In vivo and in vitro induction of human cytochrome P4503A4 by dexamethasone. Clin Pharmacol Ther

University of North Carolina, Chapel Hill 27599-7360, USA.
Clinical Pharmacology &#38 Therapeutics (Impact Factor: 7.9). 11/2000; 68(4):356-66. DOI: 10.1067/mcp.2000.110215
Source: PubMed


The aims of these experiments were to determine the effect of a therapeutic regimen of dexamethasone on cytochrome P4503A4 (CYP3A4) activity in healthy volunteers; and the concentration-effect relationship between dexamethasone and CYP3A4 activity in primary human hepatocyte cultures.
The effect of dexamethasone (8 mg administered by mouth two times a day for 5 days) on CYP3A4 activity in 12 healthy volunteers was assessed with the erythromycin breath test and urinary ratio of dextromethorphan to 3-methoxymorphinan. Concentration-effect of dexamethasone on CYP3A4-dependent testosterone 6-beta-hydroxylation was determined in human hepatocytes treated with 2 to 250 micromol/L dexamethasone.
The percent of erythromycin metabolized per hour increased from 2.20% +/- 0.60% (mean +/- SD) at baseline to 2.67% +/- 0.55% on day 5 of dexamethasone (mean increase in hepatic CYP3A4 activity 25.7% +/- 24.6%; P = .004). The mean urinary ratio of dextromethorphan to 3-methoxymorphinan was 28 (4.8 to 109) and 7 (1 to 23) at baseline and on day 5 of dexamethasone (mean decrease = 49%; P = .06). Substantial intersubject variability was observed in the extent of CYP3A4 induction. The extent of CYP3A4 induction was inversely correlated with baseline erythromycin breath test (r2 = 0.58). In hepatocytes, dexamethasone 2 to 250 micromol/L resulted in an average 1.7-fold to 6.9-fold increase in CYP3A4 activity, respectively. The extent of CYP3A4 induction with dexamethasone in hepatocyte preparations was inversely correlated with baseline activity (r2 = 0.59).
These data demonstrate that dexamethasone at doses used clinically increased CYP3A4 activity with extensive intersubject variability and that the extent of CYP3A4 induction was, in part, predicted by the baseline activity of CYP3A4 in both healthy volunteers and human hepatocyte cultures.

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    • "In particular, the induction and inhibition of CYP3A4 activity and the ability of the proposed in vitro system to reproduce the in vivo metabolism of a specific compound in the presence or in the absence of specific inductors/inhibitors was evaluated. The CYP3A4 activity was studied using dexamethasone (DXM) as a typical metabolic inducer of CYP3A4 (McCune et al. 2000) and ketoconazole (KETO) as a specific inhibitor (Allqvist et al. 2007); whereas testosterone was selected as a model drug to evaluate both the efficacy of the in vitro model in reproducing the metabolic reactions catalysed by the CYP3A4 isoform and the drug-drug interactions phenomena. Data show that similarly to what was observed for the other specific markers of liver function (e.g. "
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    ABSTRACT: Liver in vitro systems that allow reliable prediction of major human in vivo metabolic pathways have a significant impact in drug screening and drug metabolism research. In the present study, a novel porous scaffold composed of alginate was prepared by employing a gas-in-liquid foaming approach. Galactose residues were introduced on scaffold surfaces to promote cell adhesion and to enhance liver specific functions of the entrapped HepG2/C3A cells. Hepatoma cells in the gal-alginate scaffold showed higher levels of liver specific products (albumin and urea) and were more responsive to specific inducers (e.g. dexamethasone) and inhibitors (e.g. ketoconazole) of the CYP3A4 system than in conventional monolayer culture. HepG2/C3A cells were also more efficient in terms of rapid elimination of testosterone, used as a model substance, at rates comparable to those of in vivo excretion. In addition, an improvement in metabolism of testosterone, in terms of phase II metabolite formation, was also observed when the more differentiated HepaRG cells were used. Together the data suggest that hepatocyte/gas templated alginate-systems provide an innovative high throughput platform for in vitro drug metabolism and drug-drug interaction studies, with broad fields of application, and might provide a valid tool for minimizing animal use in preclinical testing of human relevance.
    Full-text · Article · Oct 2015 · Toxicology in Vitro
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    • "observation made by McCune et al. (2000) "
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    ABSTRACT: Abstract 1. Regulation of hepatic metabolism or transport may lead to increase in drug clearance and compromise efficacy or safety. In this study, cryopreserved human hepatocytes were used to assess the effect of 309 compounds on the activity and mRNA expression (using qPCR techniques) of CYP1A2, CYP2B6 and CYP3A4, as well as mRNA expression of six hepatic transport proteins: OATP1B1 (SCLO1B1), OCT1 (SLC22A1), MDR1 (ABCB1), MRP2 (ABCC2), MRP3 (ABCC3) and BCRP (ABCG2). 2. The results showed that 6% of compounds induced CYP1A2 activity (1.5-fold increase); 30% induced CYP2B6 while 23% induced CYP3A4. qPCR data identified 16, 33 or 32% inducers of CYP1A2, CYP2B6 or CYP3A4, respectively. MRP2 was induced by 27 compounds followed by MDR1 (16) > BCRP (9) > OCT1 (8) > OATP1B1 (5) > MRP3 (2). 3. CYP3A4 appeared to be down-regulated (≥2-fold decrease in mRNA expression) by 53 compounds, 10 for CYP2B6, 6 for OCT1, 4 for BCRP, 2 for CYP1A2 and OATP1B1 and 1 for MDR1 and MRP2. 4. Structure-activity relationship analysis showed that CYP2B6 and CYP3A4 inducers are bulky lipophilic molecules with a higher number of heavy atoms and a lower number of hydrogen bond donors. Finally, a strategy for testing CYP inducers in drug discovery is proposed.
    Full-text · Article · Sep 2014 · Xenobiotica
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    • "Treatment of HepaRG cells with dexamethasone for 72 hours induced CYP3A4 activity by 7-fold compared with the control, as measured by midazolam 19-hydroxylation (Fig. 3A). It should be noted that the concentrations of dexamethasone to elicit this effect are well above the therapeutic levels, which are in the low nanomolar to submicromolar range (McCune et al., 2000). As proposed by Pascussi et al., (2001), these low concentrations activate the glucocorticoid receptor and increase pregnane X receptor (PXR) expression leading to transactivation of CYP3A4 gene expression, whereas supramicromolar concentrations cause direct activation of PXR. "

    Full-text · Article · Jan 2014 · Drug Metabolism and Disposition
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