安非他酮及其药理活性代谢物在孕期的药代动力学
Pharmacokinetics of Bupropion and Its Pharmacologically Active Metabolites in Pregnancy.
作者信息
Fokina Valentina M, Xu Meixiang, Rytting Erik, Abdel-Rahman Sherif Z, West Holly, Oncken Cheryl, Clark Shannon M, Ahmed Mahmoud S, Hankins Gary D V, Nanovskaya Tatiana N
机构信息
Department of Pharmacology and Toxicology (V.M.F.), Maternal-Fetal Pharmacology and Biodevelopment Laboratories, Department of Obstetrics and Gynecology (M.X., E.R., S.Z.A.-R., M.S.A., T.N.N.), and Department of Obstetrics and Gynecology (H.W., S.M.C., G.D.V.H.), University of Texas Medical Branch, Galveston, Texas; and University of Connecticut Health Center, Farmington, Connecticut (C.O.).
Department of Pharmacology and Toxicology (V.M.F.), Maternal-Fetal Pharmacology and Biodevelopment Laboratories, Department of Obstetrics and Gynecology (M.X., E.R., S.Z.A.-R., M.S.A., T.N.N.), and Department of Obstetrics and Gynecology (H.W., S.M.C., G.D.V.H.), University of Texas Medical Branch, Galveston, Texas; and University of Connecticut Health Center, Farmington, Connecticut (C.O.)
出版信息
Drug Metab Dispos. 2016 Nov;44(11):1832-1838. doi: 10.1124/dmd.116.071530. Epub 2016 Aug 15.
Bupropion sustained release is used to promote smoking cessation in males and nonpregnant females. However, its efficacy as a smoking cessation aid during pregnancy is not reported. The pregnancy-associated changes in maternal physiology may alter the pharmacokinetics and pharmacodynamics of bupropion and consequently its efficacy in pregnant smokers. Therefore, the aims of this study were to determine the steady-state pharmacokinetics of bupropion during pregnancy and the effect of functional genetic variants of CYP2B6 and CYP2C19 on bupropion pharmacokinetics in pregnant women. Plasma and urine concentrations of bupropion and its metabolites hydroxybupropion (OHBUP), threohydrobupropion, and erythrohydrobupropion were determined by liquid chromatography-mass spectrometry. Subjects were genotyped for five nonsynonymous single-nucleotide polymorphisms that result in seven CYP2B6 alleles, namely *2, *3, *4, *5, *6, *7, and *9, and for CYP2C19 variants *2, *3, and 17 The present study reports that the isoform-specific effect of pregnancy on bupropion-metabolizing enzymes along with the increase of renal elimination of the drug could collectively result in a slight decrease in exposure to bupropion in pregnancy. In contrast, pregnancy-induced increase in CYP2B6-catalyzed bupropion hydroxylation did not impact the plasma levels of OHBUP, probably due to a higher rate of OHBUP glucuronidation, and renal elimination associated with pregnancy. Therefore, exposure to OHBUP, a pharmacologically active metabolite of the bupropion, appears to be similar to that of the nonpregnant state. The predicted metabolic phenotypes of CYP2B66 and variant alleles of CYP2C19 in pregnancy are similar to those in the nonpregnant state.
安非他酮缓释剂用于促进男性和未怀孕女性戒烟。然而,其在孕期作为戒烟辅助药物的疗效尚无报道。孕期母体生理的相关变化可能会改变安非他酮的药代动力学和药效学,进而影响其对孕期吸烟者的疗效。因此,本研究的目的是确定孕期安非他酮的稳态药代动力学,以及细胞色素P450 2B6(CYP2B6)和细胞色素P450 2C19(CYP2C19)功能基因变异对孕妇安非他酮药代动力学的影响。采用液相色谱-质谱法测定安非他酮及其代谢产物羟基安非他酮(OHBUP)、苏式羟基安非他酮和赤式羟基安非他酮的血浆和尿液浓度。对导致7种CYP2B6等位基因(即*2、*3、*4、5、6、7和9)的5个非同义单核苷酸多态性以及CYP2C19变异体2、3和17进行基因分型。本研究报告称,孕期对安非他酮代谢酶的亚型特异性影响,以及药物肾清除率的增加,可能共同导致孕期安非他酮的暴露量略有下降。相比之下,孕期诱导的CYP2B6催化的安非他酮羟基化增加并未影响OHBUP的血浆水平,这可能是由于OHBUP葡萄糖醛酸化率较高以及与孕期相关的肾清除所致。因此,安非他酮的药理活性代谢产物OHBUP的暴露量似乎与非孕期相似。孕期CYP2B66和CYP2C19变异等位基因的预测代谢表型与非孕期相似。