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Vol. 299, Issue 3, 998-1006, December 2001
Molecular Pharmacogenetics (M.H.C., S.X.D.) and Clinical
Pharmacology (L.L.v.M., D.J.G.) Laboratories, Department of
Pharmacology and Experimental Therapeutics, Tufts University School of
Medicine, Boston, Massachusetts; Gentest (C.J.P.), Woburn,
Massachusetts; and Department of Clinical Pharmacology (J.O.M.,
P.I.M.), Flinders University School of Medicine, Bedford Park, South
Australia
Interindividual variability in acetaminophen (APAP)
glucuronidation may contribute to differences in susceptibility to APAP intoxication in humans. The purpose of this study was to identify the
relevant UDP-glucuronosyltransferase (UGT) isoforms mediating APAP-UGT
activity in human liver microsomes (HLMs). APAP-UGT activities and
enzyme kinetics were determined using HLMs from 56 donors and nine
recombinant human UGTs. Activities mediated by UGT1A1, UGT1A4, UGT1A9,
and UGT2B7, and relative UGT1A6 protein content were quantified using
20 livers. More than 15-fold variation in liver microsomal APAP-UGT
activities was observed with a distribution skewed toward lower
activities. Although most UGTs could glucuronidate APAP, UGT1A1,
UGT1A6, and UGT1A9 were most active. UGT1A6 was a relatively
high-affinity (Km = 2.2 mM),
low-capacity enzyme; UGT1A1 was intermediate in affinity
(Km = 9.4 mM) and capacity; and UGT1A9
was a low-affinity (Km = 21 mM),
high-capacity enzyme. Km values were similar
to UGT1A1 in high- and intermediate-activity HLMs (6-10 mM) and UGT1A9
in low-activity HLMs (10-55 mM). APAP-UGT activities correlated best
with propofol-UGT (r = 0.85; UGT1A9) and
bilirubin-UGT (r = 0.66; UGT1A1) activities, but
poorly with UGT1A6 protein (r = 0.30). A kinetic
model was constructed from these data that identified UGT1A9 as the
predominant APAP-UGT (>55% total activity) in HLMs over a clinically
relevant APAP concentration range (50 µM-5 mM). UGT1A1 was also
predicted to contribute substantially at toxic concentrations (>1 mM;
>28% activity), whereas UGT1A6 was most active at relatively low
concentrations (<50 µM; >29% activity).
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