Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea.
Toxicol Appl Pharmacol. 2012 Sep 1;263(2):131-7. doi: 10.1016/j.taap.2012.03.017. Epub 2012 Apr 3.
Clinical hypothyroidism affects various metabolic processes including drug metabolism. CYP2B and CYP3A are important cytochrome P450 drug metabolizing enzymes that are regulated by the xenobiotic receptors constitutive androstane receptor (CAR, NR1I3) and pregnane X receptor (PXR, NR1I2). We evaluated the regulation of the hepatic expression of CYPs by CAR and PXR in the hypothyroid state induced by a low-iodine diet containing 0.15% propylthiouracil. Expression of Cyp3a11 was suppressed in hypothyroid C57BL/6 wild type (WT) mice and a further decrement was observed in hypothyroid CAR-/- mice, but not in hypothyroid PXR-/- mice. In contrast, expression of Cyp2b10 was induced in both WT and PXR-/- hypothyroid mice, and this induction was abolished in CAR-/- mice and in and CAR-/- PXR-/- double knockouts. CAR mRNA expression was increased by hypothyroidism, while PXR expression remained unchanged. Carbamazepine (CBZ) is a commonly used antiepileptic that is metabolized by CYP3A isoforms. After CBZ treatment of normal chow fed mice, serum CBZ levels were highest in CAR-/- mice and lowest in WT and PXR-/- mice. Hypothyroid WT or PXR-/- mice survived chronic CBZ treatment, but all hypothyroid CAR-/- and CAR-/- PXR-/- mice died, with CAR-/-PXR-/- mice surviving longer than CAR-/- mice (12.3±3.3 days vs. 6.3±2.1 days, p=0.04). All these findings suggest that hypothyroid status affects xenobiotic metabolism, with opposing responses of CAR and PXR and their CYP targets that can cancel each other out, decreasing serious metabolic derangement in response to a xenobiotic challenge.
临床甲状腺功能减退症影响包括药物代谢在内的各种代谢过程。CYP2B 和 CYP3A 是重要的细胞色素 P450 药物代谢酶,受外源性受体组成型雄烷受体 (CAR,NR1I3) 和孕烷 X 受体 (PXR,NR1I2) 调节。我们评估了低碘饮食(含 0.15%丙基硫氧嘧啶)诱导的甲状腺功能减退状态下 CAR 和 PXR 对肝 CYP 表达的调节作用。Cyp3a11 在甲状腺功能减退的 C57BL/6 野生型 (WT) 小鼠中受到抑制,在甲状腺功能减退的 CAR-/-小鼠中观察到进一步的降低,但在甲状腺功能减退的 PXR-/-小鼠中没有。相反,Cyp2b10 在 WT 和 PXR-/-甲状腺功能减退小鼠中均被诱导,而在 CAR-/-小鼠中和 CAR-/-PXR-/-双敲除小鼠中这种诱导被消除。甲状腺功能减退症增加了 CAR mRNA 的表达,而 PXR 表达保持不变。卡马西平 (CBZ) 是一种常用的抗癫痫药物,由 CYP3A 同工酶代谢。在正常饲料喂养的小鼠给予 CBZ 治疗后,CAR-/-小鼠的血清 CBZ 水平最高,WT 和 PXR-/-小鼠的水平最低。甲状腺功能减退的 WT 或 PXR-/-小鼠在慢性 CBZ 治疗中存活,但所有甲状腺功能减退的 CAR-/-和 CAR-/-PXR-/-小鼠均死亡,CAR-/-PXR-/-小鼠的存活时间长于 CAR-/-小鼠 (12.3±3.3 天 vs. 6.3±2.1 天,p=0.04)。所有这些发现表明,甲状腺功能减退状态会影响外源性代谢物的代谢,CAR 和 PXR 及其 CYP 靶标表现出相反的反应,可以相互抵消,从而减少对外源性物质挑战的严重代谢紊乱。