Identification of the metabolites of ivermectin in humans

Mass drug administration of ivermectin has been proposed as a possible malaria elimination tool. Ivermectin exhibits a mosquito‐lethal effect well beyond its biological half‐life, suggesting the presence of active slowly eliminated metabolites. Human liver microsomes, primary human hepatocytes, and...

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Main Authors: Tipthara, P, Kobylinski, KC, Godejohann, M, Hanboonkunupakarn, B, Roth, A, Adams, JH, White, NJ, Jittamala, P, Day, NPJ, Tarning, J
Format: Journal article
Language:English
Published: Wiley 2021
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author Tipthara, P
Kobylinski, KC
Godejohann, M
Hanboonkunupakarn, B
Roth, A
Adams, JH
White, NJ
Jittamala, P
Day, NPJ
Tarning, J
author_facet Tipthara, P
Kobylinski, KC
Godejohann, M
Hanboonkunupakarn, B
Roth, A
Adams, JH
White, NJ
Jittamala, P
Day, NPJ
Tarning, J
author_sort Tipthara, P
collection OXFORD
description Mass drug administration of ivermectin has been proposed as a possible malaria elimination tool. Ivermectin exhibits a mosquito‐lethal effect well beyond its biological half‐life, suggesting the presence of active slowly eliminated metabolites. Human liver microsomes, primary human hepatocytes, and whole blood from healthy volunteers given oral ivermectin were used to identify ivermectin metabolites by ultra‐high performance liquid chromatography coupled with high‐resolution mass spectrometry. The molecular structures of metabolites were determined by mass spectrometry and verified by nuclear magnetic resonance. Pure cytochrome P450 enzyme isoforms were used to elucidate the metabolic pathways. Thirteen different metabolites (M1‐M13) were identified after incubation of ivermectin with human liver microsomes. Three (M1, M3, and M6) were the major metabolites found in microsomes, hepatocytes, and blood from volunteers after oral ivermectin administration. The chemical structure, defined by LC‐MS/MS and NMR, indicated that M1 is 3″‐O‐demethyl ivermectin, M3 is 4‐hydroxymethyl ivermectin, and M6 is 3″‐O‐demethyl, 4‐hydroxymethyl ivermectin. Metabolic pathway evaluations with characterized cytochrome P450 enzymes showed that M1, M3, and M6 were produced primarily by CYP3A4, and that M1 was also produced to a small extent by CYP3A5. Demethylated (M1) and hydroxylated (M3) ivermectin were the main human in vivo metabolites. Further studies are needed to characterize the pharmacokinetic properties and mosquito‐lethal activity of these metabolites.
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spelling oxford-uuid:bd246261-c229-4b93-a812-4f124afa7cfd2022-03-27T05:29:33ZIdentification of the metabolites of ivermectin in humansJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bd246261-c229-4b93-a812-4f124afa7cfdEnglishSymplectic ElementsWiley2021Tipthara, PKobylinski, KCGodejohann, MHanboonkunupakarn, BRoth, AAdams, JHWhite, NJJittamala, PDay, NPJTarning, JMass drug administration of ivermectin has been proposed as a possible malaria elimination tool. Ivermectin exhibits a mosquito‐lethal effect well beyond its biological half‐life, suggesting the presence of active slowly eliminated metabolites. Human liver microsomes, primary human hepatocytes, and whole blood from healthy volunteers given oral ivermectin were used to identify ivermectin metabolites by ultra‐high performance liquid chromatography coupled with high‐resolution mass spectrometry. The molecular structures of metabolites were determined by mass spectrometry and verified by nuclear magnetic resonance. Pure cytochrome P450 enzyme isoforms were used to elucidate the metabolic pathways. Thirteen different metabolites (M1‐M13) were identified after incubation of ivermectin with human liver microsomes. Three (M1, M3, and M6) were the major metabolites found in microsomes, hepatocytes, and blood from volunteers after oral ivermectin administration. The chemical structure, defined by LC‐MS/MS and NMR, indicated that M1 is 3″‐O‐demethyl ivermectin, M3 is 4‐hydroxymethyl ivermectin, and M6 is 3″‐O‐demethyl, 4‐hydroxymethyl ivermectin. Metabolic pathway evaluations with characterized cytochrome P450 enzymes showed that M1, M3, and M6 were produced primarily by CYP3A4, and that M1 was also produced to a small extent by CYP3A5. Demethylated (M1) and hydroxylated (M3) ivermectin were the main human in vivo metabolites. Further studies are needed to characterize the pharmacokinetic properties and mosquito‐lethal activity of these metabolites.
spellingShingle Tipthara, P
Kobylinski, KC
Godejohann, M
Hanboonkunupakarn, B
Roth, A
Adams, JH
White, NJ
Jittamala, P
Day, NPJ
Tarning, J
Identification of the metabolites of ivermectin in humans
title Identification of the metabolites of ivermectin in humans
title_full Identification of the metabolites of ivermectin in humans
title_fullStr Identification of the metabolites of ivermectin in humans
title_full_unstemmed Identification of the metabolites of ivermectin in humans
title_short Identification of the metabolites of ivermectin in humans
title_sort identification of the metabolites of ivermectin in humans
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