Genetics of Non CYP450 mediated phase I metabolism Flashcards

1
Q

what is Flavin linked monooxygenases

A

Microsomal enzymes with FAD as prosthetic group, important in oxidation reactions at nitrogen, sulphur and phosphorous centres

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2
Q

what is Trimethylamine (TMA)

A

an unpleasant smelling compound that is a breakdown product of a number of precursors (such as L-carnitine) present in a range of foods – gut bacteria are involved in TMA formation

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2
Q

how many different forms of Flavin linked mono-oxygenases

A

At least 5 different forms but FMO3 is the major hepatic isoform in humans

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2
Q

what normally happends to TMA ?

A

Normally undergoes conversion to trimethylamine N-oxide (TMAO) by FMO3
- TMAO is less volatile and loses odur

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3
Q

Who suffers from fish odour syndrome and why

A

individuals who lack functional FMO3 as TMA isn’t converted to TMAO

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4
Q

what is the occurrence rate of subjects with fish odour syndrome

A

1/100 approx are heterozygous and shows defects in TMA metabolism

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5
Q

what is the most common mutation which can cause Fish odour syndrome

A

Pro153Leu (complete loss of activity)
Proline has a structural role in proteins by “breaking up” areas of alpha helix. Amino acid change to leucine is therefore functionally significant

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6
Q

what is the other mutation can be responsible for lack TMA oxidation

A

N61S

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7
Q

True or false - P153L + N61S have an effect on methimazole metabolism

A

Flase - there is no effects

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8
Q

what mutation is responsible for mild fish odour syndrome in children

A

E158K/E308G in FMO3 polymorphism

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9
Q

how does polymorphism in FMO3 effect sulindac metabolism

A
  • Better outcome in those with polymorphism due to slower metabolism
  • sulindac is a prodrug but is activated by gut flora prior to absorption)
  • Produced sulindac sulphide which is active, The inactive metabolite of sulindac (the sulfone) is subject to enterohepatic recirculation.
  • Both S and R epimers show anti cancer activity
  • Low FMO3 higher conc in the gut and active metabolite = better effects in good
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10
Q

what hydrolysis organophosphates in the liver and serum

A

Arylesterase - paraoxonase

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11
Q

what is PON1 associated with

A

high density lipoprotein (HDL) in serum and may protect against atherosclerosis. Hydrolyses oxidised LDL-associated cholesterol, with potential protective effects

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12
Q

what % of europeans have low activity for paraoxon hydrolysis in serum and why?

A

50, due to a polymorphism at codon 192 with a Arg to Gln amino acid substitution

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13
Q

the effects of PON1 polymorphisms are _ dependent

A

substrate
Paraoxon: low activity with Gln form. Phenylacetate: no effect. Diazoxon: higher activity with Gln form

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14
Q

what are the variation of PON1 genotypes between continents

A
  • 50% of Europeans are homozygous for Gln (low activity with paraoxon)
  • 10% of North Africans were RR homozygotes,
  • whilst a mixed ancestry South African population were 15.8% QQ
  • 15% of Japanese are Gln homozygotes
15
Q

what type of role does PON1 genotype have in CHD

A

Protective ? (some evidence)
- Low PON1 activity was associated with increased risk of CHD, but this cannot be linked to a particular polymorphism
-Low PON1 activity was associated with polymorphisms in the promoter region in the patient group, but there was no association between these polymorphisms and CHD

16
Q

What is Butyrylcholinesterase

A

Plasma esterase which hydrolyses the muscle relaxant succinylcholine - high levels in plasma

17
Q

what % of the population is heterogenous + poor hydrolysis of succs

18
Q

butyrylcholinesterase polymorphisms is _ specific. therefore most individuals with deficient hydrolysis of succinylcholine show _ hydrolysis of other substrates

A

substrate
normal

19
Q

what is used to detect individuals with deficiency phenotypically by inhibition pattern of benzoylcholine hydrolysis

A

dibucaine number

20
Q

how do you measure the dibucaine number

A
  • take plasma samples with varying levels of dibucaine and add benzoylcholine
    -Dibucaine number is % inhibition of benzoylcholine by 10 micromolar dibucaine.
  • The majority of people show approx 80% inhibition.
  • The atypical reaction shows 10-20% inhibition.
21
Q

what is the muattion responsible for the atypical form assocated with abnormal dibucaine inhibition

22
Q

what are the 3 main forms of cholinesterase deficiency

A

Atypical
fluoride-sensitive
silent

23
what is the difference between CES1 and CES2
CES1 - high levels in liver which is important in metabolism (Tamiflu) CES2 - mainly expressed in intestine and in other extra hepatic tissues
24
what are the polymorphism involved in CES1
- Gly143Glu = low activity - Asp260fS = No activity (Rare)
25
what is Dihydropyrimidine dehydrogenase (DPYD)
Metabolic enzyme that converts uracil and thymine to dihydro metabolites facilitating further metabolism to amino acids
26
what drug is metabolised by Dihydropyrimidine dehydrogenase
5-fluorouracil (5FU)is an important anticancer drug
27
Dihydropyrimidine dehydrogenase deficiency is caused by what, normally ?
Most common variant allele associated with deficiency has G to A base change in intron 14 (position 1) resulting in skipping of exon 14 and truncated protein
28
if an individual is heterozygous for DPYD mutation then they are at risk of what ? what is the occurance of heterozygous ?
- toxicity if 5FU is given - 2-3% of europeans
29
what does aldehyde dehydrogenese do ?
converts acetyaldehyde to acetate (from ethanol)
30
what are the two forms of aldehyde dehydrogenase
ALDH1 (cytosolic) and ALDH2 (mitochondrial enzymes)
31
why do east asians suffer from flushing/nausea when they consume alcohol
- amino acid substitution in ALDH2 of Glu487Lys at C-terminal end of protein - results in unstable protien - Dominant inheritance means subjects can be heterozygous - flushing/nausea is due to accumulation of acetaldehyde