Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patients

Abstract Background Recent studies indicate that inflammation may also affect CYP3A4 activity. Associations of CYP3A4-mediated metabolism of quinine, with inflammatory biomarkers were investigated in patients undergoing maintenance hemodialysis (HD). Methods A single dose of 100 mg quinine was given...

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Main Authors: Hadi Molanaei, Abdul Rashid Qureshi, Olof Heimbürger, Bengt Lindholm, Ulf Diczfalusy, Björn Anderstam, Leif Bertilsson, Peter Stenvinkel
Format: Article
Language:English
Published: BMC 2018-06-01
Series:BMC Pharmacology and Toxicology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40360-018-0221-6
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author Hadi Molanaei
Abdul Rashid Qureshi
Olof Heimbürger
Bengt Lindholm
Ulf Diczfalusy
Björn Anderstam
Leif Bertilsson
Peter Stenvinkel
author_facet Hadi Molanaei
Abdul Rashid Qureshi
Olof Heimbürger
Bengt Lindholm
Ulf Diczfalusy
Björn Anderstam
Leif Bertilsson
Peter Stenvinkel
author_sort Hadi Molanaei
collection DOAJ
description Abstract Background Recent studies indicate that inflammation may also affect CYP3A4 activity. Associations of CYP3A4-mediated metabolism of quinine, with inflammatory biomarkers were investigated in patients undergoing maintenance hemodialysis (HD). Methods A single dose of 100 mg quinine was given to 44 HD patients and the plasma concentration of quinine and its metabolite 3-OH-quinine were measured 12 h after drug intake. The ratios of quinine/3-OH-quinine and 4β-OH-cholesterol/cholesterol were used as markers of CYP3A4 activity. Inflammatory biomarkers, high-sensitive CRP (hsCRP), pentraxin 3 (PTX3) and orosomucoid were followed during 4 weeks prior to quinine administration. Results The quinine/3-OH-quinine ratio correlated with median concentrations of hsCRP (Rho = 0.48; p = 0.001) and orosomucoid (Rho = 0.44; p = 0.003), and also with interleukin-6 at 12 h after drug intake (Rho = 0.43; P = 0.004) but not PTX3. In multivariate regression analysis, the correlation between CYP3A4 activity and median hsCRP remained borderline significant (p = 0.05). 4β-OH-cholesterol/cholesterol ratio correlated with quinine/3-OH-quinine (p = 0.008), but not with any of the inflammation markers. Conclusions The association between CYP3A4 activity and inflammatory biomarkers suggest that the activity of CYP3A4 is reduced by inflammation in HD patients. Further studies are needed to confirm this finding and to assess to what extent magnitude and duration of inflammation as well as the microbiota affect drug metabolism.
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spelling doaj.art-86731a31fcfa40b59c03659a4f35c0932022-12-21T23:28:38ZengBMCBMC Pharmacology and Toxicology2050-65112018-06-011911810.1186/s40360-018-0221-6Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patientsHadi Molanaei0Abdul Rashid Qureshi1Olof Heimbürger2Bengt Lindholm3Ulf Diczfalusy4Björn Anderstam5Leif Bertilsson6Peter Stenvinkel7Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalDivision of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalDivision of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalDivision of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalDivision of Clinical Chemistry Department of Laboratory Medicine, Karolinska Institutet, Karolinska University HospitalDivision of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalDivision of Clinical Pharmacology, Department of Laboratory Medicine, |Karolinska Institutet, Karolinska University HospitalDivision of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalAbstract Background Recent studies indicate that inflammation may also affect CYP3A4 activity. Associations of CYP3A4-mediated metabolism of quinine, with inflammatory biomarkers were investigated in patients undergoing maintenance hemodialysis (HD). Methods A single dose of 100 mg quinine was given to 44 HD patients and the plasma concentration of quinine and its metabolite 3-OH-quinine were measured 12 h after drug intake. The ratios of quinine/3-OH-quinine and 4β-OH-cholesterol/cholesterol were used as markers of CYP3A4 activity. Inflammatory biomarkers, high-sensitive CRP (hsCRP), pentraxin 3 (PTX3) and orosomucoid were followed during 4 weeks prior to quinine administration. Results The quinine/3-OH-quinine ratio correlated with median concentrations of hsCRP (Rho = 0.48; p = 0.001) and orosomucoid (Rho = 0.44; p = 0.003), and also with interleukin-6 at 12 h after drug intake (Rho = 0.43; P = 0.004) but not PTX3. In multivariate regression analysis, the correlation between CYP3A4 activity and median hsCRP remained borderline significant (p = 0.05). 4β-OH-cholesterol/cholesterol ratio correlated with quinine/3-OH-quinine (p = 0.008), but not with any of the inflammation markers. Conclusions The association between CYP3A4 activity and inflammatory biomarkers suggest that the activity of CYP3A4 is reduced by inflammation in HD patients. Further studies are needed to confirm this finding and to assess to what extent magnitude and duration of inflammation as well as the microbiota affect drug metabolism.http://link.springer.com/article/10.1186/s40360-018-0221-6InflammationCYP3A4, hemodialysisDrug metabolism, quinine
spellingShingle Hadi Molanaei
Abdul Rashid Qureshi
Olof Heimbürger
Bengt Lindholm
Ulf Diczfalusy
Björn Anderstam
Leif Bertilsson
Peter Stenvinkel
Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patients
BMC Pharmacology and Toxicology
Inflammation
CYP3A4, hemodialysis
Drug metabolism, quinine
title Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patients
title_full Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patients
title_fullStr Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patients
title_full_unstemmed Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patients
title_short Inflammation down-regulates CYP3A4-catalysed drug metabolism in hemodialysis patients
title_sort inflammation down regulates cyp3a4 catalysed drug metabolism in hemodialysis patients
topic Inflammation
CYP3A4, hemodialysis
Drug metabolism, quinine
url http://link.springer.com/article/10.1186/s40360-018-0221-6
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