Mass Spectrometric Characterization of Circulating Covalent Protein Adducts Derived from a Drug Acyl Glucuronide Metabolite: Multiple Albumin Adductions in Diclofenac Patients
作者:Thomas G. Hammond、Xiaoli Meng、Rosalind E. Jenkins、James L. Maggs、Anahi Santoyo Castelazo、Sophie L. Regan、Stuart N. L. Bennett、Caroline J. Earnshaw、Guruprasad P. Aithal、Ira Pande、J. Gerry Kenna、Andrew V. Stachulski、B. Kevin Park、Dominic P. Williams
DOI:10.1124/jpet.114.215079
日期:2014.8
Covalent protein modifications by electrophilic acyl glucuronide (AG) metabolites are hypothetical causes of hypersensitivity reactions associated with certain carboxylate drugs. The complex rearrangements and reactivities of drug AG have been defined in great detail, and protein adducts of carboxylate drugs, such as diclofenac, have been found in liver and plasma of experimental animals and humans. However, in the absence of definitive molecular characterization, and specifically, identification of signature glycation conjugates retaining the glucuronyl and carboxyl residues, it cannot be assumed any of these adducts is derived uniquely or even fractionally from AG metabolites. We have therefore undertaken targeted mass spectrometric analyses of human serum albumin (HSA) isolated from diclofenac patients to characterize drug - derived structures and, thereby, for the first time, have deconstructed conclusively the pathways of adduct formation from a drug AG and its isomeric rearrangement products in vivo. These analyses were informed by a thorough understanding of the reactions of HSA with diclofenac AG in vitro. HSA from six patients without drug - related hypersensitivities had either a single drug - derived adduct or one of five combinations of 2–8 adducts from among seven diclofenac N- acylations and three AG glycations on seven of the protein’s 59 lysines. Only acylations were found in every patient. We present evidence that HSA modifications by diclofenac in vivo are complicated and variable, that at least a fraction of these modifications are derived from the drug’s AG metabolite, and that albumin adduction is not inevitably a causation of hypersensitivity to carboxylate drugs or a coincidental association.
电亲核酰基葡萄糖醛酸(AG)代谢物对蛋白质的共价修饰被假设为某些羧酸药物相关的超敏反应的原因。这些药物AG的复杂重排和反应性已经被详细定义,并且在实验动物和人类的肝脏和血浆中发现了如双氟氯噻吨(diclofenac)等羧酸药物的蛋白质加合物。然而,在缺乏明确的分子特征表征,特别是对保留葡萄糖醛酸和羧基残基的特征糖基化共轭物的鉴定的情况下,无法假定这些加合物的来源唯一或部分来自AG代谢物。因此,我们针对从双氟氯噻吨患者中分离的人血清白蛋白(HSA)进行了靶向质谱分析,以表征药物衍生的结构,从而首次明确解构了药物AG及其异构体重排产物在体内加合物形成的路径。这些分析基于对HSA与双氟氯噻吨AG在体外反应的深入理解。来自六名没有药物相关超敏反应的患者的HSA中,发现了单一的药物衍生加合物或由七种双氟氯噻吨N-酰化和三种AG糖基化中的2-8种加合物的五种组合。其中,只有酰化物在每位患者身上都被发现。我们提供证据表明,双氟氯噻吨在体内对HSA的修饰是复杂多变的,至少部分这些修饰源于该药物的AG代谢物,并且白蛋白加合并不必然导致对羧酸药物的超敏反应,也不是偶然的关联。