ABSTRACT:The cytochrome P450 (P450)-dependent conversion of phenytoin (PHT) to p-hydroxy phenytoin (pHPPH), and tolbutamide (TLB) to 4-hydroxy tolbutamide (hydroxy-TLB), in human liver microsomes was studied in the presence of increasing concentrations (0-4%) of bovine serum albumin (BSA). Therefore, the free fraction (f u ) of PHT and TLB varied. Whereas the f u of PHT (5 M) decreased, an increase (3-fold), rather than a decrease in the pHPPH formation rate was observed when BSA (<1%) was present. The stimulation was attributed to a significant decrease in apparent K m . The change, however, was diminished as the BSA concentration reached 4% (PHT f u ؍ 0.2), in which the reaction velocity remained the same as that measured in the absence of BSA. Therefore, unchanged K m (16.2 ؎ 0.7 M) and V max (9.4 ؎ 0.2 pmol/min/mg of protein) values were determined based on total PHT concentrations, whereas correction for f u led to an unbound K m (K mu ) of ϳ3.2 M. Similarly, the metabolism of TLB (50 M) was enhanced (ϳ2-fold) in the presence of 0.25% BSA but remained only 35% of the control activity (no BSA) at 1% BSA. However, the remaining activity was higher (3-fold) than that determined with an equivalent free concentration of TLB (4 M) calculated according to its f u (0.08). The difference became less significant when BSA concentration was 4% (f u < 0.02). Collectively, the results suggest a 2-fold effect of BSA on PHT and TLB hydroxylation: first, facilitation of the reactions via a decrease in K m ; second, a decrease in f u leading to a drop in reaction rate. For a given P450 reaction, therefore, the effect of BSA may depend upon enzyme affinity, catalytic capacity, and the extent of protein binding.For the longest time, it has been accepted that only unbound drug contributes to pharmacological activities. This free drug hypothesis has also found applications in drug transport, drug metabolism and disposition, receptor binding, enzyme kinetics, and inhibition processes. However, some recent findings appear to contradict this hypothesis. For example, it has been noted that during one passage through the brain, in many cases, more drug than "free drug" can penetrate through the blood-brain barrier (Spector, 2000). Similarly, the hepatic uptake of many lipophilic compounds is not necessarily restricted by protein binding (Kurz and Fichtl, 1983;Pacifici and Viani, 1992), and it has been found that the antifungal activity of itraconazole and ketoconazole is not diminished despite extensive binding albumin (Schäfer-Korting et al., 1995). In agreement, Tran et al. (1997) have reported that the K i value of stiripentol obtained in microsomal studies is more consistent with total plasma concentration than unbound concentration. All these reports suggest that factors, other than protein binding, may be involved in a given biological process.Recently, with the growing demand for quantitative predictions of in vivo pharmacokinetics and drug-drug interactions, this free drug hypothesis has been investigated. For instance, it ...