Jürgens Gesche, Lange Kai Henrik Wiborg, Reuther Lene Ørskov, Rasmussen Birgitte Buur, Brøsen Kim, Christensen Hanne Rolighed
Department of Clinical Pharmacology, Bispebjerg University Hospital, Copenhagen, Denmark.
Clin Pharmacol Ther. 2002 Mar;71(3):162-8. doi: 10.1067/mcp.2002.121373.
Our objective was to study the effect of recombinant human growth hormone (rhGH) on hepatic cytochrome P450 (CYP) activity in 30 healthy elderly men.
The study was carried out as a randomized, double-blind, placebo-controlled parallel-group study. rhGH or placebo was administered for a period of 12 weeks. CYP activity was measured before, after 12 weeks of rhGH and placebo administration, and at 4 weeks after termination of rhGH and placebo administration with use of the biomarker reactions of CYP1A2 (caffeine), CYP2C19 (mephenytoin), CYP2D6 (sparteine), CYP3A4 (endogenous cortisol metabolism), and antipyrine clearance as common markers of CYP activity.
The metabolic ratio of caffeine increased significantly in the group that received growth hormone compared with placebo (median difference, 4.55; 95% confidence interval (CI), 1.64 to 8.60; versus -0.90; 95% CI, -5.70 to 1.36), indicating an induction of CYP1A2. Moreover, the S/R ratio of mephenytoin showed a small but significant increase (median difference, 0.02; 95% CI, 0 to 0.31; versus 0; 95% CI, -0.01 to 0.06), indicating an inhibition of CYP2C19. There were no significant changes of the metabolic ratios of cortisol and sparteine or the antipyrine clearance compared with placebo.
These results indicate that growth hormone induces CYP1A2 and, to a lesser extent, inhibits CYP2C19 in elderly men, but it exerts no effects on CYP2D6 and CYP3A4. Although the induction of CYP1A2 may be of some clinical relevance, the small inhibition of CYP2C19 is probably unimportant.
我们的目的是研究重组人生长激素(rhGH)对30名健康老年男性肝脏细胞色素P450(CYP)活性的影响。
该研究作为一项随机、双盲、安慰剂对照的平行组研究进行。给予rhGH或安慰剂,为期12周。在给予rhGH和安慰剂12周之前、之后以及在停止给予rhGH和安慰剂4周后,使用CYP1A2(咖啡因)、CYP2C19(美芬妥英)、CYP2D6(司巴丁)、CYP3A4(内源性皮质醇代谢)的生物标志物反应以及安替比林清除率作为CYP活性的常见标志物来测量CYP活性。
与安慰剂相比,接受生长激素的组中咖啡因的代谢率显著增加(中位数差异,4.55;95%置信区间(CI),1.64至8.60;与之相比为-0.90;95%CI,-5.70至1.36),表明CYP1A2被诱导。此外,美芬妥英的S/R比值显示出虽小但显著的增加(中位数差异,0.02;95%CI,0至0.31;与之相比为0;95%CI,-0.01至0.06),表明CYP2C19受到抑制。与安慰剂相比,皮质醇和司巴丁的代谢率或安替比林清除率没有显著变化。
这些结果表明,生长激素在老年男性中诱导CYP1A2,在较小程度上抑制CYP2C19,但对CYP2D6和CYP3A4没有影响。虽然CYP1A2的诱导可能具有一定的临床相关性,但CYP2C19的轻微抑制可能并不重要。