The many consequences of chemical- and genetic-based modulation of drug metabolizing enzyme activities.
The induction or inhibition of the metabolizing enzyme activities by a great deal of substances (including drugs) influence their toxicological or pharmacological outcomes as well as that of other xenobiotics or drugs to which human is simultaneously exposed. The dual bioactivating/detoxificating nature of both phase I and phase II enzymes poses such modulation as an unavoidable unhealthy phenomenon. Therefore, the proposed strategies in preventive medicine which foresee boosting or depressing enzymatic effects such as those in the field of cancer chemoprevention, should be carefully reconsidered before their credibility would be compromised. As the phenotypic features, genetic polymorphisms leading to the occurrence of high or low metabolizers in the population, each at high risk to certain forms of toxicity, behave as a sort of "constitutive" enzymatic modulation. Thus, considering the double-edged sword nature (detoxi-toxicant) of these catalysts towards ubiquitous environmental pollutants, the search for individual susceptibility by means of the genotypic analysis represents a very intriguing problem. However, the knowledge of the "overall" metabolic fingerprint associated to the phenotypic analysis in a single person could offer an interesting way to (partially) control human risk by making suitable (well aimed) modifications of determined life-styles (e.g. stop smoking or drinking) or particular dietetic practices (e.g. stop eating high cooked meat or fish) as well as selecting personalised drug adjustments by physicians either in terms of dosage or fitting drug.
Paolini
M
M
Department of Pharmacology, University of Bologna, Italy. paolini@biocfarm.unibo.it
Biagi
G L
GL
Cantelli-Forti
G
G
D001682:Biological Availability; D006801:Humans; D008658:Inactivation, Metabolic / Q000235:genetics; D015262:Xenobiotics / Q000378:metabolism
D015262:Xenobiotics