ABSTRACT:Oseltamivir phosphate is an ethyl ester prodrug widely used in the treatment and prevention of both Influenzavirus A and B infections. The conversion of oseltamivir to its active metabolite oseltamivir carboxylate is dependent on ester hydrolysis mediated by carboxylesterase 1 (CES1). We recently identified two functional CES1 variants p.Gly143Glu and p.Asp260fs in a research subject who displayed significant impairment in his ability to metabolize the selective CES1 substrate, methylphenidate. In vitro functional studies demonstrated that the presence of either of the two mutations can result in severe reductions in the catalytic efficiency of CES1 toward methylphenidate, which is required for hydrolysis and pharmacological deactivation. The aim of the present study was to investigate the function of these mutations on activating (hydrolyzing) oseltamivir to oseltamivir carboxylate using the cell lines expressing wild type (WT) and each mutant CES1. In vitro incubation studies demonstrated that the S9 fractions prepared from the cells transfected with WT CES1 and human liver tissues rapidly convert oseltamivir to oseltamivir carboxylate. However, the catalytic activity of the mutant hydrolases was dramatically hindered. The V max value of p.Gly143Glu was approximately 25% of that of WT enzyme, whereas the catalytic activity of p.Asp260fs was negligible. These results suggest that the therapeutic efficacy of oseltamivir could be compromised in treated patients expressing either functional CES1 mutation. Furthermore, the potential for increased adverse effects or toxicity as a result of exposure to high concentrations of the nonhydrolyzed prodrug should be considered.Oseltamivir phosphate (Tamiflu; Roche, Nutley, NJ) is widely used in the treatment and prophylaxis of both Influenzavirus A and B infections. In addition, oseltamivir may be effective in preventing or treating avian influenza or so-called "bird flu." Oseltamivir is an ester prodrug and, in general, it is readily converted to its active form oseltamivir carboxylate mediated by hepatic carboxylesterase 1 (CES1) (Fig. 1) . The active metabolite exerts its antiviral effects via the selective inhibition of neuraminidase.Carboxylesterases are members of the ␣ hydrolase -fold family and expressed in many tissues, especially in the liver, small intestine, and lung (Satoh and Hosokawa, 2006;Ross and Crow, 2007). The major human carboxylesterases include CES1 (UniProtKB/Swiss-Prot P23141) and carboxylesterase 2 (CES2) (UniProtKB/Swiss-Prot O00748). CES1 and CES2 are largely distinguished from one another by their substrate specificity and tissue distribution (Imai et al., 2006;Satoh and Hosokawa, 2006). CES1 more readily catalyzes substrates with a relatively large acyl group and small alcohol group such as methylphenidate, temocapril, and oseltamivir (Sun et al., 2004;Imai et al., 2005;Shi et al., 2006). In contrast, CES2 preferentially hydrolyzes compounds bearing a small acyl moiety and bulky alcohol group, which includes agents such as cocaine a...