title: CYP-mediated therapeutic protein-drug interactions: clinical findings, proposed mechanisms and regulatory implications.
abstract: Therapeutic proteins (TPs) may affect the disposition of drugs that are metabolized by cytochrome P450 (CYP) enzymes, as is evident from a review of data in recently published literature and approved Biologic License Applications. Many TPs belonging to the cytokine class appear to differentially affect CYP activities. Cytokine modulators may affect CYP enzyme activities by altering cytokine effects on CYP enzymes. The alteration in CYP enzyme activities seems to result from changes in transcription factor activity for CYP enzyme expression or changes in CYP enzyme stability, which have been observed during altered immunological states such as infection and inflammation. Human growth hormone also appears to differentially affect CYP activities through unknown mechanisms. Because TP-drug interaction research is an evolving area, limited information is available during drug development on TP-drug interactions mediated by CYP inhibition or induction. The authors of this review suggest that effort be made to understand TP-drug interactions for the safe and effective use of TPs in combination with small-molecule drugs.
authors.affiliation: Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, United States Food and Drug Administration, Silver Spring, Maryland 20993, USA. jangik.lee@fda.hhs.gov
authors.forename: Jang-Ik
authors.initials: JI
authors.lastname: Lee
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Angela Y
authors.initials: AY
authors.lastname: Men
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Kenna
authors.forename: Shiew-Mei
authors.initials: SM
authors.lastname: Huang
mesh_terms: D000818:Animals; D003577:Cytochrome P-450 Enzyme System / Q000096:biosynthesis / Q000235:genetics / Q000493:pharmacokinetics / Q000502:physiology*; D004347:Drug Interactions / Q000502:physiology; D015971:Gene Expression Regulation, Enzymologic / Q000187:drug effects; D006801:Humans; D007880:Legislation, Drug / Q000592:standards / Q000639:trends*; D008657:Metabolic Clearance Rate / Q000187:drug effects / Q000502:physiology; D004364:Pharmaceutical Preparations / Q000378:metabolism* / Q000592:standards; D011506:Proteins / Q000493:pharmacokinetics* / Q000592:standards / Q000627:therapeutic use*; D014481:United States
chemical_list: D004364:Pharmaceutical Preparations; D011506:Proteins; D003577:Cytochrome P-450 Enzyme System
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