Chapter 5
Absorption, Distribution,
Metabolism, and Elimination of
           Toxics
  Biotransformation: Basic Concepts (1)
• Renal excretion of chemicals
 Biotransformation: Basic Concepts (2)
• Biological basis for xenobiotic metabolism:
   – To convert lipid-soluble, non-polar, non-excretable forms
     of chemicals to water-soluble, polar forms that are
     excretable in bile and urine.
   – The transformation process may take place as a result of
     the interaction of the toxic substance with enzymes found
     primarily in the cell endoplasmic reticulum, cytoplasm,
     and mitochondria.
   – The liver is the primary organ where biotransformation
     occurs.
Biotransformation: Basic Concepts (3)
 Biotransformation: Basic Concepts (4)
• Interaction with these enzymes may change the toxicant to
  either a less or a more toxic form.
• Generally, biotransformation occurs in two phases.
   – Phase I involves catabolic reactions that break down the toxicant
     into various components.
       • Catabolic reactions include oxidation, reduction, and hydrolysis.
           – Oxidation occurs when a molecule combines with oxygen, loses hydrogen,
             or loses one or more electrons.
           – Reduction occurs when a molecule combines with hydrogen, loses oxygen,
             or gains one or more electrons.
           – Hydrolysis is the process in which a chemical compound is split into
             smaller molecules by reacting with water.
       • In most cases these reactions make the chemical less toxic, more
         water soluble, and easier to excrete.
Biotransformation: Basic Concepts (5)
– Phase II reactions involves the binding of molecules to
  either the original toxic molecule or the toxic molecule
  metabolite derived from the Phase I reactions. The final
  product is usually water soluble and, therefore, easier to
  excrete from the body.
   • Phase II reactions include glucuronidation, sulfation, acetylation,
     methylation, conjugation with glutathione, and conjugation with
     amino acids (such as glycine, taurine, and glutamic acid).
– It is important to understand that these Phase I and II
  reactions may occur simultaneously or sequentially.
 Biotransformation: Basic Concepts (6)
• Whether the more toxic intermediate produces
  an effect is dependent on
  – how rapidly the intermediate undergoes further
    metabolism to less toxic substances,
  – how much of it is produced and accumulated in
    cells,
  – what type of cellular damage is caused by the toxic
    intermediate, and
  – what factors may affect excretion of the toxic
    material.
Example : Result of Oxidation of Benzene
         Phase I Reaction (1)
• Exposing a functional group on the starting
  compound
          Phase I Reaction (2)
• Sequential metabolism of benzene
  – Adding a functional group
          Phase I      Phase II
             Phase I Reaction (3)
• Oxidation
  – Many toxicants are metabolized by the enzymes
    cytochrome P-450 reductase and cytochrome P-450 in
    association with NADPH (nicotinamide adenine
    dinucleotide phosphate).
     • NADPH is a co-enzyme present in most cells; it interacts with
       various substances during normal cell metabolism.
  – These two enzymes are found in abundance in the
    endoplasmic reticulum of liver cells.
  – When these enzymes interact with the toxic molecule, one
    atom of oxygen is attached to the toxic molecule and
    another oxygen atom interacts with hydrogen to form water.
           Phase I Reaction (4)
• Cytochrome P450 Characteristics
  – can metabolize many xenobiotics (broad substrate
    specificity).
  – can catalyze many types of reactions
  – is widely distributed among tissues, and tissue
    distribution can be quite varied.
  – exists in multiple forms (determined by different
    genes)
  – levels can be increased by exposure to chemicals in
    the food, water, or air (induction)
             Phase II Reaction (1)
• During Phase II reactions the toxic substance or its
  metabolite is bound with a compound that generally
  renders the newly synthesized molecule less toxic. This type
  of reaction is referred to as conjugation.
• Conjugation is the joining of two substances to form s single
  molecule, which can increase water solubility and excretion.
               Phase II Reaction (2)
• There are several types of Phase II reactions, of which
  glucuronidation is probably the most important.
• Conjugation with glucuronidation
   – Glucuronidation occurs as a result of the conjugation of
     glucuronidation acid with either a metabolite from Phase I reactions
     or with the parent compound.
   – There are several chemical compounds that interact with glucuronic
     acid:
       • alcohols (R-OH)
       • carboxylic acids (R-COOH)
       • sulfhydryl compounds (R-SH)
       • amines (R-NH)
             Phase II Reaction (3)
• Conjugation with glutathione
  – Conjugation with glutathione is an important Phase II reaction
    that renders highly toxic metabolites harmless.
  – Conjugation of these intermediates with glutathione prevents
    binding with the nucleic acids, therefore preventing the
    occurrence of mutations.
     • Metabolites of organic solvents such as benzene, chloroform, and
       carbon tetrachloride are conjugated with glutathione resulting in
       decreased toxicity.
              Phase II Reaction (4)
• Illustation of glucuronidation
   – I
              Phase II Reaction (5)
• Sulfation
              Phase II Reaction (6)
• Acetylation and methylation
  – Acetylation and methylation may increase toxicity by
    decreasing water solubility and, therefore, excretion.
  – Methylation plays only a minor role in the transformation of toxic
    substances.
      • Methylation of nicotine. A methyl group is added from SAM (S-adenosyl
        methione) to nicotine.
 Deactivation versus Bioactivation (1)
• In general, Phase I and Phase II reactions are
  designed to deactivate toxic substances by
  increasing water solubility and excretion of toxic
  substances. However, these reactions may also
  bioactivate some toxicants by transforming
  inactive non-toxic molecules to active toxic forms.
Deactivation versus Bioactivation (2)
• Four potential end results of any chemical undergoing
  metabolism.
Deactivation versus Bioactivation (3)
Deactivation versus Bioactivation (4)
• Metabolism of benzo(a)pyrene
  (BP)
                  Cancer-causing
                  agents
Deactivation versus Bioactivation (5)
• Metabolism of benzene in the liver by cytochrome P450
  enzymes.
Deactivation versus Bioactivation (6)
•   Metabolism of dimethylnitrosamine.
                     carcinogenic
Deactivation versus Bioactivation (7)
• Metabolic pathway for the bioactivation of bromobenzene
   Factors Affecting Metabolism (1)
• The rate at which metabolism of toxic substances occurs is
  dependent on a variety of factors that can be categorized
  into two groups:
   – those factors that affect the metabolic processes directly, and
   – Those factors that affect the transport of toxic substance to tissues
     where metabolism occurs.
• Biotransformation is affected by the species of the test
  animal, age, sex, nutritional status, disease, enzyme
  induction or inhibition, and genetics.
   – Newborn babies and young infants are more susceptible to a
     variety of chemicals such as pesticides because the cytochrome
     p450 enzymes --- important in pesticide detoxification reaction ---
     are not well developed.
   Factors Affecting Metabolism (2)
• A balanced diet will provide the necessary protein as well
  as essential metals and minerals such as copper, zinc, and
  calcium to assist normal cellular enzymatic activities
  associated with biotransformation.
• Protein-deficient diets can result in a decrease in protein
  synthesis, thus affecting the synthesis of enzymes involved
  in the metabolic reactions used in detoxification.
   Factors Affecting Metabolism (3)
• Cirrhosis of the liver is often caused by excessive drinking
  of alcohol. During the disease process the liver cells are
  damaged and replaced by connective tissue. If enough
  cells are killed, the ability of the liver to metabolize toxic
  substances is dramatically reduced.
• Cirrhosis cal also be caused by repeated exposure to
  arsenic or to high levels of vitamin A. Exposure to
  chemicals such as carbon tetrachloride and vinyl chloride
  may result in liver cell damage and decrease metabolism of
  toxic substances. These two substances are also associated
  with the development of liver cancer.
   Factors Affecting Metabolism (4)
• Kidneys are damaged by absorption and concentration of
  heavy metals (e.g., Hg, Cd, etc.) in the cells of the proximal
  convoluted tubules of the nephron.
     Factors Affecting Transport and
              Absorption (1)
• Absorption rate, perfusion rate, plasma protein
  binding, and storage will affect the rate at which a
  toxic substance is delivered to the tissue where
  metabolism occurs.
• The perfusion rate of a given tissue is important in
  determining how quickly a toxic substance will be
  transformed. Organs such as the liver and
  kidneys have a high perfusion rate relative to
  other tissue types. These organs have the potential
  to extract and detoxify larger quantities of
  toxicants from the blood.
   Factors Affecting Transport and
            Absorption (2)
• Toxic substances bound to proteins in the blood do not
  easily move across cell membranes. In many cases this
  slows the rate at which the toxicant is metabolized because
  the substance may not be readily absorbed by the tissue
  where detoxification occurs.
                   Excretion (1)
• The faster a substance is eliminated from the body, the
  more unlikely a biological effect will be.
• The primary organs involved in excretion are the kidneys,
  liver, and lung.
                   Excretion (2)
• Excretion by the liver
   – Many toxic substances are stored and detoxified in the
     liver. The toxic substances are then excreted into the
     bile. Bile is produced in the liver by the hepatic cells.
   – This mechanism is important in removing large
     protein-bound toxicants such as heavy metals.
   – Excretion of the toxicant from the liver to the intestinal
     tract will usually result in the substance being removed
     in the feces.
   – However, the intestinal bacteria are also capable of
     producing enzymes that cause the detoxified substance
     to become less water soluble.
                       Excretion (3)
• Excretion by the liver
   – As a result, the toxic substance may be reabsorbed from
     the digestive tract. The process of excreting toxic
     substances from the liver and their subsequent
     reabsorption from the digestive tract is referred to as
     enterohepatic circulation.
       • Gluconated polycyclic aromatic hydrocarbons and glutathione
         conjugates of trichloroethylene are reabsorbed by this mechanism and
         therefore retained.
   – Detoxification of toxic substances before they reach the other
     portions of the systemic circulation is referred to as the “first-pass
     effect.” This effect can decrease the systemic toxicity of those
     substances absorbed from the digestive tract.
                      Excretion (4)
• Excretion by the kidneys
  – The kidneys receive 25 percent of the cardiac output. The high
    perfusion rate not only results in significant exposure to circulating
    toxic substances, but also facilitate the excretion of the toxicants.
  – Toxic substances enter the kidneys as a result of active and passive
    transport mechanisms present in the glomerulus and the nephron
    tubules.
  – Several heavy metals --- such as cadmium, lead and mercury --- are
    excreted by the kidneys. These metals are bound to plasma
    protein. The protein-metal complex has a low molecular weight
    and is able to pass through the glomerulus to the nephron.
    However, this complex may be reabsorbed by active transport
    mechanisms in the proximal convoluted tubules.
                    Excretion (5)
• Excretion by the lungs
  – Excretion of volatile toxic gases, such as those
    associated with organic compounds, occurs in the lungs.
    The transfer of gases from the blood to the lungs is
    influenced by concentration gradients and by their
    solubility in water.
     • Ethylene --- which is only slightly soluble in water --- will
       readily diffuse from the blood into the lungs and will therefore
       be easily removed.
     • Chloroform however, is more water soluble and will not diffuse
       as easily from the blood into the lungs.
          Cytochrome P450
– Cytochromes P450 (CYPs) belong to the superfamily of
  proteins containing a heme cofactor and, therefore, are
  hemoproteins.
An Example of P450 Catalytic Cycle