Abstract Metabolism is a major determinant of the pharmacokinetic properties of most drugs and is often behind bioavailability problems, drug-drug interactions, and metabolic idiosyncrasies. Cytochrome P450 (CYP) enzymes are a superfamily of microsomal hemoproteins catalysing the metabolic reactions of several exogenous compounds. The majority of crucial steps within drug metabolism are in connection with CYP enzymes. In the present study, in vivo, in vitro, and in silico approaches were applied and characterised to evaluate the effects of chemical entities on CYP-mediated metabolism. CYP2B6 was used as a target enzyme for these studies. For evaluation of the CYP inhibition potential of new chemical entities, a novel in vitro test system utilising the n-in-one approach was developed. This method proved to be robust and applicable to screening purposes. Validation of the n-in-one assay was done by comparing its performance to commonly used in vitro techniques using six structurally diverse drugs. All assay types yield remarkably similar results with the majority of the CYP forms tested. Several chemicals were screened in vitro and in silico in order to find potent and selective chemical inhibitors for CYP2B6. Ticlopidine, thioTEPA and 4-(4-chlorobenzylpyridine) were found to be highly effective inhibitors of CYP2B6. The selectivity of thioTEPA proved to be very high, whereas ticlopidine and 4-(4-chlorobenzylpyridine) also inhibited other CYPs. At a concentration level of 1 μM for ticlopidine and 0.1 μM for 4-(4-chlorobenzylpyridine), the inhibitory effect towards other CYPs was negligible. Due to wide clinical use and relevance, clopidogrel and ticlopidine were selected for further in vivo interaction studies. Both clopidogrel and ticlopidine significantly inhibited the CYP2B6-catalysed bupropion hydroxylation and patients receiving either clopidogrel or ticlopidine are likely to need dose adjustments when treated with drugs primarily metabolised by CYP2B6. The effect of impaired kidney function on CYP2B6 activity and on bupropion pharmacokinetics was also explored. In patients with kidney disease, the bupropion AUC and Cmax were significantly higher and the apparent oral clearance of bupropion was notably lower compared to healthy controls. The present results indicate that the in silico and in vitro methods used are helpful in predicting in vivo drug-drug interactions. The effective utilisation of these models in the early phases of drug discovery could therefore help to target the in vivo studies and to eliminate metabolically unfavourable drug candidates.

Abstract Liquid chromatography (LC) combined with mass spectrometry (MS) is a powerful tool for qualitative and quantitative analytics of organic molecules from various matrices, and the use of this hyphenated technique is very common in bioanalytical laboratories. In this study, LC/MS methods and the required sample preparation applications were developed for plant flavonoid and drug metabolism studies. The main focus was in developing methods to be used during cytochrome P450 (CYP) -specific drug interaction studies. Traditional high performance liquid chromatography (HPLC) and new, more efficient and faster ultra-performance liquid chromatography (UPLC) were utilized together with time-of-flight (TOF) and triple quadrupole (QqQ) mass spectrometry. In the flavonoid study, collision-induced radical cleavage of flavonoid glycosides was tested and observed to be a suitable tool for the structure elucidation of the 15 flavonol glycosides extracted from the medicinal plant Rhodiola rosea. Ten of these glycosides were previously unreported in the plant. Several unreported in vivo bupropion metabolites were identified from human urine when developing the method for the new and more extensive in vitro and in vivo N-in-one interaction cocktail assays. The qualified analysis methods developed here enable faster analysis for the N-in-one cocktail assays, in turn enabling a more efficient screening of drugs that affect CYP-enzyme activities. In the case of the human in vitro cocktail assay, fourteen compounds were analyzed using a single LC/MS/MS run. The method has proven to be very reliable and has been used in several interaction studies utilizing different sample matrices. The in vivo cocktail assay that was developed enables totally non-invasive sample collection from the patients, the urine sample being sufficient for the UPLC/MS/MS analysis of all target compounds. The last part of the study consisted of developing a specific and very sensitive UPLC/MS/MS method for the analysis of one of the in vivo cocktail analytes, the antidiabetic drug repaglinide, from human placenta perfusates. / Tiivistelmä Nestekromatografia (LC) yhdistettynä massaspektrometriaan (MS) on tehokas työväline kvalitatiivisessa ja kvantitatiivisessa analytiikassa, ja tätä tekniikkaa käytetään erityisesti bioalan laboratorioissa. Tässä väitöskirjatyössä kehitettiin ja sovellettiin LC/MS- ja näytteenkäsittelymenetelmiä kasvien flavonoidimetabolian ja lääkeaineiden metaboliatuotteiden tutkimukseen keskittyen erityisesti sytokromi P450 (CYP) -entsyymispesifisten lääkeaineiden interaktiotutkimuksiin tarvittaviin menetelmiin. Työssä hyödynnettiin perinteistä korkean erotuskyvyn nestekromatografiaa (HPLC) ja uutta, suorituskyvyltään vielä tehokkaampaa ja nopeampaa nestekromatografiaa (UPLC) yhdessä lentoaika- (TOF) ja kolmoiskvadrupolimassaspektrometrian (QqQ) kanssa. Tutkimustyön flavonoidimetaboliaan keskittyneessä osuudessa havaittiin törmäyksen aiheuttaman (CID) radikaalipilkkoutumisen soveltuvan lääkinnällisenä kasvina käytetystä ruusujuuresta (Rhodiola rosea) uutettujen viidentoista flavonoliglykosidin rakennemääritykseen. Kymmentä näistä löydetyistä glykosideista ei oltu aiemmin raportoitu ruusujuuresta. Tutkimustyön keskeisimpänä tavoitteena kehitettiin kvalifioidut LC/MS -analyysimenetelmät käytettäväksi aikaisempaa kattavampien in vitro ja in vivo -olosuhteiden N-in-one -tyyppisten CYP-entsyymi-interaktiotutkimusten analyyttisenä työkaluna. Näitä analyysimenetelmiä kehitettäessä löydettiin ja tunnistettiin ihmisen virtsasta aiemmin raportoimattomia metaboliitteja CYP2B6 -entsyymin malliaineena käytetyn bupropionin annostelun jälkeen. Kyseisten kehitettyjen analyysimenetelmien avulla CYP-entsyymien toimintaan vaikuttavien lääkeaineiden tutkiminen on aiempaa nopeampaa ja antaa yhdellä kertaa samasta tutkimuksesta entistä laaja-alaisempaa tietoa. In vitro -tutkimusta varten kehitetty LC/MS/MS -analyysimenetelmä on osoittautunut erittäin käyttökelpoiseksi lukuisissa interaktiotutkimuksissa, ja in vivo -tutkimusta varten kehitetty UPLC/MS/MS -analyysimenetelmä mahdollistaa täysin ei-invasiivisen näytteenoton potilaista. Tutkimustyön viimeisessä vaiheessa kehitettiin erittäin herkkä ja spesifinen UPLC/MS/MS -analyysimenetelmä CYP2C8-entsyymin toiminnan malliaineena käytetyn repaglinidin analysoimiseksi koejärjestelystä, jossa tutkitaan yhdisteiden kulkeutumista raskausaikana äidin ja sikiön verenkierron välillä istukan kautta.

Abstract Cytochrome P450 (CYP) enzymes are the major metabolizers of xenobiotics, e.g. drugs, and environmental toxins. Thus, changes in CYP expression have an important impact on drug metabolism and susceptibility to chemical toxicity. In the present study, the transcriptional mechanisms of both constitutive and inducible regulation of the Cyp2a5 gene in mouse liver were investigated. Mouse primary hepatocyte cultures were used as the main model system together with cell and molecular biology methods. The key activation regions of the Cyp2a5 5' promoter were determined using reporter gene assays. Two major transcription activation sites of the Cyp2a5 5' promoter, called the proximal and the distal, were found. Transcription factors hepatocyte nuclear factor-4 (HNF-4) and nuclear factor I were shown to bind to the proximal promoter. Aryl hydrocarbon receptor nuclear translocator (ARNT) and upstream stimulatory factor bound to a common palindromic E-box element in the distal promoter region. All three response elements were shown to be essential for constitutive expression of CYP2A5 in murine hepatocytes. ARNT appeared to control Cyp2a5 transcription without a heterodimerization partner suggesting active involvement of the ARNT homodimer in mammalian gene regulation. Aryl hydrocarbon receptor (AHR) ligands were shown to induce Cyp2a5 transcriptionally by an AHR-dependent mechanism, and established Cyp2a5 as a novel AHR-regulated gene. The AHR response element and the E-box, identified in these studies, were located near to each other and close to a separately defined nuclear factor (erythroid-derived 2)-like 2 binding site in the distal region of the Cyp2a5 promoter, suggesting cooperation between these elements. Peroxisome proliferator-activated receptor gamma coactivator-1α was shown to up-regulate Cyp2a5 transcription through coactivation of HNF-4α. This indicates that xenobiotic metabolism can be regulated by modification of co-activation. The present results show that CYP2A5 is regulated by several different cross-regulatory pathways. The regulatory mechanisms involved in the transcription of the Cyp2a5 gene may also control other CYP genes, especially the human ortholog CYP2A6, and may explain some of the individual variations in the metabolism of xenobiotics.

Abstract Drug metabolism is one of the most important events a drug faces after administration. Traditionally, drug metabolism has only been considered as a major clearance and elimination step in the pharmacokinetics of a drug. However, drug metabolism is also one of the important factors behind safety and toxicity issues in drug discovery and development. Some of the mechanisms behind metabolism-related toxicity we do understand well while others, especially the role of reactive metabolites, need further research. The thesis reviews the role of drug metabolism in the drug discovery and development process from the point of view of metabolism and metabolites. Special emphasis is put on reviewing the metabolism behind human toxicity and safety, and the roles of circulating and reactive metabolites in particular. Ospemifene is a nonsteroidal selective estrogen receptor modulator recently approved for the treatment of vulvar and vaginal atrophy in postmenopausal women with moderate to severe dyspareunia. The present study characterized the in vitro and in vivo metabolism and potential drug interactions of ospemifene. The principal human metabolites were identified and the adequacy nonclinical animal exposure was evaluated. The major human cytochrome P450 enzymes involved in the formation of principal metabolites were also identified and the clinical consequences assessed. Finally, the interaction potential of ospemifene as a cytochrome P450 enzyme inducer or inhibitor was investigated. As a result, ospemifene was considered to be safe drug from a metabolic interaction point of view. This study was part of the drug development program of ospemifene and practically all of the in vitro study data were included in the marketing authorization application of ospemifene. Ospemifene was also a case molecule in the development of new methodologies to study drug metabolism and drug-drug interactions. / Tiivistelmä Lääkeainemetabolia on lääkeaineen farmakokinetiikassa tärkeä puhdistuma- ja eliminaatioaskel, jonka rooli on ymmärretty varsin hyvin. Lääkeainemetabolialla on myös merkittävä vaikutus lääkeaineen toksisuuteen ja lääkkeen käytön turvallisuuteen. Osa lääkeainemetaboliaan liittyvistä toksisuusmekanismeista selvitetty hyvin, mutta erityisesti reaktiivisiin metaboliitteihin liittyvä osa vaatii vielä tutkimusta. Tämän työn kirjallisuusosassa katselmoidaan lääkeainemetabolian merkitystä lääkekehitysprosessissa painottaen erityisesti lääkeainemetabolian sekä reaktiivisten ja verenkierrossa kiertävien metaboliatuoteiden vaikutusta toksisuuteen ihmisellä ja merkitystä turvalliseen lääkkeiden käyttöön. Ospemifeeni on uusi ei-steroidinen selektiivinen estrogeenireseptorimodulaattori, joka on hyväksytty yhdynnänaikaisesta kivusta kärsivien postmenopausaalisten naisten vulvan ja vaginan limakalvojen kuivumisen hoitoon. Tässä tutkimuksessa selvitettiin ospemifeenin lääkeainemetaboliaa ihmisellä ja koe-eläimillä sekä mahdollisia lääkeinteraktioita. Tutkimuksessa tunnistettiin tärkeimmät metaboliitit ihmisellä ja arvioitiin eläinkokeissa käytettyjen koe-eläinten altistumisen kattavuus niille. Työssä selvitettiin myös tärkeimmät päämetaboliitteja katalysoivat sytokromi P450 -entsyymit ja arvioitiin löydösten kliinistä merkitystä. Lisäksi tutkittiin aiheuttaako ospemifeeni lääkeinteraktioita muille lääkeaineille indusoimalla tai inhiboimalla sytokromi P450 -entsyymejä. Tutkimustulosten perusteella ospemifeenia voidaan pitää lääkeainemetabolian suhteen turvallisena lääkkeenä. Tämä tutkimus oli osa ospemifeenin lääkekehitysohjelmaa ja käytännössä kaikki tutkimustyön in vitro -tietoaineisto oli mukana ospemifeenin myyntilupa-hakemuksissa lääketurvallisuusviranomaisille. Ospemifeenia käytettiin tutkimustyön aikana myös yhtenä esimerkkimolekyylinä kehitettäessä uusia menetelmiä lääkeainemetabolian ja lääkeinteraktioiden tutkimiseen.