title: Changes in cytochrome P450s-mediated drug clearance in patients with hepatocellular carcinoma in vitro and in vivo: a bottom-up approach.
abstract: Hepatocellular carcinoma (HCC) accompanied by severe liver dysfunction is a serious disease, which results in altered hepatic clearance. Generally, maintenance doses depend upon drug clearance, so individual dosage regimens should be customized for HCC patients based on the condition of patients. Based on clearance of CYP isoform-specific substrates at the microsomal level (CLM), microsomal protein per gram of liver (MPPGL), liver weight, hepatic blood flow, hepatic clearance values (CLH) for 10 CYPs in HCC patients (n=102) were extrapolated using a predictive bottom-up pharmacokinetic model. Compared with controls, the CLM values for CYP2C9, 2D6, 2E1 were significantly increased in HCC patients. Additionally, CYP1A2, 2C8, 2C19 CLM values decreased while the values for CYP2A6, 2B6, 3A4/5 were unchanged. The MPPGL values in HCC tissues were significantly reduced. CLH values of HCC patients for CYP1A2, 2A6, 2B6, 2C8, 2C19, and 3A4/5 were significantly reduced, while this for CYP2E1 were markedly increased and those for CYP2C9 and 2D6 did not change. Moreover, disease (fibrosis and cirrhosis) and polymorphisms of the CYP genes have influenced the CLH for some CYPs. Prediction of the effects of HCC on drug clearance may be helpful for the design of clinical studies and the clinical management of drugs in HCC patients.
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Gao
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Xiao-Pei
authors.initials: XP
authors.lastname: He
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Yun-Fei
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Na
authors.initials: N
authors.lastname: Gao
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Tian
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wen
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Lin-Jing
authors.initials: LJ
authors.lastname: Jia
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Han
authors.initials: H
authors.lastname: Jin
authors.affiliation: Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.
authors.forename: Hai-Ling
authors.initials: HL
authors.lastname: Qiao
mesh_terms: D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000473:pathology; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism*; D018757:GABA Modulators / Q000378:metabolism / Q000493:pharmacokinetics; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism; D007700:Kinetics; D008113:Liver Neoplasms / Q000378:metabolism* / Q000473:pathology; D008657:Metabolic Clearance Rate; D008862:Microsomes, Liver / Q000378:metabolism; D008874:Midazolam / Q000378:metabolism / Q000493:pharmacokinetics; D009853:Omeprazole / Q000378:metabolism / Q000493:pharmacokinetics; D004364:Pharmaceutical Preparations / Q000378:metabolism*; D054328:Proton Pump Inhibitors / Q000378:metabolism / Q000493:pharmacokinetics
chemical_list: D018757:GABA Modulators; D007527:Isoenzymes; D004364:Pharmaceutical Preparations; D054328:Proton Pump Inhibitors; D003577:Cytochrome P-450 Enzyme System; D009853:Omeprazole; D008874:Midazolam
keywords: bottom-up IVIVE approach; cytochrome P450s; hepatic clearance; hepatocellular carcinoma; microsomal protein per gram of liver