Pharmacogenomics research and clinical implementation in Brazil
BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY
Authors: Rodrigues-Soares, Fernanda; Suarez-Kurtz, Guilherme
Abstract
We searched PubMed entries and the Lattes database of Brazilian Pharmacogenetics Network investigators, for pharmacogenetic/genomic (PGx) studies in the Brazilian population, focusing on the drugs and genes included in the Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. Warfarin was the most extensively studied drug in a PGx context: a genomewide association study targeting warfarin stable dose identified significant signals in VKORC1 and CYP2C9, several PGx dosing algorithms were developed based on these and other genes, and the implications of population admixture on extrapolation of dosing recommendations in the CPIC guidelines were examined. A study in renal transplanted patients disclosed association of CYP3A5*6 and CYP3A5*7 with tacrolimus dosing, which led to addition of these variants to CYP3A5*3 in the CPIC tacrolimus guideline. Studies verified predisposition of HIV-positive carriers of UGT1A1*28 to severe atazanavir-induced hyperbilirubinaemia, intolerance to 5-fluorouracyl in gastrointestinal cancer patients with deleterious DPYD variants, failure of HCV-infected carriers of IFNL3 rs12979860 to obtain a sustained viral response to PEG-IFN-alpha, and hypersensitivity reactions to abacavir in HIV-positive carriers of HLA-B*57:01. No prospective analyses of drug therapy outcomes or cost-effectiveness assessments of PGx-guided therapy were found. In conclusion, the limited adoption of PGx-informed drug prescription in Brazil reflects combination of recognized barriers to PGx implementation worldwide plus factors specific to the Brazilian population. The latter include rarity/absence of genetic variants on which international PGx guidelines are based (eg HLA-B*15.02 for phenytoin and carbamazepine) and the caveat of extrapolating to the admixed Brazilian population, guidelines based on categorical variables, such as continental ancestry (eg warfarin guidelines), "race" or ethnicity.
UGT-mediated metabolism plays a dominant role in the pharmacokinetic behavior and the disposition of morusin in vivo and in vitro
JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL ANALYSIS
Authors: Hou, Chuqi; Liu, Wenqin; Liang, Zhi; Han, Weichao; Li, Jinqing; Ye, Ling; Liu, Menghua; Cai, Zheng; Zhao, Jie; Chen, Yi; Liu, Shuwen; Tang, Lan
Abstract
Morusin is a prenylated flavone isolated from mulberry, the branch and root bark of various Morus species, which possesses diverse pharmacological activities. However, it lacks extensive studies about its absorption and disposition. This study investigated the pharmacokinetic behavior of morusin in rat, and its first-pass metabolism in situ. The metabolic pathway of morusin was further investigated by 12 human recombinant UDP-glucuronosyltransferases (UGTs), 9 CYP450s, as well as liver and intestinal microsomes. Four mono-glucuronide metabolites (M-5-G, M-4'-G, M-2'-G, and M11-2) were identified in rat intestine and bile by LC-MS/MS, while three of them were also detected in plasma (M-5-G, M-4'-G, and M11-2). M-4'-G was the principal conjugate. However, few CYP450 metabolites were found in rat intestine and bile. Only a small amount of M1-1 could be detected in rat plasma. UGT1A1, 1A3, 1A7, and 2B7 were the major contributors to morusin glucuronidation. Morusin exhibited substrate inhibition kinetic characteristics in all UGTs. Clearance rates of M-4'-G in HLM, RLM, UGT1A1, UGTIA3, and UGT2B7 were 137.02,127.55, 32.54, 41.18, and 35.07 ml/min/mg, respectively. Besides, CYP3A5, 3A4, and 2C19 primarily contributed to the oxidative metabolism of morusin. The pharmacokinetic curves of morusin and its conjugates presented double peaks, showing that an enterohepatic recycling may exist. In conclusion, glucuronidation was confirmed to be the crucial metabolic pathway for morusin in vivo, and M-4'-G was the main metabolite. (C) 2018 Elsevier B.V. All rights reserved.