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Vol. 27, Issue 9, 1057-1063, September 1999
Department of Pharmacology and Toxicology, University of
Alabama at Birmingham, Birmingham, Alabama (C.N.F., J.L.F., J.W.) and
Departments of Medicinal Chemistry (J.H.) and Pharmacokinetics and
Biopharmaceutics (H.v.E.C., S.S.), Astra Pain Control AB,
Södertälje, Sweden
The metabolism of the local anesthetics lidocaine and ropivacaine
(ropi) involves several steps in humans. Lidocaine is mainly hydrolyzed
and hydroxylated to 4-OH-2,6-xylidine (4-OH-xyl). The metabolism of
ropi, involving dealkylation and hydroxylation, gives rise to
3-OH-ropi, 4-OH-ropi, 3-OH-2'6'-pipecoloxylidide (3-OH-PPX), and
2-OH-methyl-ropi. Because the metabolites are hydroxylated, they are
particularly prone to subsequent Phase II conjugation reactions such as
sulfation and glucuronidation. This study focused on the in vitro
sulfation of these metabolites as well as another suspected metabolite
of ropi, 2-carboxyl-ropi. All the metabolites were synthesized for the
subsequent enzymatic studies. Five cloned human sulfotransferases (STs)
were used in this study, namely, the phenol-sulfating form of ST
(P-PST-1), the monoamine-sulfating form of ST (M-PST),
estrogen-ST (EST), ST1B2, and dehydroepiandrosterone-ST (DHEA-ST), all
of which are expressed in human liver. The results demonstrate that all
of the metabolites except 2-OH-methyl-ropi and 2-carboxyl-ropi can be
sulfated. It was also found that all of the STs can conjugate the
remaining hydroxylated metabolites except DHEA-ST. However, there are
large differences in the capacity of the individual human ST isoforms
to conjugate the different metabolites. P-PST-1 sulfates 3-OH-PPX,
3-OH-ropi, and 4-OH-xyl; M-PST and EST conjugate 3-OH-PPX, 3-OH-ropi,
and 4-OH-ropi whereas ST1B2 sulfates only 4-OH-xyl. The most
extensively sulfated ropi metabolite is 3-OH-PPX. In conclusion, all of
the hydroxylated metabolites of lidocaine and ropi can be sulfated if
the hydroxyl group is attached to the aromatic ring in the metabolites.
The human ST enzymes that are considered to be responsible for the
sulfation of these metabolites in vivo are P-PST-1, M-PST, EST, and
ST1B2. These enzymes are also found in the liver; this is the most
important tissue for the metabolism of ropi in humans, demonstrated by
Halldin et al. (1996).
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