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ÎÒÏÖÔÚÕýÔÚ×öµÄÒ»¸öÖ²ÎïÒ©·¢ÏÖÊÇ·ÇÏßÐÔ£¬Ëæºó×öÁ˵°°×½áºÏʵÑéºÍϸ°ûÉ«ËØP450µÄʵÑ飬½á¹û·¢ÏÖµ°°×½áºÏÔÚµÍŨ¶ÈʱºÜ²»Îȶ¨£¬Ó¦¸ÃÊǵÍŨ¶ÈÇøÓòÏßÐÔÉÏÉý£¬¸ßŨ¶ÈÇøÓò»ù±¾Îȶ¨¡£CYPʵÑé·¢ÏÖCYP2D6ÊÇÖ÷Òª´úлø£¬¶øÕâ¸öÒ©»òÆä´úл²úÎïÔòÖ÷Òª¿ÉÒÔÓÕµ¼CYP3A4ºÍCYPA2µÄ´ß»¯»îÐÔ¡£ ÇëÎÊÕâЩ½á¹ûÒªÔõô½âÊÍ·ÇÏßÐÔÄØ£¿±¾À´ÒѾͶÁËÎÄÕ£¬µ«ÊÇÉó¸åÈËÖ¸³öÎÒÃÇÕâÒ»²¿·Ö˵µÄ²»ÊǺÜÇå³þ£¬»³ÒÉÕâЩ²»ÄܽâÊÍ·ÇÏßÐÔ¡£ ÏÂÃæÕâ¶Î»°ÊÇÉó¸åÈ˵ϰ£¬Çë´óÉñ´Í½Ì¸ÃÔõô»Ø´ð°¡£¿ The authors demonstrated that 5 microg/mL Ò©ÎïA cannot inhibit metabolism of dextromethorphan, which is mainly mediated by CYP2D6. And in the in vivo study, the authors suggested that non-linear pharmacokinetics of Ò©ÎïA is due to the saturation of metabolism mediated by CYP2D6. However, the maximum unbound concentration of Ò©Îï is estimated to be around 13£¨Ò©ÎïÌåÄÚ×î´óŨ¶È£© * 0.15£¨ÌåÄÚÓÎÀëµÄÒ©Î = 1.95 microg/mL. Thus, under such condition, CYP2D6-mediated metabolism cannot be inhibited at the plasma concentration of Ò©ÎïA the authors tested judging from the in vitro inhibition study. How do the authors explain such discrepancy? |
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