CYP2C9 Genotype-Dependent Effects on in Vitro Drug-Drug Interactions: Switching of Benzbromarone Effect from Inhibition to Activation in the CYP2C9.3 Variant
作者:Matthew A. Hummel、Charles W. Locuson、Peter M. Gannett、Dan A. Rock、Carrie M. Mosher、Allan E. Rettie、Timothy S. Tracy
DOI:10.1124/mol.105.013763
日期:2005.9
The CYP2C9.3 variant exhibits marked decreases in substrate turnover compared with the wild-type enzyme, but little is known regarding the effect this variant form may have on the occurrence of drug-drug interactions. To examine this possibility, the effect of the potent CYP2C9 inhibitor, benzbromarone, was studied with regard to CYP2C9.1- and CYP2C9.3-mediated flurbiprofen metabolism to evaluate whether the variant enzyme exhibits differential inhibition kinetics. Although benzbromarone inhibited CYP2C9.1 activity as expected, CYP2C9.3-mediated flurbiprofen 4′-hydroxylation was activated in the presence of benzbromarone. T1 relaxation studies revealed little change in distances of flurbiprofen protons from the heme iron of either CYP2C9.1 or CYP2C9.3 in the presence of benzbromarone compared with flurbiprofen alone. Spectral binding studies were also performed to investigate whether benzbromarone affected substrate binding, with the addition of benzbromarone having little effect on flurbiprofen-binding affinity in both CYP2C9.1 and CYP2C9.3. Docking studies with the 2C9.1 structure crystallized with a closed active site identified multiple but overlapping subsites with sufficient space for benzbromarone binding in the enzyme when flurbiprofen was positioned closest to the heme. If the closed conformation of 2C9.3 is structurally similar to 2C9.1, as expected for the conservative I359L mutation, then the dynamics of benzbromarone binding may account for the switching of drug interaction effects. In conclusion, the I359L amino acid substitution found in CYP2C9.3 not only reduces metabolism compared with CYP2C9.1 but can also dramatically alter inhibitor effects, suggesting that differential degrees of drug inhibition interactions may occur in individuals with this variant form of CYP2C9.
与野生型酶相比,CYP2C9.3变体的底物周转率明显下降,但人们对这种变体形式可能对发生药物间相互作用的影响知之甚少。为了研究这种可能性,我们研究了强效 CYP2C9 抑制剂苯溴马隆对 CYP2C9.1 和 CYP2C9.3 介导的氟比洛芬代谢的影响,以评估变异酶是否表现出不同的抑制动力学。尽管苯溴马隆抑制了 CYP2C9.1 的活性,但在苯溴马隆存在的情况下,CYP2C9.3 介导的氟比洛芬 4′-羟基化被激活。T1 驰豫研究显示,与单独使用氟比洛芬相比,在有苯溴马隆存在的情况下,氟比洛芬质子与 CYP2C9.1 或 CYP2C9.3 血红素铁的距离变化不大。此外,还进行了光谱结合研究,以调查苯溴马隆是否会影响底物的结合,在 CYP2C9.1 和 CYP2C9.3 中,添加苯溴马隆对氟比洛芬的结合亲和力几乎没有影响。利用封闭活性位点结晶的 2C9.1 结构进行的对接研究发现,当氟比洛芬最靠近血红素时,该酶中有多个但相互重叠的亚位点,有足够的空间与苯溴马隆结合。如果 2C9.3 的封闭构象在结构上类似于 2C9.1,正如保守的 I359L 突变所预期的那样,那么苯溴马隆结合的动力学可能是药物相互作用效应转换的原因。总之,与 CYP2C9.1 相比,在 CYP2C9.3 中发现的 I359L 氨基酸替代不仅会降低代谢,而且还会显著改变抑制剂的效果,这表明在具有这种变异形式 CYP2C9 的个体中可能会出现不同程度的药物抑制相互作用。