Glucuronides

葡糖醛酸苷
  • 文章类型: Journal Article
    一项非靶向代谢组学研究确定了人类尿液中四种潜在的肺癌诊断生物标志物。潜在的生物标志物之一是具有561+的m/z值的未鉴定特征。从人尿中分离出“561”,初步鉴定为27-nor-5β-胆甾烷-3α,7α,12α,使用1HNMR和质谱分析,具有未知C24,25立体化学的24,25戊醇葡糖苷酸。在先前的报告中,糖苷配基的C24,25立体化学,27-nor-5β-胆甾烷-3α,7α,12α,24,25戊醇,被发现是24S,25R通过丙酮化物-TMS衍生物的GC分析。制备真实样品,发现其立体化学与“561+”不相同。为了确定C24,25立体化学,27-nor-5β-胆甾烷-3α的四种C24,C25非对映异构醇,7α,12α,由手性氨基酸制备24,25戊醇。使用LCMS方法,“561+”糖苷配基的C24、C25立体化学被确定为24R,25S.手里拿着正确的aglycone,它与葡萄糖醛酸偶联完成了首次报道的27-nor-5β-胆甾烷-3α的合成,7α,12α,24R,25S戊醇葡糖苷酸。氘标记27-nor-5β-胆甾烷-3α,7α,12α,24R,还合成了25S戊醇以用作MS定量的内标。
    An untargeted metabolomic study identified four potential lung cancer diagnostic biomarkers in human urine. One of the potential biomarkers was an unidentified feature possessing a m/z value of 561+. \"561+\" was isolated from human urine and tentatively identified as 27-nor-5β-cholestane-3α,7α,12α,24,25 pentol glucuronide with unknown C24,25 stereochemistry using 1H NMR and mass spectrometry. In a prior report, the C24,25 stereochemistry of the aglycone, 27-nor-5β-cholestane-3α,7α,12α,24,25 pentol, was found to be 24S,25R through GC analysis of the acetonide-TMS derivative. An authentic sample was prepared and found not to have the same stereochemistry as \"561+\". To identify the C24,25 stereochemistry, four C24,C25 diastereoisomeric alcohols of 27-nor-5β-cholestane-3α,7α,12α,24,25 pentol were prepared from chiral amino acids. Using an LCMS method, the C24,C25 stereochemistry of the \"561+\" aglycone was determined to be 24R,25S. With the correct aglycone in hand, it was coupled with glucuronic acid to complete the first reported synthesis of 27-nor-5β-cholestane-3α,7α,12α,24R,25S pentol glucuronide. Deuterium labeled 27-nor-5β-cholestane-3α,7α,12α,24R,25S pentol was also synthesized for use as an internal standard for MS quantitation.
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  • 文章类型: Journal Article
    菠菜(Spinaciaoleracea)是世界上最著名的蔬菜之一,富含各种健康益处的必需代谢产物。它是一种有潜力成为营养食品的有价值的植物来源。本研究旨在评估单一特征标记化合物,以建立HPLC-DAD方法的验证,该方法适用于使用菠菜样品开发营养食品。通过LC-Q-TOF/MS分析从菠菜样品如冻干菠菜(FDS)和菠菜提取物浓缩物(SEC)中鉴定出六种代谢物(1-6)。在六种代谢物中,3\',4\',5-三羟基-3-甲氧基-6,7-亚甲基二氧黄酮4'-葡糖苷酸(TMG)因其最高的丰度和高选择性而被选择为标记化合物。特异性,准确度,线性度精度,重复性,检测限(LOD),根据AOAC国际指南验证了菠菜样品(FDS和SEC)中TMG的定量限(LOQ)。通过在基峰强度(BPI)和紫外(UV)色谱图中监测标记化合物与菠菜样品的其他化合物的良好分离来确认特异性。TMG的校准曲线(15.625~500μg/mL)与LOD和LOQ值具有合理的线性关系(R2=0.999),分别。TMG的回收率对于FDS为93-101%,对于SEC为90-95%。日内和日间的精度分别小于3%和6%。因此,菠菜样品中TMG的HPLC-DAD验证方法(FDS和SEC)首先是根据AOAC和KFDA法规建立的,用于批准功能性食品中的功能性成分。
    Spinach (Spinacia oleracea) is one of the most famous vegetables worldwide, rich in essential metabolites for various health benefits. It is a valuable plant source that has the potential to be a nutraceutical. This study aimed to evaluate the single characteristic marker compound to establish the validation of HPLC-DAD methods applied to the development of a nutraceutical using spinach samples. Six metabolites (1-6) were identified from the spinach samples such as freeze-dried spinach (FDS) and spinach extract concentrate (SEC) by LC-Q-TOF/MS analysis. Among the six metabolites, 3\',4\',5-trihydroxy-3-methoxy-6,7-methylenedioxyflavone 4\'-glucuronide (TMG) was selected as a marker compound due to its highest abundance and high selectivity. The specificity, accuracy, linearity, precision, repeatability, limit of detection (LOD), and limit of quantification (LOQ) of TMG in the spinach samples (FDS and SEC) were validated according to AOAC international guideline. The specificity was confirmed by monitoring the well separation of the marker compound from other compounds of spinach samples in the base peak intensity (BPI) and ultraviolet (UV) chromatogram. The calibration curve of TMG (15.625~500 μg/mL) had reasonable linearity (R2 = 0.999) considered with LOD and LOQ values, respectively. Recovery rate of TMG was 93-101% for FDS and 90-95% for SEC. The precision was less than 3 and 6% in the intraday and interday. As a result, the HPLC-DAD validation method of TMG in the spinach samples (FDS and SEC) was first established with AOAC and KFDA regulations for approving functional ingredients in functional foods.
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  • 文章类型: Journal Article
    目的:药物诱导的肠病通常与某些葡萄糖醛酸化药物的治疗应用有关。一种这样的药物是霉酚酸(MPA),一种公认的免疫抑制剂,其胃肠道不良反应是主要问题。最近发现了来自肠道微生物群的细菌β-葡糖醛酸糖苷酶(β-G)在MPA诱导的肠病中的作用。细菌β-G水解MPAG,MPA的葡萄糖醛酸代谢产物在胆汁中排泄,导致MPA的消化积累,这反过来又有利于这些不良事件。因此,我们假设驯服细菌β-G活性可能会减少MPA的消化暴露并防止其毒性。
    方法:通过使用多尺度方法,我们评估了增加浓度的MPA对肠上皮细胞(Caco-2细胞系)活力的影响,扩散,和移民。然后,我们研究了阿莫沙平的抑制特性,先前描述的细菌β-G抑制剂,通过使用分子动力学模拟,并在基于大肠杆菌的β-G活性测定中评估了其阻断MPAG水解的效率。在小鼠模型中评价阿莫沙平的药理作用。
    结果:我们观察到MPA损害肠上皮细胞稳态。阿莫沙平可有效阻断MPAG水解为MPA,并显着减少小鼠对MPA的消化暴露。因此,在MPA治疗的小鼠中施用阿莫沙平可显着减轻胃肠道病变。
    结论:总的来说,这些结果表明,MPA的消化积累参与了MPA胃肠道不良反应的病理生理过程。这项研究提供了细菌β-G抑制剂在葡萄糖醛酸化药物诱导的肠病中的治疗潜力的概念验证。
    OBJECTIVE: Drug-induced enteropathy is often associated with the therapeutic use of certain glucuronidated drugs. One such drug is mycophenolic acid (MPA), a well-established immunosuppressant of which gastrointestinal adverse effects are a major concern. The role of bacterial β-glucuronidase (β-G) from the gut microbiota in MPA-induced enteropathy has recently been discovered. Bacterial β-G hydrolyzes MPAG, the glucuronide metabolite of MPA excreted in the bile, leading to the digestive accumulation of MPA that would favor in turn these adverse events. We therefore hypothesized that taming bacterial β-G activity might reduce MPA digestive exposure and prevent its toxicity.
    METHODS: By using a multiscale approach, we evaluated the effect of increasing concentrations of MPA on intestinal epithelial cells (Caco-2 cell line) viability, proliferation, and migration. Then, we investigated the inhibitory properties of amoxapine, a previously described bacterial β-G inhibitor, by using molecular dynamics simulations, and evaluated its efficiency in blocking MPAG hydrolysis in an Escherichia coli-based β-G activity assay. The pharmacological effect of amoxapine was evaluated in a mouse model.
    RESULTS: We observed that MPA impairs intestinal epithelial cell homeostasis. Amoxapine efficiently blocks the hydrolysis of MPAG to MPA and significantly reduces digestive exposure to MPA in mice. As a result, administration of amoxapine in MPA-treated mice significantly attenuated gastrointestinal lesions.
    CONCLUSIONS: Collectively, these results suggest that the digestive accumulation of MPA is involved in the pathophysiology of MPA-gastrointestinal adverse effects. This study provides a proof-of-concept of the therapeutic potential of bacterial β-G inhibitors in glucuronidated drug-induced enteropathy.
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  • 文章类型: Journal Article
    药物代谢物鉴定是药物发现和开发中药物代谢和药代动力学(DMPK)研究的组成部分。通常需要明确鉴定测试化合物的代谢修饰方面,例如筛选代谢软点和支持代谢物合成。目前,LC-HRMS是代谢物鉴定的主要分析平台。然而,对常用的碰撞诱导解离(CID)和高能碰撞解离(HCD)产生的产物离子谱的解释通常无法识别代谢修饰的位置,尤其是葡萄糖醛酸化。最近,介绍了配备有电子激活解离(EAD-HRMS)的ZenoTOF7600质谱仪。本研究的主要目的是应用EAD-HRMS来识别vepdegestrant(ARV-471)的代谢位点,由多个官能团组成的模型化合物。将ARV-471在狗肝微粒体中孵育,并检测到12个I相代谢物和葡糖醛酸苷。EAD通过正交碎裂产生独特的产物离子,这使得能够准确确定ARV-471的代谢位点,包括苯酚葡糖醛酸化,哌嗪N-脱烷基化,戊二酰亚胺水解,哌啶氧化,和哌啶内酰胺的形成。相比之下,CID和HCD光谱解释未能确定三种O-葡糖苷酸和三种I相代谢物的修饰位点。结果表明,尽管EAD-HRMS在鉴定各种类型的药物代谢产物中的实用性尚待进一步评估,但EAD在葡糖苷酸和I相代谢产物的明确结构阐明中具有优于CID和HCD的显着优势。重要性声明在药物发现和开发中非常需要通过LC-HRMS明确鉴定代谢修饰位点。如筛选代谢软点和支持代谢物合成。然而,通常使用的CID和HCD光谱通常无法为明确的结构阐明提供有用的信息。在这项研究中,EAD片段技术用于鉴定ARV-471的葡萄糖醛酸化和I期代谢位点,其结果明显优于CID和HCD。
    Drug metabolite identification is an integrated part of drug metabolism and pharmacokinetics studies in drug discovery and development. Definitive identification of metabolic modification sides of test compounds such as screening metabolic soft spots and supporting metabolite synthesis are often required. Currently, liquid chromatography-high resolution mass spectrometry is the dominant analytical platform for metabolite identification. However, the interpretation of product ion spectra generated by commonly used collision-induced disassociation (CID) and higher-energy collisional dissociation (HCD) often fails to identify locations of metabolic modifications, especially glucuronidation. Recently, a ZenoTOF 7600 mass spectrometer equipped with electron-activated dissociation (EAD-HRMS) was introduced. The primary objective of this study was to apply EAD-HRMS to identify metabolism sites of vepdegestrant (ARV-471), a model compound that consists of multiple functional groups. ARV-471 was incubated in dog liver microsomes and 12 phase I metabolites and glucuronides were detected. EAD generated unique product ions via orthogonal fragmentation, which allowed for accurately determining the metabolism sites of ARV-471, including phenol glucuronidation, piperazine N-dealkylation, glutarimide hydrolysis, piperidine oxidation, and piperidine lactam formation. In contrast, CID and HCD spectral interpretation failed to identify modification sites of three O-glucuronides and three phase I metabolites. The results demonstrated that EAD has significant advantages over CID and HCD in definitive structural elucidation of glucuronides and phase I metabolites although the utility of EAD-HRMS in identifying various types of drug metabolites remains to be further evaluated. SIGNIFICANCE STATEMENT: Definitive identification of metabolic modification sites by liquid chromatography-high resolution mass spectrometry is highly needed in drug metabolism research, such as screening metabolic soft spots and supporting metabolite synthesis. However, commonly used collision-induced dissociation (CID) and higher-energy collisional dissociation (HCD) fragmentation techniques often fail to provide critical information for definitive structural elucidation. In this study, the electron-activated dissociation (EAD) was applied to identifying glucuronidation and oxidative metabolism sites of vepdegestrant, which generated significantly better results than CID and HCD.
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  • 文章类型: Journal Article
    含有羧酸部分的药物和药物代谢物可以在体内进行缀合以形成1-β-O-酰基-葡糖苷酸(1-β-O-AG)。除了水解,这些缀合物可以经历自发的酰基迁移,和阴离子化反应,导致一系列位置异构体。容易的转酰化已被认为是导致酰基葡糖醛酸的毒性的机制。这些过程的动力学被认为是一个因素。先前的1HNMR光谱和HPLC-MS研究已经进行了测量三种非甾体抗炎药的1-β-O-AG的降解速率(伊布芬酸,R-布洛芬,S-布洛芬)和二甲基类似物(此处称为“布洛芬”)。这些研究还确定了两种缓冲水溶液中水解和酰基迁移的相对贡献,和人类血浆。这里,报告了详细的动力学分析,为4个AG中的每一个提供在缓冲液中观察到的酰基迁移和水解反应的单独速率常数,以及母体1-β-O-AG的总降解速率常数。使用密度泛函理论对反应物和转酰反应的过渡态进行计算建模,表明活化能的差异反映了取代和立体化学对转酰/水解速率的影响。
    Drugs and drug metabolites containing a carboxylic-acid moiety can undergo in vivo conjugation to form 1-β-O-acyl-glucuronides (1-β-O-AGs). In addition to hydrolysis, these conjugates can undergo spontaneous acyl migration, and anomerisation reactions, resulting in a range of positional isomers. Facile transacylation has been suggested as a mechanism contributing to the toxicity of acyl glucuronides, with the kinetics of these processes thought to be a factor. Previous 1H NMR spectroscopic and HPLC-MS studies have been conducted to measure the degradation rates of the 1-β-O-AGs of three nonsteroidal anti-inflammatory drugs (ibufenac, R-ibuprofen, S-ibuprofen) and a dimethyl-analogue (termed here as \"bibuprofen\"). These studies have also determined the relative contributions of hydrolysis and acyl migration in both buffered aqueous solution, and human plasma. Here, a detailed kinetic analysis is reported, providing the individual rate constants for the acyl migration and hydrolysis reactions observed in buffer for each of the 4 AGs, together with the overall degradation rate constants of the parent 1-β-O-AGs. Computational modelling of the reactants and transition states of the transacylation reaction using density functional theory indicated differences in the activation energies that reflected the influence of both substitution and stereochemistry on the rate of transacylation/hydrolysis.
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  • 文章类型: Journal Article
    激素和神经递质对体内平衡至关重要,它们的破坏与从癌症到焦虑症的各种疾病有关。肠道微生物β-葡糖醛酸酶(GUS)酶对内源性葡糖醛酸的差异再激活可能会影响疾病发作和治疗的个体差异。使用多元,在体外,和体内方法,我们表明,无菌小鼠体内有活性的内生物活性物质水平降低,不同的肠道微生物Loop1和FMNGUS酶驱动激素和神经递质的再激活.我们证明了一系列FDA批准的药物通过以保守的方式拦截酶的催化循环来防止这种再活化。最后,我们发现,在常规小鼠中抑制GUS会减少血清和肠道中游离的5-羟色胺,并增加其非活性的葡糖苷酸。我们的结果阐明了肠道微生物酶在维持内生体内稳态中的不可或缺性,并表明这种代谢的治疗性破坏促进了个体间的反应变异性。
    Hormones and neurotransmitters are essential to homeostasis, and their disruptions are connected to diseases ranging from cancer to anxiety. The differential reactivation of endobiotic glucuronides by gut microbial β-glucuronidase (GUS) enzymes may influence interindividual differences in the onset and treatment of disease. Using multi-omic, in vitro, and in vivo approaches, we show that germ-free mice have reduced levels of active endobiotics and that distinct gut microbial Loop 1 and FMN GUS enzymes drive hormone and neurotransmitter reactivation. We demonstrate that a range of FDA-approved drugs prevent this reactivation by intercepting the catalytic cycle of the enzymes in a conserved fashion. Finally, we find that inhibiting GUS in conventional mice reduces free serotonin and increases its inactive glucuronide in the serum and intestines. Our results illuminate the indispensability of gut microbial enzymes in sustaining endobiotic homeostasis and indicate that therapeutic disruptions of this metabolism promote interindividual response variabilities.
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  • 文章类型: Journal Article
    氯酚(CPs)是一类对环境造成巨大威胁的污染物,它们广泛用于工业和农业废物,杀虫剂,除草剂,纺织品,药品和塑料。在CP中,《斯德哥尔摩公约》将五氯苯酚列为持久性有机污染物之一。这项研究旨在鉴定参与CPs代谢消除的UDP-葡萄糖基转移酶(UGT)亚型。在人肝微粒体(HLM)与辅助因子尿苷-二磷酸葡萄糖醛酸酸(UDPGA)的孵育混合物中检测到CPs'单葡萄糖醛酸。HLMs催化的葡萄糖醛酸化代谢反应方程式遵循Michaelis-Menten或底物抑制类型。利用重组酶和化学试剂抑制实验对参与CP的葡糖醛酸化的主要UGT同工型进行表型化。UGT1A6可能是单氯苯酚异构体葡糖醛酸化的主要酶。UGT1A1,UGT1A6,UGT1A9,UGT2B4和UGT2B7是代谢二氯酚和三氯酚异构体的最重要的五种UGT同工型。UGT1A1和UGT1A3是催化四氯苯酚和五氯苯酚异构体的最重要的UGT同工型。使用大鼠肝微粒体(RLMs)研究物种差异,猪肝微粒体(PLM),狗肝微粒体(DLM),和猴肝微粒体(MyLMs)。所有这些结果有助于阐明CPs的代谢消除和毒性。
    Chlorophenols (CPs) are a group of pollutants that pose a great threat to the environment, they are widely used in industrial and agricultural wastes, pesticides, herbicides, textiles, pharmaceuticals and plastics. Among CPs, pentachlorophenol was listed as one of the persistent organic pollutants (POPs) by the Stockholm convention. This study aims to identify the UDP-glucosyltransferase (UGT) isoforms involved in the metabolic elimination of CPs. CPs\' mono-glucuronide was detected in the human liver microsomes (HLMs) incubation mixture with co-factor uridine-diphosphate glucuronic acid (UDPGA). HLMs-catalyzed glucuronidation metabolism reaction equations followed Michaelis-Menten or substrate inhibition type. Recombinant enzymes and chemical reagents inhibition experiments were utilized to phenotype the main UGT isoforms involved in the glucuronidation of CPs. UGT1A6 might be the major enzyme in the glucuronidation of mono-chlorophenol isomer. UGT1A1, UGT1A6, UGT1A9, UGT2B4 and UGT2B7 were the most important five UGT isoforms for metabolizing the di-chlorophenol and tri-chlorophenol isomers. UGT1A1 and UGT1A3 were the most important UGT isoforms in the catalysis of tetra-chlorophenol and pentachlorophenol isomers. Species differences were investigated using rat liver microsomes (RLMs), pig liver microsomes (PLMs), dog liver microsomes (DLMs), and monkey liver microsomes (MyLMs). All these results were helpful for elucidating the metabolic elimination and toxicity of CPs.
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  • 文章类型: Journal Article
    真菌蒽醌类皮胞苷和皮胆红素是合成染料的有吸引力的替代品,但它们的代谢在很大程度上是未知的。我们进行了定性的体外研究,以确定他们的代谢使用人肝微粒体和细胞质,以及重组人细胞色素P450(CYP),UDP-葡糖醛酸基转移酶(UGT)和磺基转移酶(SULT)酶。此外,来自大鼠的肝微粒体和胞质部分,使用小鼠和猪。在存在烟酰胺腺嘌呤二核苷酸磷酸的情况下,将生物色素与酶一起孵育后,UDP-葡萄糖醛酸,3'-磷酸腺苷-5'-磷酸硫酸盐(PAPS)或S-腺苷甲硫氨酸(SAM)使CYP氧化,葡糖醛酸化,磺化或甲基化,我们观察到皮肤细胞素的几种氧化和结合代谢物,但没有观察到皮肤胆红素。人CYP1A1、1A2、1B1、2A6、2B6、2C8、2C9、2C19、2D6、2E1、3A4和3A7催化皮胞嘧啶氧化。人UGT1A1、1A3、1A7、1A8、1A9、1A10和2B15催化了皮胞嘧啶葡糖苷酸的形成。人SULT1B1、1C2和2A1磺化皮细胞素。在人肝微粒体中,皮蛋白聚糖的氧化比结合更快。在人类之间的皮蛋白聚糖葡糖醛酸化中观察到物种差异,rat,老鼠和猪总之,许多CYP和缀合酶代谢皮肤细胞素,而在体外的人肝脏部分中,皮胆红素没有代谢。结果表明,人体内会代谢皮肤细胞素。
    Fungal anthraquinones dermocybin and dermorubin are attractive alternatives for synthetic dyes but their metabolism is largely unknown. We conducted a qualitative in vitro study to identify their metabolism using human liver microsomes and cytosol, as well as recombinant human cytochrome P450 (CYP), UDP-glucuronosyltransferase (UGT) and sulfotransferase (SULT) enzymes. Additionally, liver microsomal and cytosolic fractions from rat, mouse and pig were used. Following incubations of the biocolourants with the enzymes in the presence of nicotinamide adenine dinucleotide phosphate, UDP-glucuronic acid, 3\'-phosphoadenosine-5\'-phosphosulfate (PAPS) or S-adenosyl methionine (SAM) to enable CYP oxidation, glucuronidation, sulfonation or methylation, we observed several oxidation and conjugation metabolites for dermocybin but none for dermorubin. Human CYP1A1, 1A2, 1B1, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, 3A4 and 3A7 catalysed dermocybin oxidation. The formation of dermocybin glucuronides was catalysed by human UGT1A1, 1A3, 1A7, 1A8, 1A9, 1A10 and 2B15. Human SULT1B1, 1C2 and 2A1 sulfonated dermocybin. Dermocybin oxidation was faster than conjugation in human liver microsomes. Species differences were seen in dermocybin glucuronidation between human, rat, mouse and pig. In conclusion, many CYP and conjugation enzymes metabolized dermocybin, whereas dermorubin was not metabolized in human liver fractions in vitro. The results indicate that dermocybin would be metabolized in humans in vivo.
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  • 文章类型: Journal Article
    醇的简便和选择性的β-D-葡糖醛酸化,如(-)-薄荷醇,胆固醇,(+)-和(-)-冰片,和2-金刚烷醇,使用市售的1,2,3,4-四-O-乙酰基-β-D-葡糖醛酸甲酯作为糖基供体和三甲基甲硅烷基双(三氟甲磺酰基)酰亚胺(Tf2NTMS)(0.5当量)作为活化剂在1,4-二恶烷中在60°C下得到中等产率的产物。当胆留醇时,MS4A的添加增加了D-葡糖苷酸的β:α比,(+)-冰片,和2-金刚烷醇被用作受体底物。
    A facile and selective β-D-glucuronidation of alcohols, such as (-)-menthol, cholestanol, (+)- and (-)-borneols, and 2-adamantanol, using commercially available methyl 1,2,3,4-tetra-O-acetyl-β-D-glucuronate as the glycosyl donor and trimethylsilyl bis(trifluoromethanesulfonyl)imide (Tf2NTMS) (0.5 equivalent) as the activator in 1,4-dioxane at 60 °C gave products in moderate yields. The addition of MS4A increased the β : α ratios of D-glucuronides when cholestanol, (+)-borneol, and 2-adamantanol were used as the acceptor substrate.
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  • 文章类型: Journal Article
    肝功能损害,由于肝硬化,降低细胞色素P450酶(CYPs)的活性。使用基于生理的药代动力学(PBPK)模型来预测CYP底物的这种作用已经得到了完善。但肝硬化对尿苷-葡萄糖醛酸基转移酶(UGT)活性的影响研究较少,PBPK模型报道较少。UGT酶参与CYP3A羟基化后咪达唑仑的初级N-葡糖醛酸化和1'-OH-咪达唑仑的葡糖醛酸化。在这项研究中,Simcyp®用于建立咪达唑仑的PBPK模型,其主要代谢产物咪达唑仑-N-葡糖苷酸(UGT1A4)和1'-OH咪达唑仑(CYP3A4/3A5)和次级代谢产物1'-OH-咪达唑仑-O-葡糖苷酸(UGT2B7/2B4),允许模拟肝硬化对咪达唑仑的原发性和继发性葡萄糖醛酸化的影响。在外推到Child-Pugh(CP)A类肝硬化患者之前,在非肝硬化受试者中验证了该模型,B,和C.我们的模型成功地预测了咪达唑仑及其代谢物在非肝硬化和肝硬化患者中的暴露,86%的观察到的血浆浓度在预测的第5-95百分位数之内,并且观察到的AUCinf和Cmax的几何平均值在预测的0.7-1.43倍之内。模拟代谢率(AUC葡糖醛酸/AUCparent,MR),计算咪达唑仑-N-葡糖苷酸对咪达唑仑的影响(表明UGT1A4活性),并降低了40%(CPA),48%(CPB),和75%(CPC)。对于1'-OH-咪达唑仑-O-葡糖苷酸至1'-OH-咪达唑仑,MR(表明UGT2B7/2B4活性)下降了35%(CPA),51%(CPB),和64%(CPC)。观察到的数据证实了这些预测的MR。因此,这项工作增加了Simcyp®预测肝硬化对UGT1A4和UGT2B7/UGT2B4底物药代动力学影响的信心。意义陈述本文介绍了咪达唑仑及其代谢物的PBPK模型,并验证了使用Simcyp®肝功能损害人群模型时对药代动力学曲线的准确模拟。咪达唑仑-N-葡糖苷酸和1'-OH-咪达唑仑-O-葡糖苷酸的暴露变化反映了肝硬化患者UGT1A4和UGT2B7/2B4葡糖苷酸活性降低的影响。本研究中使用的方法可以扩展到验证受肝硬化影响的其他UGT酶的建模。
    Hepatic impairment, due to liver cirrhosis, decreases the activity of cytochrome P450 enzymes (CYPs). The use of physiologically based pharmacokinetic (PBPK) modeling to predict this effect for CYP substrates has been well-established, but the effect of cirrhosis on uridine-glucuronosyltransferase (UGT) activities is less studied and few PBPK models have been reported. UGT enzymes are involved in primary N-glucuronidation of midazolam and glucuronidation of 1\'-OH-midazolam following CYP3A hydroxylation. In this study, Simcyp was used to establish PBPK models for midazolam, its primary metabolites midazolam-N-glucuronide (UGT1A4) and 1\'-OH midazolam (CYP3A4/3A5), and the secondary metabolite 1\'-OH-midazolam-O-glucuronide (UGT2B7/2B4), allowing to simulate the impact of liver cirrhosis on the primary and secondary glucuronidation of midazolam. The model was verified in noncirrhotic subjects before extrapolation to cirrhotic patients of Child-Pugh (CP) classes A, B, and C. Our model successfully predicted the exposures of midazolam and its metabolites in noncirrhotic and cirrhotic patients, with 86% of observed plasma concentrations within 5th-95th percentiles of predictions and observed geometrical mean of area under the plasma concentration curve between 0 hours to infinity and maximal plasma concentration within 0.7- to 1.43-fold of predictions. The simulated metabolic ratio defined as the ratio of the glucuronide metabolite AUC over the parent compound AUC (AUCglucuronide/AUCparent, metabolic ratio [MR]), was calculated for midazolam-N-glucuronide to midazolam (indicative of UGT1A4 activity) and decreased by 40% (CP A), 48% (CP B), and 75% (CP C). For 1\'-OH-midazolam-O-glucuronide to 1\'-OH-midazolam, the MR (indicative of UGT2B7/2B4 activity) dropped by 35% (CP A), 51% (CP B), and 64% (CP C). These predicted MRs were corroborated by the observed data. This work thus increases confidence in Simcyp predictions of the effect of liver cirrhosis on the pharmacokinetics of UGT1A4 and UGT2B7/UGT2B4 substrates. SIGNIFICANCE STATEMENT: This article presents a physiologically based pharmacokinetic model for midazolam and its metabolites and verifies the accurate simulation of pharmacokinetic profiles when using the Simcyp hepatic impairment population models. Exposure changes of midazolam-N-glucuronide and 1\'-OH-midazolam-O-glucuronide reflect the impact of decreases in UGT1A4 and UGT2B7/2B4 glucuronidation activity in cirrhotic patients. The approach used in this study may be extended to verify the modeling of other uridine glucuronosyltransferase enzymes affected by liver cirrhosis.
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