<?xml version="1.0" encoding="UTF-8"?><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="pmc-domain-id">3416</journal-id><journal-id journal-id-type="pmc-domain">molecules</journal-id><journal-title-group><journal-title>Molecules : A Journal of Synthetic Chemistry and Natural Product Chemistry</journal-title><abbrev-journal-title>Molecules</abbrev-journal-title></journal-title-group><publisher><publisher-name>Multidisciplinary Digital Publishing Institute (MDPI)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmcid">PMC6155437</article-id><article-id pub-id-type="pmcaid">6155437</article-id><article-id pub-id-type="pmcaiid">6155437</article-id><article-id pub-id-type="pmid">28287454</article-id><article-id pub-id-type="doi">10.3390/molecules22030443</article-id><title-group><article-title>AM-2201 Inhibits Multiple Cytochrome P450 and Uridine 5′-Diphospho-Glucuronosyltransferase Enzyme Activities in Human Liver Microsomes</article-title></title-group><contrib-group content-type="author"><contrib><name name-style="western"><surname>Kim</surname><given-names initials="JH">Ju-Hyun</given-names></name><xref ref-type="aff" rid="af1-molecules-22-00443">1</xref></contrib><contrib><name name-style="western"><surname>Kwon</surname><given-names initials="SS">Soon-Sang</given-names></name><xref ref-type="aff" rid="af1-molecules-22-00443">1</xref></contrib><contrib><name name-style="western"><surname>Kong</surname><given-names initials="TY">Tae Yeon</given-names></name><xref ref-type="aff" rid="af1-molecules-22-00443">1</xref></contrib><contrib><name name-style="western"><surname>Cheong</surname><given-names initials="JC">Jae Chul</given-names></name><xref ref-type="aff" rid="af2-molecules-22-00443">2</xref></contrib><contrib><name name-style="western"><surname>Kim</surname><given-names initials="HS">Hee Seung</given-names></name><xref ref-type="aff" rid="af2-molecules-22-00443">2</xref></contrib><contrib><name name-style="western"><surname>In</surname><given-names initials="MK">Moon Kyo</given-names></name><xref ref-type="aff" rid="af2-molecules-22-00443">2</xref></contrib><contrib><name name-style="western"><surname>Lee</surname><given-names initials="HS">Hye Suk</given-names></name><xref ref-type="aff" rid="af1-molecules-22-00443">1</xref><xref rid="c1-molecules-22-00443" ref-type="author-notes">*</xref></contrib></contrib-group><contrib-group content-type="editor"><contrib><name name-style="western"><surname>Muñoz-Torrero</surname><given-names initials="D">Diego</given-names></name><role>Academic Editor</role></contrib></contrib-group><aff id="af1-molecules-22-00443"><label>1</label>Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon 14662, Korea; jhyunkim@catholic.ac.kr (J.-H.K.); zuzutnseo@naver.com (S.-S.K.); kongtaeyun@naver.com (T.Y.K.)</aff><aff id="af2-molecules-22-00443"><label>2</label>Forensic Chemistry Laboratory, Forensic Science Division, Supreme Prosecutor’s Office, 157 Banpo-daero, Seocho-gu, Seoul 06590, Korea; Saturn-jjc@spo.go.kr (J.C.C.); hskjay@spo.go.kr (H.S.K.); inmk@spo.go.kr (M.K.I.)</aff><author-notes><fn id="c1-molecules-22-00443"><label>*</label><p>Correspondence: <email>sianalee@catholic.ac.kr</email>; Tel.: +82-2-2164-4061</p></fn></author-notes><pub-date><day>10</day><month>3</month><year>2017</year></pub-date><volume>22</volume><issue>3</issue><fpage>443</fpage><page-range>443</page-range><pub-history><event event-type="pmc-release"><date><day>13</day><month>11</month><year>2018</year></date></event></pub-history><permissions><copyright-statement>© 2017 by the authors.</copyright-statement><license><license-p>Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://creativecommons.org/licenses/by/4.0/" ext-link-type="uri">http://creativecommons.org/licenses/by/4.0/</ext-link>).</license-p></license></permissions><self-uri xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="molecules-22-00443.pdf" content-type="pmc-pdf"><?cloudpmc-path 5bce/6155437/e015b6bdaa31/molecules-22-00443.pdf?><?cloudpmc-bucket app?><?size 2183310?></self-uri><abstract id="abstract1"><title>Abstract</title><p>AM-2201 is a synthetic cannabinoid that acts as a potent agonist at cannabinoid receptors and its abuse has increased. However, there are no reports of the inhibitory effect of AM-2201 on human cytochrome P450 (CYP) or uridine 5′-diphospho-glucuronosyltransferase (UGT) enzymes. We evaluated the inhibitory effect of AM-2201 on the activities of eight major human CYPs (1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, and 3A4) and six major human UGTs (1A1, 1A3, 1A4, 1A6, 1A9, and 2B7) enzymes in pooled human liver microsomes using liquid chromatography–tandem mass spectrometry to investigate drug interaction potentials of AM-2201. AM-2201 potently inhibited CYP2C9-catalyzed diclofenac 4′-hydroxylation, CYP3A4-catalyzed midazolam 1′-hydroxylation, UGT1A3-catalyzed chenodeoxycholic acid 24-acyl-glucuronidation, and UGT2B7-catalyzed naloxone 3-glucuronidation with IC<sub>50</sub> values of 3.9, 4.0, 4.3, and 10.0 µM, respectively, and showed mechanism-based inhibition of CYP2C8-catalyzed amodiaquine <italic>N</italic>-deethylation with a <italic>K<sub>i</sub></italic> value of 2.1 µM. It negligibly inhibited CYP1A2, CYP2A6, CYP2B6, CYP2C19, CYP2D6, UGT1A1, UGT1A4, UGT1A6, and UGT1A9 activities at 50 μM in human liver microsomes. These in vitro results indicate that AM-2201 needs to be examined for potential pharmacokinetic drug interactions in vivo due to its potent inhibition of CYP2C8, CYP2C9, CYP3A4, UGT1A3, and UGT2B7 enzyme activities.</p><sec id="kwd-group1" sec-type="kwd-group" disp-level="2"><p><bold>Keywords:</bold> AM-2201, cytochrome P450 inhibition, UDP-glucuronosyltransferase inhibition, human liver microsomes, drug-drug interaction</p></sec></abstract><custom-meta-group><custom-meta><meta-name>status</meta-name><meta-value>released</meta-value></custom-meta><custom-meta><meta-name>display-pdf</meta-name><meta-value>yes</meta-value></custom-meta><custom-meta><meta-name>is-olf</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>is-manuscript</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>is-preprint</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>is-journal-matter</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>is-scanned</meta-name><meta-value>no</meta-value></custom-meta><custom-meta><meta-name>is-retracted</meta-name><meta-value>no</meta-value></custom-meta></custom-meta-group></article-meta><notes notes-type="article-notes"><sec id="historyarticle-meta1" sec-type="history" disp-level="2"><p>Received 2017 Feb 22; Accepted 2017 Mar 8; Collection date 2017 Mar.</p></sec></notes></front><body><sec id="sec1-molecules-22-00443" disp-level="1"><title>1. Introduction</title><p>Synthetic cannabinoids are a group of substances with functionally similar effects to Δ9-tetrahydrocannabinol (THC), which is responsible for the major psychoactive effects of cannabis, and generally bind to cannabinoid receptor type 1 (CB<sub>1</sub>) or 2 (CB<sub>2</sub>) [<xref rid="B1-molecules-22-00443" ref-type="bibr">1</xref>]. The synthetic cannabinoid JWH-018 was first detected in herbal smoking mixtures, called Spice, in 2008; 160 synthetic cannabinoids are now monitored by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) through the EU Early Warning System [<xref rid="B2-molecules-22-00443" ref-type="bibr">2</xref>]. The continued emergence of synthetic cannabinoids on the recreational and illicit drug markets has caused unexpected and serious events and has become a global public health issue [<xref rid="B3-molecules-22-00443" ref-type="bibr">3</xref>,<xref rid="B4-molecules-22-00443" ref-type="bibr">4</xref>,<xref rid="B5-molecules-22-00443" ref-type="bibr">5</xref>,<xref rid="B6-molecules-22-00443" ref-type="bibr">6</xref>,<xref rid="B7-molecules-22-00443" ref-type="bibr">7</xref>,<xref rid="B8-molecules-22-00443" ref-type="bibr">8</xref>,<xref rid="B9-molecules-22-00443" ref-type="bibr">9</xref>]. AM-2201 (<xref rid="molecules-22-00443-f001" ref-type="fig">Figure 1</xref>) is a third-generation synthetic cannabinoid, modified by introduction of a fluorine atom to JWH compounds, and exerts potent pharmacological actions on brain function, causing psychoactive and intoxicating effects [<xref rid="B10-molecules-22-00443" ref-type="bibr">10</xref>].</p><fig id="molecules-22-00443-f001" position="float"><?disp-level 2?><label>Figure 1</label><caption><p>Chemical structure of AM-2201.</p></caption><alternatives><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="image" xlink:href="molecules-22-00443-g001.jpg"><?cloudpmc-path blobs/5bce/6155437/265185ce484a/molecules-22-00443-g001.jpg?><?cloudpmc-bucket cdn?><?image-server-status LOAD_COMPLETED?><?original-height 997?><?original-width 688?><?scaled-height 997?><?scaled-width 688?></graphic><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="thumb" xlink:href="molecules-22-00443-g001.gif"><?cloudpmc-path blobs/5bce/6155437/91885b052a3b/molecules-22-00443-g001.gif?><?cloudpmc-bucket cdn?></graphic></alternatives></fig><p>It has been increasingly found in recreational users and intoxication cases, as well as herbal products marketed for recreational use, such as incense blends [<xref rid="B3-molecules-22-00443" ref-type="bibr">3</xref>,<xref rid="B6-molecules-22-00443" ref-type="bibr">6</xref>,<xref rid="B7-molecules-22-00443" ref-type="bibr">7</xref>,<xref rid="B11-molecules-22-00443" ref-type="bibr">11</xref>,<xref rid="B12-molecules-22-00443" ref-type="bibr">12</xref>,<xref rid="B13-molecules-22-00443" ref-type="bibr">13</xref>,<xref rid="B14-molecules-22-00443" ref-type="bibr">14</xref>,<xref rid="B15-molecules-22-00443" ref-type="bibr">15</xref>,<xref rid="B16-molecules-22-00443" ref-type="bibr">16</xref>,<xref rid="B17-molecules-22-00443" ref-type="bibr">17</xref>,<xref rid="B18-molecules-22-00443" ref-type="bibr">18</xref>]. Cytochrome P450 (CYP) 1A2 and CYP2C9 enzymes play major roles in the metabolism of AM-2201 to 4-hydroxyfluoropentyl-AM-2201, AM-2201 pentanoic acid, and 5-hydroxypentyl-AM-2201 [<xref rid="B19-molecules-22-00443" ref-type="bibr">19</xref>].</p><p>Variability of drug metabolism due to inhibition and induction of uridine 5'-diphospho-glucuronosyltransferase (UGT) enzymes, as well as CYP enzymes, is an important complicating factor in pharmacology and toxicology, drug therapy, environmental exposure, and risk assessment [<xref rid="B20-molecules-22-00443" ref-type="bibr">20</xref>,<xref rid="B21-molecules-22-00443" ref-type="bibr">21</xref>]. Phytocannabinoids, such as THC, cannabidiol, and cannabinol, inhibit CYPs 1A1, 1A2, 2A6, 2B6, 2C9, 2D6, 3A4, and 3A5 activities in human liver microsomes and recombinant CYP enzymes; cannabidiol is the most potent inhibitor of many CYPs [<xref rid="B22-molecules-22-00443" ref-type="bibr">22</xref>,<xref rid="B23-molecules-22-00443" ref-type="bibr">23</xref>,<xref rid="B24-molecules-22-00443" ref-type="bibr">24</xref>,<xref rid="B25-molecules-22-00443" ref-type="bibr">25</xref>,<xref rid="B26-molecules-22-00443" ref-type="bibr">26</xref>,<xref rid="B27-molecules-22-00443" ref-type="bibr">27</xref>,<xref rid="B28-molecules-22-00443" ref-type="bibr">28</xref>,<xref rid="B29-molecules-22-00443" ref-type="bibr">29</xref>]. Cannabidiol inhibited UGT1A9 and UGT2B7 activities, and cannabinol inhibited UGT1A9 activity in human liver and intestine microsomes and recombinant UGT enzymes [<xref rid="B30-molecules-22-00443" ref-type="bibr">30</xref>]. Understanding the roles of synthetic cannabinoids in the regulation of CYP and UGT is necessary to predict individual differences in synthetic cannabinoid toxicity and to prevent toxic drug–drug interactions; however, the effects of synthetic cannabinoids, including AM-2201, on the regulation of CYP and UGT enzymes remain largely unknown.</p><p>In this study, the inhibitory effects of AM-2201 on eight major human CYP activities (CYPs 1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, and 3A4) and six major UGT activities (UGTs 1A1, 1A3, 1A4, 1A6, 1A9, and 2B7) were examined using pooled human liver microsomes to evaluate the possibility of AM-2201-induced drug interactions.</p></sec><sec id="sec2-molecules-22-00443" disp-level="1"><title>2. Results and Discussion</title><p>AM-2201 potently inhibited CYP2C9-catalyzed diclofenac 4′-hydroxylation and CYP3A4-mediated midazolam 1′-hydroxylation, with IC<sub>50</sub> values of 11.9 and 6.9 µM, respectively, and moderately inhibited CYP2C8-catalyzed amodiaquine <italic>N</italic>-deethylation with an IC<sub>50</sub> value of 53.8 µM in human liver microsomes (<xref rid="molecules-22-00443-t001" ref-type="table">Table 1</xref>).</p><table-wrap id="molecules-22-00443-t001" position="float"><?disp-level 2?><label>Table 1</label><caption><p>Inhibitory effect of AM-2201 on major CYP metabolic activities in human liver microsomes.</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" colspan="1">Marker Enzymes</th><th rowspan="2" align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" colspan="1">CYP</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1">IC<sub>50</sub> (μM)</th><th rowspan="2" align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" colspan="1"><italic>K<sub>i</sub></italic> (μM) (<italic>K</italic><sub>inact</sub>, min<sup>−1</sup> or Inhibition Mode)</th></tr><tr><th align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">No Preincubation</th><th align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">With Preincubation *</th></tr></thead><tbody><tr><td align="center" valign="middle" rowspan="1" colspan="1">Phenacetin <italic>O</italic>-deethylase</td><td align="center" valign="middle" rowspan="1" colspan="1">1A2</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Coumarin 7-hydroxylase</td><td align="center" valign="middle" rowspan="1" colspan="1">2A6</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Bupropion hydroxylase</td><td align="center" valign="middle" rowspan="1" colspan="1">2B6</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">21.9</td><td align="center" valign="middle" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Amodiaquine <italic>N</italic>-deethylase</td><td align="center" valign="middle" rowspan="1" colspan="1">2C8</td><td align="center" valign="middle" rowspan="1" colspan="1">53.8</td><td align="center" valign="middle" rowspan="1" colspan="1">6.9</td><td align="center" valign="middle" rowspan="1" colspan="1">2.1 (<italic>k</italic><sub>inact</sub>: 0.0516)</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Diclofenac 4′-hydroxylase</td><td align="center" valign="middle" rowspan="1" colspan="1">2C9</td><td align="center" valign="middle" rowspan="1" colspan="1">11.9</td><td align="center" valign="middle" rowspan="1" colspan="1">11.9</td><td align="center" valign="middle" rowspan="1" colspan="1">3.9 (competitive)</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">[<italic>S</italic>]-Mephenytoin 4′-hydroxylase</td><td align="center" valign="middle" rowspan="1" colspan="1">2C19</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">31.3</td><td align="center" valign="middle" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1">Bufuralol 1′-hydroxylase</td><td align="center" valign="middle" rowspan="1" colspan="1">2D6</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">NI</td><td align="center" valign="middle" rowspan="1" colspan="1">-</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Midazolam 1′-hydroxylase</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3A4</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">6.9</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3.8</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4.0 (competitive)</td></tr></tbody></table><table-wrap-foot><fn id="fn2"><p>* AM-2201 was preincubated for 30 min in the presence of reduced β-nicotinamide adenine dinucleotide phosphate (NADPH) before the addition of the substrate. NI: no inhibition, inhibition &lt;50% at 50 μM of AM-2201. Cocktail substrate concentrations used for the assessment of IC<sub>50</sub> were as follows: 50 μM phenacetin, 2.5 μM coumarin, 2.5 μM amodiaquine, 10 μM diclofenac, 100 μM [<italic>S</italic>]-mephenytoin, 5.0 μM bufuralol, and 2.5 μM midazolam. The inhibition of CYP2B6 activity was evaluated separately using 50 μM bupropion. Data were derived from the average of three determinations.</p></fn></table-wrap-foot></table-wrap><p>AM-2201 negligibly inhibited CYP1A2-mediated phenacetin <italic>O</italic>-deethylation, CYP2A6-mediated coumarin 7-hydroxylation, CYP2B6-mediated bupropion hydroxylation, CYP2C19-mediated [<italic>S</italic>]-mephenytoin 4′-hydroxylation, and CYP2D6-mediated bufuralol 1′-hydroxylation activities at 50 µM in human liver microsomes (<xref rid="molecules-22-00443-t001" ref-type="table">Table 1</xref>). AM-2201 competitively inhibited CYP2C9-catalyzed diclofenac 4′-hydroxylation and CYP3A4-catalyzed midazolam 1′-hydroxylation, with <italic>K</italic><sub>i</sub> values of 3.9 and 4.0 μM, respectively (<xref rid="molecules-22-00443-f002" ref-type="fig">Figure 2</xref>, <xref rid="molecules-22-00443-t001" ref-type="table">Table 1</xref>).</p><fig id="molecules-22-00443-f002" position="float"><?disp-level 2?><label>Figure 2</label><caption><p>Representative Dixon plots for the inhibitory effect of AM-2201 on (<bold>a</bold>) CYP2C9-catalyzed diclofenac 4′-hydroxylation and (<bold>b</bold>) CYP3A4-catalyzed midazolam 1′-hydroxylation activities in ultrapool human liver microsomes. Each symbol represents a substrate concentration: (<bold>a</bold>) diclofenac: ●, 2 μM; ◯, 5 μM; ▼, 10 μM; ▽, 20 μM and (<bold>b</bold>) midazolam: ●, 1 μM; ◯, 2 μM; ▼, 4 μM; ▽, 8 μM. Data represent the mean ± standard deviation (SD) (<italic>n</italic> = 3).</p></caption><alternatives><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="image" xlink:href="molecules-22-00443-g002.jpg"><?cloudpmc-path blobs/5bce/6155437/3b6320b169ed/molecules-22-00443-g002.jpg?><?cloudpmc-bucket cdn?><?image-server-status LOAD_COMPLETED?><?original-height 1730?><?original-width 3426?><?scaled-height 384?><?scaled-width 761?></graphic><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="thumb" xlink:href="molecules-22-00443-g002.gif"><?cloudpmc-path blobs/5bce/6155437/4d68085beaa4/molecules-22-00443-g002.gif?><?cloudpmc-bucket cdn?></graphic></alternatives></fig><p>AM-2201 lowered the IC<sub>50</sub> value of CYP2C8-catalyzed amodiaquine <italic>N</italic>-deethylation more than 2.5-fold after a 30-min pre-incubation with human liver microsomes and NADPH, compared with values obtained without pre-incubation (<xref rid="molecules-22-00443-t001" ref-type="table">Table 1</xref>), indicating that AM-2201 acted as a potent mechanism-based inhibitor of CYP2C8. AM-2201 decreased CYP2C8-mediated amodiaquine <italic>N</italic>-deethylation with increasing pre-incubation time in a concentration-dependent manner (<xref rid="molecules-22-00443-f003" ref-type="fig">Figure 3</xref>) with <italic>k</italic><sub>inact</sub> and apparent <italic>K</italic><sub>i</sub> values of 0.052 min<sup>−1</sup> and 2.1 µM, respectively (<xref rid="molecules-22-00443-t001" ref-type="table">Table 1</xref>).</p><fig id="molecules-22-00443-f003" position="float"><?disp-level 2?><label>Figure 3</label><caption><p>(<bold>a</bold>) Inactivation kinetics of the formation of <italic>N</italic>-deethylamodiaquine from amodiaquine in human liver microsomes by the following AM-2201 concentrations: ●, 0 μM; ◯, 0.2 μM; ▼, 0.5 μM; ▽, 1 μM; ■, 2 μM; ☐, 5 μM; ♦, 10 μM and (<bold>b</bold>) the relationship between <italic>k</italic><sub>obs</sub> and AM-2201 concentrations to estimate <italic>k</italic><sub>inact</sub> and <italic>K</italic><sub>i</sub> values of CYP2C8-mediated amodiaquine <italic>N</italic>-deethylation. Data were derived from two replicates.</p></caption><alternatives><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="image" xlink:href="molecules-22-00443-g003.jpg"><?cloudpmc-path blobs/5bce/6155437/a1e254783414/molecules-22-00443-g003.jpg?><?cloudpmc-bucket cdn?><?image-server-status LOAD_COMPLETED?><?original-height 1541?><?original-width 3647?><?scaled-height 308?><?scaled-width 729?></graphic><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="thumb" xlink:href="molecules-22-00443-g003.gif"><?cloudpmc-path blobs/5bce/6155437/a6046edbf69b/molecules-22-00443-g003.gif?><?cloudpmc-bucket cdn?></graphic></alternatives></fig><p>The inhibitory effects of AM-2201 on six major human UGT enzymes were evaluated using human liver microsomes (<xref rid="molecules-22-00443-f004" ref-type="fig">Figure 4</xref>). AM-2201 potently inhibited UGT1A3-catalyzed chenodeoxycholic acid 24-acyl-glucuronidation and UGT2B7-catalyzed naloxone 3-β-<sc>d</sc>-glucuronidation in human liver microsomes, with IC<sub>50</sub> values of 6.4 and 14.5 µM, respectively (<xref rid="molecules-22-00443-f004" ref-type="fig">Figure 4</xref>).</p><fig id="molecules-22-00443-f004" position="float"><?disp-level 2?><label>Figure 4</label><caption><p>Inhibitory effect of AM-2201 on six UGT metabolic activities in ultrapool human liver microsomes with IC<sub>50</sub> values. Cocktail substrate concentrations used for the assessment of IC<sub>50</sub> were as follows: 0.5 μM SN-38 for UGT1A1, 2 μM chenodeoxycholic acid for UGT1A3, 0.5 μM trifluoperazine for UGT1A4, 1 μM <italic>N</italic>-acetylserotonin for UGT1A6, 0.2 μM mycophenolic acid for UGT1A9, and 1 μM naloxone for UGT2B7. Data represent the mean ± SD (<italic>n</italic> = 3).</p></caption><alternatives><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="image" xlink:href="molecules-22-00443-g004.jpg"><?cloudpmc-path blobs/5bce/6155437/de0660a57192/molecules-22-00443-g004.jpg?><?cloudpmc-bucket cdn?><?image-server-status LOAD_COMPLETED?><?original-height 1880?><?original-width 3353?><?scaled-height 418?><?scaled-width 745?></graphic><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="thumb" xlink:href="molecules-22-00443-g004.gif"><?cloudpmc-path blobs/5bce/6155437/da9d79a9f441/molecules-22-00443-g004.gif?><?cloudpmc-bucket cdn?></graphic></alternatives></fig><p>AM-2201 negligibly inhibited UGT1A1-catalyzed SN-38 glucuronidation, UGT1A4-catalyzed trifluoperazine <italic>N</italic>-glucuronidation, UGT1A6-catalyzed <italic>N</italic>-acetylserotonin glucuronidation, and UGT1A9-catalyzed mycophenolic acid glucuronidation at 50 µM. AM-2201 competitively inhibited UGT1A3-catalyzed chenodeoxycholic acid 24-acyl-glucuronidation, with a <italic>K</italic><sub>i</sub> value of 4.3 μM, and showed mixed inhibition of UGT2B7-catalyzed naloxone 3-β-<sc>d</sc>-glucuronidation, with a <italic>K</italic><sub>i</sub> value of 10.0 μM, in human liver microsomes (<xref rid="molecules-22-00443-f005" ref-type="fig">Figure 5</xref>).</p><fig id="molecules-22-00443-f005" position="float"><?disp-level 2?><label>Figure 5</label><caption><p>Representative Dixon plots for the inhibitory effects of AM-2201 on (<bold>a</bold>) UGT1A3-catalyzed chenodeoxycholic acid 24-acyl glucuronidation and (<bold>b</bold>) UGT2B7-catalyzed naloxone 3′-glucuronidation in human liver microsomes. Each symbol represents the substrate concentration: (<bold>a</bold>) chenodeoxycholic acid, ●, 1 μM, ◯, 2μM, ▼, 5 μM, ▽, 10 μM; and (<bold>b</bold>) naloxone; ●, 0.5 μM; ◯, 1 μM; ▼, 2 μM; ▽, 5 μM. Data represent the mean ± SD (<italic>n</italic> = 3).</p></caption><alternatives><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="image" xlink:href="molecules-22-00443-g005.jpg"><?cloudpmc-path blobs/5bce/6155437/e5602c126141/molecules-22-00443-g005.jpg?><?cloudpmc-bucket cdn?><?image-server-status LOAD_COMPLETED?><?original-height 1831?><?original-width 3607?><?scaled-height 366?><?scaled-width 721?></graphic><graphic xmlns:xlink="http://www.w3.org/1999/xlink" content-type="thumb" xlink:href="molecules-22-00443-g005.gif"><?cloudpmc-path blobs/5bce/6155437/7b600fcd86fb/molecules-22-00443-g005.gif?><?cloudpmc-bucket cdn?></graphic></alternatives></fig><p>This in vitro study is the first to show the inhibitory potential of the popularly-used synthetic cannabinoid AM-2201 on CYP and UGT enzymes in human liver microsomes. AM-2201 was a potent competitive inhibitor of CYP2C9-catalyzed diclofenac hydroxylation with <italic>K</italic><sub>i</sub> value of 3.9 µM in human liver microsomes (<xref rid="molecules-22-00443-t001" ref-type="table">Table 1</xref>, <xref rid="molecules-22-00443-f002" ref-type="fig">Figure 2</xref>). <italic>K</italic><sub>i</sub> values for the inhibition of THC, cannabinol, and cannabidiol on CYP2C9-catalyzed diclofenac hydroxylation in human liver microsomes were 1.31 µM, 1.29 µM, and 9.88 µM, respectively [<xref rid="B27-molecules-22-00443" ref-type="bibr">27</xref>]. The <italic>K</italic><sub>i</sub> value (4.0 µM) for the competitive inhibition of AM-2201 on CYP3A4-catalyzed midazolam 1′-hydroxylation in human liver microsomes was comparable to the <italic>K</italic><sub>i</sub> (6.14 µM) of cannabidiol for CYP3A4-catalyzed diltiazem <italic>N</italic>-demethylation, but the IC<sub>50</sub> values of THC and cannabinol for CYP3A4 activity were more than 50 µM [<xref rid="B24-molecules-22-00443" ref-type="bibr">24</xref>].</p><p>Based on these in vitro results, AM-2201 may cause drug interactions with CYP2C9 substrates such as celecoxib, diclofenac, glyburide, losartan, tolbutamide, torasemide, and <italic>S</italic>-warfarin [<xref rid="B31-molecules-22-00443" ref-type="bibr">31</xref>], and CYP3A4 substrates including atorvastatin, cyclosporine, clarithromycin, estradiol, felodipine, lovastatin, nifedipine, simvastatin, and tacrolimus [<xref rid="B32-molecules-22-00443" ref-type="bibr">32</xref>].</p><p>AM-2201 was a potent mechanism-based inhibitor of CYP2C8, with a <italic>K</italic><sub>i</sub> value of 2.1 µM and its inhibitory potency was comparable to that of selective CYP2C8 inhibitor, quercetin (<italic>K</italic><sub>i</sub>, 2.0 µM) [<xref rid="B33-molecules-22-00443" ref-type="bibr">33</xref>], but was less than those produced by phenelzine (<italic>K</italic><sub>i</sub>, 54.3 µM) [<xref rid="B34-molecules-22-00443" ref-type="bibr">34</xref>] and gemfibrozil glucuronide (<italic>K</italic><sub>i</sub>, 20–52 µM) [<xref rid="B35-molecules-22-00443" ref-type="bibr">35</xref>]. These results indicate that AM-2201 may inhibit the metabolism of drugs metabolized by CYP2C8, such as cerivastatin, paclitaxel, repaglinide, and sorafenib [<xref rid="B36-molecules-22-00443" ref-type="bibr">36</xref>]. However, the inhibitory effects of THC, cannabinol, and cannabidiol on CYP2C8 activity were not evaluated, to our knowledge.</p><p>AM-2201 negligibly inhibited CYP1A2, CYP2A6, CYP2B6, CYP2C19, and CYP2D6 activities at 50 µM in human liver microsomes. However, phytocannabinoids such as THC, cannabidiol, and cannabinol showed potent inhibition of CYP2B6 activity with <italic>K</italic><sub>i</sub> values of 2.81 µM, 0.694 µM, and 2.55 µM, respectively [<xref rid="B25-molecules-22-00443" ref-type="bibr">25</xref>], and cannabidiol competitively inhibited CYP2D6 activity with a <italic>K</italic><sub>i</sub> value of 2.42 µM in human liver microsomes [<xref rid="B26-molecules-22-00443" ref-type="bibr">26</xref>].</p><p>AM-2201 showed the potent competitive inhibition (<italic>K</italic><sub>i</sub>, 4.3 µM) of UGT1A3-catalyzed chenodeoxycholic acid 24-acyl glucuronidation similar to a selective UGT1A3 inhibitor, glycyrrhetinic acid (IC<sub>50</sub>, 4.3 μM) in human liver microsomes, indicating that this compound should be used carefully with UGT1A3 substrates, such as chenodeoxycholic acid, fimasartan, losartan, candesartan, zolarsartan, and JWH-018 [<xref rid="B37-molecules-22-00443" ref-type="bibr">37</xref>,<xref rid="B38-molecules-22-00443" ref-type="bibr">38</xref>,<xref rid="B39-molecules-22-00443" ref-type="bibr">39</xref>,<xref rid="B40-molecules-22-00443" ref-type="bibr">40</xref>], to avoid possible drug interactions. </p><p>The inhibitory potency (<italic>K</italic><sub>i</sub>, 10.0 µM) of AM-2201 on UGT2B7-catalyzed naloxone 3′-glucuronidation was similar to that (<italic>K</italic><sub>i,</sub> 9.8 μM) of cannabidiol for UGT2B7-catalyzed ethanol glucuronidation [<xref rid="B30-molecules-22-00443" ref-type="bibr">30</xref>], suggesting that AM-2201 may cause drug interactions with UGT2B7 substrates, such as morphine, zidovudine, efavirenz, ethanol, carbinol, JWH-018, and flurbiprofen [<xref rid="B30-molecules-22-00443" ref-type="bibr">30</xref>,<xref rid="B40-molecules-22-00443" ref-type="bibr">40</xref>,<xref rid="B41-molecules-22-00443" ref-type="bibr">41</xref>,<xref rid="B42-molecules-22-00443" ref-type="bibr">42</xref>,<xref rid="B43-molecules-22-00443" ref-type="bibr">43</xref>,<xref rid="B44-molecules-22-00443" ref-type="bibr">44</xref>].</p><p>There is no reported systemic information on human AM-2201 pharmacokinetics, essential for the prediction of AM-2201-induced drug interaction potential, but plasma and blood concentrations for AM-2201 were reported to be 0.14 nM to 26.4 nM in recreational users and intoxication cases [<xref rid="B7-molecules-22-00443" ref-type="bibr">7</xref>,<xref rid="B45-molecules-22-00443" ref-type="bibr">45</xref>]. However, plasma or blood concentrations do not reflect tissue concentrations, particularly liver concentrations. As AM-2201 is extensively metabolized [<xref rid="B19-molecules-22-00443" ref-type="bibr">19</xref>], its metabolites may inhibit CYP and UGT activities. Consequently, these in vitro results suggest that AM-2201 should be examined in terms of potential in vivo pharmacokinetic drug interactions caused by inhibition of CYP2C8, CYP2C9, CYP3A4, UGT1A3, and UGT2B7 activities.</p></sec><sec id="sec3-molecules-22-00443" disp-level="1"><title>3. Materials and Methods</title><sec id="sec3dot1-molecules-22-00443" disp-level="2"><title>3.1. Materials and Reagents</title><p>AM-2201 was purchased from Cayman Chemical Company (Ann Arbor, MI, USA). Acetaminophen, alamethicin, chenodeoxycholic acid, coumarin, diclofenac, 7-hydroxycoumarin, midazolam, mycophenolic acid, <italic>N</italic>-acetylserotonin, naloxone, naloxone 3-β-<sc>d</sc>-glucuronide, NADPH, phenacetin, trifluoperazine, Trizma<sup>®</sup> base, and uridine 5′-diphospho-glucuronic acid (UDPGA) were purchased from Sigma-Aldrich (St. Louis, MO, USA). Ultrapool human liver microsomes (150 donors), <sup>13</sup>C<sub>2</sub>,<sup>15</sup>N-acetaminophen, bufuralol, <italic>N</italic>-desethylamodiaquine, 1′-hydroxybufuralol, 4-hydroxy-diclofenac, 4-hydroxymephenytoin, d<sub>3</sub>-4-hydroxymephenytoin, 1′-hydroxymidazolam, d<sub>9</sub>-1-hydroxybufuralol, and [<italic>S</italic>]-mephenytoin were obtained from Corning Life Sciences (Woburn, MA, USA). SN-38 was obtained from Santa Cruz Biotechnology (Dallas, TX, USA). <italic>N</italic>-Acetylserotonin β-<sc>d</sc>-glucuronide, chenodeoxycholic acid-24-acyl-β-glucuronide, mycophenolic acid β-<sc>d</sc>-glucuronide, and SN-38 glucuronide were obtained from Toronto Research Chemicals (Toronto, ON, Canada). Acetonitrile and methanol (high performance liquid chromatography (HPLC) grade) were obtained from Fisher Scientific (Fair Lawn, NJ, USA). All other chemicals were of the highest quality available.</p></sec><sec id="sec3dot2-molecules-22-00443" disp-level="2"><title>3.2. Inhibitory Effect of AM-2201 on Eight Major CYP Activities in Human Liver Microsomes</title><p>The inhibitory potencies (IC<sub>50</sub> values) of AM-2201 on CYP1A2, CYP2A6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A4 activities were evaluated in pooled human liver microsomes using a cocktail of seven CYP substrates and liquid chromatography-tandem mass spectrometry (LC-MS/MS). The incubation mixtures were prepared in total volumes of 100 µL as follows: pooled human liver microsomes (0.2 mg/mL), 1.0 mM NADPH, 10 mM MgCl<sub>2</sub>, 50 mM potassium phosphate buffer (pH 7.4), various concentrations of AM-2201 in dimethyl sulfoxide (DMSO; final concentrations of 0.1–50 µM, DMSO &lt;1% <italic>v</italic>/<italic>v</italic>), and a cocktail of seven CYP probe substrates, as described previously [<xref rid="B46-molecules-22-00443" ref-type="bibr">46</xref>]. The CYP substrates were used at concentrations approximating their respective <italic>K</italic><sub>m</sub> values: 50 µM phenacetin, 2.5 µM coumarin, 2.0 µM amodiaquine, 10 µM diclofenac, 100 µM (<italic>S</italic>)-mephenytoin, 5 µM bufuralol, and 2.5 µM midazolam. After a 3-min pre-incubation at 37 °C, the reactions were initiated by addition of NADPH and incubation proceeded for 15 min at 37 °C in a shaking water bath. The reaction was stopped by placing the tubes on ice and adding 100-µL amounts of ice-cold methanol containing internal standards (<sup>13</sup>C<sub>2</sub>,<sup>15</sup>N-acetaminophen for acetaminophen and <italic>N</italic>-desethylamodiaquine, d<sub>9</sub>-1′-hydroxybufuralol for 4′-hydroxydiclofenac, and 7-hydroxycoumarin, 4′-hydroxy-mephenytoin, 1′-hydroxybufuralol, and 1′-hydroxymidazolam). The incubation mixtures were centrifuged (13,000× <italic>g</italic>, 4 min, 4 °C). All assays were performed in triplicate and mean values were used in calculations.</p><p>To measure the mechanism-based inhibition of CYP activities, various concentrations of AM-2201 (0.1–50 µM) were pre-incubated for 30 min with human liver microsomes in the presence of NADPH. Each reaction was initiated by adding the seven-CYP probe substrate cocktail.</p><p>The inhibitory effects (IC<sub>50</sub> values) of AM-2201 on CYP2B6-catalyzed bupropion 4-hydroxylase activity were determined in ultrapool human liver microsomes using LC-MS/MS [<xref rid="B46-molecules-22-00443" ref-type="bibr">46</xref>]. The incubation mixtures were prepared in a total volume of 100 μL as follows: pooled human liver microsomes (0.2 mg/mL), 1.0 mM NADPH, 10 mM MgCl<sub>2</sub>, 50 mM potassium phosphate buffer (pH 7.4), various concentrations of AM-2201 (final concentrations of 0.1–50 μM, acetonitrile concentration &lt;1% <italic>v</italic>/<italic>v</italic>), and the CYP2B6-selective substrate bupropion (50 μM). After a 3-min pre-incubation at 37 °C, the reactions were initiated by adding a NADPH generating system and incubated for 15 min at 37 °C in a shaking water bath. The reaction was stopped by placement of the tubes on ice and addition of 100 μL of ice-cold methanol containing internal standards (d<sub>9</sub>-1-hydroxybufuralol for 4-hydroxy-bupropion). The incubation mixtures were then centrifuged (13,000× <italic>g</italic>, 4 min, 4 °C). All incubations were performed in triplicate, and average values were used.</p><p>To evaluate mechanism-based inhibition of CYP2B6 activity, various concentrations of AM-2201 (final concentrations of 0.1–50 μM, acetonitrile concentration &lt;1% <italic>v</italic>/<italic>v</italic>) were pre-incubated for 30 min with human liver microsomes in the presence of NADPH. The reaction was started by addition of the CYP2B6 probe substrate, bupropion.</p></sec><sec id="sec3dot3-molecules-22-00443" disp-level="2"><title>3.3. Inhibitory Effects of AM-2201 on Six Major UGT Activities in Human Liver Microsomes</title><p>The inhibitory effects of AM-2201 on UGT1A1, UGT1A3, UGT1A4, UGT1A6, UGT1A9, and UGT2B7 activities were evaluated by LC-MS/MS using incubation with a cocktail of UGT substrates in ultrapool human liver microsomes, as described previously [<xref rid="B47-molecules-22-00443" ref-type="bibr">47</xref>]. Each incubation mixture was prepared in a final volume of 100 µL as follows: pooled human liver microsomes (0.2 mg/mL), 5 mM UDPGA, 10 mM MgCl<sub>2</sub>, 50 mM Tris buffer (pH 7.4), various concentrations of AM-2201 in acetonitrile (final concentrations of 1–50 µM, acetonitrile &lt;1% <italic>v</italic>/<italic>v</italic>), and a UGT enzyme-specific substrate from a cocktail set (A set: 0.5 µM SN-38, 2 µM chenodeoxycholic acid, and 0.5 µM trifluoperazine; B set: 1 µM <italic>N</italic>-acetylserotonin, 0.2 µM mycophenolic acid, and 1 µM naloxone). After 3 min of pre-incubation at 37 °C, the reactions were initiated by addition of UDPGA; incubation continued for 60 min at 37 °C in a shaking water bath. The reaction was stopped by placing the tubes on ice and adding 50 µL ice-cold acetonitrile containing internal standards (propofol glucuronide for chenodeoxycholic acid 24-acyl-β-glucuronide and mycophenolic acid glucuronide, and meloxicam for SN-38 glucuronide, trifluoperazine glucuronide, <italic>N</italic>-acetylserotonin β-<sc>d</sc>-glucuronide, and naloxone 3-β-<sc>d</sc>-glucuronide). The incubation mixtures were centrifuged (13,000× <italic>g</italic>, 4 min, 4 °C). All assays were performed in triplicate and average values were used in calculations.</p></sec><sec id="sec3dot4-molecules-22-00443" disp-level="2"><title>3.4. Mechanism-based Inhibition of CYP2C8 Activity by AM-2201</title><p>The mechanism-based inhibitory effect of AM-2201 on CYP2C8 activity was further evaluated using time- and concentration-dependent inhibition assays in human liver microsomes. The microsomes (1 mg/mL) were pre-incubated with various concentrations of AM-2201 in 50 mM potassium phosphate buffer (pH 7.4) in the presence of NADPH and aliquots (10 μL) of the pre-incubated mixtures were withdrawn at 15, 25, and 35 min after incubation commenced and added to other tubes containing 2 µM amodiaquine, 1 mM NADPH, 50 mM potassium phosphate buffer (pH 7.4), and 10 mM MgCl<sub>2</sub> in 90 μL reaction mixtures. The second reaction was terminated after incubation for 10 min by adding 100-µL amounts of ice-cold methanol containing d<sub>9</sub>-1′-hydroxybufuralol. The incubation mixtures were centrifuged (13,000× <italic>g</italic>, 4 min, 4 °C), and then 50 µL of each supernatant was diluted with 50 µL of water. Aliquots (5 µL) of the diluted supernatants were analyzed by LC-MS/MS.</p></sec><sec id="sec3dot5-molecules-22-00443" disp-level="2"><title>3.5. Kinetic Analysis</title><p>To determine <italic>K</italic><sub>i</sub> values of AM-2201 for CYP2C9 and CYP3A4, human liver microsomes (0.15 mg/mL) were incubated with various concentrations of substrates (2–20 μM diclofenac for CYP2C9 and 1–8 μM midazolam for CYP3A4), 1 mM NADPH, 10 mM MgCl<sub>2</sub>, and various concentrations of AM-2201 in 50 mM potassium phosphate buffer (pH 7.4) in a total incubation volume of 100 μL. The reactions were initiated by addition of NADPH at 37 °C and stopped after 10 min by placing the incubation tubes on ice and adding 100 μL of ice-cold methanol containing an internal standard (d<sub>9</sub>-1-hydroxybufuralol). The incubation mixtures were centrifuged (13,000× <italic>g</italic>, 4 min, 4 °C) and then 50 μL of the supernatant was diluted with 50 μL of water. Aliquots (5 μL) of the diluted supernatants were analyzed by LC-MS/MS.</p><p>To determine <italic>K</italic><sub>i</sub> values of AM-2201 for UGT1A3 and UGT2B7 enzymes, human liver microsomes (0.15 mg/mL) were incubated with various concentrations of chenodeoxycholic acid (1–10 μM) for UGT1A3 or of naloxone (0.5–5 μM) for UGT2B7, 5 mM UDPGA, 10 mM MgCl<sub>2</sub>, and various concentrations of AM-2201 in 50 mM Tris buffer (pH 7.4) in a total incubation volume of 100 μL. The reactions were initiated by addition of UDPGA at 37 °C and stopped after 60 min by placing the incubation tubes on ice and adding 100 μL of ice-cold methanol containing propofol glucuronide (internal standard for UGT1A3) or meloxicam (internal standard for UGT2B7). The incubation mixtures were centrifuged (13,000× <italic>g</italic>, 4 min, 4 °C), and then, 50 μL of the supernatant was diluted with 50 μL of water. Aliquots (5 μL) of the diluted supernatants were analyzed by LC-MS/MS.</p></sec><sec id="sec3dot6-molecules-22-00443" disp-level="2"><title>3.6. LC-MS/MS Analysis</title><p>A tandem mass spectrometer (TSQ Quantum Access; Thermo Scientific, San Jose, CA, USA) equipped with an electrospray ionization (ESI) source, coupled to a Nanospace SI-2 LC system (Tokyo, Japan), was used. The column and autosampler temperatures were 50 °C and 6 °C, respectively.</p><p>The metabolites formed from CYP substrates were quantified simultaneously by a LC-MS/MS method described previously [<xref rid="B46-molecules-22-00443" ref-type="bibr">46</xref>]. The ESI source settings in positive-ion mode for metabolite ionization were: capillary voltage, 4200 V; vaporizer temperature, 350 °C; capillary temperature, 330 °C; sheath gas pressure, 35 psi; and auxiliary gas pressure, 15 psi. Quantification was performed by selected reaction monitoring (SRM) of the [M + H]<sup>+</sup> ion and the related product ion for each metabolite: acetaminophen, 152.1 &gt; 110.3; <italic>N</italic>-desethylamodiaquine, 328.1 &gt; 283.0; 7-hydroxycoumarin, 163.0 &gt; 107.2; 4-hydroxybupropion, 256.1 &gt; 238.0; 4′-hydroxydiclofenac, 312.0 &gt; 231.1; 4′-hydroxy-mephenytoin; 235.1 &gt; 150.1; 1′-hydroxybufuralol, 278.1 &gt; 186.1; 1′-hydroxymidazolam, 341.9 &gt; 324.0; <sup>13</sup>C<sub>2</sub>,<sup>15</sup>N-acetaminophen 155.1 &gt; 111.2; and d<sub>9</sub>-1′-hydroxybufuralol, 287.2 &gt; 187.0. Analytical data were processed using Xcalibur software (version 2.1, Thermo Scientific).</p><p>The metabolites formed from the six UGT cocktail substrates were measured simultaneously using the LC-MS/MS method [<xref rid="B47-molecules-22-00443" ref-type="bibr">47</xref>]. The ESI source settings in both positive- and negative-ion modes for metabolite ionization were: capillary voltage, 4200 V; vaporizer temperature, 350 °C; capillary temperature, 330 °C; sheath gas pressure, 35 psi; and auxiliary gas pressure, 15 psi. Each metabolite was quantified via SRM in the negative-ion mode: chenodeoxycholic acid 24-acyl-β-glucuronide, 567.2 &gt; 391.0, mycophenolic acid glucuronide, 495.2 &gt; 318.9, propofol glucuronide (IS), 353.3 &gt; 177.1; and positive ion-mode: SN-38 glucuronide, 569.0 &gt; 393.0, trifluoperazine glucuronide, 584.2 &gt; 408.1, <italic>N</italic>-acetylserotonin-β-<sc>d</sc>-glucuronide, 395.2 &gt; 219.0, naloxone 3-β-<sc>d</sc>-glucuronide, 504.0 &gt; 310.0, meloxicam (IS), 352.0 &gt; 115.1. Data were processed using Xcalibur software.</p></sec><sec id="sec3dot7-molecules-22-00443" disp-level="2"><title>3.7. Data Analysis</title><p>IC<sub>50</sub> values (concentration of inhibitor causing 50% inhibition of the original enzyme activity) were calculated using the SigmaPlot program (ver. 11.0; Systat Software, Inc., San Jose, CA, USA). The apparent kinetic parameters for inhibitory potential (<italic>K</italic><sub>i</sub> and <italic>k</italic><sub>inact</sub> values) and inhibition mode were estimated from the fitted curves using the Enzyme Kinetics program (ver. 1.1; Systat Software Inc., San Jose, CA, USA).</p></sec></sec><sec id="sec4-molecules-22-00443" disp-level="1"><title>4. Conclusions</title><p>AM-2201 potently inhibited CYP2C9-catalyzed 4′-hydroxylation, CYP3A4-catalyzed midazolam 1′-hydroxylation, UGT1A3-catalyzed chenodeoxycholic acid 24-acyl-glucuronidation, and UGT2B7-catalyzed naloxone 3-glucuronidation, with <italic>K<sub>i</sub></italic> values of 3.9, 4.0, 4.3, and 10.0 µM, respectively, and showed potent mechanism-based inhibition of CYP2C8-catalyzed amodiaquine <italic>N</italic>-deethylation, with a <italic>K<sub>i</sub></italic> value of 2.1 µM. AM-2201 should be examined in terms of potential in vivo pharmacokinetic drug interactions attributable to its inhibition of CYP2C8, CYP2C9, CYP3A4, UGT1A3, and UGT2B7 activities.</p></sec><sec id="ack1" sec-type="ack" disp-level="1"><title>Acknowledgments</title><p>This work was supported by the National Research Foundation of Korea (NRF) grant, funded by the Korea government (MSIP) (NRF-2015M3A9E1028325) and Supreme Prosecutor’s Office.</p></sec><sec id="notes1" disp-level="1"><title>Author Contributions</title><p>J.-H.K., S.-S.K., and T.Y.K performed the experiments and data analysis, J.C.C., H.S.K., and M.K.I. conceived and designed the experiments, H.S.L. were responsible for the study conception and design, data analysis, and writing of the manuscript.</p></sec><sec id="notes2" disp-level="1"><title>Conflicts of Interest</title><p>The authors declare no conflict of interest.</p></sec><sec id="fn-group1" sec-type="fn-group" disp-level="1"><title>Footnotes</title><fn-group><fn id="fn1"><p><bold>Sample Availability:</bold> Not available.</p></fn></fn-group></sec><sec id="ref-list1" sec-type="ref-list" disp-level="1"><title>References</title><sec id="ref-list1_sec2" disp-level="2"><ref-list><ref id="B1-molecules-22-00443"><label>1.</label><mixed-citation><named-content content-type="citation-string">Fattore L., Fratta W. 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