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The Role of Human Cytochrome P450 Enzymes in the Formation of 2-Hydroxymetronidazole: CYP2A6 is the High Affinity (Low Km)Catalyst.

Drug Metab Dispos. 2013 Jun 27;

Authors: Pearce RE, Cohen-Wolkoweiz M, Sampson M, Kearns GL


Despite its wide-spread clinical use since the 1960's, the specific enzymes involved in the biotransformation of metronidazole have not been previously identified. Hence, in vitro studies were conducted to identify and characterize the cytochromes P450 enzymes involved in the formation of the major metabolite, 2-hydroxymetronidazole. Formation of 2-hydroxymetronidazole in human liver microsomes was consistent with bi-phasic, Michaelis-Menten kinetics. Although several cDNA-expressed P450 enzymes catalyzed 2-hydroxymetronidazole formation at a supra-therapeutic concentration of metronidazole (2000 μM), at a "therapeutic concentration" of 100 μM only CYPs 2A6, 3A4, 3A5 and 3A7 catalyzed metronidazole 2-hydroxylation at rates substantially greater than control vector and CYP2A6 catalyzed 2-hydroxymetronidazole formation at rates 6-fold higher than the next most active enzyme. Kinetic studies with these recombinant enzymes revealed that CYP2A6 has a Km=289 μM which is comparable to the Km for the high affinity enzyme (low Km) in human liver microsomes, whereas the Kms for the CYP3A enzymes corresponded with the low affinity (high Km) component. The sample-to-sample variation in 2-hydroxymetronidazole formation correlated significantly with CYP2A6 activity (r≥0.970, P<0.001) at substrate concentrations of 100 and 300 μM. Selective chemical inhibitors of CYP2A6 inhibited metronidazole 2-hydroxylation in a concentration-dependent manner and inhibitory antibodies against CYP2A6 virtually eliminated metronidazole 2-hydroxylation (>99%). Chemical and antibody inhibitors of other P450 enzymes had little or no effect on metronidazole 2-hydroxylation. These results suggest that CYP2A6 is the primary catalyst responsible for the 2-hydroxylation of metronidazole, a reaction that may function as a marker of CYP2A6 activity both in vitro and in vivo.

PMID: 23813797 [PubMed - as supplied by publisher]