CYP3A4基础与临床研究进展

细胞色素P4503A4(CYP3A4)是存在人类肝脏及肠道中的一种主要的细胞色素CYP450酶,约占成人肝脏CYP450酶总量的25%左右。临床中约有50%的药物是通过其代谢,并且其基因位点突变也与其多种疾病相关,知晓CYP3A4的表达水平和不同功能的遗传学基础,无论是对疾病的发病基础、临床药物的应用,会带来前所未有的启发,在药物应用过程中,通过对基因组学的认识,从而可以在基因层面了解个体代谢差异产生的原因,调整药物用量,提高疗效,最终使药物副作用降到最低限。目前对CYP3A4的研究渐趋于成熟,已逐渐阐明了其药物间相互作用的机制,它能够被多种药物竞争性抑制或者诱导,并受到某些蛋白受体的调控影响,可改变药物的药代动力学,增强或降低药效,造成个体用药差异,这也是造成药物间相互作用的重要原因。然而CYP3A4基因多态性与基因导向治疗关系,还有待进一步深入研究。该文对CYP3A4基因多态性、分布以及与临床疾病及用药的研究现状作一综述。     

家蚕细胞色素P450的基因组学分析

细胞色素P450参与许多基础代谢过程, 确保有机体避免外源复合物对它们的伤害. 将预测的家蚕基因同已知的P450基因进行蛋白质序列比对, 在家蚕基因组中发现86个可能的细胞色素P450基因, 初步将它们归于32个P450亚家族. 通过比较基因组学分析, 发现细胞色素P450基因在果蝇与家蚕中的分布规律具有总体上的相似性, 但在某些P450基因家族中的分布也有差异. 特别是在CYP4A, CYP4C, CYP4D, CYP6A, CYP6AE, CYP6B和CYP9A等7个亚家族中P450s差异分布更明显. 进一步将这些P450基因的DNA序列与家蚕ESTs进行核酸序列比对, 其中49个可能P450基因发现有ESTs证据, 证明了这些基因在转录水平的真实性.     

CYP2C8及CYP3A4细胞表达体系的构建及其在小分子激酶药物对紫衫醇代谢途径抑制研究中的应用

构建CYP2C8及其3种突变体细胞表达体系,以紫杉醇为底物研究CYP2C8基因多态性对其酶活性的影响,以及构建CYP2C8和CYP3A4共转染细胞体系研究小分子激酶抑制剂对紫杉醇代谢途径的抑制。根据基因文库分别合成CYP3A4以及CYP2C8及其3种突变体CYP2C8*2(805AT)、CYP2C8*3(416GA,1196AG)、CYP2C8*4(792CG)的基因编码片段,将其连接到PEGFP-N1表达质粒,测序验证。将CYP2C8野生型及其突变体分别转染HepG2细胞,24 h后加入紫杉醇进行孵育,通过建立好的LC-MS/MS方法对代谢物进行定量分析。同时,也将野生型CYP2C8和CYP3A4质粒按一定的浓度比转入Hep G2细胞构建共表达体系。并筛选出合适的质粒浓度比转染细胞,在加入紫杉醇孵育时,同时加入小分子激酶抑制剂,考察小分子激酶抑制剂对紫杉醇代谢途径的抑制作用。结果表明,CYP2C8*4代谢酶对紫杉醇的代谢能力存在明显差异,其中CYP2C8*2和CYP2C8*3代谢活性分别是野生型的81%(P0.05)和87%(P0.05),而CYP2C8*4则是野生型的65%(P0.01)。尼洛替尼完全抑制了紫杉醇的代谢,阿法替尼对紫杉醇的两条代谢途径抑制达30%,而伊马替尼选择性抑制了CYPD3A4的活性。不同基因型CYP2C8对紫杉醇的代谢存在差异,可能是导致临床疗效不同的原因。小分子激酶抑制剂在与紫杉醇联合使用时,对紫杉醇代谢的抑制各不相同。     

CYP3A5*3 基因多态性对癫痫患者卡马西平及其主要代谢物浓度的影响

背景:卡马西平(carbamazepine,CMZP)主要由CYP3A酶家族代谢,其代谢酶主要包括CYP3A5。本研究探讨了CYP3A5基因多态性与卡马西平血清浓度(CMZP)之间的关系,对个体化药物治疗的开展具有十分积极的意义。目的:CYP3A5*3的基因型可以影响CYP3A药物的药代动力学。本研究旨在评估CYP3A基因多态性对癫痫患者血清卡马西平稳态浓度及其代谢物水平的影响。方法:研究共纳入278例患者,检测个体卡马西平的血清浓度及CYP3A5基因型,并探讨CYP3A5基因型对卡马西平稳态血药浓度的影响。结果:根据基因型分为成CYP3A5表达组(CYP3A5*1/*1和CYP3A5*1/*3)和非表达组(CYP3A5*3/*3)两组。278例患者中120例为CYP3A5表达组,158例患者为CYP3A5非表达组。CYP3A5非表达组的总卡马西平剂量和剂量标准化后的卡马西平血清浓度均高于CYP3A5表达组(P=0.608和P=0.000)。CYP3A5表达组中卡马西平环氧化物浓度更高(P=0.000),但这两组间的血清药物浓度无显著差异(P=0.090)。结论:CYP3A5*3基因多态性与卡马西平的血清浓度之间有密切的关系。CYP3A5基因影响了卡马西平血药浓度水平和代谢过程,其可能是导致卡马西平在癫痫患者中个体变异的一个重要因素。     

细胞色素P450在植物三萜和甾醇骨架修饰中的功能研究进展

植物三萜类化合物在植物生长发育、抵御逆境胁迫与病虫害、生物间相互作用以及传递信息等方面发挥重要作用,植物甾醇具有重要的药用价值.细胞色素P450单加氧酶(CYP450)是参与植物代谢的最大酶家族,在三萜及甾醇骨架结构多样化及功能化修饰中具有关键作用.到目前为止,研究发现约有80个CYP450参与植物三萜代谢,包括亚家族CYP51H, CYP71A, D, CYP72A, CYP81Q, CYP87D, CYP88D, L, CYP93E, CYP705A, CYP708A和CYP716A, C, E, S, U, Y,它们参与包括特定病原体的化学防御功能和药理活性的三萜及其皂苷类化合物的代谢.亚家族CYP51G, CYP85A, CYP90B-D, CYP710A, CYP724B和CYP734A与甾醇和类固醇激素的生物合成有关.本文针对CYP450基因在三萜及甾醇化合物形成过程中不同位点的修饰功能进行概述,重点探讨了陆地植物CYP450基因11个家族的进化及在双子叶、单子叶植物中五环三萜物质合成过程中的功能.以期为充分利用具有重要价值的抗肿瘤、抗艾滋病的三萜物质的合成生物学的研究及其代谢调控提供进一步的理论依据.     

新疆维汉民族多囊卵巢综合征患者CYP17基因多态性及与发病机制的关系

目的:探讨细胞色素P450酶17(CYP17)基因多态性及其与多囊卵巢综合征(PCOS)发病机制的关系。方法:选择2015年1月~2017年2月我院收治的新疆维汉民族PCOS患者260例为PCOS组,另选取同期在我院门诊检查的健康育龄妇女237例为对照组,采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)技术检测两组受试者的CYP17基因多态性,比较两组等位基因及基因频率的分布,结合其临床资料分析CYP17基因多态性与PCOS发病机制的关系。结果:PCOS组体质量指数(BMI)、卵泡刺激素(FSH)水平低于对照组,黄体生成激素(LH)、睾酮(TES)及黄体生成激素与卵泡刺激素的比值(LH/FSH)高于对照组,差异有统计学意义(P0.05)。PCOS组CYP17基因A1A1、A1A2、A2A2型频率分别为34.62%、41.92%、23.46%,与对照组的34.18%、43.88%、21.94%比较差异无统计学意义(P0.05);PCOS组等位基因A1、A2频率为55.58%、44.42%,与对照组的56.12%、43.88%比较差异无统计学意义(P0.05);PCOS组不同CYP17基因型者的FSH、LH及LH/FSH水平整体比较差异无统计学意义(P0.05);PCOS组BMI水平A2A2A1A2A1A1,TES水平A2A2A1A1A1A2,差异均有统计学意义(均P0.05);对照组不同CYP17基因型者的BMI、FSH、LH、TES及LH/FSH水平整体比较差异均无统计学意义(P0.05)。结论:CYP17基因-34bp处T/C单核苷酸多态性是人群中一种常见的碱基置换,与PCOS的发病机制无明显的相关性。     

细胞色素P450：肿瘤研究中的新热点

细胞色素P450（CYP450）是体内重要的Ⅰ相代谢酶,与许多前致癌物和致癌物的活化有关。CYP450是目前肿瘤研究中新的热点之一。深入研究CYP450在肿瘤发生、发展过程中的作用机制及基因多态性与肿瘤易感性的关系,对肿瘤防治有积极作用。现就近年来CYP450在肿瘤领域的研究进展进行综述。     

细胞色素P450：肿瘤研究中的新热点

细胞色素P450(CYP450)是体内重要的Ⅰ相代谢酶,与许多前致癌物和致癌物的活化有关。CYP450是目前肿瘤研究中新的热点之一。深入研究CYP450在肿瘤发生、发展过程中的作用机制及基因多态性与肿瘤易感性的关系,对肿瘤防治有积极作用。现就近年来CYP450在肿瘤领域的研究进展进行综述。     

104名藏族志愿者中细胞色素P450 2C19m1的基因多态性

细胞色素P450 2C19（CYP2C19）参与临床上许多重要药物的代谢。根据其代谢S－美芬妥英或其他CYP2C19底物的能力不同,有强代谢者（EMs）和弱代谢者（PMs）之分。PMs表型的频发率存在明显的种族差异。在本文中,我们主要报道了细胞色素P450 2C19 m1在中国藏族人群中的多态性分布。在104例无血缘关系藏族人群中,49人（47.1%）为CYP2C19野生型纯合子（wt/wt）,46人（44.2%）为CYP2C19m1杂合子（wt/m1）,9人（8.7%）为CYP2C19m1突变型纯合子（m1/m1）。CYP2C19野生型等位基因频率为0.692,CYP2C19m1等位基因频率为0.308。该结果与国内外报道的中国其余民族的CYP2C19m1等位基因频率相比具有一定可比性。 关键词：细胞色素P450 2C19;基因型;藏族;聚合酶链反应;限制性内切核酸酶片段长度多态（RFLP）Abstract: Cytochrome P 450 2C19（CYP2C19） is involved in the metabolism of a number of clinically used drugs. Individuals can be characterized as extensive metabolizers （EMs）or poor metabolizers（PMs）, according to the drugs-metabolized ability of CYP2C19 in population studies. The incidence of poor metabolizer phenotype shows marked interracial differences. In this article we report the gene polymorphism of CYP2C19 in Zang population. There were 49 wild-type homozygotes（wt/wt）, 46 were heterozygotes（wt/m1） and 9 were homozygotes（m1/m1） among 104 unrelated Zang subjects. The frequency of CYP2C19m1 allele was 0.308, which was in agreement with that in other published data.     

细胞色素P4501B1基因多态性与乳腺癌易感性研究进展

细胞色素P450（cytochrome,CYP）1B1是P450超基因家族酶系的一个重要成员,广泛分布于肝外组织,其代谢受到外源性致癌物、雌激素等多种因素的调控。该基因存在遗传多态性,艮前已对CYP1B1基因多态性与乳腺癌易感性进行了多项研究。本文就CYP1B1基因的多态性、调控机制及其与乳腺癌的关系进行了综述。     

Metabolism, Pharmacogenetics, and Metabolic Drug–Drug Interactions of Antipsychotic Drugs

1. Antipsychotic drugs are extensively metabolised by cytochrome P450 (CYP) enzymes.2. Dispositions of a number of antipsychotic drugs have been shown to cosegregate with polymorphism of CYP2D6.3. Metabolic drug–drug interactions have frequently been observed when antipsychotics are coadministered with other drugs.4. Many antipsychotic drugs are converted to active metabolites which can contribute to the therapeutic or side effects of the parent drug.5. Information concerning the individual CYP isoenzymes involved in the metabolism of antipsychotic drugs is important for the safe clinical use of this group of drugs.     

人类细胞色素P450与药物氧化代谢遗传多态性分子机制的研究现状

近年,在表型及基因型上均发现存在药物氧化代谢多态性,特别是对于人类细胞色素Ｐ４５０氧化酶与药氧化代谢遗传多态性的关系进行了深入的研究。有关ＣＹＰ２Ｄ６、ＣＹＰ２Ｃ１９等的突变已大多被鉴定;ＣＹＰ１Ａ１、ＣＹＰ１Ａ２等在表型存在多态性而确切的遗传机制尚不清楚。     

Contributions of CYP2C9/CYP2C19 genotypes and drug interaction to the phenytoin treatment in the Korean epileptic patients in the clinical setting

We examined the contribution of CYP2C9 and CYP2C19 genotypes and drug interactions to the phenytoin metabolism among 97 Korean epileptic patients to determine if pharmacogenetic testing could be utilized in routine clinical practice. The CYP2C9 polymorphism is a wellknown major genetic factor responsible for phenytoin metabolism. The CYP219 polymorphism, with a high incidence of variant alleles, has a minor influence on phenytoin treated Koran patients. Using a multiple regression model for evaluation of the CYP2C9 and CYP2C19 genotypes, together with other non-genetic variables, we explained 39.6% of the variance in serum phenytoin levels. Incorporation of genotyping for CYP2C9 and CYP2C19 into a clinical practice may be of some help in the determination of phenytoin dosage. However, because concurrent drug treatment is common in patients taking phenytoin and many environmental factors are likely to play a role in drug metabolism, these factors may overwhelm the relevance of CYP polymorphisms in the clinical setting. Further investigations with an approach to dose assessment that includes comprehensive interpretation of both pharmacogenetic and pharmacokinetic data along with understanding of the mechanism of drug interactions in dosage adjustment is warranted.     

Deletion of the entire cytochrome P450 CYP2D6 gene as a cause of impaired drug metabolism in poor metabolizers of the debrisoquine/sparteine polymorphism.

The debrisoquine/sparteine polymorphism is associated with a clinically important genetic deficiency of oxidative drug metabolism. From 5% to 10% of Caucasians designated as poor metabolizers (PMs) of the debrisoquine/sparteine polymorphism have a severely impaired capacity to metabolize more than 25 therapeutically used drugs. The impaired drug metabolism in PMs is due to the absence of cytochrome P450IID6 protein. The gene controlling the P450IID6 protein, CYP2D6, is located on the long arm of chromosome 22. A pseudogene CYP2D8P and a related gene CYP2D7 are located upstream from CYP2D6. This gene locus is highly polymorphic. After digestion of genomic DNA with XbaI endonuclease, restriction fragments of 11.5 kb and 44 kb represent mutant alleles of the cytochrome CYP2D6 gene locus associated with the PM phenotype. In order to elucidate the molecular mechanism of the mutant allele reflected by the XbaI 11.5-kb fragment, a genomic library was constructed from leukocyte DNA of one individual homozygous for this fragment and screened with the human IID6 cDNA. The CYP2D genes were isolated and characterized by restriction mapping and partial sequencing. We demonstrate that the mutant 11.5-kb allele results from a deletion involving the entire functional CYP2D6 gene. This result provides an explanation for the total absence of P450IID6 protein in the liver of these PMs.     

An evaluation of the P450 inhibition and induction potential of daptomycin in primary human hepatocytes

Two in vitro studies assessed the potential of daptomycin (Cubicin), a newly marketed antibiotic, to affect the cytochrome P450 (CYP450) isoforms in primary cultured human hepatocytes. Both induction and inhibition of isoforms 1A2, 2A6, 2C9, 2C19, 2D6, 2E1, and 3A4 were evaluated. The highest concentrations of daptomycin used in both the induction and inhibition assays were approximately eight-fold higher than the peak total drug concentration (50-60 microg/mL), or the peak free drug concentration (estimated 5-6 microg/mL), in plasma at the clinical dose regimen of 4 mg/kg qd. Results in primary human hepatocytes indicate that daptomycin, at concentrations up to 400 microg total drug/mL, demonstrated no biologically significant induction of any of the CYP450 isoform activities in comparison with the negative control or known inducers. At daptomycin concentrations up to 40 microg free drug/mL, no biologically significant inhibition of the activities of these CYP450 isoforms was observed as compared with known inhibitors. The human hepatocyte results demonstrate that daptomycin has no effects on hepatic CYP450-mediated drug metabolism and, therefore, suggest that daptomycin is unlikely to show potential for pharmacokinetic interactions with concomitantly administered drugs that are metabolized by CYP450 isoforms.     

No regional differences of cytochrome P450 expression in the liver of Cynomolgus monkeys (Macaca fascicularis).

Non-human primates are frequently used in toxicological studies the result of which are extrapolated to humans, but background data on drug metabolism ability among monkeys derived from different countries has not been published, especially on the key enzyme, cytochrome P450 (CYP450). We assessed the amounts of hepatic CYP450 obtained from cynomolgus monkeys of different ages and from different countries in this study. There were no regional differences of total P450 content, as well as major CYP450 isozymes (CYP 1A, 2A, 2B, 2C, 2D, 2E1 and 3A4) in cynomolgus monkeys by westernblot analysis. Similarly, there were no significant differences with hybrid cynomolgus monkeys, but variations in individual values were large. As for aging, total P450 contents declined in old cynomolgus monkeys (12-32 years of age). These results indicate the usefulness of basic data of hepatic CYP450 obtained from cynomolgus monkeys of different ages and from different countries.     

Drugs impact on CYP-450 enzyme family: A pharmacogenetical study of response variation

Pharmacogenetics is the study of genetic basis in the individual response to drugs. A thorough knowledge of this will lead to a future where tailor-made drugs, suiting an individual, can be used. Scandinavian countries have been known for wide usage of pharmacogenetics and the most widely used application is for genotyping CYP2D6 in treating psychiatric illness. The CYP-450 enzyme, a super family of microsomal drug-metabolizing enzymes, is the most important of enzymes that catalyzes phase-I drug metabolism reaction. CYP2D6 is a member of this family and it has been most intensively studied and the best example of pharmacogenetics variation in drug metabolism. Neuro-transmitter and drug acting CNS viz. codeine, dextromethorphan, metoprolol and tryptyline etc. are well metabolized by this enzyme. Thus, CYP2D6 is one of the most important and responsible enzymes which regulates bioavailability and metabolism of drug. Presently 75 alleles of CYP2D6 have been described which are responsible for variance of metabolism and toxicity of drugs. Thus, by determining variance of CYP2D6 using molecular approaches viz., PCR, real-time PCR, DNA micro-array and molecular docking can determine the adverse effects, drug toxicity, bioavailability and therapeutic potential of new drug.     

Progress in cytochrome P450 active site modeling

Models capable of predicting the possible involvement of cytochromes P450 in the metabolism of drugs or drug candidates are important tools in drug discovery and development. Ideally, functional information would be obtained from crystal structures of all the cytochromes P450 of interest. Initially, only crystal structures of distantly related bacterial cytochromes P450 were available-comparative modeling techniques were used to bridge the gap and produce structural models of human cytochromes P450, and thereby obtain some useful functional information. A significant step forward in the reliability of these models came four years ago with the first crystal structure of a mammalian cytochrome P450, rabbit CYP2C5, followed by the structures of two human enzymes, CYP2C8 and CYP2C9, and a second rabbit enzyme, CYP2B4. The evolution of a CYP2D6 model, leading to the validation of the model as an in silico tool for predicting binding and metabolism, is presented as a case study.     

Cytochromes P450 and experimental models of drug metabolism

For the development of new drugs, evaluation of drug-drug interactions with already known compounds, as well as for better understanding of metabolism pathways of various toxicants and pollutants, we studied the drug metabolism mediated by cytochromes P450. The experimental approach is based on animal drug-metabolising systems. From the ethical as well as rational reasons, the selection of an appropriate system is crucial. Here, it is necessary to decide on the basis of expected CYP system involved. For CYP1A-mediated pathways, all the commonly used experimental models are appropriate except probably the dog. On the contrary, the dog seems to be suitable for modelling of processes depending on the CYP2D. With CYP2C, which is possibly the most large and complicated subfamily, the systems based on monkey ( Maccacus rhesus ) may be a good representative. The CYP3A seems to be well modelled by pig or minipig CYP3A29. Detailed studies on activities with individual isolated CYP forms are needed to understand in full all aspects of inter-species differences and variations.