Cytochrome p450 Flashcards

1
Q

How many CYP genes?

A

> 200 CYP genes characterised, 12 mammalian families

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2
Q

Evolutionary changes in location:

A
  • Prokaryotic- cytoplasmic

- Eukaryotic- membrane bound

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3
Q

CYP membrane:

A

Endoplasmic* reticulum (microsomes):

  • Exogenous* (drugs, pollutants)
  • Endogenous (fatty acids, prostaglandins)

Mitochondria:
- Steroidogenesis

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4
Q

How many CYPs isolated and sequenced in human genome?

A

> 50 different CYPs

- Classified based on amino acid sequence (primary structure

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5
Q

How many families of CYPs?

A

12
> 40% homology
- Families 1, 2 and 3 important for drug metabolism

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6
Q

How many CYP subfamilies?

A
  • > 60% homology
    e. g., Family 2 has 6 subfamilies - 2A, 2B, 2C, 2D, 2E, 2F
  • Each has 1- 15 members (different gene products)
  • Each CYP enzyme has a different molecular weight
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7
Q

CYP nomenclature?

e.g. CYP2D6

A
  • 2 represents the family
  • D designates the subfamily
  • 6 = individual gene

Usually different genes are for different animal species –
e.g. CYP2D6 (human), CYP2D1 (rat), CYP2D15 (dog)

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8
Q

What does the CYP system do?

A
  • Provides metabolic ‘safety
    net’
  • Acts on a wide variety of chemical structures
  • Common goal to introduce/expose functional groups
  • Regulation via multiple mechanisms, both genetic and environmental (prior drug and chemical exposure)
  • Large inter-individual variability
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9
Q

CYP expression and activity in disease:

A
  • Reported reduced activity of CYP2D6, CYP3A4 in cancer and HIV1
Downregulation of CYPs mediated by pro-inflammatory mediators affecting gene transcription 
interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) 

Inconsistent and limited data on the effect of obesity on CYP expression and activity2,3

Effect of coeliac disease, CKD, liver cirrhosis on certain CYPs4

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10
Q

Multicomponent system – operates in two steps.

A

1) Activation of O2 (potentially dangerous)

2) Oxidation of drug

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11
Q

Components of CYP system:

A

1) Haemoproteins
- cytochrome P450
- cytochrome b5

2) Flavoproteins
- FP1 - NADPH-cytochrome P450 reductase (FAD and FMN)
- FP2 - NADH-cytochrome b5 reductase

3) Lipid component - phosholipid membrane (endoplasmic reticulum in the intact cell)

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12
Q

Central role and binding properties of CYPs:

A
  • CYP oxidation cycle
  • -> Efficient, protects activated O2 species
  • Two binding sites
  • -> Substrate - active site on protein, site of catalysis
  • O2 (or CO) - haeme ligand
  • -> CO binding has an absorption spectrum with a maximum at 450nm
  • Enzyme kinetics often described by Michaelis-Menten principles
  • -> Assumes a single substrate binding site
  • -> Rapid equilibrium and formation of Enzyme-Substrate complex
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13
Q

CYP cycle – activation of O2 :

A

1) Start with drug molecule (RH) binded to CYP450
2) Binding of molecule = conformational change from low to high spin status
3) Changed reduction potential of enzyme – more likely to accept electrons
4) The donor of electron = NADPH
5) TO FACILIATE ELECTRON TRANDFER YOU NEED FP1
6) Iron now reduced – enzyme is ready to bind to oxygen
7) The oxygen then binds
8) Ready to accept another electron (two electron transfers) – source = NADPH again
9) Peroxy state = active – will very quickly be protonated which will trigger release of water molecule
10) Cytrop450??
11) Release of oxidated drug molecule (R-OH)
12) Enzyme now goes back to initial form where the water molecule is bound

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14
Q

Function of other microsomal components:

A
  • FP2 (second reductase) uses:
  • -> NAD not NADP
  • -> cytochrome b5 not cytochrome P450
  • Cytochrome b5 uses:
    –> FP2 not FP1
    –> can transfer electrons directly to cytochrome P450
    Provides flexibility in electron supply and transfer
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15
Q

Determinants of CYP metabolism:

A
  1. Topography of the active site – specificity
  2. Degree of steric hindrance restricting access of the iron-oxygen complex to the possible site of metabolism
  3. Ease of electron or hydrogen abstraction from the C (or N or S) atom

Mechanism the same for all CYPs

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16
Q

Specificity of CYPs:

A
  • CYP enzymes considered for metabolic DDI screening in drug development:
    • -> CYP1A2, -2B6, -2C8, -2C9, -2C19, - 2D6 and CYP3A
    • -> Focus will be on three major CYPs:
  • CYP2D6, CYP2C9 and CYP3A4
  • Each CYP enzyme has its own degree of specificity
    • > Some CYPs have narrow specificity (CYP2C9)
    • > Some have broad and overlapping (CYP3A4)
  • Chemical structure and phys-chem properties of drug affect the preference for a particular CYP
17
Q

Guidelines for drug substrate preference:

A
  • CYP2D6: Arylalkylamines (basic) with site of oxidation 5-7Å from protonated nitrogen
  • CYP2C9: Neutral or acidic molecules with site of oxidation 5-8Å from H-bond donor heteroatom.
  • Molecules tend to be amphipathic with a region of lipophilicity at the site of hydroxylation and an area of hydrophilicity around the H-bond forming region
  • CYP3A4: Lipophilic and ‘bulky’, neutral or basic molecules with site of oxidation often basic nitrogen (N-dealkylation) or allylic positions
18
Q

What is CYP2D6:

A

Arylalkylamines (basic) with site of oxidation 5-7 Å from protonated nitrogen

Ecstasy

Fluoxetine

19
Q

What is CYP2C9?

A

Neutral or acidic molecules with site of oxidation 5-8 Å from H-bond donor heteroatom.

20
Q

What is CYP3A4?

A

Lipophilic and ‘bulky’, neutral or basic molecules with site of
oxidation often basic nitrogen (N-dealkylation) or allylic positions
(a-carbons)

21
Q

Importance of knowing which CYPs metabolise particular drug:

A
  • Genetic polymorphisms – existence of poor metabolisers (CYP2D6)
  • Polymorphism contributes to inter-individual variability in drug pharmacokinetics (also efficacy and safety)
  • –> Tacrolimus – CYP3A5
  • -> Mycophenolic acid – UGT1A9
  • -> 6-mercaptopurine - TPMT
  • Drug-drug interaction potential
  • -> 2 or more drugs metabolised by the same CYP may compete for metabolism
22
Q

Multimodal distribution of CYP2D6 in population:

A
  • Poor Metaboliser (PM) – lack CYP2D6 gene
  • Extensive Metabolizer (EM)
  • Ultra-rapid metabolizer (UM)
23
Q

Does ethnicity affect metabolism:

A
  • For example - 7% of Caucasian population are PMs

- New drugs should not be exclusively metabolised by CYP2D6!

24
Q

Therapeutic consequences of CYP2D6 polymorphisms:

PM

A
  • Higher plasma concentrations of CYP2D6 substrates compared to EMs – higher risk of side effects (e.g. fluvoxamine)
25
Q
Therapeutic consequences of CYP2D6 polymorphisms:
Extensive Metabolizer (EM)
A

normal activity

26
Q

Therapeutic consequences of CYP2D6 polymorphisms:

Ultra-rapid Metabolizer (UM) – gene duplication

A
  • Low plasma concentrations of CYP2D6 substrates compared to EMs – likely risk of therapeutic failure
27
Q

Predicting and avoiding drug-drug interactions:

A
  • Important to know the contribution of CYPs to metabolism of a new drug
  • What is the major CYP contributing? Multiple enzymes involved?
  • Is the drug an inhibitor of CYPs/transporters?
    (Routine screening - FDA requirement)
  • Co-administration of the enzyme inhibitor leads to increased plasma concentrations of the ‘victim’ drug
  • Findings have labelling implications!