Toxicity reactive metabolites

Several chemical compounds may cause inflammation or constriction of the blood vessel wall (vasoconstriction). Ergot alkaloids at high doses cause constriction and thickening of the vessel wall. Allylamine may also induce constriction of coronary arteries, thickening of their smooth muscle walls, and a disease state that corresponds to coronary heart disease. The culprit is a toxic reactive metabolite of allylamine, acrolein, that binds covalently to nucleophilic groups of proteins and nucleic acids in the cardiac myocytes. 

Pohl LR. An immunochemical approach to identifying and characterizing protein targets of toxic reactive metabolites. Chem Res Toxicol 1993 6 786-793. 

Because of the rare and unpredictable nature of hepatobihary reactions to terbinafine, the mechanism of hepatotoxicity has been hypothesized to be either immunological or metabolically mediated. A potentially toxic reactive metabolite of terbinafine, 7,7-dimethylhept-2-ene-4-jmal (TBF-A), the A-dealkylation product of terbinafine, has been identified in vitro (43). The authors speculated that this allylic aldehyde metabolite, formed by hver enzymes and conjugated with glutathione, would be transported across the canalicular membrane of hepatocytes and concentrated in the bile. The reactive monoglutathione conjugate could bind to hepatobiliary proteins and cause direct toxicity. Alternatively, it could modify canahcular proteins and lead to an immune-mediated reaction, causing cholestatic dysfunction. 

Benzidine is metabolized to highly toxic, reactive metabolites, such as N-hydroxyarylamides and N-hydroxyarylamines, which act as procarcinogens and are more mutagenic than parent compounds. The metabolites act as DNA adducts and bind to cell receptors. The metabolites on conjugation with sulfuric, acetic, and glucuronic acids form ultimate carcinogens. Acetylated benzidine metabolites such as N-acetoxyarylamines are known to cause bladder cancer in dye industry workers. 

Information is also limited on the role of 1,1,1-trichloroethane metabolites in the compound s toxicity. Reactive metabolites are important in the carcinogenicity of other chloroethanes (i.e.,... 

Mechanisms of Cardiotoxicity Chemical compounds often affect the cardiac conducting system and thereby change cardiac rhythm and force of contraction. These effects are seen as alterations in the heart rate, conduction velocity of impulses within the heart, and contractivity. For example, alterations of pH and changes in ionic balance affect these cardiac functions. In principle, cardiac toxicity can be expressed in three different ways (1) pharmacological actions become amplified in an nonphysiological way (2) reactive metabolites of chemical compounds react covalently with vital macromolecules... 

Allemand H, Pessayre D, Descatoire V, et al. 1978. Metabolic activation of trichloroethylene into a chemically reactive metabolite toxic to the liver. J Pharmacol Exp Ther 204 714-723. 

Reactive Metabolite Formation, Mechanism-Based CYP Inhibition, and Relationship to Toxicity... 

The presence of chemically reactive structural features in potential drug candidates, especially when caused by metabolism, has been linked to idiosyncratic toxicity [56,57] although in most cases this is hard to prove unambiguously, and there is no evidence that idiosyncratic toxicity is correlated with specific physical properties per se. The best strategy for the medicinal chemist is avoidance of the liabilities associated with inherently chemically reactive or metabolically activated functional groups [58]. For reactive metabolites, protein covalent-binding screens [59] and genetic toxicity tests (Ames) of putative metabolites, for example, embedded anilines, can be employed in risky chemical series. 

Gillette, J.R. 1994. Commentary. Perspective on the role of chemically reactive metabolites of foreign compounds in toxicity. I. Correlation of changes in covalent binding of reactivity metabolites with changes in the incidence and severity of toxicity. Biochem. Pharmacol. 23, 2785. 

The reactions of nucleophiles with benzoquinone and related compounds can also be viewed as Michael reactions. Benzoquinone is one of the reactive metabolites of benzene, a solvent also associated with aplastic anemia (Fig. 8.14). A similar reactive metabolite is responsible for the hepatotoxicity of acetaminophen (Fig. 4.71), the most common cause of acute liver failure however, most of this reactive metabolite is detoxified by reaction with glutathione, and it is only when glutathione is depleted to approximately 10% of the normal level that significant toxicity ensues. 

The principal application of PBPK models is in the prediction of the target tissue dose of the toxic parent chemical or its reactive metabolite. Use of the target tissue dose of the toxic moiety of a chemical in risk assessment calculations provides a better basis of relating to the observed toxic effects than the external or exposure concentration of the parent chemical. Because PBPK models facilitate the prediction of target tissue dose for various exposure scenarios, routes, doses, and species, they can help reduce the uncertainty associated with the conventional extrapolation approaches. Direct application of modeling includes... 

Sometimes CYPs can also produce reactive metabolite species that, instead of undergoing the normal detoxification pathway, can act as irreversible CYP inhibitors, thus causing toxicity. Such reactive metabolites that cause CYP inactivation are called MBI and are described in Chapter 9. Mechanism-based enzyme inhibition is associated with irreversible or quasi-irreversible loss of enzyme function, requiring synthesis of new enzymes before activity is restored. The consequences of MBI could be auto-inhibition of the clearance of the inactivator itself or prolonged inhibition of the clearance of other drugs that are cleared by the same isozyme. There may also be serious immunotoxicological consequences if a reactive intermediate is covalently bound to the enzyme. Therefore, screening of new compounds for MBI is now a standard practice within the pharmaceutical industry. 

Buta-1,3-diene (10.101, Fig. 10.24) is a gaseous chemical used heavily in the rubber and plastics industry, the presence of which in the atmosphere is also a concern. Butadiene is suspected of increasing the risks of hematopoietic cancers, and it is classified as a probable human carcinogen. Butadiene must undergo metabolic activation to become toxic the metabolites butadiene monoepoxide (10.102, a chiral compound) and diepoxybutane (10.103, which exists in two enantiomeric and one meso-form) react with nucleic acids and glutathione [160 - 163], as does a further metabolite, 3,4-epoxybutane-l,2-diol (10.105). Interestingly, butadiene monoepoxide is at least tenfold more reactive than diepoxybutane toward nucleic acids or H20. Conjugation between the C=C bond and the oxirane may account for this enhanced reactivity. 

In summary, a growing body of evidence suggests that at least part of the chronic toxicity of buta-1,3-diene is caused by reactive metabolites that bear an epoxy or ,/Tunsaluralcd carbonyl group. These metabolites form adducts with protective (glutathione) or critical (e.g., nucleic acids) endogenous nucleophiles [163] [166] [167],... 

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