Carvedilol is a b-adrenoceptor antagonist, and has been clinically used to treat chronic heart failure as well as hypertension, angina pectoris, and cardiac arrhythmias.1,2) Orally administered carvedilol undergoes stereoselective first-pass metabolism, and the blood concentration of R-enantiomer with low b-blocking activity is approximately 2-fold higher than that of S-enantiomer with high b-blocking activity. [3][4][5] Carvedilol is metabolized extensively via aliphatic side-chain oxidation, aromatic ring oxidation, and conjugation pathways.6) Oldham and Clarke reported that oxidative activity of carvedilol is observed in cytochrome P450 (CYP) 2D6, 1A2, 3A4, and 2C9.7) In addition, Ohno et al. reported that UDPglucuronosyltransferase (UGT) 2B7, 1A1, and 2B4 are capable of catalyzing the glucuronidation of carvedilol.8) However, it has been unknown whether the intestine also plays a role in the first-pass presystemic metabolism of carvedilol, although several CYP and UGT isoforms are expressed in human intestinal epithelial cells. 9,10) We previously investigated the metabolism of carvedilol in human intestinal epithelial Caco-2 cells.9) The metabolism of R-carvedilol was not significant in Caco-2 cells cultured on plastic dishes, whereas S-carvedilol was significantly metabolized in the cells. The metabolism of S-carvedilol was further increased by the treatment of Caco-2 cells with 50 m M b-naphthoflavone (b-NF) for 3 d. In addition, the mRNA expression level of the UGT1A subfamily in b-NF-treated Caco-2 cells was higher than that in non-treated cells, whereas the expression level of UGT2B4 and UGT2B7 mRNA in b-NF-treated Caco-2 cells were lower than that in non-treated cells.9) On the other hand, Takekuma et al. have recently evaluated the glucuronidation of racemic carvedilol by recombinant UGT1A1 and UGT2B7, and reported that UGT1A1 and UGT2B7 was mainly involved in the glucuronidation of R-and S-carvedilol, respectively. 11) These findings suggested that UGT was not involved in the stereoselective metabolism of carvedilol in b-NF-treated Caco-2 cells.The aim of the present study was to identify the CYP enzyme responsible for the stereoselective metabolism of carvedilol in b-NF-treated Caco-2 cells. We evaluated the effect of b-NF-treatment on the expression of CYP mRNA in Caco-2 cells, and then investigated the effect of CYP-specific inhibitors on the metabolism of carvedilol in b-NF-treated Caco-2 cells cultured on plastic dishes. Moreover, we examined whether the oxidation of carvedilol in microsomes of b-NF-treated Caco-2 cells was faster than glucuronidation of the drug. That is, the oxidation of carvedilol in microsomes was evaluated in the presence of NADPH, whereas glucuronidation was evaluated in the presence of UDP-glucuronic acid (UDPGA).
10) MATERIALS AND METHODS
MaterialsCarvedilol was kindly supplied by Daiichi Pharmaceutical (Tokyo, Japan). 1a,25-Dihydroxyvitamin D 3 (VD 3 ), b-NF, and ketoconazole were purchased from Wako Pure Chemicals (Osaka, Japan). Quinidine hydrochloride, furafylline, ...