Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Drug Metab Dispos. 2012 Jan;40(1):18-24. doi: 10.1124/dmd.111.041400. Epub 2011 Sep 27.
The combination of lopinavir (LPV) and ritonavir (RTV) is one of the preferred regimens for the treatment of HIV infection with confirmed efficacy and relatively low toxicity. LPV alone suffers the poor bioavailability due to its rapid and extensive metabolism. RTV boosts the plasma concentration of LPV by suppressing its metabolism and thus increasing LPV efficacy. In the current study, we found that RTV also inhibits LPV bioactivation. LPV bioactivation was investigated in human liver microsomes and cDNA-expressed human cytochromes P450. Twelve GSH-trapped reactive metabolites of LPV were identified by using a metabolomic approach. Semicarbazide-trapped reactive metabolites of LPV were also detected. RTV effectively suppressed all pathways of LPV bioactivation via CYP3A4 inhibition. Our data together with previous reports suggest that LPV plus RTV is an ideal combination because RTV not only boosts LPV plasma concentration, but it decreases LPV bioactivation.
洛匹那韦(LPV)和利托那韦(RTV)的联合使用是治疗 HIV 感染的首选方案之一,其疗效确切且毒性相对较低。由于 LPV 代谢迅速且广泛,其生物利用度较差。RTV 通过抑制其代谢来提高 LPV 的血浆浓度,从而提高 LPV 的疗效。在本研究中,我们发现 RTV 还抑制 LPV 的生物活化。采用代谢组学方法在人肝微粒体和 cDNA 表达的人细胞色素 P450 中研究了 LPV 的生物活化。通过使用代谢组学方法鉴定了 LPV 的 12 个 GSH 捕获的反应性代谢物。还检测到 LPV 的氨基脲捕获的反应性代谢物。RTV 通过抑制 CYP3A4 有效地抑制了 LPV 生物活化的所有途径。我们的数据与以前的报告一起表明,LPV 加 RTV 是一种理想的组合,因为 RTV 不仅可以提高 LPV 的血浆浓度,还可以降低 LPV 的生物活化。