Kawauchi Shoji, Nakamura Tsutomu, Yasui Hiroyuki, Nishikawa Chikako, Miki Ikuya, Inoue Jun, Horibe Sayo, Hamaguchi Tsuneo, Tanahashi Toshihito, Mizuno Shigeto
1. Department of Medical Pharmaceutics, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-machi, Higashinada-ku, Kobe, 658-8558, Japan; ; 2. Educational Center for Clinical Pharmacy, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-machi, Higashinada-ku, Kobe, 658-8558, Japan;
3. Department of Pharmaceutical Health Care, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, 7-2-1 Kamiohno, Himeji, 670-8524, Japan;
Int J Med Sci. 2014 Sep 13;11(12):1208-17. doi: 10.7150/ijms.9866. eCollection 2014.
Non-steroidal anti-inflammatory drugs induce the serious side effect of small intestinal ulcerations (SIUs), but little information is available regarding the consequences to drug metabolism and absorption.
We examined the existence of secondary hepatic inflammation in rats with indomethacin (INM)-induced SIUs and assessed its relationship to the cytochrome P450 (CYP) and P-glycoprotein (mdr1a), the major drug-metabolizing factors in the small intestine and the liver.
Gene expression of the CYP family of enzymes and mdr1a was measured with quantitative real-time polymerase chain reaction (qPCR). Vancomycin (VCM), a poorly absorbed drug, was administered intraduodenally to rats with SIUs.
INM induced SIUs predominantly in the lower region of the small intestine with high expression of inflammatory markers. Liver dysfunction was also observed, which suggested a secondary inflammatory response in rats with SIUs. In the liver of rats with SIUs, the expression of CYP2C11, CYP2E1, and CYP3A1 was significantly decreased, and loss of CYP3A protein was observed. Although previous studies have shown a direct effect of INM on CYP3A activity, we could not confirm any change in hepatic CY3A4 expression (major isoform of human CYP3A) in vitro. The plasma VCM concentration was increased in rats with SIUs due to partial absorption from the mucosal injury, but not in normal mucosa.
INM-induced SIUs had a subtle effect on intestinal CYP expression, but had an apparent action on hepatic CYP, which was influenced, at least in part, by the secondary inflammation. Furthermore, drug absorption was increased in rats with SIUs.
非甾体类抗炎药会引发小肠溃疡(SIU)这一严重副作用,但关于其对药物代谢和吸收的影响却知之甚少。
我们研究了吲哚美辛(INM)诱导的SIU大鼠继发性肝脏炎症的存在情况,并评估了其与细胞色素P450(CYP)和P-糖蛋白(mdr1a)的关系,这两者是小肠和肝脏中主要的药物代谢因子。
采用定量实时聚合酶链反应(qPCR)检测CYP酶家族和mdr1a的基因表达。将吸收不良的药物万古霉素(VCM)经十二指肠给予患有SIU的大鼠。
INM主要在小肠下部诱导SIU,炎症标志物表达较高。还观察到肝功能障碍,这表明SIU大鼠存在继发性炎症反应。在患有SIU的大鼠肝脏中,CYP2C11、CYP2E1和CYP3A1的表达显著降低,且观察到CYP3A蛋白缺失。尽管先前的研究表明INM对CYP3A活性有直接影响,但我们在体外未能证实肝脏CY3A4表达(人CYP3A的主要同工型)有任何变化。由于黏膜损伤导致部分吸收,患有SIU的大鼠血浆VCM浓度升高,但正常黏膜组未出现这种情况。
INM诱导的SIU对肠道CYP表达有细微影响,但对肝脏CYP有明显作用,这至少部分受到继发性炎症的影响。此外,患有SIU的大鼠药物吸收增加。