Title : Characterization of the selectivity and mechanism of human cytochrome P450 inhibition by the human immunodeficiency virus-protease inhibitor nelfinavir mesylate.

Pub. Date : 1998 Jul

PMID : 9660842






7 Functional Relationships(s)
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1 At therapeutic concentrations (steady-state plasma concentrations approximately 4 microM), nelfinavir was found to be a competitive inhibitor of only testosterone 6beta-hydroxylase (CYP3A4) with a Ki concentration of 4. Nelfinavir cytochrome P450 family 3 subfamily A member 4 Homo sapiens
2 The inhibitory potency of nelfinavir toward CYP3A4 suggested the possibility of in vivo inhibition of this isoform, whereas in vivo inhibition of other P450s was considered unlikely. Nelfinavir cytochrome P450 family 3 subfamily A member 4 Homo sapiens
3 In a one-sequence crossover study in 12 healthy volunteers, nelfinavir inhibited the elimination of the CYP3A substrate terfenadine and the carboxylate metabolite of terfenadine. Nelfinavir cytochrome P450 family 3 subfamily A member 4 Homo sapiens
4 The 24-hr urinary recoveries of 6beta-hydroxycortisol were reduced by an average of 27% during nelfinavir treatment, consistent with CYP3A inhibition by nelfinavir. Nelfinavir cytochrome P450 family 3 subfamily A member 4 Homo sapiens
5 Inhibition of CYP3A4 by nelfinavir in vitro was NADPH-dependent requiring the catalytic formation of a metabolite or a metabolic intermediate. Nelfinavir cytochrome P450 family 3 subfamily A member 4 Homo sapiens
6 Although incubations with nelfinavir showed a time- and concentration-dependent loss of CYP3A4 activity, the partial or complete recovery of enzyme activity upon dialysis indicated that inhibition was reversible. Nelfinavir cytochrome P450 family 3 subfamily A member 4 Homo sapiens
7 Collectively, these results suggest that the probable mechanism for CYP3A4 inhibition by nelfinavir is a transient metabolic intermediate or stable metabolite that coordinates tightly but reversibly to the heme moiety of the P450. Nelfinavir cytochrome P450 family 3 subfamily A member 4 Homo sapiens