中药注射剂对CYP450酶的影响研究进展

通过查阅、整理和分析近年来国内外有关中药注射剂对CYP450酶影响的文献,研究中药注射剂对CYP450酶的影响,从代谢性相互作用角度讨论中药注射剂在临床应用中的安全性问题。关于中药注射剂对CYP450酶影响的研究较少,部分中药注射剂对CYP450酶存在不同程度的影响。深入分析研究中药注射剂对CYP450酶活性的影响,预测可能发生的药物相互作用,对指导中药注射剂的合理使用,减少由药物联用所致不良反应具有重要意义。     

体外代谢体系中中药及其成分对肝脏CYP450代谢酶抑制作用的研究进展

细胞色素P450 (CYP450)是肝微粒体中参与体内I相代谢反应的酶,临床上90%以上的药物都经CYP450氧化代谢,其被诱导或抑制是引起药物相互作用的主要机制。通过离体器官、细胞或酶系统进行的体外代谢研究以其精准、简化等特点近年来发展迅速。中药的体外代谢研究可推断药物可能的代谢途径和参与代谢的CYP450酶,研究药物的相互作用,更好地解释中药及其成分的作用机制,促进临床合理用药。本文就中药、中药成分、中药提取物在不同种属肝微粒体中对CYP450代谢酶活性的抑制作用进行综述,以期为中药-中药、中药-化学药物之间相互作用研究提供借鉴与参考。     

细胞色素P450酶介导的中药注射剂代谢性相互作用研究现状及思考

中药注射剂因药物相互作用引起的不良反应问题日益凸显,而细胞色素P450（CYP450）酶是影响药物体内处置过程的重要因素,其表达和功能的改变常常引起药动学的变化,是代谢性药物相互作用的主要靶点。因此,开展中药注射剂与化学药的药物相互作用研究十分必要,就CYP450酶介导的中药注射剂与化学药相互作用的研究现状以及常见的中药注射剂对CYP450酶影响的研究进行综述,为中药注射剂的临床应用和相互作用研究提供参考。     

CYP450酶特性及其应用研究进展

细胞色素P450（CYP450）是药物和其他内、外源物的主要代谢酶,本文综述了人体内参与药物代谢的几种主要代谢酶CYP3A4、CYP2D6、CYP2C9、CYP2C19、CYP2E1、CYP1A2和CYP2A6的分子生物学特征,中药对药物代谢酶的影响及药物代谢酶在临床药物治疗和新药研究过程中的应用。     

中药注射剂对细胞色素P450酶亚型的调控作用

对近年来国内外报道的中药注射剂对细胞色素P450(CYP)酶亚型调控作用的研究进行总结和分析,了解中药注射剂对CYP酶影响的研究现状.已上市的中药注射剂已有上百种,但其对CYP酶亚型调控作用的研究仍很少,只有十几种.研究 结果 显示,不同的中药注射剂对CYP酶亚型可产生抑制或诱导作用.因此应重视中药注射剂对CYP酶影响研究及可能引发的代谢性药物相互作用,避免药品不良反应增加或疗效降低,促进临床合理用药,提高中药注射剂在临床应用的安全性和有效性.     

体外系统性评价79种中药注射剂对9种人细胞色素P450酶的抑制作用

中药注射剂在临床经常与化学药物联用治疗多种复杂疾病,但其中药-药物的相互作用还没有得到充分的研究,有时甚至被临床忽视。本文研究国家食品药品监督管理局批准的79种中药注射剂,评价它们对人体药物代谢酶-细胞色素P450(CYP450)的潜在抑制作用。使用9种人CYP450s(包括CYP1A、CYP2A6、CYP2B6、CYP2C8、CYP2C9、CYP2C19、CYP2D6、CYP2E1和CYP3A)、特异性底物和中药注射剂共同孵育,使用灵敏度、准确度高的液相串联质谱(LC-MS/MS)对探针形成的代谢产物进行定量分析,评价79种中药注射剂对CYP450的体外抑制作用。在79种中药注射液中,当在中药注射液5%(v/v)和注射用粉针剂2倍日最大使用剂量换算浓度CMDD(mg·mL-1)筛选时有37种中药注射剂对CYP1A、24种中药注射剂对CYP2A6、41种中药注射剂对CYP2B6、36种中药注射剂对CYP2C9、41种中药注射剂对CYP2C19、41种中药注射剂对CYP2D6、25种中药注射剂对CYP2E1和42种中药注射剂对CYP3A表现出50%的抑制率或更强的抑制作用。在预孵育或与人肝微粒体共孵育30 min后,观察到2种中药注射剂对CYP1A、5种中药注射剂对CYP2A6、5种中药注射剂对CYP2B6、6种中药注射剂对CYP2C8、1种中药注射剂对CYP2D6、6种中药注射剂对CYP3A呈现时间依赖性抑制(TDI)作用。结果表明,中药注射剂存在基于CYP450的中药-药物相互作用及时间依赖性的中药-药物相互作用,需要临床医生用药提高警惕。     

不同功效中药对细胞色素P_(450)影响的研究进展

<正>细胞色素P45(0Cytochrome P450,CYP450)是人体内一种重要的代谢酶,在人体内易被联合应用的药物诱导和抑制,从而导致药物浓度发生巨大的变化,产生增效或毒副作用。CYP450发现于20世纪50年代。最近几十年,随着中药在临床上广泛应用和研究的不断深入,中药的代谢研究已成为中药研究的热     

去氢厄弗酚在小鼠肝微粒体中代谢产物及CYP450酶亚型的鉴定

目的建立去氢厄弗酚(DHE)小鼠体外肝微粒体孵育方法,鉴定DHE在小鼠肝微粒体中的代谢产物及参与DHE代谢的CYP450酶亚型。方法采用UPLC-Q-TOF-MS/MS分析鉴定DHE在体外肝微粒体共温孵后的代谢产物,筛选7种CYP450酶亚型,并通过特异性化学抑制剂法,鉴别参与DHE代谢的主要CYP450酶亚型。结果在体外肝微粒体共温孵后,检测到4个代谢产物;所筛选的7种CYP450酶亚型中,CYP1A2、CYP2C8和CYP2D2对DHE体外肝微粒体代谢的参与度较高。结论在肝脏中,有多种代谢酶亚型参与DHE的代谢,表明DHE在临床上不易与其他药物产生相互作用。     

甘草对药物代谢酶以及化学药物体内代谢的影响

甘草对肝细胞色素P450(CYP450)酶活性具有诱导或抑制作用,对一些化学药物如氨茶碱、安替比林、丙米嗪、利多卡因、氯沙坦等的体内代谢产生影响,合用时使这些药物的药物代谢动力学发生改变,在临床应用过程中应注意。因此,需要进一步在人体内研究甘草提取物及其有效成分与其他药物的相互作用。从CYP450酶角度研究中药,有利于从分子水平探讨中药的作用机制或毒性机制,并有可能揭示中药之间或中药与西药产生相互作用的关系,防止临床配伍用药后的不良反应,从而提高中药临床应用的有效性与安全性,促进临床合理用药。本文综述了甘草对药物代谢酶以及化学药物体内代谢的影响。     

中药注射剂对细胞色素P450的调控与药物相互作用预测

近年来中药注射剂在临床上应用广泛,与其他药物联合应用极为普遍,联合用药是否会产生细胞色素P450（CYP）酶介导的代谢性药物相互作用,从而影响疗效和用药安全,已越来越受到关注.本文就近年来中药注射剂对CYP酶影响的国内外研究进行了综述,按各亚型酶进行归类,归纳了中药注射剂对CYP各亚型酶的作用（诱导、抑制）,以预测中药注射剂及与哪些药物联合应用时可能会产生潜在的代谢性药物相互作用,与哪些药物可安全联用,从而为临床安全合理用药及相关研究提供参考,保障患者用药安全有效,规避用药风险.     

Polymorphic metabolism by functional alterations of human cytochrome P450 enzymes

The study of cytochrome P450 pharmacogenomics is of particular interest because of its promise in the development of rational means to optimize drug therapy with respect to patient’s genotype to ensure maximum efficacy with minimal adverse effects. Drug metabolizing P450 enzymes are polymorphic and are the main phase I enzymes responsible for the metabolism of clinical drugs. Therefore, polymorphisms in the P450s have the most impact on the fate of clinical drugs in phase I metabolism since almost 80% of drugs in use today are metabolized by these enzymes. Predictive genotyping for P450 enzymes for a more effective therapy will be routine for specific drugs in the future. In this review, we discuss the current knowledge of polymorphic metabolism by functional alterations in nonsynonymous SNPs of P450 1A2, 2A6, 2C8, 2C9, 2C19, 2D6, and 3A4 enzymes.     

药物代谢酶遗传多态性对药物神经毒性的影响

神经毒性是药物常见的毒性反应之一。神经系统对药物引起的损害尤其敏感,药物引起神经系统结构和功能的微小改变即可表现出严重的精神或行为异常,因此药物引起的神经毒性越来越得到人们的关注。药物引起的神经毒性存在个体差异,其中遗传因素对这种差异的产生发挥重要作用。药物代谢酶影响药物体内的生物转化过程,因此代谢酶的遗传多态性在一定程度上决定了不同个体对药物神经毒性的易感性。本篇综述将着重探讨药物代谢酶中的细胞色素P450酶、谷胱甘肽转移酶和N-乙酰转移酶遗传多态性对药物神经毒性易感性的影响。     

Risk of seizures associated with psychotropic medications: emphasis on new drugs and new findings

Psychotropic medications in the classes of antidepressants, antipsychotics and mood stabilisers have been recognised in the literature and clinical settings as having high epileptogenic potential. Among these three classes, clozapine, tricyclic antidepressants (TCAs) and lithium are agents that clinicians have historically recognised as precipitants of drug-induced seizures. There are few reports that review the epileptogenic risk of newer psychotropic agents; in this qualitative review, the authors provide an update on the most recently published reports on seizures associated with antidepressants, antipsychotics, mood stabilisers, anxiolytics and sedative-hypnotics. In general, the epileptogenic risks of the newer psychotropic agents appear to be quite low as long as dosing strategies are consistent with recommended guidelines. Whilst newer psychotropic medications appear to be safe in patients with epilepsy, few studies have specifically addressed this population. In addition, the potential for drug interactions between antiepileptic drugs and psychotropics may be substantial with certain agents. For example, many psychotropes are both substrates and inhibitors of cytochrome P450 (CYP450) isoenzymes, whilst many antiepileptic drugs are both substrates and inducers of CYP450 activity. Every attempt should be made to minimise potential interactions when these agents are concomitantly administered.     

CYP2C9、CYP2C19、CYP3A4基因多态性对磺脲类降糖药代谢的影响

磺脲类口服降糖药在人体内主要经过肝脏代谢。肝脏中的细胞色素氧化酶P450是一种重要的药物代谢酶系统,在人群中存在基因多态性,导致药物疗效和不良反应在个体间存在着较大的差异。本文将对CYP450中的几种重要的代谢酶亚型CYP2C9、CYP2C19、CYP3A4的基本结构、基因多态性、种族差异及其对磺脲类降糖药代谢的影响作一综述。     

Risk of seizures associated with psychotropic medications: emphasis on new drugs and new findings

Psychotropic medications in the classes of antidepressants, antipsychotics and mood stabilisers have been recognised in the literature and clinical settings as having high epileptogenic potential. Among these three classes, clozapine, tricyclic antidepressants (TCAs) and lithium are agents that clinicians have historically recognised as precipitants of drug-induced seizures. There are few reports that review the epileptogenic risk of newer psychotropic agents; in this qualitative review, the authors provide an update on the most recently published reports on seizures associated with antidepressants, antipsychotics, mood stabilisers, anxiolytics and sedative-hypnotics. In general, the epileptogenic risks of the newer psychotropic agents appear to be quite low as long as dosing strategies are consistent with recommended guidelines. Whilst newer psychotropic medications appear to be safe in patients with epilepsy, few studies have specifically addressed this population. In addition, the potential for drug interactions between antiepileptic drugs and psychotropics may be substantial with certain agents. For example, many psychotropes are both substrates and inhibitors of cytochrome P450 (CYP450) isoenzymes, whilst many antiepileptic drugs are both substrates and inducers of CYP450 activity. Every attempt should be made to minimise potential interactions when these agents are concomitantly administered.     

植物药-化学药药代动力学相互作用及机制研究进展

植物药用于疾病治疗和保健的历史悠久。近年来,随着植物药与化学药联合应用的增多,二者相互作用和不良反应的报道逐渐增多。已知植物药中多种成分是P-糖蛋白和细胞色素P450的底物,同时也可诱导或抑制二者活性,是导致植物药-化学药相互作用的重要原因之一。本文就植物药-化学药药代动力学相互作用及可能机制进行综述。     

Modulation of cytochrome-P450 inhibition (CYP) in drug discovery: a medicinal chemistry perspective

Cytochrome P450 (CYP450) has widely been implicated for drug-drug interactions (DDI) in the pharmaceutical industry. Inhibition or induction of this enzyme family has led to withdrawal of multiple drugs from the market leading to major time and financial losses for the pharmaceutical industry. CYP450 plays a prevailing role in the biotransformation of a large number of structurally diverse drugs. Few isoenzymes of the CYP enzyme family (CYP3A4, 2D6 and 2C9 family) are mainly involved in metabolism of most of the drugs. To avoid such interactions and potentially minimize DDI, major pharmaceutical organizations prefer to incorporate CYP enzyme screening at an early stage of their discovery program. While this has been a prevalent practice in the pharmaceutical industry lately, there is very limited literature available reviewing the relationship between chemotypes and CYP isoforms. This review will collate literature pertaining to CYP-inhibition modulation through physicochemical parameters and chemical modification and thus bring to focus commonly used trends by medicinal chemists world-wide.     

The role of non—P450 enzymes in drug oxidation.

In addition to cytochrome P450, oxidation of drugs and other xenobiotics can also be mediated by non–P450 enzymes, the most significant of which are flavin monooxygenase, monoamine oxidase, alcohol dehydrogenase, aldehyde dehydrogenase, aldehyde oxidase and xanthine oxidase. This article highlights the importance of these non–P450 enzymes in drug metabolism. A brief introduction to each of the non–P450 oxidizing enzymes is given in this review and the oxidative reactions have been illustrated with clinical examples. Drug oxidation catalyzed by enzymes such as flavin monooxygenase and monoamine oxidase may often produce the same metabolites as those generated by P450 and thus drug interactions may be difficult to predict without a clear knowledge of the underlying enzymology. In contrast, oxidation via aldehyde oxidase and xanthine oxidase gives different metabolites to those resulting from P450 hydroxylation. Although oxidation catalyzed by non-P450 enzymes can lead to drug inactivation, oxidation may be essential for the generation of active metabolite(s). The activation of a number of prodrugs by non–P450 enzymes is thus described. It is concluded that there is still much to learn about factors affecting the non–P450 enzymes in the clinical situation.     

The human drug metabolizing cytochromes P450

The superfamily of heme-thiolate proteins known as the cytochromes P450 is responsible for the oxidative metabolism of the majority of drugs. Thus, the phenotypes of individuals with respect to their levels of catalytically active cytochromes P450 determines to a large part the substantial interindividual variation observed in the metabolic clearance of drugs. Over the past 10 years 15 different human cytochromes P450 involved in drug metabolism have been isolated and characterized to varying degrees. This brief review discusses the characterization of these cytochromes P450 and how this knowledge has been used by the pharmaceutical industry to aid in the development of new drugs.     

Recent progress on bioinformatics, functional genomics, and metabolomics research of cytochrome P450 and its impact on drug discovery

The cytochrome P450 superfamily is responsible primarily for human drug metabolism, which is of critical importance for the drug discovery and development. Rapid advancement of bioinformatics, functional genomics and metabolomics has been made over the last decade. These disciplines are essential in target identification, lead discovery and optimization. In this review, we summarize the recent progress on cytochrome P450 and its role on drug metabolism in the context of bioinformatics, functional genomics and metabolomics. Data are integrated into various databases and web-based platforms on cytochrome P450. These research tools and resources are playing an increasingly important role in drug discovery, and are helping in achieving the ultimate goal of personalized medicine, that is, to prescribe personalized drugs according to each person's genetic makeup, metabolic level, and drug disposition.