title: Polymorphic hydroxylation of perhexiline in vitro.
abstract: OBJECTIVE
  The aims of this study were to examine the in vitro enzyme kinetics and CYP isoform selectivity of perhexiline monohydroxylation using human liver microsomes.
  
  
  METHODS
  Conversion of rac-perhexiline to monohydroxyperhexiline by human liver microsomes was assessed using a high-performance liquid chromatography assay with precolumn derivatization to measure the formation rate of the product. Isoform selective inhibitors were used to define the CYP isoform profile of perhexiline monohydroxylation.
  
  
  RESULTS
  The rate of perhexiline monohydroxylation with microsomes from 20 livers varied 50-fold. The activity in 18 phenotypic perhexiline extensive metabolizer (PEM) livers varied about five-fold. The apparent Km was 3.3 +/- 1.5 micro m, the Vmax was 9.1 +/- 3.1 pmol min-1 mg-1 microsomal protein and the in vitro intrinsic clearance (Vmax/Km) was 2.9 +/- 0.5 micro l min-1 mg-1 microsomal protein in the extensive metabolizer livers. The corresponding values in the poor metabolizer livers were: apparent Km 124 +/- 141 micro m; Vmax 1.4 +/- 0.6 pmol min-1 mg-1 microsomal protein; and intrinsic clearance 0.026 micro l min-1 mg-1 microsomal protein. Quinidine almost completely inhibited perhexiline monohydroxylation activity, but inhibitors selective for other CYP isoforms had little effect.
  
  
  CONCLUSIONS
  Perhexiline monohydroxylation is almost exclusively catalysed by CYP2D6 with activities being about 100-fold lower in CYP2D6 poor metabolizers than in extensive metabolizers. The in vitro data predict the in vivo saturable metabolism and pharmacogenetics of perhexiline.
authors.affiliation: Department of Clinical Pharmacology, Flinders Medical Centre and Flinders University of South Australia, Bedford Park, Australia.
authors.forename: L B
authors.initials: LB
authors.lastname: Sørensen
authors.forename: R N
authors.initials: RN
authors.lastname: Sørensen
authors.forename: J O
authors.initials: JO
authors.lastname: Miners
authors.forename: A A
authors.initials: AA
authors.lastname: Somogyi
authors.forename: N
authors.initials: N
authors.lastname: Grgurinovich
authors.forename: D J
authors.initials: DJ
authors.lastname: Birkett
mesh_terms: D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000494:pharmacology; D005838:Genotype; D006801:Humans; D006900:Hydroxylation; D008862:Microsomes, Liver / Q000378:metabolism; D010480:Perhexiline / Q000378:metabolism*; D011110:Polymorphism, Genetic; D011802:Quinidine / Q000494:pharmacology
chemical_list: D004791:Enzyme Inhibitors; D019389:Cytochrome P-450 CYP2D6; D011802:Quinidine; D010480:Perhexiline