title: Selective tissue distribution of tibolone metabolites in mature ovariectomized female cynomolgus monkeys after multiple doses of tibolone.
abstract: Tibolone is a selective tissue estrogenic activity regulator (STEAR). In postmenopausal women, it acts as an estrogen on brain, vagina, and bone, but not on endometrium and breast. Despite ample supporting in vitro data for tissue-selective actions, confirmative tissue levels of tibolone metabolites are not available. Therefore, we analyzed tibolone and metabolites in plasma and tissues from six ovariectomized cynomolgus monkeys that received tibolone (0.5 mg/kg/day by gavage) for 36 days and were necropsied at 1, 1.25, 2.25, 4, 6, and 24 h after the final dose. The plasma and tissue levels of active, nonsulfated (tibolone, 3alpha-hydroxytibolone, 3beta-hydroxytibolone, and Delta(4)-tibolone), monosulfated (3alpha-sulfate,17beta-hydroxytibolone and 3beta-sulfate,17beta-hydroxytibolone), and disulfated (3alpha,17beta-disulfated-tibolone and 3beta,17betaS-disulfated-tibolone) metabolites were measured by validated gas chromatography with mass spectrometry and liquid chromatography with tandem mass spectrometry. Detection limits were 0.1 to 0.5 ng/ml (plasma) and 0.5 to 2 ng/g (tissues). In brain tissues, estrogenic 3alpha-hydroxytibolone was predominant with 3 to 8 times higher levels than in plasma; levels of sulfated metabolites were low. In vaginal tissues, major nonsulfated metabolites were 3alpha-hydroxytibolone and the androgenic/progestagenic Delta(4)-tibolone; disulfated metabolites were predominant. Remarkably high levels of monosulfated metabolites were found in the proximal vagina. In endometrium, myometrium, and mammary glands, levels of 3-hydroxymetabolites were low and those of sulfated metabolites were high (about 98% disulfated). Delta(4)-Tibolone/3-hydroxytibolone ratios were 2 to 3 in endometrium, about equal in breast and proximal vagina, and 0.1 in plasma and brain. It is concluded that tibolone metabolites show a unique tissue-specific distribution pattern explaining the tissue effects in monkeys and the clinical effects in postmenopausal women.
authors.affiliation: Research and Development, NV Organon, Oss, The Netherlands. herman.verheul@organon.com
authors.forename: H A M
authors.initials: HA
authors.lastname: Verheul
authors.forename: M L P S
authors.initials: ML
authors.lastname: van Iersel
authors.forename: L P C
authors.initials: LP
authors.lastname: Delbressine
authors.forename: H J
authors.initials: HJ
authors.lastname: Kloosterboer
mesh_terms: D000284:Administration, Oral; D000818:Animals; D001711:Biotransformation; D001921:Brain / Q000378:metabolism; D001940:Breast / Q000378:metabolism; D002851:Chromatography, High Pressure Liquid; D004334:Drug Administration Schedule; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D008252:Macaca fascicularis; D015394:Molecular Structure; D009652:Norpregnenes / Q000008:administration & dosage / Q000097:blood / Q000737:chemistry / Q000493:pharmacokinetics*; D010052:Ovariectomy; D015203:Reproducibility of Results; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage / Q000097:blood / Q000737:chemistry / Q000493:pharmacokinetics*; D013431:Sulfates / Q000493:pharmacokinetics; D053719:Tandem Mass Spectrometry; D014018:Tissue Distribution; D014599:Uterus / Q000378:metabolism; D014621:Vagina / Q000378:metabolism
chemical_list: C485705:3-hydroxytibolone; D009652:Norpregnenes; D020845:Selective Estrogen Receptor Modulators; D013431:Sulfates; C485706:delta(4)-tibolone; C027385:tibolone