ABSTRACT:Marker substrates, chemical inhibitors, and inhibitory antibodies are important tools for the identification of cytochrome P450 (P450) isoform responsible for the metabolism of therapeutic agents in vitro. In view of the versatile and nonspecific nature of P450 enzymes, many of the marker substrates and chemical inhibitors used for P450 in vitro reaction phenotyping are isoform selective but not specific. Recently, the use of marker substrate and chemical inhibitors in CYP2D6 in vitro reaction phenotyping was questioned by Granvil et al. (2002). In comparison of a panel of 15 recombinant P450 enzymes, they found that in addition to CYP2D6, CYP1A1 is also capable of catalyzing the formation of 4-hydroxylated metabolite of debrisoquine and that the intrinsic clearance of debrisoquine by CYP2D6-mediated 4-hydroxylation is only about twice that by CYP1A1. In their study, they have also demonstrated that quinidine inhibits both CYP2D6-and CYP1A1-mediated debrisoquine 4-hydroxylation. In view of these important findings, we have reevaluated various approaches used to identify P450 isoform(s) responsible for the metabolism of therapeutic agents. While acknowledging the value of inhibitory antibodies in P450-phenotyping studies, it is our opinion that in well conducted in vitro experiments, isoform-selective chemical inhibitors can also provide valuable and reliable information. Hopefully, future efforts may produce even better P450 isoform-selective marker substrates and inhibitors.For most drugs, biotransformation is the major route of elimination, and oxidative metabolism by P450 1 enzymes is a common metabolic pathway (Rendic, 2002). Therefore, it is important to assess the relative contribution of metabolic pathways to the overall elimination processes and to identify the P450 isoforms responsible for oxidative reactions. In vitro P450 phenotyping has proven to be very successful in predicting the potential of drug interactions and the polymorphic impact on drug disposition (Lin and Lu, 1998;Dahl, 2002). As a result, pharmaceutical companies routinely include in vitro reaction P450 phenotyping in the drug candidate selection process.Ever since the pioneering work of Smith and coworkers (Mahgoub et al., 1977;Sloan et al., 1978), the 4-hydroxylation of debrisoquine has been recognized as a marker reaction of human CYP2D6. Urinary metabolic ratio defined as debrisoquine to 4-hydroxydebrisoquine measured following an oral dose of debrisoquine is generally considered as an accurate assessment of an individual's metabolic capacity of CYP2D6. Based on the metabolic ratios, individuals are phenotypically classified as being poor metabolizer (PM), extensive metabolizer (EM), or ultra-rapid metabolizer (UM) phenotypes, each displaying characteristic pharmacokinetic patterns and clinical outcomes (Eichelbaum and Gross, 1990;Dahl et al., 1995;Meyer and Zanger, 1997). The debrisoquine pharmacokinetic profile of an individual with EM phenotype can be changed to a pattern similar to that of an individual with PM phenotyp...