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Antimicrobial Agents and Chemotherapy, March 1999, p. 549-556, Vol. 43, No. 3
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Metabolic Characterization of a Tripeptide Human Immunodeficiency
Virus Type 1 Protease Inhibitor, KNI-272, in Rat Liver
Microsomes
Akiko
Kiriyama,*
Tomoyuki
Nishiura,
Hirokazu
Yamaji, and
Kanji
Takada
Department of Pharmacokinetics, Kyoto
Pharmaceutical University, Yamashina-ku, Kyoto 607-8414, Japan
Received 10 March 1998/Returned for modification 7 September
1998/Accepted 17 December 1998
 |
ABSTRACT |
KNI-272 is a tripeptide protease inhibitor for treating human
immunodeficiency virus type 1 (HIV-1). In in vitro stability studies
using rat tissue homogenates, KNI-272 concentrations in the liver,
kidney, and brain decreased significantly with time. Moreover, in
tissue distribution studies, KNI-272 distributed highly to the liver,
kidney, and small intestine in vivo. From these results and reported
physiological parameters such as the tissue volume and tissue blood
flow rate, we considered the liver to be the main organ which takes
part in the metabolic elimination of KNI-272. Then the hepatic
metabolism of KNI-272 was more thoroughly investigated by using rat
liver microsomes. KNI-272 was metabolized in the rat liver microsomes,
and five metabolites were found. The initial metabolic rate constant
(kmetabolism) tended to decrease when the
KNI-272 concentration in microsomal suspensions increased. The
calculated Michaelis-Menten constant (Km) and
the maximum velocity of KNI-272 metabolism
(Vmax), after correction for the unbound drug
concentration, were 1.12 ± 0.09 µg/ml (1.68 ± 0.13 µM)
and 0.372 ± 0.008 µg/mg of protein/min (0.558 ± 0.012 nmol/mg of protein per min), respectively. The metabolic clearance
(CLint,metabo), calculated as
Vmax/Km, was 0.332 ml/mg of protein per min. Moreover, by using selective cytochrome P-450
inhibitors and recombinant human CYP3A4 fractions, KNI-272 was
determined to be metabolized mainly by the CYP3A isoform. In addition,
ketoconazole, a representative CYP3A inhibitor, inhibited KNI-272
metabolism competitively, and the inhibition constant
(Ki) was 4.32 µM.
 |
INTRODUCTION |
The human immunodeficiency virus
type 1 (HIV-1) encodes a virus-specific aspartic protease that mediates
crucial proteolytic processing of viral protein precursors at a late
stage in the replication of the virus (14). Antiretroviral
therapy directed at the reverse transcriptase of HIV-1 has had limited
success because of drug toxicity and the emergence of viral resistance (22). With the recent appreciation of the continuous,
high-level replication of HIV-1 which occurs in vivo (23,
53), the limitations of current therapies are better understood,
as is the urgent need for new and effective antiretroviral agents.
Therefore, the inhibition of HIV protease has attracted widespread
interest because of its potential use in the therapeutic intervention
of AIDS (14, 15, 43, 51). Several HIV-1 protease inhibitors
(25, 36, 46) have been discovered based on the transition
state analogue concept, which was known to be effective in studies of
inhibitors of aspartic proteases such as renin and pepsin (20,
54). Recently, HIV-1 protease inhibitors, such as indinavir,
ritonavir, and saquinavir, have generated worldwide interest as
therapeutic agents for the control of HIV infection.
KNI-272, which was synthesized by Mimoto et al. (42), has
one of the strongest HIV-1 protease-inhibitory activities in in vitro
antiviral testing (27), and the highest bioavailability (BA)
after intraduodenal (i.d.) administration to rats (29, 30),
of the KNI series compounds. Moreover, we have already reported the
pharmacokinetic characteristics of KNI-272. The BA values of KNI-272
after i.d. administration to rats were 24 to 45% (30, 49)
when KNI-272 was dissolved in various solvents, and those after oral
administration to beagles were 7 to 26% when KNI-272 was formulated in
various capsules (32). The biliary and urinary excretions of
KNI-272 were both around 1% as the intact drug in rats when KNI-272
was administered intravenously (i.v.) to rats at doses of 1.0 and
10.0 mg/kg of body weight (31), and excretion of KNI-272 was
assumed not to be the main route of elimination from the circulatory
system in rats. Furthermore, some HIV-1 protease inhibitors, HIV-1
reverse transcriptase inhibitors, and renin inhibitors were
reported to be metabolized in rat, dog, and human livers
(1-4, 16, 17, 35).
In this study, we found by an in vitro stability study using rat tissue
homogenates and an in vivo tissue distribution study that the liver was
the main eliminating organ for KNI-272 in the rat. Then, the metabolic
characteristics of KNI-272, such as the metabolic kinetics, the P-450
isozymes responsible for KNI-272 metabolism, and their effects on the
formation of metabolites of KNI-272, were investigated by using rat
liver microsomes and various selective cytochrome P-450 inhibitors.
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MATERIALS AND METHODS |
Materials.
KNI-272 was kindly supplied by Japan Energy Co.
(Tokyo, Japan). NADP, glucose-6-phosphate (G6P), and G6P dehydrogenase
(G6PDH) were purchased from Sigma Chemical Company (St. Louis, Mo.).
Ketoconazole (KCZ), chloramphenicol (CP), and quinidine (QND) were
supplied by Janssen-Kyowa Co., Ltd. (Tokyo, Japan), Boehringer Mannheim (Tokyo, Japan), and Wako Pure Chemical Industries Ltd. (Osaka, Japan),
respectively. Nalidixic acid (NA) and cimetidine (CIM) were purchased
from Nacalai Tesque, Inc. (Kyoto, Japan). Recombinant human CYP3A4
prepared from lymphoblastic cells was purchased from Daiichi Pure
Chemicals Co., Ltd. (Osaka, Japan). The cytochrome P-450 content was
about 68 pmol/mg of protein. Propylene glycol (PG) and acetonitrile
(high-performance liquid chromatography [HPLC] grade) were obtained
from Nacalai Tesque, Inc. and Kanto Chemical Co., Inc. (Tokyo, Japan),
respectively. All other reagents used were of analytical grade and were
commercially obtained.
Animal experiments.
Wistar male rats (SLC, Shizuoka, Japan),
weighing 300 to 400 g, were used throughout the study. The rats
were housed in pairs under controlled environmental conditions and fed
commercial feed pellets. All rats had free access to food and water.
The biological samples obtained were frozen immediately after
collection and stored in a freezer at
20°C until analysis.
In vitro stability in various rat tissue homogenates.
After
light ether anesthesia, rats were sacrificed by exsanguination and
infused with 20 ml of Krebs-Henseleit buffer (pH 7.4) through the
abdominal aorta in order to remove blood from all tissues. The liver,
kidney, lung, spleen, brain, small intestine, and skeletal muscle were
excised immediately, rinsed in ice-cold oxygenated (95%
O2-5% CO2) Krebs-Henseleit buffer, weighed,
and homogenized in 4 volumes of Krebs-Henseleit buffer. All procedures for the tissue preparation were carried out under ice-cold conditions. The assay mixture contained 1.0 µg of KNI-272/ml and 0.1 g of tissue homogenate/ml in Krebs-Henseleit buffer in a final volume of 1.0 ml. The reaction was started by addition of the tissue homogenate
suspension to a preincubated drug solution at 37°C, and the reaction
was carried out at 37°C with bubbling of 95% O2-5%
CO2 gas to the incubation mixture for 2 h. The
reaction was stopped by the addition of 2 volumes of methanol. The
stability of KNI-272 in each tissue homogenate was estimated by
comparison of the KNI-272 concentration after the incubation with its
initial concentration. As a control experiment, samples without tissue homogenates and without bubbling gas were also run, and no decreases in
KNI-272 concentration were observed in these samples.
In vivo tissue distribution studies.
After anesthesia by an
intraperitoneal (i.p.) injection of urethane (1.0 g/kg), KNI-272
solution dissolved in 70% PG was administered i.v. to rats via the
jugular vein, corresponding to a drug dose of 10.0 mg/kg of body
weight. Four hours after drug administration, the rats were sacrificed
by bleeding from the inferior vena cava and were infused with ice-cold
saline to remove the blood from all tissues. This time was chosen based
on our previous study with rats, which demonstrated that the plasma
KNI-272 concentration reached the terminal elimination phase 4 h
following i.v. administration at a 10.0-mg/kg dose (31).
After whole blood was obtained from the inferior vena cava, the brain,
lung, heart, liver, kidney, stomach, small intestine, spleen, adipose
tissue, and skeletal muscle were excised immediately, rinsed in
ice-cold saline, weighed, and homogenized in 4 volumes of saline,
except for the liver and adipose tissue. The liver was homogenized in 3 volumes of saline, whereas the adipose tissue was cut into pieces, then
extracted in 4 volumes of methanol. All procedures for tissue
preparation were carried out under ice-cold conditions. KNI-272
concentrations in the blood, Cblood, and the
tissues (organs), Ctissue, were determined by an
HPLC method (see below).
The apparent tissue-to-blood distribution ratio,
Kp,app, was determined from the relationship
Kp,app =
Ctissue/
Cblood.
In vitro metabolism by rat liver microsomes. (i) Microsomal
preparation.
Rat liver was freshly obtained and homogenized in
ice-cold 1.15% KCl solution. The homogenate was centrifuged at
9,000 × g for 15 min, and the supernatant was
centrifuged at 105,000 × g for 60 min to obtain a
microsomal pellet. The microsomal pellet was resuspended in 0.1 M
phosphate buffer (pH 7.4) to a concentration of 8.0 mg of protein per
ml. The protein concentration was determined by the method of Lowry et
al. (40).
(ii) Metabolic assay.
Typically, the incubation mixture
contained an NADPH-generating system (0.5 mM NADP, 5 mM G6P, 2 U of
G6PDH/ml, and 5 mM MgCl2), 0.5 to 20.0 µg of KNI-272/ml,
and a microsomal suspension at 0.8 mg of protein per ml in 1.0 ml of
0.1 M phosphate buffer. After 5 min of preincubation at 37°C in a
water bath, the reaction was initiated by the addition of 100 µl of a
microsomal suspension at 8.0 mg of protein per ml. The reaction was
stopped at the appropriate time by the addition of 200 µl of ice-cold
0.1 N NaOH solution. Moreover, a control incubation containing no NADPH
was also run.
(iii) Identification of involved cytochrome P-450 isoforms.
To identify the cytochrome P-450 isoforms responsible for KNI-272's
hepatic metabolism, a number of cytochrome P-450 inhibitors thought to
be selective for individual enzymes were used: NA for CYP1A
(18), CP for CYP2B (11), QND for CYP2B6 (7,
12, 21, 26), KCZ for CYP3A (45) and CIM for CYP3A
(8). Various concentrations of each inhibitor (final
concentrations, 0.3 to 45.0 µM) were preincubated with the
NADPH-generating system and KNI-272 (final concentrations, 0.5 to 3.0 µM) for 5 min at 37°C prior to the addition of 100 µl of a
microsomal suspension at 8.0 mg of protein per ml. The reaction was
stopped at each time (10 or 15 min) by the addition of 200 µl of
ice-cold 0.1 N NaOH solution.
In addition, the metabolism of KNI-272 was investigated by using
recombinant human CYP3A4. The incubation mixture contained
the
NADPH-generating system, 1.0 µg of KNI-272/ml, and recombinant
human
CYP3A4 at 0.5 mg of protein per ml in 0.5 ml of 0.1 M phosphate
buffer.
After 5 min of preincubation at 37°C, the reaction was
initiated by
the addition of 1 µl of 500 µg of KNI-272/ml and
was carried out at
37°C with shaking in a water bath. After 30
min, the reaction was
stopped by the addition of 200 µl of ice-cold
0.1 N NaOH
solution.
(iv) Data analysis.
In vitro metabolic activities of KNI-272
were estimated from the loss of KNI-272 by using rat liver microsomes
under linear conditions. The initial metabolic rate constants
(kmetabolism) of KNI-272 were determined by
linear regression using linear data points of the KNI-272
concentration-time plots, namely, those between 0 and 5 to 20 min. The
apparent Michaelis-Menten constant (Km,app) and
apparent maximum velocity of the metabolism
(Vmax,app) of KNI-272 were estimated from the
total KNI-272 concentration as a substrate concentration by fitting the
obtained data to a Michaelis-Menten equation using a nonlinear
least-squares regression analysis with a weighting factor of zero.
To obtain the unbound concentration of KNI-272 in microsomal
suspensions, the results of binding experiments in rat liver
microsomes
were used. The total KNI-272 concentrations in rat
liver microsomes
were converted to unbound concentrations by substituting
calculated
binding parameters for the equations described under
"Binding
experiments in rat liver microsomes" below. Then the
unbound
concentration was obtained as a positive solution of an
equation of the
second degree and used as substrate concentrations
to estimate the
Michaelis-Menten constant (
Km) and the maximum
velocity of the metabolism (
Vmax) of KNI-272 by
the method described
above.
The effects of various cytochrome P-450 inhibitors were estimated by
the ratio of either KNI-272 decrease or metabolite formation
in the
presence and absence of inhibitors. The inhibition constant
(
Ki) by KCZ was estimated from the
x-axis intercept in a plot
of the slopes of Lineweaver-Burk
analysis against the KCZ
concentrations.
Binding experiments in rat liver microsomes.
The binding
characteristics of KNI-272 in rat liver microsomal suspensions were
determined by an ultrafiltration method (37) using a
disposable ultrafiltration cartridge (Centricon-10;
10,000-molecular-weight cutoff; Amicon, Inc., Beverly, Mass.). Various
concentrations of KNI-272 (0.5 to 50.0 µg/ml) were added to the rat
liver microsomes (0.8 mg of protein per ml), and then the microsomal
suspensions were incubated at 37°C for 30 min. After sampling for the
determination of total KNI-272 concentration
(Ctotal), the aliquot was applied to the
ultrafiltration cartridge, which was centrifuged at 1,500 × g for 30 min. The filtrate was used to determine the unbound KNI-272 concentration (Cunbound). The bound
KNI-272 concentration in rat liver microsomal suspensions
(Cbound) was determined by the equation
Ctotal
Cunbound.
The association constant (
Ka) and the total
concentration of binding sites [
n(
P)] were estimated by
fitting the obtained data
to a model of specific and nonspecific
binding sites (
50) as
described below by using a nonlinear
least-squares regression
analysis with a weighting factor of zero. The
experimentally obtained
Cbound and
Cunbound values were substituted in the
following equation,
and binding parameters were obtained when the total
square error
between the experimentally obtained value and the value
calculated
by the equation became the minimum value.
where subscripts 1 and 2 denote specific and nonspecific binding
sites, respectively, and
n and
P are the number
of binding
sites per molecule of microsomal protein and the total
protein
concentration,
respectively.
Analytical procedures. (i) Determination of KNI-272
concentrations.
The concentrations of KNI-272 in rat blood and
plasma were measured by an HPLC assay method described in detail
previously (30). The detection limit of this analytical
method of KNI-272 was considered to be 2.0 ng (coefficient of
variation = 8.5%). Briefly, 1 ml of 0.1 N NaOH, 200 µl of
isoamyl alcohol, and 5 ml of dichloromethane were added to 100 µl of
a biological sample. After extraction, the organic liquid was
evaporated and the residue was dissolved in the mobile phase, of which
an aliquot was injected into the HPLC system, which was equipped with a
column-switching apparatus.
This HPLC system consisted of two pumps: P
1, a Shimadzu
(Kyoto, Japan) LC-6A pump, and P
2, a Waters (Milford,
Mass.) M45J
pump. The flow rates of pumps P
1 and
P
2 were both 1.0 ml/min.
The UV detector was a Shimadzu
SPD-10A, connected to a Shimadzu
C-R4A Chromatopac. For column
switching, a motor-actuated six-port
column-switching valve (Kyoto
Chromato Co., Ltd., Kyoto, Japan)
was used. The precolumn
(C
2) was dry packed with Chemcosorb 5-octyldecyl
silane
(ODS)-H (4 mm [inner diameter] by 10 mm; Chemco Scientific
Co., Ltd.,
Osaka, Japan). The analytical column (C
1) was also
a
Chemcosorb 5-ODS-H (4.6 mm [inner diameter] by 250 mm) and was
maintained at 65°C for all the separations. The compositions of
the
two mobile phases were as follows: mobile phase 1, acetonitrile-water
(50:50), mobile phase 2, acetonitrile-water (25:75).
The pretreated sample was injected by using a Waters WISP 710B
automatic sample injector on the precolumn, and KNI-272 was
first
adsorbed onto the precolumn with mobile phase 2 during 0.8
min.
Thereafter, the line was switched to mobile phase 1, and
KNI-272 was
transferred to an analytical column with mobile phase
1. At 0.5 min
after switching, mobile phase 1 was removed from
the precolumn by
mobile phase 2, and the HPLC system was ready
for a new cycle. The
KNI-272 that eluted from the analytical column
was detected by UV
absorption monitored at 208 nm. Levels were
estimated by the
chromatographic technique of comparing peaks
obtained from plasma or
blood to which were added known amounts
of KNI-272. A set of six or
seven calibration standards was run
with each series of unknown
samples.
To analyze the KNI-272 concentration in various tissue homogenates,
KNI-272 was extracted by 2 volumes of methanol and the
methanol extract
was evaporated. Then a method similar to that
described above was
used.
(ii) Determination of KNI-272 metabolic activity.
The
concentrations of KNI-272 and its metabolites in rat liver microsomal
suspensions were also determined by a general HPLC method. After
termination of the reaction, KNI-272 and its metabolites in the
reaction mixture were extracted by 3.0 ml of ethyl acetate, except in
the case of the inhibition study using NA, where diethyl ether was
used, and the organic liquid was evaporated. The residue was then
dissolved with the mobile phase, and an aliquot was injected into the
HPLC system. The HPLC system consisted of a Shimadzu LC-10A pump, a
Shimadzu SPD-10A variable-wavelength UV-VIS detector, and a Waters WISP
710B automatic sample injector. The analytical column was a Chemcosorb
5-ODS-H (4.6 mm [inner diameter] by 250 mm) and was maintained at
50°C for all separations. The composition of the mobile phase was
water containing 0.01% trifluoroacetic acid-acetonitrile (70:30), and
the flow rate was 0.8 ml/min. KNI-272 and metabolites eluted from the
analytical column were detected by UV absorption monitored at 208 nm.
In this study, the detectable metabolites in this experimental
condition were evaluated, and the formation of each metabolite was
estimated from the metabolite's peak area, detected by the HPLC method.
Statistics.
Results were expressed as means or means ± standard errors (SE). The statistical difference was assumed to be
significant when P < 0.05 (by the two-sided
t test).
 |
RESULTS |
The in vitro stabilities of KNI-272 in rat tissue homogenates were
determined, and the results are shown in Fig.
1. After incubation the KNI-272
concentrations in the liver, kidney, and brain homogenates decreased
significantly to 62, 91, and 62% compared with the initial
concentrations. The KNI-272 concentrations also decreased in the other
tissue homogenates, although these differences were not significant.

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FIG. 1.
In vitro stabilities of KNI-272 in various rat tissue
homogenates. Each column represents the mean ± SE from three to
seven experiments (one to three rats per experiment). *,
significantly different from the initial concentration (1.0 µg/ml)
(P < 0.05).
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Table 1 shows the obtained
Kp,app of KNI-272 and the physiological
parameters (6), such as the tissue volume (V) and
tissue blood flow rate (Q), in various rat tissues. KNI-272
easily distributed into the liver, kidney, and small intestine but was
not detected in the muscle. Although the liver and kidney are the main
organs from which KNI-272 was eliminated, KNI-272 highly distributed to
these organs. In addition, the liver has a 4.5-times-large V
and a 1.3-times-larger Q than the kidney. Consequently, we
considered the liver to be the main organ which takes part in the
metabolic elimination of KNI-272, and we investigated the hepatic
metabolism of KNI-272 more fully, using rat liver microsomes.
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TABLE 1.
Physiological parameters and
Kp,app of KNI-272 in various rat tissues after
i.v. administration to rats at 10.0 mg/kg
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In Fig. 2, chromatographic peaks of three
major metabolites (M1, M2, and M4) and two minor metabolites (M3 and
M5) were detected after 10 min of incubation of KNI-272 with rat liver
microsomes. The presence of these peaks was NADPH dependent and their
sizes increased with continued incubation, whereas the chromatographic peak of KNI-272 decreased with time. The retention times on the HPLC of
M1, M2, M3, M4, M5, and KNI-272 were 8.0, 9.5, 11.8, 16.0, 31.0, and
20.3 min, respectively.

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FIG. 2.
Reversed-phase HPLC chromatograms of KNI-272 and its
metabolites after incubation in rat liver microsomes. Two micrograms
per milliliter of KNI-272 was incubated with rat liver microsomes (0.8 mg of protein per ml) in the absence (a) or presence (b) of an
NADPH-generating system at 37°C for 10 min.
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In Fig. 3, the metabolic profile of
KNI-272 in the reconstituted rat liver microsome system is shown. The
kmetabolism of KNI-272 were 0.195, 0.130, 0.037, 0.025, 0.016, and 0.007 min
1 at the initial
concentrations of 0.5, 1.0, 2.0, 5.0, 10.0, and 20.0 µg/ml,
respectively. Thus, as the KNI-272 concentration increased, the
metabolic rate of KNI-272 tended to decrease in the examined concentration range.

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FIG. 3.
Metabolic profile of KNI-272 in rat liver microsomes.
Each point represents the mean ± SE from three experiments (two
to three rats per experiment). Initial concentrations of KNI-272 in rat
liver microsomal reaction mixture are 0.5 ( ), 1.0 (), 2.0 ( ),
5.0 ( ), 10.0 ( ), and 20.0 ( ) µg/ml.
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Fig. 4 shows the rate of KNI-272
metabolism normalized to the protein content as a function of KNI-272
concentration and its double-reciprocal plot (inset) in the rat liver
microsomes after 5 min of incubation. The obtained
Km,app and Vmax,app,
which were calculated from total KNI-272 concentrations in rat liver
microsomes, were 3.03 ± 0.24 µg/ml (4.54 ± 0.36 µM) and
0.404 ± 0.010 µg/mg of protein per min (0.606 ± 0.015 nmol/mg of protein per min), respectively, and the apparent metabolic
intrinsic clearance (CLint,metab), CLint,metab,app, calculated as
Vmax,app/Km,app, was
0.133 ml/min/mg of protein. Moreover, we determined the binding
characteristics of KNI-272 in the rat liver microsomes to calculate the
Km and Vmax. In Fig.
5, the binding profile of KNI-272 in the
rat liver microsomal suspensions is shown. The calculated
Ka1, Ka2, and
n(P) were 0.935 ± 0.207 ml/µg, 0.396 ± 0.011 ml/µg, and 1.801 ± 0.184 µg/ml, respectively. After the
KNI-272 concentration in the rat liver microsomes was corrected for its unbound concentration, the Km and
Vmax were calculated to be 1.12 ± 0.09 µg/ml (1.68 ± 0.13 µM) and 0.372 ± 0.008 µg/mg of
protein/min (0.558 ± 0.012 nmol/mg of protein per min),
respectively. Then the CLint,metab was calculated as 0.332 ml/mg of protein/min.

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FIG. 4.
Rate of KNI-272 metabolism as a function of KNI-272
concentration and its Lineweaver-Burk plot (inset) in rat liver
microsomes. Each point represents the mean ± SE from three
experiments (two to three rats per experiment). The incubation time was
5 min at 37°C with shaking.
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FIG. 5.
Binding profile of KNI-272 in rat liver microsomes. The
protein concentration of rat liver microsomes was 0.8 mg/ml in 0.1 M
phosphate buffer (pH 7.4).
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To investigate the involvement of cytochrome P-450 isozymes,
the effects of various specific cytochrome P-450 inhibitors on KNI-272
metabolism by rat liver microsomes were examined, and the alterations
of KNI-272 metabolic activity after 10 min of incubation are shown as
percentages of the control activity (without the inhibitor). The
initial KNI-272 concentration in the reaction mixture was 3.0 µM. The
metabolic activity of KNI-272 varied to 94.5 ± 18.0, 108.6 ± 9.1, 100.5 ± 13.8, and 74.0 ± 11.2% by the addition of
NA, CP, QND, and CIM at 3.0 µM, respectively, and significant
decreases were not observed. Only with the addition of KCZ did the
metabolic activity decrease significantly, to 29.8 ± 1.7, 22.6 ± 3.5, and 23.7 ± 2.4% at 0.3, 3.0, and 30.0 µM
KCZ, respectively (n = 3 to 5 experiments). Although
CIM decreased the metabolic activity, the results were not significant.
Both KCZ and CIM are known to be the inhibitors of the CYP3A subfamily. Furthermore, the Lineweaver-Burk plot and the Dixon plot of KNI-272 metabolism, shown in Fig. 6a and b,
respectively, were determined in order to kinetically investigate the
effect of KCZ. As the reaction velocity was insufficient to reach the
Vmax,app at the highest KCZ concentration in
this inhibition study, the correct metabolic parameters were not
calculated. Therefore, we determined Vmax,app
(in micrograms per milligram of protein per minute) and Km,app (in micrograms per milliliter) as
follows: 0.351 ± 0.028 and 7.93 ± 0.92, 0.291 ± 0.033 and 8.78 ± 1.42, 0.302 ± 0.038 and 11.8 ± 1.9, and
0.109 ± 0.005 and 3.49 ± 0.30 at the KCZ concentrations of
4.5, 15.0, 30.0, and 45.0 µM, respectively. Except for the parameter
value at 45.0 µM KCZ, Km,app increased
significantly with increasing KCZ concentration. In contrast,
Vmax,app was independent of KCZ concentration.
Therefore, KCZ is considered to be a competitive inhibitor, with a
Ki of 4.32 µM.

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FIG. 6.
Inhibition kinetics of KNI-272 metabolism by KCZ in rat
liver microsomes. Each point represents the mean from three experiments
(two to three rats per experiment). (a) Lineweaver-Burk plot. KCZ
concentrations in the rat liver microsomal reaction mixture are 4.5 (), 15.0 ( ), 30.0 ( ), and 45.0 ( ) µM. , control (no
KCZ). (Inset) Plot of the slopes from the Lineweaver-Burk plot against
the KCZ concentration. The Ki was estimated from
the x-axis intercept. (b) Dixon plot. KNI-272 concentrations
in the rat liver microsomal reaction mixture are 0.5 (), 1.0 ( ),
2.0 ( ), and 3.0 ( ) µM.
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We then investigated the change in KNI-272 metabolite formation in the
presence of KCZ (Fig. 7). The formation
of M1, M2, and M4 decreased as the KCZ concentration increased. The
changes in M5 formation were not determined at 3.0 and 30.0 µM of
KCZ, because M5 was the minor metabolite and the peaks of M5 and KCZ on
our HPLC chromatogram were too close to each other for adequate resolution. As the KCZ concentration increased, the two peaks overlapped. M3 was the smallest among the five metabolites formed (as
shown in Fig. 2). Therefore, the effect of KCZ on M3 formation could
not be investigated.

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FIG. 7.
Inhibitory effect of ketoconazole on KNI-272 metabolite
formations in rat liver microsomes. (a) M1; (b) M2; (c) M4; (d) M5.
N.D., not determined. Each column represents the mean ± SE from
three experiments (two to three rats per experiment). *,
significantly different from the control (P < 0.05).
The concentration of KNI-272 was 3.0 µM. The incubation time was 15 min. The formation of each metabolite was determined from the
metabolite's peak area, detected by the HPLC method.
|
|
The recombinant human CYP3A4 was used instead of rat liver microsomes
to confirm that CYP3A4 is responsible for KNI-272 metabolism. After 30 min of incubation, the KNI-272 concentration decreased significantly,
to 37.6%, and the metabolic activity was 0.0416 ± 0.0024 µg/mg
of protein per min.
 |
DISCUSSION |
By now, many HIV-1 protease inhibitors have been developed
(5, 13, 19, 25, 28, 36, 41, 46, 52). Some HIV-1 protease
inhibitors and renin inhibitors, which are aspartic protease inhibitors
similar to HIV-1 protease inhibitors, were reported to be metabolized
in the liver, and several metabolites were identified (3, 4, 16,
17, 35). The most important drug-metabolizing enzymes are the
cytochrome P-450s, a group of monooxygenases. They are located in
almost all tissues, with the highest concentration by far found in the
liver. These enzymes catalyze the biotransformation of lipophilic drugs
to more-polar compounds, which are readily excreted by the kidney into
the urine. Therefore, we tried to determine which tissue metabolically
eliminates KNI-272 by using various rat tissue homogenates. KNI-272
concentrations decreased mainly in the liver, kidney, and brain
homogenates. In general, the liver is known to be the main metabolic
tissue in which various drugs are metabolized. Although there is a bulk
blood flow through the lungs, and although the small intestine has a
large tissue volume, a large surface area, and a long residence time of
drugs, decreases in KNI-272 concentration were not observed in these tissues. If KNI-272 concentrations in these tissue homogenates had
decreased, then they could not be ignored as eliminating tissues for
KNI-272. Although KNI-272 concentrations decreased significantly in
brain homogenates, it is known that a blood-brain barrier exists in
vivo. Therefore, peptidic drugs, such as KNI-272, presumably are not
able to enter the brain through blood circulation. In fact, KNI-272
distributed highly to the liver, kidney, and small intestine, but
little or hardly at all to the brain, heart, spleen, and skeletal
muscle. Accordingly, we concluded that KNI-272 is mainly eliminated
from the liver in rats, based on the above results and the
physiological parameters (the tissue volume and tissue blood flow), and
we more thoroughly investigated KNI-272 metabolism, using rat liver microsomes.
In our previous study (33), KNI-272 bound about 90% in rat
and human plasma. As KNI-272 is also considered to be highly bound in
the microsomal suspensions, the KNI-272 concentration in microsomal
suspensions was corrected back to its unbound concentration, and the
Km and Vmax were
calculated. The Vmax obtained from in vitro
experiments, expressed in micrograms per milligram of protein per
minute, was multiplied by the term 464 (45 mg of protein per g of
liver × a 10.3-g liver/250-g rat) as a scaling factor
(24) to yield estimates for the whole liver. Consequently,
the Vmax was estimated to be 172 µg/min in a
250-g rat, and the CLint,metab obtained in an in vitro
study was 154 ml/min in a 250-g rat. We previously investigated the
hepatic extraction ratio (E) using rats by comparing areas
under the concentration-time curve (AUC) obtained after i.v. infusion
with that obtained after portal venous infusion at 10.0 mg/kg/h, and
E was estimated to be 0.368. Then CLint,metab
was calculated to be 166 ml/min in a 250-g rat, assuming the
well-stirred model (44); thus, the two
CLint,metab values were very similar.
The present study showed that KNI-272 was metabolized in the rat liver
microsomes, and the kmetabolism decreased with
the increase in initial concentration. On the other hand, we
investigated the effects of the KNI-272 dose, between 1.0 and 50.0 mg/kg, on the plasma kinetics of KNI-272 (34) As a result,
the total clearance (CLtotal) decreased and the AUC per
dose increased after i.v. administration of KNI-272 at a 50.0-mg/kg
dose. In addition, the biliary and urinary excretions of KNI-272 after
i.v. administration were about 1%. If these dose-dependent
pharmacokinetics were caused by nonlinear plasma protein binding
(33), the CLtotal would increase inversely with
the dose. Consequently, we concluded that these results were partly
caused by the saturation of hepatic metabolism.
The metabolism of KNI-272 was thought to involve the CYP3A isozyme, at
least in the formation of M1, M2, M4, and M5 in this study. Some HIV-1
protease inhibitors and renin inhibitors have been reported to be
metabolized in rats, dogs, and humans, and some metabolites were
identified (3, 4, 16, 17, 35). Furthermore, several
compounds, containing indinavir and ritonavir, which are potent and
selective HIV-1 protease inhibitors (13, 28, 41, 52), were
found to be mostly or partly metabolized by CYP3A isoforms (9, 10,
16, 35, 38, 39). The chemical structures of HIV-1 protease
inhibitors and renin inhibitors show similarities. Therefore, these
drugs are theoretically metabolized through the same cytochrome P-450
isozymes. Moreover, it is reported that CYP3A is partly involved in
the metabolism of L-696,229 and L-738,372, both HIV-1 reverse
transcriptase inhibitors (47, 48). At present, it is general
practice that more than two drugs are administered to a patient in
clinical situations. Therefore, it is possible that such drugs and
KNI-272 may interact with each other through hepatic metabolism. In
this study, we detected five KNI-272 metabolites on an HPLC
chromatogram generated in rat liver microsomes, although their chemical
structures have not been determined. After the metabolites of KNI-272
are identified, we will be able to consider the metabolic kinetics,
drug interactions, and species differences in metabolism, etc., more precisely.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Department of
Pharmacokinetics, Kyoto Pharmaceutical University, Nakauchi-cho 5, Misasagi, Yamashina-ku, Kyoto 607-8414, Japan. Phone: 075-595-4626. Fax: 075-595-6311. E-mail:
akiko.kiriyama.takada{at}nifty.ne.jp.
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