Age-dependent kinetics and metabolism of dichloroacetate: possible relevance to toxicity.
Dichloroacetate (DCA) is an investigational drug for certain metabolic diseases. It is biotransformed principally by the zeta-1 family isoform of glutathione transferase (GSTz1), also known as maleylacetoacetate isomerase (MAAI), which catalyzes the penultimate step in tyrosine catabolism. DCA causes a reversible peripheral neuropathy in several species, including humans. However, recent clinical trials indicate that adults are considerably more susceptible to this adverse effect than children. We evaluated the kinetics and biotransformation of DCA and its effects on tyrosine metabolism in nine patients treated for 6 months with 25 mg/kg/day and in rats treated for 5 days with 50 mg/kg/day. We also measured the activity and expression of hepatic GSTz1/MAAI. Chronic administration of DCA causes a striking age-dependent decrease in its plasma clearance and an increase in its plasma half-life in patients and rats. Urinary excretion of unchanged DCA in rats increases with age, whereas oxalate, an end product of DCA metabolism, shows the opposite trend. Low concentrations of monochloroacetate (MCA), which is known to be neurotoxic, increase as a function of age in the urine of dosed rats. MCA was detectable in plasma only of older animals. Hepatic GSTz1/MAAI-specific activity was inhibited equally by DCA treatment among all age groups, whereas plasma and urinary levels of maleylacetone, a natural substrate for this enzyme, increased with age. We conclude that age is an important variable in the in vivo metabolism and elimination of DCA and that it may account, in part, for the neurotoxicity of this compound in humans and other species.
Shroads
Albert L
AL
Departments of Medicine, University of Florida Colleges of Medicine and Pharmacy, University of Florida, Gainesville, Florida, USA.
Guo
Xu
X
Dixit
Vaishali
V
Liu
Hui-Ping
HP
James
Margaret O
MO
Stacpoole
Peter W
PW
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000187:drug effects / Q000378:metabolism*; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003999:Dichloroacetic Acid / Q000097:blood / Q000493:pharmacokinetics* / Q000633:toxicity*; D006801:Humans; D008297:Male; D053858:Metabolic Networks and Pathways / Q000187:drug effects / Q000502:physiology*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D051381:Rats; D017207:Rats, Sprague-Dawley
D003999:Dichloroacetic Acid