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Biotransformation of Xenobiotics...
Overview
• Major Phase I and Phase II enzymes
• Reaction mechanisms, substrates
• Enzyme inhibitors and inducers
• Genetic polymorphism
• Detoxification
• Metabolic activation
• FDA guidances related to biotransformation
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Biotransformation of Xenobiotics...
Introduction
• Purpose
– Converts lipophilic to hydrophilic compounds
– Facilitates excretion
• Consequences
– Changes in PK characteristics
– Detoxification
– Metabolic activation
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
Phase I: Hydrolysis
• Carboxyesterases & peptidases
– hydrolysis of esters
– eg: valacyclovir, midodrine
– hydrolysis of peptide bonds
– e.g.: insulin (peptide)
• Epoxide hydrolase
– H2O added to expoxides
– eg: carbamazepine
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Biotransformation of Xenobiotics...
Phase I: Reductions
• Azo reduction
– N=N to 2 -NH2 groups
– eg: prontosil to sulfanilamide
• Nitro reduction
– N=O to one -NH2 group
– eg: 2,6-dinitrotoluene activation
• N-glucuronide conjugate hydrolyzed by gut microflora
• Hepatotoxic compound reabsorbed
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Biotransformation of Xenobiotics...
Reductions
• Carbonyl reduction
– Alcohol dehydrogenase (ADH)
• Chloral hydrate is reduced to trichlorothanol
• Disulfide reduction
– First step in disulfiram metabolism
• Sulfoxide reduction
– NSAID prodrug Sulindac converted to active
sulfide moiety
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Biotransformation of Xenobiotics...
Reductions
• Quinone reduction
– Cytosolic flavoprotein NAD(P)H quinone
oxidoreductase
• two-electron reduction, no oxidative stress
• high in tumor cells; activates diaziquone to more
potent form
– Flavoprotein P450-reductase
• one-electron reduction, produces superoxide ions
• metabolic activation of paraquat, doxorubicin
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Biotransformation of Xenobiotics...
Reductions
• Dehalogenation
– Reductive (H replaces X)
• Enhances CCl4 toxicity by forming free radicals
– Oxidative (X and H replaced with =O)
• Causes halothane hepatitis via reactive acylhalide
intermediates
– Dehydrodechlorination (2 X’s removed, form C=C)
• DDT to DDE
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Biotransformation of Xenobiotics...
Phase I: Oxidation-Reduction
• Alcohol dehydrogenase
– Alcohols to aldehydes
– Genetic polymorphism; Asians metabolize
alcohol rapidly
– Inhibited by ranitidine, cimetidine, aspirin
• Aldehyde dehydrogenase
– Aldehydes to carboxylic acids
– Inhibited by disulfiram
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Biotransformation of Xenobiotics...
Phase I: Monooxygenases
• Monoamine oxidase
– Primaquine, haloperidol, tryptophan are
substrates
– Activates 1-methyl-4-phenyl-1,2,5,6-
tetrahydropyridine (MPTP) to neurotoxic toxic
metabolite in nerve tissue, resulting in
Parkinsonian-like symptoms
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Biotransformation of Xenobiotics...
Monooxygenases
Monooxygenases
• Flavin-containing mono-oxygenases
– Generally results in detoxification
– Microsomal enzymes
– Substrates: nicotine, cimetidine,
chlopromazine, imipramine
– Repressed rather than induced by
phenobarbital, 3-methylcholanthrene
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Biotransformation of Xenobiotics...
Cytochrome P450
catalytic 16
Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
• Heteroatom dealkylation
– O-dealkylation (e.g., dextromethorphan to
dextrophan by CYP2D6)
– N-demethylation of caffeine to:
theobromine (CYP2E1)
paraxanthine (CYP1A2)
theophylline (CYP2E1)
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
• Dehydrogenation
– Abstraction of 2 H’s with formation of C=C
– Activation of Acetaminophen to hepatotoxic
metabolite N-acetylbenzoquinoneimine
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
CYP1A1/ 2
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Biotransformation of Xenobiotics...
CYP2B6
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Biotransformation of Xenobiotics...
CYP2C19
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Biotransformation of Xenobiotics...
CYP2C19
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Biotransformation of Xenobiotics...
CYP2D6
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Biotransformation of Xenobiotics...
CYP2E1
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Biotransformation of Xenobiotics...
CYP3A4
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Biotransformation of Xenobiotics...
CYP4A9/ 11
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Biotransformation of Xenobiotics...
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Biotransformation of Xenobiotics...
Inhibition of P450
• Drug-drug interactions due to reduced rate
of biotransformation
• Competitive
– S and I compete for active site
– e.g., rifabutin & ritonavir; dextromethorphan
& quinidine
• Mechanism-based
– Irreversible; covalent binding to active site
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Biotransformation of Xenobiotics...
polymorphism
• Crigler-Nijar syndrome (severe): inactive
enzyme; severe hyperbilirubinemia;
inducers have no effect
• Gilbert’s syndrome (mild): reduced
enzyme activity; mild hyperbilirubinemia;
phenobarbital increases rate of bilirubin
glucuronidation to normal
• Patients can glucuronidate p-nitrophenol,
morphine, chloroamphenicol 37
Glucuronidation & -
Biotransformation of Xenobiotics...
glucuronidase
• Conjugates excreted in bile or urine (MW)
-glucuronidase from gut microflora cleaves
glucuronic acid
• Aglycone can be reabsorbed & undergo
enterohepatic recycling
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Biotransformation of Xenobiotics...
Glucuronidation and -
glucuronidase
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Biotransformation of Xenobiotics...
Sulfation
Sulfation
polymorphism
• Several types of methyltransferases in
human tissues
– Phenol O-methyltransferase, Catechol O-
methyltransferase, N-methyltransferase, S-
methyltransferase
• Genetic polymorphism in thiopurine
metabolism
– high activity allele, increased toxicity
– low activity allele, decreased efficacy 44
Biotransformation of Xenobiotics...
polymorphism
• Rapid and slow acetylators
– Various mutations result in decreased enzyme
activity or stability
– Incidence of slow acetylators
• 70% in Middle Eastern populations; 50% in
Caucasians; 25% in Asians
– Drug toxicities in slow acetylators
• nerve damage from dapsone; bladder cancer in
cigarette smokers due to increased levels of
hydroxylamines
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Biotransformation of Xenobiotics...
Glutathione Conjugation
Glutathione Conjugation
• Conjugation of N-acetylbenzoquinoneimine
(activated metabolite of acetaminophen)
• O-demethylation of organophosphates
• Activation of trinitroglycerin
– Products are oxidized glutathione (GSSG),
dinitroglycerin, NO (vasodilator)
• Reduction of hydroperoxides
– Prostaglandin metabolism
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Biotransformation of Xenobiotics...
Glutathione Conjugation
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Biotransformation of Xenobiotics...
Glutathione-S-transferase
Glutathione Conjugation
Industry
In vitro guidance
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Biotransformation of Xenobiotics...
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In vitro guidance: timing of
Biotransformation of Xenobiotics...
studies
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Biotransformation of Xenobiotics...
References
• Casarett and Doull’s Toxicology, The Basic Sciences of
Poisons, 5th Edition, Klassen, Amdur & Doull (eds),
Macmillan Publishing Co.
• CDER Guidance for Industry: Drug Metabolism/Drug
Interaction Studies in the Drug Development Process:
Studies in Vitro, April 1997, CLIN 3
• Davit B, Reynolds K, Yuan R et al. FDA evaluations using
in vitro metabolism to predict and interpret in vivo
metabolic drug-drug interactions: impact on labeling. J
Clin Pharmacol 1999 Sep;39(9):899-910
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