Perturbation of sterol biosynthesis by itraconazole and ketoconazole in Leishmania mexicana mexicana infected macrophages.

The azole antifungals ketoconazole and itraconazole possess in vitro antileishmanial activity against Leishmania mexicana mexicana amastigotes in macrophages (cell line J774G8). As in yeast and fungi, the activity is likely to be due to inhibition of the cytochrome P-450-dependent 14 alpha-demethylation of lanosterol and/or 24,25-dihydrolanosterol. Indeed, 50% inhibition of ergosterol synthesis was observed at 0.21 microM ketoconazole and 0.15 microM itraconazole. At 5 microM ketoconazole, traces of ergosterol could be found, whereas no ergosterol could be detected in cells treated with 5 microM itraconazole. The inhibition of ergosterol biosynthesis was concomitant with an accumulation of the 14 alpha-methylsterols lanosterol and 24,25-dihydrolanosterol. Fifty percent inhibition of cholesterol synthesis in uninfected macrophages was achieved at 0.95 microM and 1.5 microM itraconazole and ketoconazole, respectively. In infected macrophages all [14C]acetate was incorporated in ergosterol, suggesting an inhibition in cholesterol synthesis in the host cells. An inhibition of ergosterol synthesis coincided with increasing cholesterol synthesis. The latter synthesis was inhibited at concentrations greater than 1 microM. However, even at 5 microM cholesterol synthesis was higher than under control conditions.

Liarozole fumarate inhibits the metabolism of 4-keto-all-trans-retinoic acid.

The metabolism of 4-keto-all-trans-retinoic-acid (4-keto-RA), a biologically active oxygenated metabolite of all-trans-retinoic (RA), has been examined. In vitro, incubation of [14C]4-keto-RA with hamster liver microsomes in the presence of NADPH produced two major radioactive metabolites which were more polar than the parent compound. Following isolation, appropriate derivatization and analysis by GC-MS, these compounds were tentatively identified as 2-hydroxy- and 3-hydroxy-4-ketoretinoic acid. Formation of both hydroxy-keto derivatives was suppressed by the imidazole-containing P450 inhibitor liarozole fumarate (IC50, 1.3 microM). In vitro, an i.v. injection of 4-keto-RA (20 micrograms) into rats was followed by rapid disappearance of the retinoid from plasma with a half-life of 7 min. Pretreatment with liarozole fumarate (40 mg/kg, -60 min) reduced the elimination rate of 4-keto-RA: it prolonged the plasma half-life of the retinoid to 12 min, without affecting its distribution volume. These results indicate the important role of the P450 enzyme system in the metabolism of 4-keto-RA both in vitro and in vivo. The inhibitory effect of liarozole fumarate on this metabolic process may contribute to the reported retinoid-mimetic activity of this drug.

R 76713 and enantiomers: selective, nonsteroidal inhibitors of the cytochrome P450-dependent oestrogen synthesis.

The triazole derivative, R 76713 and its enantiomers R 83839(-) and R 83842(+) are effective inhibitors of the aromatization of androstenedione. For human placental microsomes, the (+) enantiomer (R 83824) is about 1.9- and 32-times more active than the racemate (IC50 2.6 nM) and the (-) enantiomer, respectively. R 83842 is about 30- and 1029-times more active than 4-hydroxyandrostene-3,17-dione and aminoglutethimide. This potency might originate from its high affinity for the microsomal cytochrome P450 (P450). Indeed, R 83842, compared to R 76713 and R 83839, forms a more stable P450-drug complex. Difference spectral measurements indicate that the triazole nitrogen N-4 coordinates to the haem iron. The reversed type 1 spectral changes suggest that R 76713 is able to displace the substrate from its binding place and the stable complex formed in particular with the (+) enantiomer suggests that its N-1-substituent occupies a lipophilic region of the apoprotein moiety. Kinetic analysis implies that there is a competitive part in the inhibition of the human placental aromatase by R 76713. The Ki values for R 76713, R 83842 and R 83839 are 1.3 nM, 0.7 nM and 18 nM, respectively. These results are indicative of stereospecificity for binding. Up to 10 microM, R 76713 and its enantiomers have no statistically significant effect on the regio- and stereoselective oxidations of testosterone in male rat liver microsomes. All three compounds have no effect on the P450-dependent cholesterol synthesis, cholesterol side-chain cleavage and 7 alpha-hydroxylation and 21-hydroxylase. At 10 microM, R 76713 has a slight effect on the bovine adrenal 11 beta-hydroxylase. This effect originates mainly from R 83839, the less potent aromatase inhibitor. On the other hand, the inhibition of the 17,20-lyase of rat testis observed at concentrations greater than or equal to 0.5 microM, originates rather from R 83842. However, 50% inhibition is only achieved at 1.8 microM R 83842, i.e. at a concentration about 1300-times higher than that needed to reach 50% inhibition of the human placental aromatase.

Mass spectral investigation of the metabolites of lorcainide in man.

[3H] Lorcainide hydrochloride was administered orally to healthy male volunteers. About 97% of the total radioactivity was excreted in the urine and faeces within four days of its administration. The metabolites were purified by adsorption chromatography, liquid-liquid extraction, thin layer chromatography or by gas chromatography-mass spectrometry after silylation of the samples. When there was a sufficient amount available, the samples were submitted to a nuclear magnetic resonance analysis. The results were confirmed by comparison of spectral data obtained from the reference compounds. The major metabolites of lorcainide were formed by aromatic hydroxylation, O-methylation and oxidative N-dealkylation. The urinary phenolic metabolites were present both as free aglycons and conjugates.

On the pharmacokinetics of domperidone in animals and man III. Comparative study on the excretion and metabolism of domperidone in rats, dogs and man.

The excretion and metabolism of the novel gastrokinetic and antinauseant drug domperidone were studied after oral administration of the 14C-labelled compound to rats, dogs and man, and after intravenous administration to rats and dogs. Excretion of the radioactivity was almost complete within four days. In the three species, the radioactivity was excreted for the greater part with the faeces. Biliary excretion of the radioactivity amounted to 65% of the dose 24 hours after intravenous administration in rats. Unchanged domperidone as determined by radioimmunoassay, accounted in urine for 0.3% in dogs, 0.4% in man, and in faeces for 9% in dogs and 7% in man. The main metabolic pathways of domperidone in the three species were the aromatic hydroxylation at the benzimidazolone moiety, resulting in hydroxy-domperidone -the main faecal metabolite-, and the oxidative N-dealkylation at the piperidine nitrogen, resulting in 2,3-dihydro-2-oxo-1H-benzamidazole-1-propanoic acid the major radioactive urinary metabolite- and 5-chloro-4-piperidinyl-1,3-dihydro-benzimidazol-2-one. In urine the two first metabolites were present partly as conjugates. A mass balance for the major metabolites in urine, faeces, bile and plasma samples was made up after radio-HPLC (reverse-phase HPLC with on-line radioactivity detection) of various extracts. Only minor species differences were detected.

Excretion and metabolism of lorcainide in rats, dogs and man.

After p.o. or i.v. administration of 3H-lorcainide, excretion of the radioactivity was almost complete within four days. In rats and dogs, about 35% of the dose was excreted in the urine and about 60% in the faeces. However, in humans, 62% was excreted in the urine and 35% in the faeces. In rats, about 70% of the orally administered radioactivity was excreted in the bile within 24 hours. Enterohepatic circulation was proven by "donor-acceptor" coupling in rats. Lorcainide was extensively metabolized. Urinary and faecal metabolites were isolated by extraction and high pressure liquid chromatography (HPLC), and characterized by chromatographic comparison with reference compounds, by mass spectrometry, and NMR. The mass balance for unchanged lorcainide and its major metabolites (determined by radio-HPLC) was very similar in the urine and faeces. Only minor quantitative differences were observed between intravenously and orally dosed animals, and between male and female rats. Major biotransformation pathways in the three species were: hydroxylation, O-methylation and glucuronidation. 4-Hydroxy-3-methoxy-lorcainide was the main metabolite. alpha-Oxidation resulting in alpha, 4-dihydroxy-3-methoxy-lorcainide, was observed in dogs only. Minor pathways were: oxidative N-dealkylation and amide hydrolysis. A remarkable 5-hydroxy-3,4-dimethoxy-metabolite was identified unambiguously in the three species.

Identification of a biliary metabolite of cisapride.

Radiolabeled cisapride was administered orally to male Wistar rats. The drug was metabolized extensively, resulting in the formation of a large number of urinary and faecal metabolites. In bile-cannulated rats a major metabolite was excreted with the bile whose structure could not be elucidated with the aid of the registered electron impact and desorption chemical ionization spectra. Therefore the biliary metabolite was subjected to extensive analytical procedures combining fast atom bombardment mass spectrometry, thermospray liquid chromatography/mass spectrometry, nuclear magnetic resonance and ultraviolet analysis. The results of this study allowed the identification of the biliary metabolite as the O-sulphate of metabolically formed 3'-hydroxy-cisapride.

In-vitro metabolism of etomidate by rat liver fractions.

(R)-(+)-etomidate and (S)-(-)-etomidate were found to be metabolized in-vitro by various rat liver homogenization fractions: the 16,000 g supernatant fraction caused a more intensive metabolic breakdown than the microsomal fraction; the 100,000 g supernatant fraction was only slightly active. The metabolism was somewhat more rapid and more extensive for the (R)-(+)-etomidate than for the (S)-(-)-isomer. For both isomers, a dose-dependence was observed: the smaller the substrate concentration, the smaller the relative amount of unmetabolized drug, and the more the rate of metabolic breakdown after a certain incubation time slowed down. Only minor qualitative differences between the metabolic pathways of the two isomers were observed. The main metabolic pathway for the in-vitro metabolism was the hydrolysis of the ethyl ester. Decarboxylation and oxidative N-dealkylation were also observed.

Identification of alkaloids; the condensation products of biogenic amines with formaldehyde, enzymatically formed from 5-methyltetrahydrofolic acid.

The use of thin-layer chromatography has demonstrated that incubations of indoleamines with 5-methyl[14-C]tetrahydrofolic acid and an enzyme previously described as an N-methyltransferase, do not yield Nw, N1, or O-methylated products. Further elucidation by thin-layer chromatography, gas chromatography, mass spectrometry and selected ion monitoring enabled us to identify the reaction products as tetrahydroisoquinolines and tetrahydro-beta-carbolines in mixtures incubated respectively with catecholamines and indoleamines in the presence of 5-methyl[14-C]tetrahydrofolic acid and enzyme. The alkaloids have been shown to originate from a spontaneous condensation of the corresponding amines with formaldehyde, this latter being formed in the first stage of the reaction by enzymatic conversion from 5-methyltetrahydrofolic acid.

Domperidone for the symptomatic treatment of chronic post-prandial nausea and vomiting.

Forty patients with postprandial nausea and vomiting from a variety of underlying causes, were given either domperidone 20 mg t.d.s. or placebo in a double-blind study lasting two weeks. The tablets were taken before meals and no other anti-emetics were used. Nausea and vomiting were reduced in those patients given the active therapy, the results being recorded as excellent in 62% in the domperidone group and 18% of controls.

In vitro metabolism of lidoflazine by rat and dog liver fractions.

Lidoflazine was metabolized very rapidly by 16000 g supernatant fractions of rat and dog liver. The rate and the extent of metabolism were considerably superior for rat liver. Lidoflazine metabolites were purified by extraction and thin-layer chromatography and identified by mass spectrometry. The main pathways of the in vitro metabolism by rat and dog liver fractions were the same. Oxidative N-dealkylation was the most important. An incubation of major metabolite 1-[4,4-bis(4-fluorophenyl)-butyl]piperazine, with rat liver fraction was performed. A hydroxylated metabolite and a ketopiperazine metabolite were detected only in the dog experiments.

Plasma levels, biotransformation and excretion of oxatomide (R 35 443) in rats, dogs and man.

Plasma levels, biotransformation and excretion of oxatomide were studied after single oral doses of 14C-oxatomide in male rats, dogs and humans. Oxatomide was very well absorbed, and almost completely metabolized in the three species. Excretion of the metabolites was very rapid and complete within a few days; the 14C label was excreted more in the faeces (54-62%) than in the urine (27-40%). Major metabolic pathways of oxatomide were oxidative N-dealkylations at the piperazine nitrogens and at the benzimidazolone nitrogen in rats and man, and also aromatic hydroxylation at the benzimidazolone moiety in man. The main urinary metabolite in the three species was 2,3-dihydro-2-oxo-1H-benzimidazole-1-propanoic acid, resulting from the oxidative N-dealkylation at the 1-piperazine nitrogen.

Structural characterization of drugs and oxygenated metabolites by laser microprobe mass spectrometry (LAMMA).

Laser microprobe mass analysis (LAMMA) was used for the structural characterization of polyfunctional drugs and their oxygenated metabolites, in particular the N-oxides. The spectra usually yield the molecular weight as well as intense fragments. The structural information is characteristically distributed between the positive and negative ions. To rationalize the unfamiliar fragmentation, tentative pathways are introduced. Key elements are the formation of odd-electron molecular (and fragment) ions, the correlation between cations and anions, as well as the three-dimensional representation of structures. The combination of mild desorption and abundant fragmentation makes LAMMA a valuable tool in the study of N-oxides.

Identification of 17 alpha,20 alpha-dihydroxyprogesterone in testicular extracts after incubation with ketoconazole.

The antifungal ketoconazole affects testosterone synthesis in dispersed rat testicular cells. In the presence of ketoconazole an accumulation of 17 alpha,20 alpha-dihydroxyprogesterone has been observed. This steroid was isolated from the testis of Wistar rats after a [4-14C]progesterone incorporation in the presence of ketoconazole. Its identification was achieved from the gas chromatographic/mass spectrometric analysis of the isolated radioactive fraction. A chemical derivatization of the fraction with butylboronic acid followed by mass spectrometric analysis confirmed the presence of 17 alpha,20 alpha-dihydroxyprogesterone.

On the use of laser microprobe mass spectrometry for the analysis of organic biomolecules.

Laser microprobe mass spectrometry has been applied to a variety of organic polyfunctional molecules, covering a wide range of polarity and mass spectrometric behaviour. The technique apparently combines desorption under relatively soft conditions with extensive fragmentation and hence allows much structural information from intactly released thermolabiles to be obtained. The mass spectra appear unfamiliar in comparison to conventional techniques. Interpretation is attempted in a purely empirical way by means of the evidence from our database and tentative hypotheses to rationalize the desorption and ionization by laser microbeam irradiation of organic solids. Selected examples are presented to illustrate the potential and limitations of the method in the field of biomolecules, such as pyridoxine and pyridoxal phosphate, nucleosides, nucleotides and related analogues, drugs and the corresponding N-oxides.

Excretion and metabolism of flunarizine in rats and dogs.

The excretion and metabolism of (E)-1-[bis(4-fluorophenyl)methyl]-4-(3-phenyl-2-propenyl)piperazine dihydrochloride (flunarizine hydrochloride, R 14 950, Sibelium) were studied after single oral doses in rats and dogs, using tritium-labelled as well as 14C-labelled drug. Flunarizine was well absorbed in both species. The mass balance for the unchanged drug and its major metabolites in urine, bile and faeces, as estimated with radio-HPLC, ALLOWED an explanation of the differences observed for the excretion pattern of the radioactivity in flunarizine-14C and flunarizine-3H dosed rats, and in male and female rats. Main metabolic pathway in male rats was the oxidative N-dealkylation resulting in bis(4-fluorophenyl)methanol and a number of complementary metabolites of the cinnamylpiperazine moiety, of which hippuric acid was the main one. In female rats and male dogs, however, hydroxy-flunarizine was the main metabolite, resulting from the aromatic hydroxylation of the phenyl ring of the cinnamyl moiety. Enterohepatic circulation of bis(4-fluorophenyl)methanol and hydroxy-flunarizine was proved by "donor-acceptor" coupling in rats; in bile and urine, these two metabolites were present mainly as glucuronides. The glucuronide of hydroxy-flunarizine was also the main plasma metabolite in dogs.

Excretion and biotransformation of cisapride in dogs and humans after oral administration.

The excretion and biotransformation of cisapride, a novel gastrokinetic drug, were studied after a single po dose of [14C]cisapride in dogs and humans. The excretion of radioactivity amounted to 97% within 4 days after a 1 mg/kg dose in dogs (72% in feces and 25% in urine). After a 10-mg dose in humans, 44% was excreted in the 0-24-hr urine and 37% in the 0-35-hr feces; excretion was complete within 4 days. Excretion of the parent drug was greater in dogs (0.4-1.3% of the dose in urine, 23% in feces) than in humans (0.2% in urine, 4-6% in feces). This was due, at least in part, to a larger proportion of amine glucuronidation and sulfation in dogs. N-Deal-kylation at the piperidine nitrogen resulting in the main urinary metabolite, norcisapride, and aromatic hydroxylation of the 4-fluorophenyl ring were major metabolic pathways in both species. Norcisapride excretion accounted for 14% of the dose in dogs and 41-45% in humans. Minor metabolic pathways were O-dealkylation at the 4-fluorophenoxy group and piperidine oxidation. Peak plasma levels and AUC values of norcisapride in humans were 8-9 times lower than those of cisapride. Apart from more amine conjugation in dogs, the biotransformation of cisapride was similar in dogs and humans.

Excretion and biotransformation of cisapride in rats after oral administration.

The excretion and biotransformation of cisapride, a novel gastrokinetic drug, were studied after single (10, 40, and 160 mg/kg) and repeated (10 mg/kg/day) po administration to rats, using three different radiolabels. In fasted rats, cisapride was absorbed almost completely, except for the 160 mg/kg dose. Cisapride was metabolized extensively to at least 30 metabolites. The excretion of the metabolites amounted to more than 80% of the dose at 24 hr and was almost complete at 96 hr after dosing. In bile duct-cannulated rats, 60% was excreted in the bile within 24 hr, 45% of which underwent enterohepatic circulation. The main urinary metabolites, 4-fluorophenyl sulfate and norcisapride, primarily resulted from the N-dealkylation at the piperidine. Another major metabolic pathway was aromatic hydroxylation, occurring on either the 4-fluorophenoxy or the benzamide rings. The resulting phenolic metabolites were eliminated as conjugates in the bile; a large portion of them were subjected to a rapid enterohepatic circulation before their final excretion in the feces. Minor metabolic pathways included piperidine oxidation, O-dealkylation, O-demethylation of the methoxy substituent at the benzamide, and amine glucuronidation. Only minor quantitative dose- and sex-dependent differences could be observed for the mass balance of the metabolites. Upon repeated po dosing, steady state excretion rates were already attained after two to three doses, and excretion and metabolite patterns were very similar to those after single dose administration.

Metabolism of alfentanil by isolated hepatocytes of rat and dog.

1. The biotransformation of 3H-alfentanil was studied using suspension cultures of isolated hepatocytes of male and female rats and of dogs. 2. In hepatocytes of the male rat, alfentanil was readily metabolized, following linear Michaelis-Menten kinetics over the concentration range 5-400 microM. The metabolism was strongly inhibited by the cytochrome P-450 inhibitors metyrapone, alpha-naphthoflavone and piperonyl butoxide. 3. The major metabolites of alfentanil, which were formed in suspension cultures of male rat hepatocytes, were identified by h.p.l.c. co-chromatography and by mass spectrometry and included N-[4-(hydroxymethyl)-4-piperidinyl]-N-phenylpropanamide, N-[4-(methoxymethyl)-4-piperidinyl]-N-phenylpropanamide or noralfentanil and N-[1-[2-(4-ethyl-4,5-dihydro-5-oxo-1-H-tetrazol-1-yl)ethyl]- 4-(hydroxymethyl)-4-piperidinyl]-N-phenylpropanamide or desmethylalfentanil. 4. The major in-vitro metabolic pathways of alfentanil in hepatocytes of the three sources were oxidative N-dealkylation at the piperidine nitrogen and oxidative O-demethylation at the methoxymethyl moiety.