaluate the effect of CYP2D6, CYP3A,ABCB1, POR and NR1I2 genotypes on donepezil clearance

Aims

A large interindividual variability in plasma concentrations has been reported in patients treated with donepezil, the most frequently prescribed antidementia drug. We aimed to evaluate clinical and genetic factors influencing donepezil disposition in a patient population recruited from a naturalistic setting.

Methods

A population pharmacokinetic study was performed including data from 129 older patients treated with donepezil. The patients were genotyped for common polymorphisms in the metabolic enzymes CYP2D6 and CYP3A, in the electron transferring protein POR and the nuclear factor NR1I2 involved in CYP activity and expression, and in the drug transporter ABCB1.

Results

The average donepezil clearance was 7.3 l h⁻¹ with a 30% interindividual variability. Gender markedly influenced donepezil clearance (P < 0.01). Functional alleles of CYP2D6 were identified as unique significant genetic covariate for donepezil clearance (P < 0.01), with poor metabolizers and ultrarapid metabolizers demonstrating, respectively, a 32% slower and a 67% faster donepezil elimination compared with extensive metabolizers.

Conclusion

The pharmacokinetic parameters of donepezil were well described by the developed population model. Functional alleles of CYP2D6 significantly contributed to the variability in donepezil disposition in the patient population and should be further investigated in the context of individual dose optimization to improve clinical outcome and tolerability of the treatment.     

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。     

阿司匹林联合华法林对HepG2细胞中CYP3A4酶的抑制作用

目的研究阿司匹林联用华法林对肝药物代谢酶CYP3A4活性的影响及其机制。方法不同质量浓度的阿司匹林、华法林及联合用药处理Hep G2细胞48 h,采用MTT法检测细胞存活率;通过荧光素酶报告基因技术检测各组对PXR转录酶活性和酶CYP3A4活性的影响;采用荧光定量PCR法和Western blotting法检测Hep G2细胞的酶CYP3A4的m RNA和蛋白表达水平。结果与对照组比较,阿司匹林组、联合用药组细胞的孕烷X受体(PXR)转录酶活性、酶CYP3A4活性均显著降低(P0.01),CYP3A4 m RNA和蛋白表达水平显著降低(P0.05、0.01),华法林组均无显著差异。结论阿司匹林联用华法林能够抑制药物代谢酶CYP3A4活性,其机制可能是通过抑制PXR受体的m RNA和蛋白表达实现的。     

The effect of organic solvents on enzyme kinetic parameters of human CYP3A4 and CYP1A2 in vitro

Abstract

Enzyme kinetic parameters provide essential quantitative information about characterization of individual steps in drug metabolism. Such enzymes are located in a (partially) aqueous environment. For in vitro measurements potential lipophilic substrates regularly require organic solvents to achieve concentrations sufficient for access of the drug to the binding site of the enzyme. However, solvents may interact with the enzymes. In this study, we investigated the effects of methanol, ethanol, acetonitrile and dimethyl sulfoxide (1% to 4%) on the assessment of k_m, V_max and Cl_int for the metabolism of midazolam via CYP3A4 to 1-hydroxymidazolam and the metabolism of caffeine to paraxanthine via CYP1A2 using expressed enzymes in vitro. The presence of acetonitrile proved the highest apparent V_max value for paraxanthine formation but the lowest values for 1-hydroxymidazolam formation. The k_m value for midazolam showed no systematic effects of organic solvents, while for caffeine k_m was up to 8-fold lower for solvent free samples compared to solvent containing samples. The present example suggests that effects of solvents may considerably influence enzyme kinetic parameters beyond a mere change in apparent activity. These effects illustrate a difference for individual enzyme--substrate pairs, solvents, and solvent concentrations. What remains is the determination to which extent these effects compromise in vitro–in vivo extrapolations, and which solvents are most appropriate.     

Metabolism of CJ-036878, N-(3-phenethoxybenzyl)-4-hydroxybenzamide,in liver microsomes and recombinant cytochrome P450 enzymes: metabolite identification by LC-UV/MSn and 1H-NMR

The identification of metabolites in the early stages of drug discovery is important not only for guiding structure–activity relationships (SAR) and structure–metabolism relationships (SMR) strategies, but also for predicting the potential for adverse events. The present study investigated the phase I metabolism of CJ-036878 (N-(3-phenethoxybenzyl)-4-hydroxybenzamide), a potent antagonist of the N-methyl-D-asparatate (NMDA) receptor, using liver microsomes and representative recombinant cytochrome P450 enzymes. The structures of the oxidative metabolites M1–M11 were confirmed by LC-UV/MSⁿ and/or ¹H-nuclear magnetic resonance (NMR). It was found that CJ-036878 is metabolized through three routes: (1) aliphatic hydroxylation that generates M1 and M2; (2) aromatic hydroxylation that produces M3–M5, M7 and M8; and (3) dimerization through an oxidative phenol coupling reaction that yields M10 and M11. The use of recombinant human cytochrome P450 enzymes suggested that CYP3A4 is the major enzyme involved in the oxidative metabolism of CJ-036878, with minor contributions from CYP1A2, CYP2C19, and CYP2D6.     

豆腐果苷对人孕烷X受体介导的CYP3A4和MDR1的转录调节作用

目的:建立和验证人孕烷X受体(human pregnant X receptor,hPXR)介导的CYP3A4、MDR1药物诱导剂的体外筛选体系,考察豆腐果苷对hPXR介导的CYP3A4、MDR1的转录调节作用。方法:利用构建的双荧光素酶报告基因系统,将表达载体和报告载体共转染HepG2细胞,以10μmol/L利福平为阳性对照,用不同浓度(0.004、0.04、0.4μmol/L)豆腐果苷处理48h后裂解细胞进行双荧光素酶活性检测。结果:不同浓度的豆腐果苷均不能通过激活hPXR来介导CYP3A4和MDR1表达上调,各浓度处理组的双荧光素酶比活性值与DMSO溶媒组差异无统计学意义(P>0.05)。结论:成功构建了hPXR介导的CYP3A4和MDR1药物诱导剂的体外筛选体系,并发现豆腐果苷不能通过激活hPXR介导CYP3A4和MDR1的表达上调。     

三氯乙烯对3种细胞色素P450酶基因表达的影响

目的 探讨三氯乙烯（Trichloroethylene,TCE)对人体淋巴细胞瘤细胞株（MCL-5）中3种细胞色素P450酶基因（CYP1A1、CYP2E1、CYP3A4）表达的影响,并研究剂量反应关系和时间反应关系,方法 用常规的细胞培养方法,0.5、1.0、1.5、2.0mmol/L TCE处理细胞12、24、48、72h。利用提纯RNA和cDNA的药盒,合成cDNA,然后逆转录聚合酶反应（RT-PCR）表达3种CYP450基因,以β-Actin作为内对照,分析不同处理剂量和时间时基因表达的强度。结果 在MCL-5细胞株中都有基本的表达,CYP1A1表达在用1.0、1.5、2.0mmol/LTCE处理48h后有被上调的趋势,而且上调趋势随处理时间延长耐加强;CYP2E1、CYP3A4表达不受TCE处理时间长短的影响。3种CYP450酶基因的表达受TCE剂量的影响。3随0.5mol/L,1.0、1.5、2.0mmol/L剂量的增加有上调的趋势,结论 TCE对CYP450酶系统中的CYP2E1、CYP1A1、CYP3A4基因有明显的诱导作用。这些基因被诱导后的结果。可能会导致相对应酶活性的增加,同时加强对TCE的代谢,使TCE的代谢产物增加。     

复方银杏叶胶囊对肝损伤大鼠CYP2E1、CYP3A4的影响

目的研究复方银杏叶胶囊(CGB)对酒精性肝损伤大鼠CYP2E1、CYP3A4活性的影响。方法正常组和酒精性肝损伤模型组均以CGB[(250 mg/(kg.d)]灌胃,分别在灌胃CGB前及灌胃1周后,灌胃探针药氯唑沙宗(50 mg/kg)及氨苯砜(20 mg/kg),于探针药灌后24 h内不同时间点采血,测定各探针药血药浓度。结果灌胃CGB前,模型组氯唑沙宗和氨苯砜的AUC0-24、Cmax均显著低于正常组(P<0.05或P<0.01)。灌胃CGB后,模型组氯唑沙宗和氨苯砜的AUC0-24、Cmax均较灌胃前显著升高(P<0.05或P<0.01);且氯唑沙宗的t1/2灌胃CGB后明显高于灌胃前(P<0.05)。结论 CGB能够明显抑制酒精性肝损伤大鼠CYP2E1、CYP3A4酶活性。     

Regulation of human pregnane X receptor and its target gene cytochrome P450 3A4 by Chinese herbal compounds and a molecular docking study

1. The pregnane X receptor (PXR) plays a critical role in the regulation of human cytochrome P450 3A4 (CYP3A4) gene. In this study, we investigated the effect of an array of compounds isolated from Chinese herbal medicines on the activity of PXR using a luciferase reporter gene assay in transiently transfected HepG2 and Huh7 cells and on the expression of PXR and CYP3A4 in LS174T cells. Furthermore, molecular docking was performed to investigate the binding modes of herbal compounds with PXR.

2. Praeruptorin A and C, salvianolic acid B, sodium danshensu, protocatechuic aldehyde, cryptotanshinone, emodin, morin, and tanshinone IIA significantly transactivated the CYP3A4 reporter gene construct in either HepG2 or Huh7 cells. The PXR mRNA expression in LS174T cells was significantly induced by physcion, protocatechuic aldehyde, salvianolic acid B, and sodium danshensu. However, epifriedelanol, morin, praeruptorin D, mulberroside A, tanshinone I, and tanshinone IIA significantly down-regulated the expression of PXR mRNA in LS174T cells.

3. All the herbal compounds tested can be readily docked into the ligand-binding cavity of PXR mainly through hydrogen bond and aromatic interactions with Ser247, Gln285, His407, and Arg401.

4. These findings suggest that herbal medicines can significantly regulate PXR and CYP3A4 and this has important implication in herb–drug interactions.

     

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。     

A clinical study to assess CYP1A2 and CYP3A4 induction by AZD7325, a selective GABA(A) receptor modulator - an in vitro and in vivo comparison

AIM(S)

To investigate the potential of AZD7325 to induce CYP1A2 and CYP3A4 enzyme activities.

METHODS

Induction of CYP1A2 and CYP3A4 by AZD7325 was first evaluated using cultured human hepatocytes. The effect of multiple doses of 10 mg AZD7325 on the pharmacokinetics of midazolam and caffeine was then examined in healthy subjects.

RESULTS

The highest CYP1A2 and CYP3A4 induction responses were observed in human hepatocytes treated with 1 or 10 µm of AZD7325, in the range of 17.9%–54.9% and 76.9%–85.7% of the positive control responses, respectively. The results triggered the further clinical evaluation of AZD7325 induction potential. AZD7325 reached a plasma C_max of 0.2 µm after 10 mg daily dosing to steady-state. AZD7325 decreased midazolam geometric mean AUC by 19% (0.81-fold, 90% CI 0.77, 0.87), but had no effect on midazolam C_max (90% CI 0.82, 0.97). The mean CL/F of midazolam increased from 62 l h⁻¹ (midazolam alone) to 76 l h⁻¹ when co-administered with AZD7325. The AUC and C_max of caffeine were not changed after co-administration of AZD7325, with geometric mean ratios (90% CI) of 1.17 (1.12, 1.23) and 0.99 (0.95, 1.03), respectively.

CONCLUSIONS

While AZD7325 appeared to be a potent CYP3A4 inducer and a moderate CYP1A2 inducer from in vitro studies, the expected efficacious dose of AZD7325 had no effect on CYP1A2 activity and only a weak inducing effect on CYP3A4 activity. This comparison of in vitro and in vivo results demonstrates the critical role that clinical exposure plays in evaluating the CYP induction risk of a drug candidate.