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Vol. 283, Issue 3, 1552-1562, 1997
Departments of
Pharmaceutics (M.F.P., M.K., J.M.F., D.D.S.,
K.E.T.),
Medicinal Chemistry (K.L.K.) and
Surgery (C.L.M., J.D.P.),
University of Washington, Seattle, Washington
Cytochrome P450 3A (CYP3A) metabolizes a diverse array of clinically
important drugs. For some of these (e.g., cyclosporine, verapamil, midazolam), CYP3A in the intestinal mucosa contributes to
their extensive and variable first-pass extraction. To further characterize this phenomenon, we measured CYP3A content and catalytic activity toward the probe substrate midazolam in mucosa isolated from
duodenal, jejunal and ileal sections of 20 human donor intestines. For
comparison, the same measurements were performed for 20 human donor
livers, eight of which were obtained from the same donors as eight of
the intestines. Excellent correlations existed between homogenate and
microsomal CYP3A content for the three intestinal regions. Median
microsomal CYP3A content was greatest in the duodenum and lowest in the
ileum (31 vs. 17 pmol/mg of protein). With respect to
midazolam 1
-hydroxylation kinetics, the median
Km for each intestinal region was similar to the
median hepatic Km, ~4 µM. In contrast, the
median Vmax decreased from liver to duodenum to
jejunum to ileum (850 vs. 644 vs. 426 vs. 68 pmol/min/mg). Intrinsic clearance
(Vmax/Km) followed a
similar trend for the intestinal regions; median duodenal intrinsic
clearance was comparable to hepatic intrinsic clearance (157 and 200 µl/min/mg, respectively). Vmax correlated with
CYP3A content for all tissues except the ileum. Duodenal and jejunal
Vmax and CYP3A content varied by >30-fold among
donors. Microsomes prepared from every other 1-foot section of six
intestines were also analyzed for CYP3A as well as for two coenzymes.
In general, CYP3A activity, CYP3A content and CYP reductase activity
rose slightly from duodenum to middle jejunum and then declined to
distal jejunum and ileum. Cytochrome b5 content and cytochrome b5 reductase activity varied
little throughout the intestinal tract. Regional intrinsic midazolam
1
-hydroxylation clearance was greatest for the jejunum, followed by
the duodenum and ileum (144, 50 and 19 ml/min, respectively).
Collectively, these results demonstrate that the upper small intestine
serves as the major site for intestinal CYP3A-mediated first-pass
metabolism and provides a rationale for interindividual differences in
oral bioavailability for some CYP3A substrates.
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C. K. Yeung, D. H. Lang, K. E. Thummel, and A. E. Rettie Immunoquantitation of FMO1 in Human Liver, Kidney, and Intestine Drug Metab. Dispos., September 1, 2000; 28(9): 1107 - 1111. [Abstract] [Full Text] |
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T. E. Lackner Advances in Managing Overactive Bladder Journal of Pharmacy Practice, August 1, 2000; 13(4): 277 - 289. [Abstract] [PDF] |
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D. Cong, M. Doherty, and K. S. Pang A New Physiologically Based, Segregated-Flow Model to Explain Route-Dependent Intestinal Metabolism Drug Metab. Dispos., February 1, 2000; 28(2): 224 - 235. [Abstract] [Full Text] |
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J. H. Hochman, M. Chiba, J. Nishime, M. Yamazaki, and J. H. Lin Influence of P-Glycoprotein on the Transport and Metabolism of Indinavir in Caco-2 Cells Expressing Cytochrome P-450 3A4 J. Pharmacol. Exp. Ther., January 1, 2000; 292(1): 310 - 318. [Abstract] [Full Text] |
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W. Jacobsen, G. Kirchner, K. Hallensleben, L. Mancinelli, M. Deters, I. Hackbarth, K. Baner, L. Z. Benet, K.-F. Sewing, and U. Christians Small Intestinal Metabolism of the 3-Hydroxy-3-methylglutaryl-Coenzyme A Reductase Inhibitor Lovastatin and Comparison with Pravastatin J. Pharmacol. Exp. Ther., October 1, 1999; 291(1): 131 - 139. [Abstract] [Full Text] |
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S. Ekins, G. Bravi, J. H. Wikel, and S. A. Wrighton Three-Dimensional-Quantitative Structure Activity Relationship Analysis of Cytochrome P-450 3A4 Substrates J. Pharmacol. Exp. Ther., October 1, 1999; 291(1): 424 - 433. [Abstract] [Full Text] |
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Q.-Y. Zhang, D. Dunbar, A. Ostrowska, S. Zeisloft, J. Yang, and L. S. Kaminsky Characterization of Human Small Intestinal Cytochromes P-450 Drug Metab. Dispos., July 1, 1999; 27(7): 804 - 809. [Abstract] [Full Text] |
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J. H. Lin, M. Chiba, and T. A. Baillie Is the Role of the Small Intestine in First-Pass Metabolism Overemphasized? Pharmacol. Rev., June 1, 1999; 51(2): 135 - 158. [Abstract] [Full Text] [PDF] |
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M. A. Gibbs, K. L. Kunze, W. N. Howald, and K. E. Thummel Effect of Inhibitor Depletion on Inhibitory Potency: Tight Binding Inhibition of CYP3A by Clotrimazole Drug Metab. Dispos., May 1, 1999; 27(5): 596 - 599. [Abstract] [Full Text] |
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J. M. Fisher, S. A. Wrighton, P. B. Watkins, P. Schmiedlin-Ren, J. C. Calamia, D. D. Shen, K. L. Kunze, and K. E. Thummel First-Pass Midazolam Metabolism Catalyzed by 1alpha ,25-Dihydroxy Vitamin D3-Modified Caco-2 Cell Monolayers J. Pharmacol. Exp. Ther., May 1, 1999; 289(2): 1134 - 1142. [Abstract] [Full Text] |
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J. M. Fisher, S. A. Wrighton, J. C. Calamia, D. D. Shen, K. L. Kunze, and K. E. Thummel Midazolam Metabolism by Modified Caco-2 Monolayers: Effects of Extracellular Protein Binding J. Pharmacol. Exp. Ther., May 1, 1999; 289(2): 1143 - 1150. [Abstract] [Full Text] |
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M. F. Paine, P. Schmiedlin-Ren, and P. B. Watkins Cytochrome P-450 1A1 Expression in Human Small Bowel: Interindividual Variation and Inhibition by Ketoconazole Drug Metab. Dispos., March 1, 1999; 27(3): 360 - 364. [Abstract] [Full Text] |
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M. A. Gibbs, K. E. Thummel, D. D. Shen, and K. L. Kunze Inhibition of Cytochrome P-450 3A (CYP3A) in Human Intestinal and Liver Microsomes: Comparison of Ki Values and Impact of CYP3A5 Expression Drug Metab. Dispos., February 1, 1999; 27(2): 180 - 187. [Abstract] [Full Text] |
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