ABSTRACT:Induction of cytochrome P450 3A4 (CYP3A4) is determined typically by employing primary culture of human hepatocytes and measuring CYP3A4 mRNA, protein and microsomal activity. Recently a pregnane X receptor (PXR) reporter gene assay was established to screen CYP3A4 inducers. To evaluate results from the PXR reporter gene assay with those from the aforementioned conventional assays, 14 drugs were evaluated for their ability to induce CYP3A4 and activate PXR. Sandwiched primary cultures of human hepatocytes from six donors were used and CYP3A4 activity was assessed by measuring microsomal testosterone 6␤-hydroxylase activity. Hepatic CYP3A4 mRNA and protein levels were also analyzed using branched DNA technology/Northern blotting and Western blotting, respectively. In general, PXR activation correlated with the induction potential observed in human hepatocyte cultures. Clotrimazole, phenobarbital, rifampin, and sulfinpyrazone highly activated PXR and increased CYP3A4 activity; carbamazepine, dexamethasone, dexamethasone-t-butylacetate, phenytoin, sulfadimidine, and taxol weakly activated PXR and induced CYP3A4 activity, and methotrexate and probenecid showed no marked activation in either system. Ritonavir and troleandomycin showed marked PXR activation but no increase (in the case of troleandomycin) or a significant decrease (in the case of ritonavir) in microsomal CYP3A4 activity. It is concluded that the PXR reporter gene assay is a reliable and complementary method to assess the CYP3A4 induction potential of drugs and other xenobiotics.

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ABSTRACT:Cultured human hepatocytes are a valuable in vitro system for evaluating new molecular entities as inducers of cytochrome P450 (P450) enzymes. The present study summarizes data obtained from 62 preparations of cultured human hepatocytes that were treated with vehicles (saline or dimethylsulfoxide, 0.1%), ␤-naphthoflavone (33 M), phenobarbital (100 or 250 M), isoniazid (100 M) and/or rifampin (20 or 50 M), and examined for the expression of P450 enzymes based on microsomal activity toward marker substrates, or in the case of CYP2C8, the level of immunoreactive protein. The results show that CYP1A2 activity was markedly induced by ␤-naphthoflavone (on average 13-fold, n ‫؍‬ 28 preparations), and weakly induced by phenobarbital (1.9-fold, n ‫؍‬ 25) and rifampin (2.3-fold, n ‫؍‬ 22); CYP2A6 activity tended to be increased with phenobarbital (n ‫؍‬ 7) and rifampin (n ‫؍‬ 3) treatments, but the effects were not statistically significant; CYP2B6 was induced by phenobarbital (6.5-fold, n ‫؍‬ 13) and rifampin (13-fold, n ‫؍‬ 14); CYP2C8 was induced by phenobarbital (4.0-fold, n ‫؍‬ 4) and rifampin (5.2-fold, n ‫؍‬ 4); CYP2C9 was induced by phenobarbital (1.8-fold, n ‫؍‬ 14) and rifampin (3.5-fold, n ‫؍‬ 10); CYP2C19 was markedly induced by rifampin (37-fold, n ‫؍‬ 10), but relatively modestly by phenobarbital (7-fold, n ‫؍‬ 9); CYP2D6 was not significantly induced by phenobarbital (n ‫؍‬ 5) or rifampin (n ‫؍‬ 5); CYP2E1 was induced by phenobarbital (1.7-fold, n ‫؍‬ 5), rifampin (2.2-fold, n ‫؍‬ 5), and isoniazid (2.3-fold, n ‫؍‬ 5); and, CYP3A4 was induced by phenobarbital (3.3-fold, n ‫؍‬ 42) and rifampin (10-fold, n ‫؍‬ 61), but not by ␤-naphthoflavone. Based on these observations, we generalize that ␤-naphthoflavone induces CYP1A2 and isoniazid induces CYP2E1, whereas rifampin and, to a lesser extent phenobarbital, tend to significantly and consistently induce enzymes of the CYP2A, CYP2B, CYP2C, CYP2E, and CYP3A subfamilies but not the 2D subfamily. Drugs and NMEs5 are often screened for their ability to induce P450 and other drug-metabolizing enzymes with the aim of predicting or explaining drug-drug interactions and pharmacokinetic tolerance.

Protein expression of major hepatic uptake and efflux drug transporters in human pediatric (n=69) and adult (n=41) livers was quantified by LC-MS/MS. Transporter protein expression of OCT1, OATP1B3, P-gp and MRP3 was age-dependent. Particularly, significant differences were observed in transporter expression (p <0.05) between the following age-groups: neonates vs. adults (OCT1, OATP1B3, P-gp), neonates or infants vs. adolescents and/or adults (OCT1, OATP1B3 and P-gp), infants vs. children (OATP1B3 and P-gp) and adolescents vs. adults (MRP3). OCT1 showed the largest increase, of almost 5-fold, in protein expression with age. Ontogenic expression of OATP1B1 was confounded by genotype and was revealed only in livers harboring SLCO1B1*1A/*1A. In livers > 1 year, tissues harboring SLCO1B1*14/*1A showed 2.5-fold higher (P<0.05) protein expression than SLCO1B1*15/*1A. Integration of these ontogeny data in physiologically based pharmacokinetic (PBPK) models will be a crucial step in predicting hepatic drug disposition in children.

Cytochrome P450 3A4 (CYP3A4), an enzyme that is highly expressed in the human liver and small intestine, plays a major role in the metabolism of a large variety of xenobiotics, including an estimated 50% of therapeutic drugs, as well as many endogenous compounds. The expression of CYP3A4 can be induced by xenobiotics. Such induction leads to accelerated metabolism of the xenobiotics themselves (autoinduction) or of concomitantly administered CYP3A4 substrates/drugs, thereby significantly altering their pharmacokinetic and pharmacodynamic profiles. During the past decade, much progress has been made in our understanding of the biological mechanisms responsible for regulation of CYP3A4 expression. It is now known that many xenobiotics induce CYP3A4 expression via the pregnane X receptor (PXR) pathway, while others are thought to act through the constitutive androstane receptor (CAR) and the vitamin D receptor (VDR). As a result, most pharmaceutical companies have recognized that it is important to evaluate CYP3A4 induction potential preclinically and are using primary cultures of human hepatocytes and/or PXR reporter gene assays. In general, the results from these two assay methods correlate well. The reporter gene assays in particular can be used to rapidly screen hundreds of drug candidates, whereas methods using primary human hepatocyte cultures may more accurately assess the potential for CYP3A4 induction in vivo. Although it is important to consider CYP3A4 induction in the early stages of the drug development process, it should be recognized that the assessment of induction potential preclinically is a difficult and imprecise endeavor and can be complicated by many factors.

ABSTRACT:Apparent intrinsic clearance (CL int,app ) of 7-ethoxycoumarin, phenacetin, propranolol, and midazolam was measured using rat and human liver microsomes and freshly isolated and cryopreserved hepatocytes to determine factors responsible for differences in rates of metabolism in these systems. The cryopreserved and freshly isolated hepatocytes generally provided similar results, although there was greater variability using the latter system. The CL int,app values in hepatocytes are observed to be lower than that in microsomes, and this difference becomes greater for compounds with high CL int,app . This could partly be attributed to the differences in the free fraction (f u ). The f u in hepatocyte incubations (f u,hep-inc ) was influenced not only by the free fraction of compounds in the incubation buffer (f u,buffer ) but also by the rate constants of uptake (k up ) and metabolism (k met ). This report provides a new derivation for f u,hep-inc , which can be expressed as, where the C hep , C buffer , V hep , and V buffer represent the concentrations of a compound in hepatocytes and buffer and volumes of hepatocytes and buffer, respectively. For midazolam, the f u,hep-inc was calculated, and the maximum metabolism rate in hepatocytes was shown to be limited by the uptake rate.The determination of in vitro intrinsic clearance (CL int ) for drug candidates in the early discovery stage is a common practice in the pharmaceutical industry (Houston, 1994;Lave et al., 1997;Obach et al., 1997). The CL int values of drug candidates can help to confirm whether metabolism is the main clearance pathway when it is compared with the total body clearance in vivo. It is also helpful in rank-ordering drug candidates based on their metabolic stabilities, assessing species and gender differences in metabolic clearance, and projecting the metabolic clearance of drug candidates in humans. The in vitro CL int may be derived from enzyme kinetic data such as V max /K m (Lin et al., 1996;Tan and Pang, 2001;Griffin and Houston, 2004) or from the in vitro t 1/2 values where subK m substrate concentrations are used (Lave et al., 1997, Obach, 1999Lau et al., 2002;Jones and Houston, 2004). The CL int can be calculated from the experimental apparent intrinsic clearance, CL int,app , by correcting for free fraction of test compounds in the incubations. To further predict the in vivo hepatic clearance from the in vitro intrinsic clearance, a well stirred model is often used (Naritomi et al., 2001;Ito and Houston, 2004). A survey of literature revealed that in hepatocyte incubations, the free fraction of test compound has not been well defined. Simply assuming a steady state where the intracellular free concentration equals the extracellular free concentration may allow one to roughly estimate CL int for some compounds. However, clearance, after a dose in vitro or in vivo, is actually a dynamic system such that at any given time the amount of compound getting into a cell typically equals the amount of compound leaving the cell by diffus...

ABSTRACT:Bortezomib [N-(2,3-pyrazine)carbonyl-L-phenylalanine-L-leucine boronic acid] is a potent first-in-class dipeptidyl boronic acid proteasome inhibitor that was approved in May 2003 in the United States for the treatment of patients with relapsed multiple myeloma where the disease is refractory to conventional lines of therapy. Bortezomib binds the proteasome via the boronic acid moiety, and therefore, the presence of this moiety is necessary to achieve proteasome inhibition. Metabolites in plasma obtained from patients receiving a single intravenous dose of bortezomib were identified and characterized by liquid chromatography/mass spectrometry (LC/MS) and liquid chromatography/tandem mass spectrometry (LC/MS/MS). Metabolite standards that were synthesized and characterized by LC/MS/MS and high field nuclear magnetic resonance spectroscopy (NMR) were used to confirm metabolite structures. The principal biotransformation pathway observed was oxidative deboronation, most notably to a pair of diastereomeric carbinolamide metabolites. Further metabolism of the leucine and phenylalanine moieties produced tertiary hydroxylated metabolites and a metabolite hydroxylated at the benzylic position, respectively. Conversion of the carbinolamides to the corresponding amide and carboxylic acid was also observed. Human liver microsomes adequately modeled the in vivo metabolism of bortezomib, as the principal circulating metabolites were observed in vitro. Using cDNA-expressed cytochrome P450 isoenzymes, it was determined that several isoforms contributed to the metabolism of bortezomib, including CYP3A4, CYP2C19, CYP1A2, CYP2D6, and CYP2C9. The development of bortezomib has provided an opportunity to describe the metabolism of a novel boronic acid pharmacophore.

Transport of macromolecules across the blood-brain-barrier (BBB) requires both specific and nonspecific interactions between macromolecules and proteins/receptors expressed on the luminal and/or the abluminal surfaces of the brain capillary endothelial cells. Endocytosis and transcytosis play important roles in the distribution of macromolecules. Due to the tight junction of BBB, brain delivery of traditional therapeutic proteins with large molecular weight is generally not possible. There are multiple pathways through which macromolecules can be taken up into cells through both specific and nonspecific interactions with proteins/receptors on the cell surface. This review is focused on the current knowledge of receptor-mediated endocytosis/transcytosis and brain delivery using the Angiopep-2-conjugated system and the molecular Trojan horses. In addition, the role of neonatal Fc receptor (FcRn) in regulating the efflux of Immunoglobulin G (IgG) from brain to blood, and approaches to improve the pharmacokinetics of therapeutic biologics by generating Fc fusion proteins, and increasing the pH dependent binding affinity between Fc and FcRn, are discussed.