CYP2A enzymes and their use in therapeutic and diagnostic method
A technology of enzyme activity and substances, applied in the field of regulating nicotine metabolism in the individual body, can solve the problems of low effect, unknown oral nicotine replacement therapy, etc.
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Embodiment 1
[0175] Epidemiological studies
[0176] We examined the prevalence of CYP2A6 gene mutations in 126 tobacco-dependent Caucasian smokers and 143 Caucasian individuals who had smoked but were not addicted (eg, exposed controls). There are two purposes. The first is to determine the incidence of individuals with insufficient CYP2A6 activity (eg, homozygous for a null CYP2A6 allele). The second is to determine whether slowed CYP2A6-mediated nicotine metabolism due to having a null CYP2A6 allele reduces the chance of becoming a dependent smoker.
[0177] In this example, a study was conducted to evaluate the CYP2A6 genotype in a group of individuals and the effect of CYP2A6 on the smoking behavior of the individuals.
[0178] The subjects were unrelated healthy individuals, each with 4 Caucasian grandparents, who were divided into three groups. The first group comprised only tobacco dependent (TD, DSM-IV (“DSM” = Diagnostic Statistical Manual of the American Psychiatric Associati...
Embodiment 2
[0200] Coumarin Phenotype Test and CYP2A6 Genotype Test
[0201] A. Coumarin test
[0202] Coumarin is a selective and specific substrate of human CYP2A6, which can be used to: (1) identify individuals who may be therapeutically resistant to CYP2A6 inhibitors; (2) fine-tune the dose based on the initial concentration of CYP2A6 activity; and (3) conduct a risk assessment to identify individuals who will not benefit from treatment or who may be at risk of toxicity due to inhibitors or CYP2A6 substrates themselves. Coumarin trials fall into two categories:
[0203] (1) Coumarin test only available in urine
[0204] Coumarin 5mg is made into capsules or other dosage forms, and is given orally to fasting patients after emptying the residual bladder. Urine was collected for the first 2 hours and the subsequent 6 hours. Urinary excretion of the coumarin metabolite 7-hydroxycoumarin (free and bound) was measured by HPLC as described in the previous example. The relative activity ...
Embodiment 3
[0220] in vivo phenotyping
[0221] The plasma kinetics of nicotine and coumarin were compared after oral administration to 10 smokers and 9 non-smokers (12 males, 7 females) with known CYP2A6 genotypes. The dose of nicotine was 4.0 mg (expressed as base) and the dose of coumarin was 50 mg. Plasma concentrations of nicotine, cotinine, coumarin and 7-hydroxycoumarin were determined as described above.
[0222] By determining the metabolite of coumarin, 7-hydroxycoumarin (7-hydroxycoumarin [μM] * 1 / * 1=5.6±2.9; * 1 / * 2 or * 1 / * 3-3.8+1.1, p=0.04), found that coumarin makes * 1 / * 1 (wild-type homozygous, n=13) and heterozygous ( * 1 / * 2; * 1 / * 3,n=4) and homozygous ( * 2 / * 2, n=2) had optimal separation at 45 minutes. Optimal separation was found with nicotine at 90 minutes (nicotine [nM] * 1 / * 1=24±15; * 1 / * 2 or * 1 / * 3=29±12; * 2 / * 2=52±3; * 2 / * 2 pairs * 1 / * 2 or * 1 / * 3, p=0.01; * 2 / * 2 pairs * 1 / * 1, p=0.0001). Separation di...
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