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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Genotyping of the polymorphic drug metabolizing enzymes cytochrome P450 2D6 and 1A1, and N-acetyltransferase 2 in a Russian sample

Gaikovitch, Elena A. 14 July 2003 (has links)
Die Umwandlung in wasserlösliche Verbindungen, die renal ausgeschieden werden können, ist ein grundlegendes Prinzip im Abbau von Fremdstoffen. Hierbei unterscheidet man Phase-I- und Phase-II-Reaktionen. Die Aktivität vieler Phase-I- und Phase-II-Enzyme ist genetisch beeinflusst und kann starke interindividuelle Unterschiede im Metabolismus von Fremdstoffen verursachen und dadurch das Krebsrisiko und das Risiko für Arzneimittelnebenwirkungen beeinflussen. Die Häufigkeitsverteilungen der Allele der Gene, die Phase-I- und Phase-II-Enzyme kodieren, zeigen eine große interethnische Varianz. Die Polymorphismen dieser Enzyme wurden bisher jedoch noch nicht in der größten slawischen Volksgruppe, der russischen, untersucht. An der vorliegenden Studie nahm eine Gruppe von 325 Personen russischer Abstammung teil - gesunde Probanden bzw. Patienten, die nicht an einer malignen Erkrankung litten. Die Polymorphismen von zwei Enzymen der Phase I, CYP1A1 und CYP2D6, und von einem Enzym der Phase II, NAT2, wurden mittels PCR-RFLP-Genotypisierung und Real-time-PCR-Verfahren komplett untersucht. Die Häufigkeit der CYP1A1 Allele mit hoher Aktivität, CYP1A1*2A und CYP1A1*2B, betrug 4,6% (3,1%-6,5%) bzw. 5,1% (3,5%-7,1%). Die Häufigkeiten der genetischen Varianten von CYP1A1 waren: m1 (3801T>C) - 9,8% (95% Vertrauensbereich, 7,7%-12,4%), m2 (2455A>G) - 5,0% (95% VB, 3,5%-7,1%), m4 (2453C>A) - 2,5% (1,4%-4,0%), m5 (-4335G>A) - 25,8% (22,5%-29,4%), m6 (-3219C>T) - 6,0% (4,3%-8,1%), und m7 (-3229G>A) - 2,9% (1,8%-4,5%). Die Mutation m3, die bisher nur bei Afrikaner gefunden wurde, konnten wir nicht nachweisen. 5,9% (3,5%-9,2%) aller Probanden waren CYP2D6 Langsam-Metabolisierer und 3,4% (1,7%-6,3%) wurden als Ultraschnell-Metabolisierer identifiziert (CYP2D6*1x1/*1). Bei der Genotypisierung von acht verschiedenen Punktmutationen im NAT2-Gen ergab sich für 59,7% (54,1%-65,1%) der Studienteilnehmer ein Genotyp, der mit einer Langsam-Acetylierer-Status einhergeht. 34,7% (29,6%-40,2%) der Probanden hatten ein und 5,6% (3,3%-8,6%) zwei für die Schnellacetylierung kodierende Allele. Die Allelverteilung der für die wichtigsten Enzyme im Arzneimittelstoffwechsel kodierenden Gene ist bei Russen ähnlich wie bei anderen Kaukasiern. Es kann deshalb erwartet werden, dass die genetisch-bedingten Unterschiede in der Wirksamkeit und im Auftreten von Arzneimittelnebenwirkungen in der russischen Bevölkerung vergleichbar sind mit denen in anderen europäischen Populationen. / The basic principle of drug and xenobiotic metabolism in the body is to make them more water soluble and thus more readily excreted in the urine. Genetic polymorphisms of phases I and II xenobiotic transformation reactions are known to contribute considerably to interindividual variations in the metabolism of numerous drugs and xenobiotics and to associate with altered risk of adverse drug reactions and some cancers. The frequency of functionally important mutations and alleles of genes coding for xenobiotic metabolizing enzymes shows a wide ethnic variation. However, little is known of the frequency distribution of the major allelic variants in the Russian population. In this study we investigated 325 individuals of Russian origin, who were healthy volunteers or patients without malignant diseases. Our study included the complete investigation of two enzymes of phase I, CYP1A1 and CYP2D6, and one phase II enzyme, NAT2, using PCR-RFLP genotyping and LightCycler method. The frequencies of the CYP1A1 high-activity alleles, CYP1A1*2A and CYP1A1*2B, were 4.6% (3.1%-6.5%) and 5.1% (3.5%-7.1%), respectively. The mutations m1 (3801T>C), m2 (2455A>G), m4 (2453C>A), m5 (-4335G>A), m6 (-3219C>T), and m7 (-3229G>A) of CYP1A1 occurred in 9.8% (95% confidence interval, 7.7%-12.4%), 5.0% (95% C. I., 3.5%-7.1%), 2.5% (1.4%-4.0%), 25.8% (22.5%-29.4%), 6.0% (4.3%-8.1%), and 2.9% (1.8%-4.5%) of alleles, respectively. We did not find the m3 mutation, which has only been detected in Africans up to now. 5.9% (3.5%-9.2%) of all subjects were CYP2D6 poor metabolizers, whereas 3.4% (1.7%-6.3%) were identified as ultra-rapid metabolizers (CYP2D6*1x1/*1). Genotyping eight different single nucleotide polymorphisms in the NAT2 gene provided a genotype associated with slow acetylation in 59.7% (54.1%-65.1%) of individuals, 34.7% (29.6%-40.2%) of participants carried at least one allele encoding rapid acetylation, and 5.6% (3.3%-8.6%) were homozygous for the rapid-acetylation allele (wild-type allele *4 or mutant allele *12A). The overview of allele distribution of the important drug and xenobiotic metabolizing enzymes among Russians shows that the allele frequency is similar to that of other Caucasians. Therefore it may be expected that drug side effects and efficacy problems due to an individual's genetic background are similar compared to those in other European populations.
32

Prevalência de polimorfismos da enzima CYP2D6 em pacientes em terapia com psicotrópicos / Prevalence of CYP2D6 enzyme polymorphisms in patients on psychotropic therapy

FERNANDES, Mauricio Avelar 28 April 2017 (has links)
Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-09-13T17:47:07Z No. of bitstreams: 1 MauricioFernandes.pdf: 1547228 bytes, checksum: 87d9e63be597d8eaf8f7a783479e1294 (MD5) / Made available in DSpace on 2017-09-13T17:47:07Z (GMT). No. of bitstreams: 1 MauricioFernandes.pdf: 1547228 bytes, checksum: 87d9e63be597d8eaf8f7a783479e1294 (MD5) Previous issue date: 2017-04-28 / Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão / INTRODUCTION: In Brazil, it is reported that a great part of the patients who arrive for the primary care service have as main complaint: sadness (depression) and / or anxiety, also with more complex disorders such as problems related to abuse of alcohol and serious and persistent mental disorders, such as schizophrenia and affective psychoses (bipolar mood disorder). In the pharmacogenetic studies of antidepressants and antipsychotics, cytochrome P450 (CYPs) enzymes have been shown to be one of the most significant targets in the interindividual changes in drug response kinetic parameters. OBJECTIVE: To characterize the frequency of CYP2D6 polymorphisms (*4, *6 and *17) in users of psychotropic therapy, especially tricyclic antidepressants and antipsychotics. METHODS: Cross - sectional, descriptive study carried out in the city of São Luis – MA. RESULTS: From a total of 105 charts, a sample of 43 patients was collected. The mean age was 40.98 (± 11.04) years, of which 24 (55.81%) were male and 19 (44, 19%) of females. Regarding the pharmacotherapy, all participants (100%) were on daily use of the antipsychotic haloperidol, seventeen (39.53%) patients used risperidone and one (2.32%) patient used amitriptyline (tricyclic antidepressant), all three drugs are substrates of the enzyme CYP2D6. For the polymorphism of CYP2D6, we had a prevalence of 11 (25.48%) for allele 4, and all the patients presented with this polymorphism were heterozygous, that means they had one polymorphic allele and one normal allele. For allele 17, we had a prevalence of 4 (9.3%), also all patients being heterozygous for this allele. Allele 6 did not appear in any patient in our study. We also had two patients who presented the polymorphisms for alleles * 4 and * 17 at the same time. CONCLUSION: This study was able to characterize the frequency of CYP2D6 (* 4, * 6 and 17 *) polymorphisms in users of psychotropic therapy, including tricyclic antidepressants and antipsychotics, in addition to contributing to a higher dose / response do medication, ensuring greater safety and efficacy in the use of medicines, improving the quality of life of patients. / INTRODUÇÃO: No Brasil, tem-se o relato de que grande parte dos pacientes que chegam para o atendimento na atenção primária apresentam, como principal queixa, tristeza (depressão) e/ou ansiedade, aparecendo também transtornos mais complexos como os problemas relacionados ao abuso de álcool, assim como os transtornos mentais graves e persistentes, como a esquizofrenia e as psicoses afetivas (transtorno bipolar do humor). Nos estudos farmacogenéticos de antidepressivos e antipsicóticos, as enzimas do citrocromo P450 (CYPs) tem se mostrado um dos alvos mais significativos nas alterações interindividuais dos parâmetros cinéticos de resposta às drogas. OBJETIVO: caracterizar a frequência de polimorfismos do CYP2D6 (*4, *6 e 17*) em usuários da terapêutica com psicotrópicos, principalmente antidepressivos tricíclicos e antipsicóticos. MÉTODOS: Estudo transversal, descritivo realizado no Município de São Luís (MA). RESULTADO: De um total de 105 prontuários, coletou-se amostra de 43 pacientes, a média de idade foi de 40,98 (±11,04) anos, sendo 24 (55,81%) do sexo masculino e 19 (44,19%) do sexo feminino. Em relação à farmacoterapia, todos os participantes (100%) estavam em consumo diário do antipsicótico haloperidol, dezessete (39,53%) pacientes faziam uso de risperidona e um (2,32%) paciente utilizava amitriptilina (antidepressivo tricíclico), todos os três medicamentos são substratos da enzima CYP2D6. Para o polimorfismo da CYP2D6, tivemos para o alelo 4 uma prevalência de 11 (25,48%), sendo que todos os pacientes que apresentaram esse polimorfismo são heterozigotos, ou seja, apresentaram um alelo polimórfico e outro normal. Para o alelo 17, tivemos uma prevalência de 4 (9,3%), sendo também todos os pacientes heterozigotos para esse alelo. O alelo 6 não apareceu em nenhum paciente do nosso estudo. Tivemos também dois pacientes que apresentaram os polimorfismos para os alelos *4 e *17 ao mesmo tempo. CONCLUSÃO: Este estudo pôde caracterizar a frequência de polimorfismos do CYP2D6 (*4, *6 e 17*) em usuários da terapêutica com psicotrópicos, incluindo antidepressivos tricíclicos e antipsicóticos, além de contribuir para uma maior adequação da relação dose/resposta ao medicamento, garantindo maior segurança e eficácia quanto ao uso de medicamentos, melhorando a qualidade de vida dos pacientes.
33

Erblichkeit in der Aktivität der Enzyme CYP2D6 und CYP2C9 sowie des Transporters OATP1B1 unter Berücksichtigung der bereits bekannten genetischen Varianten / Heritiability of the activity of the enzymes CYP2D6 and CYP2C9 plus the transporter OATP1B1 considering known genetic variants

Matthaei, Johannes 06 August 2014 (has links)
HINTERGRUND UND ZIELE: Es ist allgemein anerkannt, dass neben Umweltfaktoren auch erbliche Faktoren in hohem Maße für interindividuelle Unterschiede in der Wirkweise von Arzneimitteln ursächlich sind. Die Spannweite der Arzneimittelwirkung bei gleicher Dosis kann individuell von Therapieversagen bis hin zu toxischer Überdosierung reichen und ist dabei stark von Arzneimittel-metabolisierenden Enzymen und Transportern beeinflusst. Genetische Varianten können teilweise interindividuelle Unterschiede in der Aktivität dieser Enzyme und Transporter erklären. Es bleibt jedoch unbekannt, wie viel der Variation in der Aktivität durch Erblichkeit bedingt ist und nicht durch bereits bekannte genetische Varianten erklärt werden kann. Primäres Ziel der Studie war es, diesen unbekannten erblichen Anteil in der Variation der Aktivität der Enzyme CY2D6 und CYP2C9 sowie des Transporters OATP1B1 zu quantifizieren. METHODEN: Die Erblichkeit in der Variation der Aktivität von CY2D6, CYP2C9 und OATP1B1 wurde in 20 mono- und 9 dizygoten, gleichgeschlechtlichen Zwillingspaaren untersucht. Die Testsubstanzen Metoprolol (CYP2D6) und Torasemid (CYP2C9 und OATP1B1) wurden jedem Studienteilnehmer wiederholt verabreicht und die Fläche unter der Kurve bis unendlich (AUC0-inf) für jedes Medikament und seinen Metaboliten als Marker der Enzym- (CYP2D6, CYP2C9) und Transporter- (OATP1B1) Aktivitäten bestimmt. Erblichkeit wurde mithilfe von Formeln mit den Korrelationskoeffizienten der Geschwister in den Gruppen mono- und dizygote Zwillingspaare, durch eine Strukturgleichungsmodellierung und durch Vergleich der intra- und interindividuellen Variation berechnet. ERGEBNISSE: Es wurde ein hohe Erblichkeit in der Variation der Aktivität von CYP2D6, CYP2C9 und OATP1B1 berechnet. Für CYP2D6 lag die Erblichkeit bei 88,5% -100%, für CYP2C9 und OATP1B1 bei 81% - 100%. Die bekannten genetischen Varianten konnten lediglich einen geringen Anteil der Variation in der AUC0-inf in der Studienpopulation erklären (38,2% durch genetische Varianten in CYP2D6, 6,5% durch genetische Varianten in CYP2C9 und 20,4% durch genetische Varianten in OATP1B1). FAZIT: Die Berechnungen zeigen, dass Erblichkeit einen großen Einfluss auf die Variation in der Aktivität der Enzyme CYP2D6, CYP2C9 und den Transporter OATP1B1 hat. Bekannte genetische Varianten können hiervon nur einen Teil erklären. Weitere Untersuchungen zu genetischen Regulation der Wirkweise von Arzneimitteln erscheinen vielversprechend.
34

Characteristics of cytochrome P450-catalysed drug metabolism with focus on a black Tanzanian population /

Wennerholm, Agneta, January 2003 (has links)
Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.
35

Influência do diabetes mellitus no metabolismo de fármaco marcadores de atividade dos CYP2D6 e 3A4 em ratos

SIMÕES, Juliana Savioli 28 April 2014 (has links)
O citocromo P450 (CYP450) e suas isoformas podem ser reguladas por compostos exogenos, endogenos e patologias. O Diabetes Mellitus (DM) e uma sindrome de etiologia multipla, decorrente da incapacidade da insulina em exercer adequadamente sua acao, sendo capaz de alterar a atividade do CYP450. Este estudo avalia a influencia do DM na atividade das isoformas CYP2D6 e CYP3A4 utilizando como marcadores de atividade o metoprolol (MET) e o midazolam (MDZ) respectivamente. Ratos machos Wistar, 200-250 g, foram tratados com dose unica, por via oral 20 mg/Kg para MET e 15 mg/Kg para MDZ. O DM foi induzido por estreptozotocina (50 mg/Kg) por via intravenosa. Midazolam, metoprolol e alfa-hidroximetoprolol foram analisados em plasma por cromatografia liquida de ultraperformance (coluna XR-ODS 100 mm x 3,0 mm) acoplada a espectrometro de massas. O preparo das amostras foi realizado por extracao liquido-liquido. A analise farmacocinetica do MDZ em ratos mostrou reducao significativa (54,01 vs 12,24 L/h/kg) no clearance dos animais diabeticos em relacao ao controle e aumento significativo (402,66 vs 1742,6 h.ng/mL) do AUC0- ‡ no grupo diabetico quando comparado com o controle. O DM modificou o AUC0- ‡ do MET no grupo diabetico em relacao ao controle (998,09 vs 348,45 h.ng/mL) acompanhado de reducao significativa do clearance no grupo diabetico (46,85 vs 17,80 L/h/kg). Desde que nao foi observada qualquer alteracao na farmacocinetica do alfa-hidroximetoprolol, o aumento do AUC0- ‡ do MET pode ser devido a inibicao de outra via de metabolizacao pelo DM, como comprovado pela alteracao na via do CYP3A. A analise dos dados sugere que o DM inibe a atividade do CYP3A4 e nao exerce influencia sobre a atividade do CYP2D6 / Cytochrome P450 (CYP450) and its isoforms can be regulated by exogenous and endogenous compounds and also diseases. Diabetes Mellitus (DM) is a multiple etiology syndrome resulting from a lack or inability of insulin to properly exercise its action, that can modify the CYP450 activity. This research evaluates the influence of DM on CYP2D6 and CYP3A4 isoforms activity employing metoprolol (MET) and midazolam (MDZ) as probe drugs. Male Wistar rats 200-250g, were treated with single oral dose of 20mg/kg for MET and 15 mg/kg for MDZ. Diabetes mellitus was induced by streptozotocin (50mg/kg) intravenously administered. Midazolam, metoprolol and alpha-hydroxymetoprolol were analyzed in plasma by ultraperformance liquid chromatography (column XR-ODS) coupled to a mass spectrometer. The sample preparation was perfomed using liquid-liquid extraction. Pharmacokinetics of MDZ in rats showed a significant decrease (54,01 vs 12,24 L/h/kg) of total clearance in the diabetic animals compared to control group and a significant increase (402.66 vs 1742.6 h.ng/mL) AUC0- ‡ in the diabetic group compared with the control. The DM altered the AUC0- ‡ of MET in the diabetic group compared to control (998.09 vs 348.45 h.ng/mL) followed by a significant decrease in clearance in the diabetic group (46.85 vs 17.80 L/h/kg). Since no changes in alpha- hydroxymetoprolol pharmacokinetics was observed, the increase in MET AUC0- ‡ can be explained by DM inhibition of other MET metabolization pathways. Data analysis suggests that DM inhibits CYP3A4 activity and had no effect on CYP2D6 activity / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
36

First-pass Intestinal Metabolism of Drugs : Experiences from in vitro, in vivo and simulation studies

Thörn, Helena Anna January 2012 (has links)
The bioavailability of a drug can be described as the fraction of an orally administered dose that reaches the systemic circulation and is often limited by first-pass metabolism in the gut and the liver. It is important to have knowledge about these processes since the systemic blood drug concentration is tightly connected to the effect of the drug. The general aim of this project was to quantitatively examine the role of the intestine in relation to the liver in first-pass metabolism of orally administered drugs. The first-pass metabolism of verapamil and raloxifene was investigated in detail with in vivo, in vitro and simulation studies, using the pig as an experimental model. The intestine contributed to the same extent as the liver to first-pass metabolism of R/S-verapamil in vivo in pigs. The S-isomer of verapamil was found in lower plasma concentrations compared to the R-isomer after oral dosing. The in vitro metabolism of verapamil in pig and human liver showed interspecies similarity and indicated equal intrinsic clearance for R- and S-verapamil. Through physiologically based pharmacokinetic modeling the stereoselectivity was explained by a combination of several processes, including enantioselective plasma protein binding, blood-to-plasma partition, and gut and liver tissue distribution. For raloxifene the intestine was the dominating organ in first-pass glucuronidation in vivo in pigs. Furthermore, the raloxifene concentration entering the intestine or the dose administered in the gut did not influence the plasma PK of raloxifene and indicated that the intestinal metabolism was not saturable with clinical relevant doses. For both verapamil and raloxifene, a time-dependent hepatic metabolism was noted with major consequences to the pharmacokinetic of the drugs. This project has pointed out the importance of intestinal metabolism in the overall first-pass extraction of drugs and indicates that intestinal metabolism should be considered and evaluated early in drug development.
37

CYP2D6 and CYP1A2 catalyzed metabolism of propranolol related fluorinated amines : effects of changes in amine pKa and other properties /

Upthagrove, Alana L. January 2001 (has links)
Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 169-182).
38

Pharmacokinetics and pharmacodynamics of oral oxycodone : role of active metabolites /

Lalovic, Bojan, January 2003 (has links)
Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 150-161).
39

Genetic polymorphism in dextromethorphan metabolism by CYP2D6 and CYP3A4 enzyme isoforms / Mthokozisi Muziwandile Nkosingiphile Mgwabi

Mgwabi, Mthokozisi Muziwandile Nkosingiphile January 2003 (has links)
Most administered drugs are metabolised in the liver by Phase I enzymes and more importantly by the cytochrome P450 (CYP) system. The extent of first-pass metabolism is important in determining whether the drug will have therapeutic or adverse effects after being administered to a patient. To date the CYP family has been shown to consist of 74 families denoted as CYPl to CYP118, and only a few families are significantly involved in drug metabolism. CYP3A4 is the most important isoenzyme followed by CYP2D6, CYP2C9, and CYP2C19 with a small contribution by CYP2E1, CYP2A6, and CYPlA4. CYP2D6 and CYP3A4 enzyme isoforms have been well established to exhibit interethnic and interindividual variability with regard to drug metabolising capacity. Mutation on the gene coding for a metabolising enzyme is a major cause of variation in drug metabolism. This mutation gives rise to allelic variants producing enzymes with altered metabolising activity. The presence of an allele with decreased metabolic activity in an individual gives rise to the poor metabolising (PM) phenotype. When the PM phenotype occurs at a frequency of more than 1% within a given population, then the term genetic polymorphism applies. The aberrant metabolic capacity translates into variable drug responses of more than 20-fold, leading to different susceptibility to sub-therapeutic effects or adverse drug reactions. A significant number of drugs, such as the B-adrenergic blockers, antidepressants, antipsychotic and antiarrhythmic agents, are entirely or partly metabolised by CYP2D6 and CYP3A4. Genetic polymorphism is especially important for drugs with a narrow therapeutic/toxicity window. Phenotyping involves the use of a probe drug that is administered to the subject, followed by determination of the parent drug and its metabolites in the urine. The aim of this study was to develop and validate an HPLC method for phenotypic determination of the CYP3A4 and CYP2D6 enzymes, followed by the application of the assay in a random heterogeneous population of males. Dextromethorphan (DXM) was used as an in vivo probe for simultaneous determination of the phenotypic expression of CYP2D6 and CYP3A4. An HPLC method coupled with a fluorescence detector was developed for the phenotypic determination of CYP2D6 and CYP3A4 iso-enzymes as determined by the concentration of dextromethorphan/dextrophan (DXM/DX) and dextromethorphan/3methoxy-morphinan (DXM/3MM) metabolic ratios respectively. The compounds were separated on a phenyl column (150 x 4,6 mm, 5-um particle size) serially connected to nitrile column (250 x 4,6 mm, 5-um particle size) using mobile phase of 80% (1.5% glacial acetic acid and 0.1% triethyl amine in distilled water) and 20% acetonitrile. Solid phase extraction was used to extract the analytes from urine samples using silica cartridges. The suitability of the method was demonstrated in a preliminary study with sixteen healthy Caucasian males. After a single oral 30 mg DXM dose, the volunteers were required to collect all urine samples voided 8 hours post oral dose. DXM/3HM and DXM/DX metabolic ratios were determined from collected urine samples. The method was validated for DXM and DX at a concentration range of 0.25 - 30 ug/ml, and at 0.025 - 3 ug/ml for 3MM. Calibration curves were linear with R2 values of at-least 0.999 for all compounds of interest. Recoveries were 97%, 93%, and 65% for DX, DXM and 3MM, respectively. The method was reproducible with intra-day precision having coefficients of variation percentage (CV%) of less than 17% for all analytes. Inter-day precision had a CV% of less than 14% for all analytes. The limit of detection was 30 ug/ml for all compounds. All volunteers were classified with an extensive metaboliser (EM) phenotype. In conclusion the method described is suitable for polymorphic determination of CYP2D6 and CYP3A4 in a population study, and may have value in further studies planned at investigating the critical issue of racial genetic polymorphism in ethnic groups in South Africa. / Thesis (M.Sc. (Pharm.))--North-West University, Potchefstroom Campus, 2004.
40

Genetic polymorphism in dextromethorphan metabolism by CYP2D6 and CYP3A4 enzyme isoforms / Mthokozisi Muziwandile Nkosingiphile Mgwabi

Mgwabi, Mthokozisi Muziwandile Nkosingiphile January 2003 (has links)
Most administered drugs are metabolised in the liver by Phase I enzymes and more importantly by the cytochrome P450 (CYP) system. The extent of first-pass metabolism is important in determining whether the drug will have therapeutic or adverse effects after being administered to a patient. To date the CYP family has been shown to consist of 74 families denoted as CYPl to CYP118, and only a few families are significantly involved in drug metabolism. CYP3A4 is the most important isoenzyme followed by CYP2D6, CYP2C9, and CYP2C19 with a small contribution by CYP2E1, CYP2A6, and CYPlA4. CYP2D6 and CYP3A4 enzyme isoforms have been well established to exhibit interethnic and interindividual variability with regard to drug metabolising capacity. Mutation on the gene coding for a metabolising enzyme is a major cause of variation in drug metabolism. This mutation gives rise to allelic variants producing enzymes with altered metabolising activity. The presence of an allele with decreased metabolic activity in an individual gives rise to the poor metabolising (PM) phenotype. When the PM phenotype occurs at a frequency of more than 1% within a given population, then the term genetic polymorphism applies. The aberrant metabolic capacity translates into variable drug responses of more than 20-fold, leading to different susceptibility to sub-therapeutic effects or adverse drug reactions. A significant number of drugs, such as the B-adrenergic blockers, antidepressants, antipsychotic and antiarrhythmic agents, are entirely or partly metabolised by CYP2D6 and CYP3A4. Genetic polymorphism is especially important for drugs with a narrow therapeutic/toxicity window. Phenotyping involves the use of a probe drug that is administered to the subject, followed by determination of the parent drug and its metabolites in the urine. The aim of this study was to develop and validate an HPLC method for phenotypic determination of the CYP3A4 and CYP2D6 enzymes, followed by the application of the assay in a random heterogeneous population of males. Dextromethorphan (DXM) was used as an in vivo probe for simultaneous determination of the phenotypic expression of CYP2D6 and CYP3A4. An HPLC method coupled with a fluorescence detector was developed for the phenotypic determination of CYP2D6 and CYP3A4 iso-enzymes as determined by the concentration of dextromethorphan/dextrophan (DXM/DX) and dextromethorphan/3methoxy-morphinan (DXM/3MM) metabolic ratios respectively. The compounds were separated on a phenyl column (150 x 4,6 mm, 5-um particle size) serially connected to nitrile column (250 x 4,6 mm, 5-um particle size) using mobile phase of 80% (1.5% glacial acetic acid and 0.1% triethyl amine in distilled water) and 20% acetonitrile. Solid phase extraction was used to extract the analytes from urine samples using silica cartridges. The suitability of the method was demonstrated in a preliminary study with sixteen healthy Caucasian males. After a single oral 30 mg DXM dose, the volunteers were required to collect all urine samples voided 8 hours post oral dose. DXM/3HM and DXM/DX metabolic ratios were determined from collected urine samples. The method was validated for DXM and DX at a concentration range of 0.25 - 30 ug/ml, and at 0.025 - 3 ug/ml for 3MM. Calibration curves were linear with R2 values of at-least 0.999 for all compounds of interest. Recoveries were 97%, 93%, and 65% for DX, DXM and 3MM, respectively. The method was reproducible with intra-day precision having coefficients of variation percentage (CV%) of less than 17% for all analytes. Inter-day precision had a CV% of less than 14% for all analytes. The limit of detection was 30 ug/ml for all compounds. All volunteers were classified with an extensive metaboliser (EM) phenotype. In conclusion the method described is suitable for polymorphic determination of CYP2D6 and CYP3A4 in a population study, and may have value in further studies planned at investigating the critical issue of racial genetic polymorphism in ethnic groups in South Africa. / Thesis (M.Sc. (Pharm.))--North-West University, Potchefstroom Campus, 2004.

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