Bioactivation of a Novel 2-Methylindole-Containing Dual Chemoattractant Receptor-Homologous Molecule Expressed on T-Helper Type-2 Cells/d-Prostanoid Receptor Antagonist Leads to Mechanism-Based CYP3A Inactivation: Glutathione Adduct Characterization and Prediction of In Vivo Drug-Drug Interaction
作者:Simon G. Wong、Peter W. Fan、Raju Subramanian、George R. Tonn、Kirk R. Henne、Michael G. Johnson、Michelle Tadano Lohr、Bradley K. Wong
DOI:10.1124/dmd.109.031344
日期:2010.5
The 2-methyl substituted indole, 2MI [2-(4-(4-(2,4-dichlorophenylsulfonamido)-2-methyl-1 H -indol-5-yloxy)-3-methoxyphenyl)acetic acid] is a potent dual inhibitor of 1) chemoattractant receptor-homologous molecule expressed on T-helper type-2 cells and 2) d-prostanoid receptor. During evaluation as a potential treatment for asthma and allergic rhinitis, 2MI was identified as a mechanism-based inactivator of CYP3A4 in vitro. The inactivation was shown to be irreversible by dialysis and accompanied by an NADPH-dependent increase in 2MI covalent binding to a 55- to 60-kDa microsomal protein, consistent with irreversible binding to CYP3A4. Two glutathione (GSH) adducts, G1 and G2, were identified in vitro, and the more abundant adduct (G1) was unambiguously determined via NMR to be GSH adducted to the 3-position of the 2-methylindole moiety. The potential for a clinical drug-drug interaction arising from mechanism-based inactivation of CYP3A4 by 2MI was predicted using a steady-state model, and a 4.3- to 7.5-fold increase in the exposure of midazolam was predicted at anticipated therapeutic concentrations. To better assess the potential for in vivo drug-drug interactions, the Sprague-Dawley rat was used as an in vivo model. An excellent in vitro-in vivo correlation was observed for the reduction in enzyme steady-state concentration ( E′ ss/ E ss) as well as the change in the exposure of a prototypical CYP3A substrate, indinavir (area under the curve (AUC) for indinavir/AUC). In summary, 2MI was identified as a potent mechanism-based inactivator of CYP3A and was predicted to elicit a clinically relevant drug-drug interaction in humans at an anticipated therapeutic concentration.
2-甲基取代的吲哚,2MI [2-(4-(4-(2,4-二氯苯基磺酰胺基)-2-甲基-1 H-吲哚-5-基氧基)-3-甲氧基苯基)乙酸]是一种有效的双1) 2 型 T 辅助细胞上表达的趋化剂受体同源分子和 2) d-前列腺素受体的抑制剂。在评估其作为哮喘和过敏性鼻炎的潜在治疗方法时,2MI 被确定为体外基于机制的 CYP3A4 灭活剂。该失活被证明是通过透析不可逆的,并且伴随着与 55-至 60-kDa 微粒体蛋白的 2MI 共价结合的 NADPH 依赖性增加,这与与 CYP3A4 的不可逆结合一致。在体外鉴定了两种谷胱甘肽 (GSH) 加合物,G1 和 G2,并且通过 NMR 明确确定更丰富的加合物 (G1) 是加成到 2-甲基吲哚部分 3 位的 GSH。使用稳态模型预测了 2MI 基于机制的 CYP3A4 失活引起的临床药物相互作用的可能性,并预测在预期治疗浓度下咪达唑仑的暴露量会增加 4.3 至 7.5 倍。为了更好地评估体内药物相互作用的潜力,使用 Sprague-Dawley 大鼠作为体内模型。酶稳态浓度 (E' ss/ E ss) 的降低以及原型 CYP3A 底物茚地那韦暴露量的变化(曲线下面积 (AUC))观察到良好的体外-体内相关性对于茚地那韦/AUC)。总之,2MI 被确定为一种有效的基于机制的 CYP3A 灭活剂,预计在预期的治疗浓度下会在人体中引发临床相关的药物间相互作用。