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In vitro hepatic metabolism explains higher clearance of voriconazole in children versus adults: role of CYP2C19 and flavin-containing monooxygenase 3.

Publication ,  Journal Article
Yanni, SB; Annaert, PP; Augustijns, P; Ibrahim, JG; Benjamin, DK; Thakker, DR
Published in: Drug Metab Dispos
January 2010

Voriconazole is a broad spectrum antifungal agent for treating life-threatening fungal infections. Its clearance is approximately 3-fold higher in children compared with adults. Voriconazole is cleared predominantly via hepatic metabolism in adults, mainly by CYP3A4, CYP2C19, and flavin-containing monooxygenase 3 (FMO3). In vitro metabolism of voriconazole by liver microsomes prepared from pediatric and adult tissues (n = 6/group) mirrored the in vivo clearance differences in children versus adults, and it showed that the oxidative metabolism was significantly faster in children compared with adults as indicated by the in vitro half-life (T(1/2)) of 33.8 + or - 15.3 versus 72.6 + or - 23.7 min, respectively. The K(m) for voriconazole metabolism to N-oxide, the major metabolite formed in humans, by liver microsomes from children and adults was similar (11 + or - 5.2 versus 9.3 + or - 3.6 microM, respectively). In contrast, apparent V(max) was approximately 3-fold higher in children compared with adults (120.5 + or - 99.9 versus 40 + or - 13.9 pmol/min/mg). The calculated in vivo clearance from in vitro data was found to be approximately 80% of the observed plasma clearance values in both populations. Metabolism studies in which CYP3A4, CYP2C19, or FMO was selectively inhibited provided evidence that contribution of CYP2C19 and FMO toward voriconazole N-oxidation was much greater in children than in adults, whereas CYP3A4 played a larger role in adults. Although expression of CYP2C19 and FMO3 is not significantly different in children versus adults, these enzymes seem to contribute to higher metabolic clearance of voriconazole in children versus adults.

Duke Scholars

Published In

Drug Metab Dispos

DOI

EISSN

1521-009X

Publication Date

January 2010

Volume

38

Issue

1

Start / End Page

25 / 31

Location

United States

Related Subject Headings

  • Young Adult
  • Voriconazole
  • Triazoles
  • Pyrimidines
  • Pharmacology & Pharmacy
  • Oxygenases
  • Models, Biological
  • Middle Aged
  • Microsomes, Liver
  • Liver
 

Citation

APA
Chicago
ICMJE
MLA
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Yanni, S. B., Annaert, P. P., Augustijns, P., Ibrahim, J. G., Benjamin, D. K., & Thakker, D. R. (2010). In vitro hepatic metabolism explains higher clearance of voriconazole in children versus adults: role of CYP2C19 and flavin-containing monooxygenase 3. Drug Metab Dispos, 38(1), 25–31. https://doi.org/10.1124/dmd.109.029769
Yanni, Souzan B., Pieter P. Annaert, Patrick Augustijns, Joseph G. Ibrahim, Daniel K. Benjamin, and Dhiren R. Thakker. “In vitro hepatic metabolism explains higher clearance of voriconazole in children versus adults: role of CYP2C19 and flavin-containing monooxygenase 3.Drug Metab Dispos 38, no. 1 (January 2010): 25–31. https://doi.org/10.1124/dmd.109.029769.
Yanni SB, Annaert PP, Augustijns P, Ibrahim JG, Benjamin DK, Thakker DR. In vitro hepatic metabolism explains higher clearance of voriconazole in children versus adults: role of CYP2C19 and flavin-containing monooxygenase 3. Drug Metab Dispos. 2010 Jan;38(1):25–31.
Yanni, Souzan B., et al. “In vitro hepatic metabolism explains higher clearance of voriconazole in children versus adults: role of CYP2C19 and flavin-containing monooxygenase 3.Drug Metab Dispos, vol. 38, no. 1, Jan. 2010, pp. 25–31. Pubmed, doi:10.1124/dmd.109.029769.
Yanni SB, Annaert PP, Augustijns P, Ibrahim JG, Benjamin DK, Thakker DR. In vitro hepatic metabolism explains higher clearance of voriconazole in children versus adults: role of CYP2C19 and flavin-containing monooxygenase 3. Drug Metab Dispos. 2010 Jan;38(1):25–31.
Journal cover image

Published In

Drug Metab Dispos

DOI

EISSN

1521-009X

Publication Date

January 2010

Volume

38

Issue

1

Start / End Page

25 / 31

Location

United States

Related Subject Headings

  • Young Adult
  • Voriconazole
  • Triazoles
  • Pyrimidines
  • Pharmacology & Pharmacy
  • Oxygenases
  • Models, Biological
  • Middle Aged
  • Microsomes, Liver
  • Liver