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Grapefruit Juice-Drug Interaction. Paul F. Cancalon. Florida Department of Citrus. http://www.wlap.org/wl-repository/umich/cacr/grand-rounds/20031202-annarbor-01-watkins/real/sld011.htm. P. B. Watkins 2003. Drug Taken with GJ. Drug Blood Concentration (AUC). Drug Taken without GJ. Time.
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Grapefruit Juice-Drug Interaction Paul F. Cancalon Florida Department of Citrus
http://www.wlap.org/wl-repository/umich/cacr/grand-rounds/20031202-annarbor-01-watkins/real/sld011.htmhttp://www.wlap.org/wl-repository/umich/cacr/grand-rounds/20031202-annarbor-01-watkins/real/sld011.htm P. B. Watkins 2003
Drug Taken with GJ Drug Blood Concentration (AUC) Drug Taken without GJ Time
Cytochrome P450 Definition Cytochrome P450 enzymes are a superfamily of more than 160 known members that play a major role in the metabolism a wide array of xenobiotics including drugs, chemical carcinogens, insecticides, petroleum products, and other environmental pollutants. Although the liver is the primary organ for drug metabolism, extrahepatic tissues such as lung, kidney and intestine, also play an important role for detoxification or biotransformation of xenobiotics. Each tissue has a unique P450 isozyme distribution and regulatory mechanism for cytochrome P450 gene (CYP) expression.
Cytochrome P450 Naming classification: CYP 3 A 4 *15 A-B family>40% sequence-homology isoenzyme allele sub-family>55% sequence-homology J R Oesterheld : Drug-Drug Interactions
Model of rat P450 2B1, showing mode of membrane attachment home.ccr.cancer.gov
Lock/Key or Enzyme/Substrate Reaction
P Glycoprotein Blockage www.biotechjournal.com
Furanocoumarins as potent chemical defenses Furanocoumarins are toxic compounds found primarily in species of the Apiaceae and Rutacea. They come in a variety of flavors and have adverse affects on wide variety of organisms, ranging from bacteria to mammals. Some of the furanocoumarins are photoactive--their toxicity is enhanced in the presence of ultraviolet radiation.. The furanocoumarins found in wild parsnip play a dominant role in resistance of this plant to its principal enemy the parsnip webworm
Peter Kareiva May R. Berenbaum Two potential outcomes of a coevolutionary interaction are an escalating arms race • Diversification of cytochrome P450 monooxygenases (P450s) is thought to result from antagonistic interactions between plants and their herbivorous enemies
The immediate precursors for furanocoumarin synthesis are umbelliferone and isoprene. Two categories of furanocoumarins are produced; the linear furanocoumarins have the furan ring in line with the benz-2-pyrone nucleus, while the angular furanocoumarins have the furan ring oriented at an angle to the nucleus.
Bergapten Bergaptol O O O O Bergamottin 6,7-Epoxybergamottin 6,7-DHB
O O H O O O O O H O O O O Paradisin C Paradisin A
Bergamotin Spiro3,FC726,Paradisin 3-4FC ? Bergaptol Up to 10 Spiroesters ? 6,7 DHB FC ? FCs ? FC ?
Bergaptol Geranyl side chain Bergamottin
Bergaptol 6,7-DHB
O O H O O O O O H O O O O Spiroester3 Spiro3 Bergaptol
The order of inhibitory potency of these compou nds was FC726>6,7DHBG> bergamottin > bergapten > bergaptol O O Ohnishi A et al. : Br J Pharmacol . 2000 Jul;130(6):1369 - 77. O O O O O O O O O O O O O O O O H H O O H O O H O O O H bergapten O O O O > > > > bergaptol 6,7 DHB bergamottin Paradisin A (Spiro 3)
Uptake of orally administered drug proceeds after the stomach passage via the small intestine. In the gut and liver, a series of metabolic transformation occurs. J R Oesterheld : Drug-Drug Interactions
www.siumed.edu/~dking2/ erg/images arbl.cvmbs.colostate.edu/.../ smallgut/villus
Site of Action of Some Drugs Affected by Grapefruit Juice
Calcium channel blockers Target Blocked - calcium channel blockers in actionwww.thediabetesvillage.com
Calcium channel blockers • decreases contractility in myocardial cells and tone in vascular smooth muscle www.soton.ac.uk
Time-course of recovery of CYP3A function after single doses of grapefruit juice. Greenblatt DJ, von Moltke LL, Harmatz JS, Chen G, Weemhoff JL, Jen C, Kelley CJ, LeDuc BW and Zinny MA. Clinical Pharmacology and Therapeutics 2003;74:121-12 Liver microsome method micro.magnet.fsu.edu
Paradisin C: a new CYP3A4 inhibitor from grapefruit juice Tetrahedron 58 (2002) 6631-6635Tetrahedron 58 (2002) 6631-6635 CYP3A4 inhibition assay CYPP3A4 activity is based on nifedipine oxidation. 100 mM phosphate buffer (pH 7.4) containing 50 uM nifedipine 5 mM glucose-6-phosphate, 0.5 mM 3-NADP+, glucose-6phosphate dehydrogenase. CYP3A4 is preincubated in 7 uL of the buffer at 37EC for 5 min and added to the sample solution The solution is incubated at 37EC for 1 h. The residue is analyzed by reverse phase HPLC for the nifedipine metabolite (nifedipine pyridine), and for nifedipine. The value of IC50, the concentration required for 50% inhibition of CYP3A4 activity.
Drug Drug Drug Drug Liver 10% CYP3A4 100% 20% CYP3A4 80% 10% CYP3A4 Target over 90% of saquinavir is metabolized by the cytochrome P450 isoenzyme CYP3A4 {01} . Saquinavir is thought to undergo extensive first-pass metabolism and is rapidly metabolized to a variety of inactive mono- and di-hydroxylated compounds Small Intestine
Drug Drug Drug Drug CYP3A4 Drug Enterocytes 100% Nucleus 30% 70% ? P Glycoprotein Villus
FC Drug Drug Drug Drug FC CYP3A4 Enterocytes 100% Nucleus 70% 30% X P Glycoprotein ? Villus
FC CYP3A4 FC Nucleus Competitive Enzyme/Substrate Binding Enterocyte From: P. B. Watkins 2003
CYP3A4 FC Metab FC Metab FC Metab Nucleus Enzymatic Metabolism of FC (1h) Enterocyte From: P. B. Watkins 2003
FC Metab CYP3A4 FC Metab FC Metab Nucleus Protein Catabolism Enterocyte CYP3A4 Tagging and Destruction (3D) From: P. B. Watkins 2003
Variation of Enterocyte CYP3A4 Activity And the Oral Distribution of Substrates 10 Drug Blood Concentration CYP3A4 Activity 0 Time CYP3A4 Distribution in Human Population From: P. B. Watkins 2003