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Potential Role of Cerebral Cytochrome P450 in Clinical Pharmacokinetics

Modulation by Endogenous Compounds

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Abstract

Cytochrome P450 (CYP) enzymes catalyse phase I metabolic reactions of psychotropic drugs. The main isoenzymes responsible for this biotransformation are CYP1A2, CYP2D6, CYP3A and those of the subfamily CYP2C. Although these enzymes are present in the human brain, their specific role in this tissue remains unclear. However, because CYP enzymatic activities have been reported in the human brain and because brain microsomes have been shown to metabolise the same probe substrates used to assess specific hepatic CYP activities and substrates of known hepatic CYPs, local drug metabolism is believed to be likely. There are also indications that CYP2D6 is involved in the metabolism of endogenous substrates in the brain. This, along with the fact that several neurotransmitters modulate CYP enzyme activities in human liver microsomes, indicates that CYP enzymes present in brain could be under various regulatory mechanisms and that those mechanisms could influence drug pharmacokinetics and, hence, drug response.

In this paper we review the presence of CYP1A2, CYP2C9, CYP2D6 and CYP3A in brain, as well as the possible existence of local brain metabolism, and discuss the putative implications of endogenous modulation of these isoenzymes by neurotransmitters.

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Acknowledgements

Our work is supported in part by grants 00/0034, 02/0406 and 03/1432 from Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain, and grant 02/0024 and Convenio de Farmacovigilancia, from Consejería de Sanidad y Consumo, Junta de Extremadura, Mérida, Spain, and carried out within the framework of COST B15 of the EU.

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  1. Department of Pharmacology and Psychiatry, Medical School, University of Extremadura, Avda. Elvas s/n, 06071, Badajoz, Spain

    Guillermo Gervasini, Juan Antonio Carrillo &  Julio Benitez

  2. Clinical Pharmacology Unit, Infanta Cristina University Hospital, University of Extremadura, Badajoz, Spain

    Julio Benitez

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  1. Guillermo Gervasini
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  2. Juan Antonio Carrillo
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  3. Julio Benitez
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Correspondence to Julio Benitez.

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Gervasini, G., Carrillo, J.A. & Benitez, J. Potential Role of Cerebral Cytochrome P450 in Clinical Pharmacokinetics. Clin Pharmacokinet 43, 693–706 (2004). https://doi.org/10.2165/00003088-200443110-00001

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