An approach for the quantitative consideration of genetic polymorphism data in chemical risk assessment: examples with warfarin and parathion.

In recent years, a great deal of research has been conducted to identify genetic polymorphisms. One focus has been to characterize variability in metabolic enzyme systems that could impact internal doses of pharmaceuticals or environmental pollutants. Methods are needed for using this metabolic information to estimate the resulting variability in tissue doses associated with chemical exposure. We demonstrate here the use of physiologically based pharmacokinetic (PBPK) modeling in combination with Monte Carlo analysis to incorporate information on polymorphisms into the analysis of toxicokinetic variability. Warfarin and parathion were used as case studies to demonstrate this approach. Our results suggest that polymorphisms in the PON1 gene, that give rise to allelic variants of paraoxonase, which is involved in the metabolism of paraoxon (a metabolite of parathion), make only a minor contribution to the overall variability in paraoxon tissue dose, while polymorphisms in the CYP2C9 gene, which gives rise to allelic variants of the major metabolic enzyme for warfarin, account for a significant portion of the overall variability in (S)-warfarin tissue dose. These analyses were used to estimate chemical-specific adjustment factors (CSAFs) for the human variability in toxicokinetics for both parathion and warfarin. Implications of alternatives in the calculation of CSAFs are explored. Key decision points for applying the PBPK-Monte Carlo approach to evaluate toxicokinetic variability for other chemicals are also discussed.

[1]  H. Mohrenweiser,et al.  Genetic variability in susceptibility and response to toxicants. , 2001, Toxicology letters.

[2]  A. Tward,et al.  Catalytic efficiency determines the in-vivo efficacy of PON1 for detoxifying organophosphorus compounds. , 2000, Pharmacogenetics.

[3]  A. Smolen,et al.  Characteristics of the genetically determined allozymic forms of human serum paraoxonase/arylesterase. , 1991, Drug metabolism and disposition: the biological fate of chemicals.

[4]  G. W. Jepson,et al.  Physiologically based pharmacokinetic model for the inhibition of acetylcholinesterase by organophosphate esters. , 1994, Environmental health perspectives.

[5]  D. Sanghera,et al.  The codon 55 polymorphism in the paraoxonase 1 gene is not associated with the risk of coronary heart disease in Asian Indians and Chinese. , 1998, Atherosclerosis.

[6]  A. Renwick Data-derived safety factors for the evaluation of food additives and environmental contaminants. , 1993, Food additives and contaminants.

[7]  M. Keifer,et al.  The effect of the human serum paraoxonase polymorphism is reversed with diazoxon, soman and sarin , 1996, Nature Genetics.

[8]  A. Breckenridge,et al.  Stereoselective interaction between the R enantiomer of warfarin and cimetidine. , 1986, British journal of clinical pharmacology.

[9]  G. Aithal,et al.  Association of polymorphisms in the cytochrome P450 CYP2C9 with warfarin dose requirement and risk of bleeding complications , 1999, The Lancet.

[10]  E. Chan,et al.  Stereochemical aspects of warfarin drug interactions: Use of a combined pharmacokinetic‐pharmacodynamic model , 1994, Clinical pharmacology and therapeutics.

[11]  L. Wienkers,et al.  Warfarin-fluconazole. II. A metabolically based drug interaction: in vivo studies. , 1996, Drug metabolism and disposition: the biological fate of chemicals.

[12]  D. Barnes,et al.  Reference dose (RfD): description and use in health risk assessments. , 1988, Regulatory toxicology and pharmacology : RTP.

[13]  A. Breckenridge,et al.  Kinetics of warfarin absorption in man , 1973, Clinical pharmacology and therapeutics.

[14]  H. Echizen,et al.  Metabolism of warfarin enantiomers in Japanese patients with heart disease having different CYP2C9 and CYP2C19 genotypes , 1998, Clinical pharmacology and therapeutics.

[15]  John F. Young,et al.  A physiologically based pharmacokinetic computer model for human pregnancy. , 1994, Teratology.

[16]  G. Shenfield,et al.  The role of the CYP2C9-Leu359 allelic variant in the tolbutamide polymorphism. , 1996, Pharmacogenetics.

[17]  T. Diepgen,et al.  Interethnic differences in the detoxification of organophosphates: the human serum paraoxonase polymorphism. , 1986, Archives of toxicology. Supplement. = Archiv fur Toxikologie. Supplement.

[18]  M. Linder,et al.  Genetic mechanisms for variability in drug response and toxicity. , 2001, Journal of analytical toxicology.

[19]  L. Kaminsky,et al.  Human P450 metabolism of warfarin. , 1997, Pharmacology & therapeutics.

[20]  D. Eaton,et al.  Concise review of the glutathione S-transferases and their significance to toxicology. , 1999, Toxicological sciences : an official journal of the Society of Toxicology.

[21]  L. Wienkers,et al.  Impaired (S)-warfarin metabolism catalysed by the R144C allelic variant of CYP2C9. , 1994, Pharmacogenetics.

[22]  L. Knudsen,et al.  Risk assessment: the importance of genetic polymorphisms in man. , 2001, Mutation research.

[23]  H J Clewell,et al.  Comparison of cancer risk estimates for vinyl chloride using animal and human data with a PBPK model. , 2001, The Science of the total environment.

[24]  H Furuya,et al.  Genetic polymorphism of CYP2C9 and its effect on warfarin maintenance dose requirement in patients undergoing anticoagulation therapy. , 1995, Pharmacogenetics.

[25]  D. Adler,et al.  Human and rabbit paraoxonases: purification, cloning, sequencing, mapping and role of polymorphism in organophosphate detoxification. , 1993, Chemico-biological interactions.

[26]  A. Motulsky,et al.  Plasma paraoxonase polymorphism: a new enzyme assay, population, family, biochemical, and linkage studies. , 1983, American journal of human genetics.

[27]  Harvey J. Clewell,et al.  Evaluation of the Uncertainty in an Oral Reference Dose for Methylmercury Due to Interindividual Variability in Pharmacokinetics , 1999, Risk analysis : an official publication of the Society for Risk Analysis.

[28]  M L Dourson,et al.  Genetic polymorphisms in assessing interindividual variability in delivered dose. , 2002, Regulatory toxicology and pharmacology : RTP.

[29]  H. Kay Environmental Health Criteria , 1980 .

[30]  M L Dourson,et al.  Evolution of science-based uncertainty factors in noncancer risk assessment. , 1996, Regulatory toxicology and pharmacology : RTP.

[31]  Sandra J. S. Baird,et al.  Noncancer Risk Assessment: A Probabilistic Alternative to Current Practice , 1996 .

[32]  G. Omenn,et al.  Serum paraoxonase and its influence on paraoxon and chlorpyrifos-oxon toxicity in rats. , 1990, Toxicology and applied pharmacology.

[33]  W. Trager,et al.  Genetic association between sensitivity to warfarin and expression of CYP2C9*3. , 1997, Pharmacogenetics.

[34]  W. Trager,et al.  Allelic variants of human cytochrome P450 2C9: baculovirus-mediated expression, purification, structural characterization, substrate stereoselectivity, and prochiral selectivity of the wild-type and I359L mutant forms. , 1996, Archives of biochemistry and biophysics.

[35]  M. E. Meek,et al.  Approach to assessment of risk to human health for priority substances under the Canadian environmental protection act , 1994 .

[36]  A. Rettie,et al.  A common genetic basis for idiosyncratic toxicity of warfarin and phenytoin , 1999, Epilepsy Research.

[37]  H J Clewell,et al.  Development of a physiologically based pharmacokinetic model of trichloroethylene and its metabolites for use in risk assessment. , 2000, Environmental health perspectives.

[38]  T. Shimizu,et al.  Comparisons between in-vitro and in-vivo metabolism of (S)-warfarin: catalytic activities of cDNA-expressed CYP2C9, its Leu359 variant and their mixture versus unbound clearance in patients with the corresponding CYP2C9 genotypes. , 1998, Pharmacogenetics.

[39]  T. Baglin,et al.  Influence of cytochrome P-450 CYP2C9 polymorphisms on warfarin sensitivity and risk of over-anticoagulation in patients on long-term treatment. , 2000 .

[40]  M. Gibaldi,et al.  Metabolic enantiomeric interactions: the inhibition of human (S)-warfarin-7-hydroxylase by (R)-warfarin. , 1991, Chirality.

[41]  B. La Du,et al.  The human serum paraoxonase/arylesterase polymorphism. , 1983, American journal of human genetics.

[42]  R. Kanamaru,et al.  Association between Restriction Fragment Length Polymorphism of the Human Cytochrome P450IIE1 Gene and Susceptibility to Lung Cancer , 1991, Japanese journal of cancer research : Gann.

[43]  M Ingelman-Sundberg,et al.  Genetic variability in susceptibility and response to toxicants. , 2001, Toxicology letters.