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Received for publication September 27, 2004.
Revised November 4, 2004.
Accepted for publication November 12, 2004.
The oxidative and conjugative metabolism of sertraline was examined in vitro in order to identify the enzymes involved in the generation of N-desmethyl, deaminated, and N-carbamoyl glucuronidated metabolites in human. In human liver microsomes, sertraline was N-demethylated and deaminated by cytochrome P450 enzymes with overall KM values of 98 and 114 µM, respectively, but the intrinsic clearance for N-demethylation was approximately 20-fold greater than for deamination. Using P450 isoform-selective inhibitors and recombinant heterologously expressed enzymes it was demonstrated that several P450 enzymes catalyzed sertraline N-demethylation, with CYP2B6 contributing the greatest extent and lesser contributions from CYP2C19, CYP2C9, CYP3A4, and CYP2D6. For deamination, data supported a role for CYP3A4 and CYP2C19. Purified human monoamine oxidases A and B also catalyzed sertraline deamination with comparable KM values (230-270 µM). MAO-B catalyzed the reaction approximately 3-fold faster than MAO-A. Sertraline N-carbamoyl glucuronidation was measured in human liver microsomes in bicarbonate buffer and under a CO2 atmosphere (KM = 50 µM) and was catalyzed at the fastest rate by recombinant human UGT2B7. The observation that multiple enzymes appear to be involved in sertraline metabolism suggests that there should be no single agent that could substantially alter the pharmacokinetics of sertraline, nor should there be any single drug metabolizing enzyme genetic polymorphism (e.g. CYP2D6, CYP2C19, CYP2C9, UGT1A1) that could profoundly impact the pharmacokinetics of sertraline.
Key words:
CYP2B, cytochrome P450, cytochrome P450 catalyzed oxidations, glucuronidation, microsomes, UDP glucuronyltransferases
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