The Effects of Thyroid Hormone on Cytochrome P450 and P-Glycoprotein Activity in Thyroid Cancer Patients
Interaction between thyroid hormones and commonly prescribed drugs has been well documented,
resulting in augmentation or attenuation of the action of either compound. Phase I drug
metabolism is mediated mostly by enzymes belonging to the cytochrome p450 superfamily.
Studies in animals and cell cultures have shown that thyroid hormones play an important role
in the constitutive expression of the p450 enzymes, thus potentially altering the metabolism
and the effects of a variety of drugs. P-glycoprotein is expressed in the major organs
associated with drug absorption, distribution, and elimination from the body (e.g.
intestine, kidney, liver, skin, and the blood-brain barrier). Expression of intestinal
P-glycoprotein in humans also appears to be influenced by thyroid hormones. We intend to
study the effect of thyroid hormones on the activity of CYP1A2, CYP2C19, CYP2D6, CYP3A4 and
P-glycoprotein by using a five-drug cocktail (caffeine, omeprazole, dextromethorphan,
midazolam, and fexofenadine) administered in patients with thyroid cancer, both on thyroid
hormone suppression therapy (in conditions of subclinical hyperthyroidism) and off this
treatment (in conditions of hypothyroidism) at the time of their routine radioactive iodine
scan. Additionally we will perform two skin biopsies in order to assess the pattern of
expression of metabolic enzymes and drug transport proteins on and off thyroid hormone
suppression therapy.
Interventional
Endpoint Classification: Safety/Efficacy Study, Primary Purpose: Treatment
United States: Federal Government
040140
NCT00080574
April 2004
November 2005
Name | Location |
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) | Bethesda, Maryland 20892 |