代谢
Delamanid主要通过白蛋白代谢,其次在较小程度上由CYP3A4代谢。Delamanid的代谢也可能由肝脏的CYP1A1、CYP2D6和较小程度上的CYP2E1介导。在接受Delamanid治疗的患者血浆中已鉴定出四种主要代谢物(M1-M4),其中M1和M3占人体总血浆暴露的13%-18%。尽管它们没有保留显著药理活性,但它们仍可能对QT间期延长有所贡献。这对于Delamanid的主要代谢物M1(DM-6705)尤其如此。Delamanid主要通过血清白蛋白通过6-硝基-2,3-二氢咪唑[2,1-b]恶唑部分的羟基裂解形成M1(DM-6705)。这种主要代谢物的形成被认为是Delamanid代谢途径的关键起点。M1(DM-6705)可以通过三条途径进一步催化。在第一条代谢途径中,DM-6705经历恶唑部分的羟基化形成M2((4RS,5S)-DM-6720),随后通过CYP3A4介导的羟基氧化和恶唑到亚胺酮代谢物的互变异构化形成M3((S)-DM-6718)。第二条代谢途径涉及恶唑胺的水解和脱氨形成M4(DM-6704),然后羟基化形成M6((4R,5S)-DM-6721)和M7((4S,5S)-DM-6722)以及恶唑的氧化形成另一种酮代谢物M8((S)-DM-6717)。第三条途径涉及恶唑环的水解裂解形成M5(DM-6706)。
Delamanid predominantly undergoes metabolism by albumin and to a lesser extent, CYP3A4.. The metabolism of delamanid may also be mediated by hepatic CYP1A1, CYP2D6, and CYP2E1 to a lesser extent [31966]. Four major metabolites (M1–M4) have been identified in plasma in patients receiving delamanid where M1 and M3 accounts for 13%–18% of the total plasma exposure in humans. While they do not retain significant pharmacological activity, they may still contribute to QT prolongation. This is especially true for the main metabolite of delamanid, M1 (DM-6705). Delamanid is predominantly metabolized by serum albumin to form M1 (DM-6705) via hydrolytic cleavage of the 6-nitro-2,3-dihydroimidazo[2,1-b] oxazole moiety. The formation of this major metabolite is suggested to be a crucial starting point in the metabolic pathway of delamanid. M1 (DM-6705) can be further catalyzed by three pathways. In the first metabolic pathway, DM-6705 undergoes hydroxylation of the oxazole moiety to form M2 ((4RS,5S)-DM-6720), followed by CYP3A4-mediated oxidation of hydroxyl group and tautomerization of oxazole to an imino-ketone metabolite, M3 ((S)-DM-6718). The second metabolic pathway involves the hydrolysis and deamination of the oxazole amine to form M4 (DM-6704) followed by hydroxylation to M6 ((4R,5S)-DM-6721) and M7 ((4S,5S)-DM-6722) and oxidation of oxazole to another ketone metabolite, M8 ((S)-DM-6717). The third pathway involves the hydrolytic cleavage of the oxazole ring to form M5 (DM-6706).
来源:DrugBank