Laboratory of Molecular Toxicology, School of Pharmaceutical Sciences, University of Shizuoka.
Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST).
J Toxicol Sci. 2021;46(4):167-176. doi: 10.2131/jts.46.167.
Drug-induced liver injury (DILI) is one of the major causes for the discontinuation of drug development and withdrawal of drugs from the market. Since it is known that reactive metabolite formation and being substrates or inhibitors of cytochrome P450s (P450s) are associated with DILI, we systematically investigated the association between human P450 inhibition and DILI. The inhibitory activity of 266 DILI-positive drugs (DILI drugs) and 92 DILI-negative drugs (no-DILI drugs), which were selected from Liver Toxicity Knowledge Base (US Food and Drug Administration), against 8 human P450 forms was assessed using recombinant enzymes and luminescent substrates, and the threshold values showing the highest balanced accuracy for DILI discrimination were determined for each P450 enzyme using receiver operating characteristic analyses. The results showed that among the P450s tested, CYP1A1 and CYP1B1 were inhibited by DILI drugs more than no-DILI drugs with a statistical significance. We found that 91% of drugs that showed inhibitory activity greater than the threshold values against CYP1A1 or CYP1B1 were DILI drugs. The results of internal 5-fold cross-validation confirmed the usefulness of CYP1A1 and CYP1B1 inhibition data for the threshold-based discrimination of DILI drugs. Although the contribution of these P450s to drug metabolism in the liver is considered minimal, our present findings suggest that the assessment of CYP1A1 and CYP1B1 inhibition is useful for screening DILI risk of drug candidates at the early stage of drug development.
药物性肝损伤(DILI)是药物开发中断和药物从市场撤出的主要原因之一。由于已知活性代谢物的形成以及作为细胞色素 P450(P450s)的底物或抑制剂与 DILI 相关,因此我们系统地研究了人 P450 抑制与 DILI 之间的关系。使用重组酶和发光底物评估了来自肝毒性知识库(美国食品和药物管理局)的 266 种 DILI 阳性药物(DILI 药物)和 92 种 DILI 阴性药物(无 DILI 药物)对 8 种人 P450 形式的抑制活性,并使用接收器操作特性分析为每个 P450 酶确定了用于 DILI 区分的显示最高平衡准确性的阈值值。结果表明,在所测试的 P450 中,CYP1A1 和 CYP1B1 被 DILI 药物抑制的程度超过了无 DILI 药物,具有统计学意义。我们发现,对 CYP1A1 或 CYP1B1 的抑制活性大于阈值的药物中有 91%是 DILI 药物。内部 5 倍交叉验证的结果证实了 CYP1A1 和 CYP1B1 抑制数据用于基于阈值的 DILI 药物区分的有用性。尽管这些 P450 对肝脏中药物代谢的贡献被认为很小,但我们目前的发现表明,评估 CYP1A1 和 CYP1B1 的抑制对于在药物开发的早期阶段筛选药物候选物的 DILI 风险是有用的。