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Department of Pharmacology, Istituto di Richerche di Biologia Molecolare, Merck Research Laboratories, Rome, Italy (A.D.M., A.Ce., M.F., R.L.); and Labeled Compound Synthesis, Department of Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey (A.Ch.)
(Received April 20, 2007; Accepted June 26, 2007)
| Abstract |
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CYP2C19 is a polymorphic enzyme that is absent in approximately 5% of the Caucasian population and up to 20% of the Asian population (Wrighton and Stevens, 1992
). CYP2C19 is the major P450 responsible for the oxidation of a small number of drugs, such as the (S)-enantiomer of mephenytoin, and proton pump inhibitors such as omeprazole and lansoprazole (Goldstein, 2001
; Desta et al., 2002
). The enzyme participates to various degrees in metabolic clearance of other drugs, such as phenytoin, diazepam, imipramine, propranolol, proguanil, fluoxetine, and sertraline (Goldstein, 2001
; Desta et al., 2002
) Inhibition of CYP2C19 has been implicated in clinical drug interactions between fluvoxamine and proton pump inhibitors (Yasui-Furukori et al., 2004a
,b
), alprazolam (Suzuki et al., 2004
), mephenytoin, chloroguanide, and diazepam (Yao et al., 2003
and references therein); tricyclic antidepressants and phenytoin (Shin et al., 2002
); carbamazepine/diazepam and phenytoin (Lakehal et al., 2002
); and clarithromycin and omeprazole (Calabresi et al., 2004
).
The most widely used reaction to determine the enzymatic activity of CYP2C19 is (S)-mephenytoin 4'-hydroxylation (Yuan et al., 2002
; Walsky and Obach, 2004
). A radiometric version of this assay has been described, using [14C](S)-mephenytoin (Crespi et al., 2006
). The practical challenge posed by these assays is that they require HPLC separation of the reaction product from the substrate, followed by UV, mass spectrometric, or radiochemical detection. This requirement renders the procedures relatively laborious, time-consuming, and not ideally suited for screening the large number of compounds typically required in an industrial drug discovery setting. An alternative assay using the fluorogenic nonselective CYP2C19 substrate 3-cyano-7-ethoxycoumarin has been described (Miller et al., 2000
). Even though fluorometric P450 assays are rapid, easy to perform, and amenable to automation, they suffer from a number of limitations, such as the absence of selective probes, the need to use recombinant enzyme rather than HLMs, imperfect correlation of IC50 values with those determined using classic drug substrates (Cohen et al., 2003
), and fluorescence interference by many test compounds.
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| Materials and Methods |
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Synthesis of Tritiated Mephenytoin. [phenyl-4'-Iodo](S)-Mephenytoin (2). To a 25-ml round-bottom flask were added (S)-mephenytoin (1) (0.05 mmol, 10.9 mg) and triflic acid (0.2 ml). The reaction mixture was cooled to 0°C followed by the addition of N-iodosuccinimide (0.05 mmol, 11 mg). After stirring at 0°C for 6 h, the reaction mixture was evaporated to dryness under vacuum. The crude product was further purified by reserve-phase HPLC [Zorbax Rx C18 250 x 10 mm column, water containing 0.1% TFA-acetonitrile (50:50), UV = 254 nm, flow rate = 4 ml/min, Rt = 6.5 min]. The required fractions were collected, passed through Sep-Pak C-18, and eluted with 10 ml of ethanol to yield 5 mg of (5S)-5-ethyl-3-methyl-5-(4'iodophenyl) imidazolidine-2,4-dione or [phenyl-4'-iodo](S)-mephenytoin (2) in 30% isolated yield (Fig. 1A). LC/MS: 345 (M + H)+.
[phenyl-4'-3H](S)-Mephenytoin (3). Compound 2 (5 mg) was stirred with tritium gas using catalyst 10% Pd/C (3 mg) and 5% Pd/CaCO3 (2 mg) in dimethylformamide (1 ml) for 1 h on a Trisorber manifold. The reaction mixture was filtered and coevaporated with ethanol (2 x 10 ml) to remove any exchangeable tritium gas. The crude product was purified by semipreparative HPLC [Luna Phenyl-Hexyl 250 x 10 mm column, water containing 0.1% TFA-acetonitrile (75:25), flow rate = 4 ml/min, UV = 254 nm, Rt = 20 min] to yield [phenyl-4'-3H](S)-mephenytoin (3) (24 mCi) (SA = 20 Ci/mmol as determined by LC/MS) (Fig. 1A). LC/MS: 221 (MH + 2)+. Radiochemical purity was >99% by HPLC.
[phenyl-3',4',5'-Triiodo](S)-Mephenytoin (4). To a 25-ml round-bottom flask were added (S)-(-)-mephenytoin (1) (0.05 mmol, 10.9 mg) and triflic acid (0.2 ml). The reaction mixture was cooled to 0°C followed by the addition of N-iodosuccinimide (0.5 mmol, 112.5 mg). After overnight stirring at room temperature, the reaction mixture was evaporated to dryness under vacuum. The crude product was further purified by reserve-phase HPLC (Zorbax Rx C18 250 x 10 mm column, water containing 0.1% TFA-acetonitrile (50:50), UV = 254 nm, flow rate = 4 ml/min, Rt = 15 min). The required fractions were collected, passed through Sep-Pak C-18, and eluted with 10 ml of ethanol to yield 5 mg of (5S)-5-ethyl-3-methyl-5-(3',4',5'-triiodophenyl)imidazolidine-2,4-dione or [phenyl-3',4',5' triiodo](S)-mephenytoin (4) in 17% isolated yield (Fig. 1B). LC/MS: 597 (M+H)+.
[phenyl-3',4',5'-3H](S)-Mephenytoin (5). Compound 4 (5 mg) (Fig. 1B) was stirred with tritium gas using catalyst 10% Pd/C (3 mg) and 5% Pd/CaCO3 (2 mg) in dimethylformamide (1 ml) for 1 h on Trisorber manifold. The reaction mixture was filtered and coevaporated with ethanol (2 x 10 ml) to remove any exchangeable tritium gas. The crude product was purified by semipreparative HPLC [Luna Phenyl-Hexyl 250 x 10 mm column; water containing 0.1% TFA-acetonitrile (75:25), flow rate = 4 ml/min, UV = 254 nm, Rt = 20 min] to yield [phenyl-3',4',5'-3H3](S)-mephenytoin (28 mCi; SA = 69 Ci/mmol as determined by LC/MS). LC/MS: 225 (MH + 6)+.As determined by LC-MS analysis, the proportion of tracer molecules with 1, 2, and 3 tritium atoms was 9, 38, and 51%, respectively. Tritium label in the 4' position was
50% as determined by tritium nuclear magnetic resonance. Tritium nuclear magnetic resonance (CD3OD,
): 7.3 (m, 1T, p-Ar-T), 7.36 (m, 2T, m-Ar-T). Radiochemical purity was >98% by HPLC. Compounds 3 and 5 were further purified on C18 extraction cartridges before use in radioenzymatic assays.
Radiometric CYP2C19 Assay. Reactions were carried out in a temperature-controlled microplate shaker using 96-well conical microtiter plates (Corning Glassworks, Acton, MA) containing [4'-3H] (S)-mephenytoin or [3',4',5'-3H]3(S)-mephenytoin (0.2-0.5 µCi, corresponding to a final concentration of 20-70 nM), unlabeled (S)-mephenytoin (20 µM, except otherwise noted), pooled HLMs (1 mg/ml, except otherwise noted), and 0.1 M potassium phosphate buffer, pH 7.6, in a final volume of 100 µl. Chemical inhibitors were added to the reaction mixture from stock solutions and serial dilutions in DMSO-acetonitrile-water (35:25:40, v/v), giving final solvent concentrations of 0.7% DMSO and 0.5% acetonitrile. Controls without inhibitor contained vehicle only. For determination of IC50, at least eight concentrations of chemicals were tested in duplicate. Concentration ranges were 0.0001 to 10 µM for miconazole, 0.01 to 30 µM for fluoxetine, ticlopidine, tranylcypromine, omeprazole, progesterone, clotrimazole, and amitriptyline; 0.01 to 100 µM for ketoconazole, ethynylestradiol, propranolol, cimetidine, imipramine, and carbamazepine. Inhibitory monoclonal antibodies were used at a concentration of 0.3 mg/ml. After preincubation for 10 min at 37°C, reactions were started by addition of 1 mM NADPH and an NADPH-regenerating system containing 5 mM glucose 6-phosphate, 3 mM MgCl2, and 1 U/ml glucose-6-phosphate dehydrogenase. Blanks without NADPH were run in parallel. Assays were conducted for 30 min at 37°C and stopped by addition of 20 µl of 0.5 N HCl. Plates were then centrifuged for 10 min in a microplate rotor, and the supernatant was split for analysis of tritiated water and 4'-hydroxymephenytoin. For solid-phase separation of tritiated water, 100 µl of the supernatants was loaded into the wells of a 100-mg 96-well C18 Versaplate that had been previously preconditioned by washing with methanol and water. A plate vacuum manifold (Waters, Milford, MA) was used for washing and elutions. Vacuum was applied, and the void volume was collected in the collection plate. Then, 200 µl of water was added, vacuum was applied again, and the wash was collected into the same plate. This step was repeated. Pooled void volume and water washes were transferred into scintillation vials and counted in a ß-scintillation counter. For the calculation of enzyme activity, product counts were corrected by subtraction of counts obtained in blank incubations without NADPH. Extraction plates were regenerated by washing with 5 ml of methanol and 5 ml of water and reused up to three times.
Assays with recombinant human CYP2C19 were performed as described above, except that the amount of [3',4',5'-3H]3(S)-mephenytoin was 0.14 µCi. Also, various amounts of CYP2C19 Supersomes were used instead of HLMs, as specified under Results.
Quantification of 4'-Hydroxymephenytoin. Aliquots of the acidified assay reaction mixtures (see above) and of metabolite standard curves were diluted with 50% acetonitrile and analyzed by HPLC using an Agilent HP1100 liquid chromatograph (Agilent Technologies, Palo Alto, CA) equipped with a HTL PAL Autosampler (CTC Analytics AG, Zwingen, Switzerland). Flufenamic acid was used as the internal standard. Chromatography was performed on a XTERRA MS C18 column (4.6 mm x 5 cm; 5 µm; Waters) at a flow rate of 2 ml/min, using a mobile phase consisting of a mixture of 10 mM ammonium acetate in water (A) and 10 mM ammonium acetate in acetonitrile (B), with the following gradient program: 0-0.2 min, 10% B; 0.8 min, 60% B; 1.2 min, 60% B; 1.4 min, 95% B; 2.2 min, 95% B; 2.21 min, 9% B; 2.5 min, 9% B. The eluate was split via a T-piece for injection into the mass spectrometer probe at a flow rate of 0.2 ml/min. Eluate was diverted to waste for the first minute and then injected into a Sciex API-3000 triple quadrupole mass spectrometer (PerkinElmer Life and Analytical Sciences, Boston, MA) with a Turbo Ionspray ionization source operated in the negative ion mode. 4'-Hydroxymephenytoin and flufenamic acid were detected in multiple reaction monitoring mode and identified using the transition m/z 233
190 and 280
236, respectively. Calibration curves were constructed in duplicate, using eight metabolite standard concentrations ranging from 0.014 to 30 µM. Metabolite concentrations in test samples were determined by linear least-squares regression analysis, using Analyst Quantitation Wizard software (version 1.2, Applied Biosystems, Foster City, CA).
An alternative, more sensitive method was used for analysis of tracer competition experiments. Phenytoin was used as the internal standard. Chromatography was performed on a Waters Sunfire C18 column (50 x 4.6 mm, 5 µm) at a flow rate of 1.5 ml/min using a mobile phase consisting of a mixture of solvent A (50 mM ammonia in water) and solvent B (acetonitrile) with the following gradient program: 0 to 2 min, from 5% to 95% B; 3 min, 95% B; 3.1 min, 5% B; and 3.5 min, 5% B. Detection was carried out using a TSQ Quantum Ultra mass spectrometer (ThermoFinnigan, San Jose, CA) equipped with an electrospray ion source. The mass spectrometer was operated in negative ion electrospray selective reaction monitoring mode. The selective reaction monitoring transitions of m/z 233.005
190.015 (collision energy 20 eV, scan time 0.10 s) for 4'-hydroxymephenytoin and m/z 250.990
208.010 (collision energy 21 eV, scan time 0.10 s) for phenytoin were monitored.
Calculation of Kinetic Parameters. When reactions are performed in the presence of both tritiated and unlabeled (S)-mephenytoin, comparison of the specific radioactivity of substrate and product gives information on reaction kinetics. The specific activity of tritium label in the 4' position of the substrate, SA0,is
![]() | (1) |
where c's is counts per minute in the 4' position of tritiated (S)-mephenytoin, and s is moles of total (labeled plus unlabeled) substrate molecules. For [4'-3H](S)-mephenytoin, c's equals the total tracer counts. For [3',4',5'-3H]3(S)-mephenytoin, which has 50% of label in the 4' position, c's is equal to half of the total counts. The specific activity of the tritiated water product of CYP2C19-mediated 4'-hydroxylation of the substrate, SAP, is
![]() | (2) |
where cP is counts per minute of tritiated water, and p is moles of 4'-hydroxymephenytoin. Combining eqs. 1 and 2
![]() | (3) |
where %SCT is the percentage of total label in the 4'-position of the tracer that is converted into tritiated water and %SCH is the fraction of total substrate converted into 4-hydroxymephenytoin. This ratio differs from unity if the reaction is subject to a kinetic isotope effect or to an NIH shift. In either case, hydroxylation of the tracer would not be accompanied by an equimolar release of tritiated water. In the absence of the NIH shift
![]() | (4) |
where T(V/K) is the kinetic isotope effect on the Vmax/Km ratio (Northrop, 1982
). A NIH shift of the radiolabel during hydroxylation, with retention of tritium in 4'-hydroxymephenytoin, would further increase the SA0/SAP ratio.
Kinetic parameters of 4'-hydroxymephenytoin formation were calculated using the Michaelis-Menten equation
![]() | (5) |
where v is the initial rate of product formation, Vmax is the maximal rate of product formation, and Km is the substrate concentration at 50% Vmax.
Data Analysis. Curve fitting of enzyme kinetics data to the Michaelis-Menten equation or to a four-parameter logistic inhibition model (Rodbard and Frazier, 1975
) was performed by nonlinear regression analysis using Xlfit 4.0 (IDBS, Guildford, UK).
| Results |
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Separation of Tritiated Mephenytoin from Tritiated Water Using 96-Well Solid-Phase Extraction Plates. We first assessed whether tritiated (S)-mephenytoin could be separated from the tritiated water product formed upon 4'-hydroxylation. A zero time control mixture containing HLMs to which stopping solution had been added before addition of NADPH and other assay ingredients, including approximately 106 dpm of [3',4',5'-3H]3(S)-mephenytoin and 20 µM unlabeled (S)-mephenytoin, was submitted to solid-phase extraction on 96-well extraction plates containing 100 mg of C18 sorbent. After washing of the extraction plates with water, 99.9% of the radioactivity was retained on the solid-phase resin. Only 0.027 ± 0.007% of radioactivity (mean ± S.E.M., n = 7) eluted in the void volume and aqueous washes. Tritiated mephenytoin could be recovered by eluting the solid-phase extraction resin with methanol. Similar results were obtained with [4'-3H](S)-mephenytoin (data not shown). In contrast, tritiated water (from 500 to 50,000 dpm) was not retained on the solid-phase extraction resin under the same conditions. Recovery of tritiated water in the combined void volume and aqueous washes was quantitative (data not shown).
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Reaction Kinetics with [3',4',5'-3H]3(S)-mephenytoin and [4'-3H](S)-Mephenytoin. In the absence of unlabeled (S)-mephenytoin, %SCT, the percentages of label in the 4'-position of tracer that is converted into tritiated water in 30 min at 1 mg/ml HLMs were 0.4 ± 0.1 and 1.5 ± 0.2 for [4'-3H](S)-mephenytoin and [3',4',5'-3H]3(S)-mephenytoin, respectively (mean ± S.E.M., n = 5). In the experiment depicted in Fig. 5, addition of unlabeled substrate led to a dosedependent decrease in formation of tritiated water from [4'-3H](S)-mephenytoin (Fig. 5A) and [3',4',5'-3H]3(S)-mephenytoin (Fig. 5B) with IC50 values of 46 and 27 µM, respectively. Average IC50 values ± S.E.M. from four separate experiments were 33 ± 7 and 30 ± 5 µM, respectively, which were not statistically different by two-tailed Student's t test (p = 0.7). The formation of 4'-hydroxymephenytoin followed Michaelis-Menten kinetics, with a Km of 35 ± 7 µM and Vmax of 20 ± 1 pmol/min/mg microsomal protein (Fig. 5C). The ratio of the specific radioactivity of substrate versus product, SA0/SAP, was derived from these data as described under Materials and Methods.SA0/SAP values were 2.1 ± 0.2 and 1.1 ± 0.2 for [4'-3H](S)-mephenytoin and [3',4',5'-3H]3(S)-mephenytoin, respectively (mean ± S.E.M. from data obtained at eight different substrate concentrations).
Effect of CYP2C19 Inhibitors. The effects of ticlopidine, progesterone, ethynylestradiol, ketoconazole, miconazole, and omeprazole on NADPH-dependent formation of tritiated water from [3',4',5'-3H](S)-mephenytoin in HLM are shown in Fig. 6. The inhibitory effect of additional drugs was determined using radiometric assay, and IC50 values were compared with those obtained by HPLC-MS/MS analysis of the unlabeled reaction product. As summarized in Table 1, IC50values for inhibition of formation of tritiated water and 4'-hydroxymephenytoin were very similar. IC50 values differed less than 2.5-fold for all 15 compounds tested. If compounds with IC50 >30 µM were excluded, there was a good correlation of log(IC50) values between the two assays, with a correlation coefficient (r2) of 0.95 (Fig. 7). The correlation coefficient for the linear relationship between IC50 values in the two assays was 0.79.
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| Discussion |
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Recombinant CYP2C19 catalyzed NADPH-dependent release of tritiated water from tritiated (S)-mephenytoin. In HLMs, this reaction is also NADPH-dependent and mediated almost exclusively by CYP2C19, as shown by its sensitivity to inhibitors of this enzyme, including inhibitory antibodies, and the lack of inhibition by neutralizing monoclonal antibodies against CYP2A6, CYP2D6, and CYP3A4/5. Furthermore, unlabeled (S)-mephenytoin inhibited the reaction with an IC50 of approximately 30 µM, in good agreement with the substrate Km for formation of 4'-hydroxymephenytoin (35 ± 7 µM), as expected if the formation of radiolabeled and unlabeled products are mediated by the same enzyme. The Km and Vmax (20 pmol/min/mg protein) determined for (S)-mephenytoin 4'-hydroxylation in pooled HLMs were in reasonable agreement with previously reported data [57 µM and 58 pmol/min/mg (Walsky and Obach, 2004
) and 30 µM and 40 pmol/min/mg (Galetin and Houston, 2006
), respectively]. The somewhat lower Vmax value obtained in the present study may be due to enzyme inhibition by the organic solvent present in our assay. Acetonitrile does not affect (S)-mephenytoin 4'-hydroxylase activity, whereas 0.7% DMSO inhibits activity by approximately 50% (Chauret et al., 1998
; Hickman et al., 1998
; Busby et al., 1999
). The choice of this solvent was dictated by the need to use the assay for screening chemicals from our sample collection, which are prepared and stored in DMSO.
Studies in human volunteers receiving oral doses of [14C]-labeled and tritiated mephenytoin indicated that the tritium label in the 4'-position of the drug was extensively retained during formation of the 4'-hydroxylated reaction product (Küpfer et al., 1981
). The most likely explanation for this phenomenon is the existence of an NIH shift, with migration of the tritium isotope to the adjacent 3'- and 5'-positions of the phenyl ring (Daly et al., 1972
). To minimize tritium retention, we introduced tritium label also into the 3'- and 5'-positions of (S)-mephenytoin, such that 4'-hydroxylation would necessarily be accompanied by tritium release into the solvent. The existence of an NIH shift was confirmed by the result that tritium release from triply labeled tracer was significantly higher than that from the tracer containing tritium at the 4'-position only. The finding that the SA0/SAP ratio for tritium release from [3',4',5'-3H]3(S)-mephenytoin was close to unity argues against the existence of a significant kinetic isotope effect.
Assay sensitivity is limited by the specific radioactivity of the substrate and its relatively low turnover in HLM. The Vmax for (S)-mephenytoin 4'-hydroxylation is more than 50-fold lower than that of testosterone-6ß-hydroxylation and diclofenac 4'-hydroxylation, marker reactions for CYP3A4 and CYP2C9, respectively (Walsky and Obach, 2004
; Di Marco et al., 2005a
,b
). For this reason, (S)-mephenytoin 4'-hydroxylase assays require higher concentrations of HLM and longer incubation times (Walsky and Obach, 2004
). To obtain product counts on the order of several thousand disintegrations per minute without having to resort to excessively high amounts (>0.5 µCi) of radiolabeled substrate or long (>30 min) incubation times, most of the experiments described in the present article were done with a relatively high concentration (1 mg/ml) of HLM. For P450 inhibition assays, it may be preferable to use lower amounts of microsomes to avoid extensive binding of hydrophobic drugs to membrane phospholipids, which may artifactually increase their IC50 (Margolis and Obach, 2003
). As shown in Fig. 3, it is possible to reduce the HLM concentration to 0.25 mg/ml, while maintaining product counts of several hundred disintegrations per minute, which can be accurately quantified. When the enzyme source is recombinant CYP2C19, which has a much higher specific activity than HLMs, assays can be conducted at very low (<0.1 mg/ml) concentrations of microsomal protein, as shown in Fig. 2.
To validate the use of the new assay as a method for determining the potential of drugs to inhibit CYP2C19, we determined IC50 values for a series of 15 structurally diverse drugs and compared the results with those obtained in the conventional (S)-mephenytoin 4'-hydroxylase assay, with product quantification by LC-MS/MS. The results of this analysis indicate that IC50 values obtained with the new radiometric method are very similar to those determined by conventional assay. IC50 values differed less than 2.5-fold for all compounds tested. Importantly, none of the drugs would be misclassified as either a strong (<1 µM) or weak (>50 µM) inhibitor (Crespi and Stresser, 2000
) on the basis of the IC50 determined by radiometric versus conventional assay (within the limit of standard errors). Taken together, these results demonstrate that the present method represents a high-throughput radiometric version of the classic (S)-mephenytoin 4'-hydroxylase assay and a valuable new tool for rapid screening of the inhibitory potential of investigational drugs.
| Acknowledgments |
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| Footnotes |
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ABBREVIATIONS: P450, cytochrome P450; HPLC, high-performance liquid chromatography; HLM, human liver microsome; TFA, trifluoroacetic acid; Rt, retention time; LC, liquid chromatography; MS, mass spectrometry; SA, specific activity; DMSO, dimethyl sulfoxide; MS/MS, tandem mass spectrometry.
Address correspondence to: Dr. Ralph Laufer, Istituto di Ricerche di Biologia Molecolare (IRBM) P. Angeletti, Via Pontina km 30,600, 00040 Pomezia (Roma), Italy. E-mail: ralph_laufer{at}merck.com
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