Effects of 27 CYP3A4 protein variants on saxagliptin metabolism in vitro

Saxagliptin is a dipeptidyl peptidase 4 (DPP‐4) inhibitor widely used in patients with type 2 diabetes. It can increase the amount of insulin after meals and lower blood sugar. CYP450 3A4 (CYP3A4) can metabolize about 30%–40% of therapeutic drugs. Individual differences caused by CYP3A4 genetic poly...

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Published in:Fundamental & clinical pharmacology 2022-02, Vol.36 (1), p.150-159
Main Authors: liu, Qian, Ou‐Yang, Qiu‐Geng, Lin, Qian‐Meng, Lu, Xiang‐Ran, Ma, Ya‐Qing, Li, Ying‐Hui, Xu, Ren‐Ai, Lin, Dong‐dong, Hu, Guo‐Xin, Cai, Jian‐Ping
Format: Article
Language:English
Subjects:
Adamantane - analogs & derivatives
Adamantane - pharmacokinetics
Baculovirus
Biocompatibility
Chromatography, Liquid
CYP3A4
CYP3A4 protein
Cytochrome P-450 CYP3A - genetics
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2
Dipeptides
Dipeptidyl-peptidase IV
Drug metabolism
Drug use
Gene polymorphism
genetic polymorphism
Humans
In vivo methods and tests
Insects
Insulin
Liquid chromatography
Mass spectrometry
Mass spectroscopy
Meals
Metabolism
Metabolites
Microsomes
Peptidase
Peptidases
personalized treatment
Pharmacology
Protein turnover
saxagliptin
Side effects
Tandem Mass Spectrometry
Toxicity
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Summary:Saxagliptin is a dipeptidyl peptidase 4 (DPP‐4) inhibitor widely used in patients with type 2 diabetes. It can increase the amount of insulin after meals and lower blood sugar. CYP450 3A4 (CYP3A4) can metabolize about 30%–40% of therapeutic drugs. Individual differences caused by CYP3A4 genetic polymorphisms can lead to treatment failure, unpredictable side effects, or severe drug toxicity. The aim of this study was to evaluate the catalytic activities of 27 CYP3A4 variants on saxagliptin metabolism in vitro, which were identified in human CYP alleles. We successfully constructed 27 kinds of wild‐type and variant vectors of pFast‐dual‐OR‐3A4 by overlap extension PCR and prepared 27 kinds of CYP3A4 highly expressed cell microsomes by baculovirus insect cell expression system. The ultra‐performance liquid chromatography tandem mass spectrometry (UPLC‐MS/MS) was used to detect the concentrations of the metabolite of saxagliptin (5‐hydroxysaxagliptin) and the internal standard. Compared with the wild‐type CYP3A4.1, the intrinsic clearance values of most varieties decreased to 1.91%–77.08%. Most of these varieties showed a decrease in Vmax and an increase in Km values compared with wild type. We are the first to report the vitro metabolic data of 27 CYP3A4 variants of the metabolism of saxagliptin which can deepen our understanding of individualized drug use by combining previous studies about the effects of CYP3A4 variants of drug metabolism. With further in vivo studies, we hope it can guide individualized drug use in the clinic when the variants with low metabolic activity to saxagliptin were sequenced in the human body.
ISSN:0767-3981
1472-8206
DOI:10.1111/fcp.12693