another old, but interesting item - abstract only:

Involvement of human cytochrome P450 2D6 in the bioactivation of acetaminophen [2000]

Abstract

Acetaminophen (APAP), a widely used analgesic and antipyretic agent, can cause acute hepatic necrosis in both humans and experimental animals when consumed in large doses. It is generally accepted that N-acetyl-p-benzoquinone imine (NAPQI) is the toxic, reactive intermediate whose formation from APAP is mediated by cytochrome P450. Several forms of P450 in humans, including 2E1, 1A2, 2A6, 3A4, have been shown to catalyze the oxidation of APAP to NAPQI. We now present evidence which demonstrates that human cytochrome P450 2D6 (CYP2D6) is also involved in the bioactivation of APAP. The formation of NAPQI from APAP by cDNA-expressed CYP2D6 was examined. K(m) and V(max) values were 1.76 mM and 3.02 nmol/min/nmol of P450, respectively, such that the efficiency of CYP2D6 in the conversion of APAP to NAPQI is approximately one-third of that of CYP2E1. The contribution of CYP2D6 to the total formation of NAPQI from APAP (1 mM) in human liver was investigated using quinidine (1 microm) as a CYP2D6-specific inhibitor, and varied from 4.5 to 22.4% among 10 livers, with an average at 12.6%. The correlation between the contribution of CYP2D6 to NAPQI formation in human liver microsomes and the CYP2D6 activity probed by the O-demethylation of dextromethorphan was studied, and found to be strong (r(2) = 0.85), and significant (P <.0001). Our findings indicate that CYP2D6, one of the major P450 isoforms in humans and also one of the pharmacogenetically important isoforms, may contribute significantly to the formation of the cytotoxic metabolite NAPQI, especially in CYP2D6 ultra-rapid and extensive metabolizers and at toxic doses of APAP when plasma APAP concentrations reach 2 mM or more.

https://pubmed.ncbi.nlm.nih.gov/11095574/

#CYP2D6 #pharmacogenetics

Involvement of human cytochrome P450 2D6 in the bioactivation of acetaminophen - PubMed

Acetaminophen (APAP), a widely used analgesic and antipyretic agent, can cause acute hepatic necrosis in both humans and experimental animals when consumed in large doses. It is generally accepted that N-acetyl-p-benzoquinone imine (NAPQI) is the toxic, reactive intermediate whose formation from APA …

PubMed

old but interesting; abstract only:

Significance of CYP2D6 oxidation genotype as a risk factor in development of allergic diseases [2003]

Abstract

The relationship between genetically determined polymorphic metabolism and susceptibility to allergic diseases has aroused much interest. The aim of our study was to evaluate whether patients with allergic diseases, like atopic asthma and allergic rhinitis differ from healthy persons in their CYP2D6 genotype. Study completed 400 persons, 100 patients with allergic diseases--62 with atopic asthma and 38 with allergic rhinitis and 300 healthy volunteers as a control group. The results of our study revealed a statistically significant predominance of extensive metabolizers among patients with allergic diseases in comparison to healthy volunteers. Relative risk (odds ratio) of development of allergic diseases was 1.85 times higher (p < 0.05), atopic asthma was 1.97 times higher (p < 0.05), allergic rhinitis 1.68 times higher (p > 0.05; NS) for persons with extensive CYP2D6 genotype. Our results represent some evidence for a possible relationship between extensive CYP2D6 genotype and the higher susceptibility to development of allergic diseases.

https://pubmed.ncbi.nlm.nih.gov/12879776/

#allergies #immunology #CYP2D6 #genetics

[Significance of CYP2D6 oxidation genotype as a risk factor in development of allergic diseases] - PubMed

The relationship between genetically determined polymorphic metabolism and susceptibility to allergic diseases has aroused much interest. The aim of our study was to evaluate whether patients with allergic diseases, like atopic asthma and allergic rhinitis differ from healthy persons in their CYP2D6 …

PubMed
Case report: metoclopramide induced acute dystonic reaction in adolescent CYP2D6 poor metabolizers

Metoclopramide is indicated for the management of gastroesophageal reflux, gastric stasis, nausea, and vomiting. Metoclopramide-induced acute dystonic reactions (MIADRs), along with repetitive involuntary protrusion of the tongue, are well-known ...

PubMed Central (PMC)

@kijekijikokwe

Thanks for posting. Very useful info. My daughter had neuroleptic malignant syndrome from Reglan; she was also on Zofran & other drugs. I suspect CYP2D6 saturation was the problem. Still upset that pharmacogenomics isn't yet a thing in clinical practice in US. Also that the hospital chief of pharmacy over-rode her gastro team (they wanted to try erythromycin).

Hope it works out - please post updates.

#CYP2D6