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ABSTRACT

Title
In vitro inhibition of cytochrome P450 (CYP) 2C8-mediated drug metabolism by the flavonoid diosmetin
 
Authors
L. Quintieri, P. Palatini, S. De Martin and M. Floreani
Dept. of Pharmacology and Anesthesiology, Universityof Padova, Padova, Italy
 
 
Abstract
Background: The use of dietary supplements and/or herbal medications containing flavonoids has constantly increased in recent years, in spite of their potential for interaction with co-administered drugs. Recently, Rajnarayana et al reported that oral treatment of healthy volunteers with diosmin, the 7-rhamnosyl-D-glucoside of diosmetin (3’,5,7-trihydroxy-4-methoxyflavone), a flavone present in widely used pharmaceutical preparations, significantly increases the bioavailability of diclofenac [1]. We have recently demonstrated that diosmetin, the absorbable aglycone form of diosmin [2], to which oral diosmin is converted by rhamnosidases of Enterobacteriacae [3], is a potent in vitro inhibitor of human cytochrome P450 (CYP) 2C9 [4], the CYP form mainly responsible for diclofenac biotransformation, thereby providing an explanation for the observation of Rajnarayana et al [1].
Objectives: Since CYP2C9 shares more than 80% amino acid sequence identity with CYP2C8, a CYP form responsible for the biotransformation of various important drugs [5], e.g. the conversion of the antitumor agent paclitaxel to its inactive metabolite 6α-hydroxy-paclitaxel [6], the aim of the present study was to ascertain whether diosmetin also inhibits in vitro CYP2C8 activity, using paclitaxel conversion to 6α-hydroxy-paclitaxel as a marker reaction. As in many countries, diosmin is marketed in association (9:1, w/w) with hesperidin, the 7-rhamnosyl-D-glucoside of the flavanone hesperetin (3’,5,7-trihydroxy-4-methoxyflavanone), we also assessed the effect of hesperetin on CYP2C8.
Results: Diosmetin and hesperetin inhibited 6α-hydroxy-paclitaxel production by human liver microsomes in a concentration-dependent manner, diosmetin being about 16-fold more potent than hesperetin (mean IC50 values 4.25±0.02 and 68.47±3.27 µM, respectively). Therefore, we only characterized the mechanism of diosmetin inhibition of CYP2C8 activity, since hesperetin concentrations close to its IC50 value are unlikely to be reached in vivo. Diosmetin proved to be a reversible, dead-end, full inhibitor of CYP2C8 activity. Kinetic analysis indicated that this flavonoid caused linear mixed-type inhibition of CYP2C8-mediated paclitaxel metabolism, since it decreased Vmax and increased the Km value of the enzymatic reaction. Consistent with this observation, the apparent catalytic efficiency (Vmax/Km) of human liver microsomes for this reaction was markedly decreased. Non linear fitting of untransformed initial velocity data to the equation describing mixed inhibition gave a mean Ki (inhibitor dissociation constant) value of 3.13±0.11 µM.
Conclusions: This study provides the first demonstration that diosmetin, the absorbable aglycone form of diosmin, is a potent inhibitor of CYP2C8 at concentrations similar to those reached in vivo after administration of diosmin-containing pharmaceuticals [2]. This finding may have important clinical implications, since CYP2C8 metabolizes various important drugs. For example, more that 60% paclitaxel is converted by CYP2C8 to its inactive metabolite 6α-hydroxy-paclitaxel [7].
 
References:
[1] Rajnarayana et al. Drug Metabol. Drug Interact. 2007; 22: 165-174.
[2] Cova et al. Int. J. Clin. Pharmacol. Ther. Toxicol.1992; 30: 29-33.
[3] Serra et al. Bioorg. Med. Chem. 2008; 16: 4009-4018.
[4] Quintieri et al. Drug Metab. Pharmacokinet. 2010; 25: 466-476.
[5] Totah and Rettie Clin. Pharmacol. Ther. 2005; 77: 341-352
[6] Rahman et al. Cancer Res.1994; 54: 5543-5546.
[7] Cresteil et al. Drug. Metab. Dispos. 2002; 30: 438-445