Pharmacometabolomic approach to predict QT prolongation in guinea pigs

PLoS One. 2013 Apr 4;8(4):e60556. doi: 10.1371/journal.pone.0060556. Print 2013.

Abstract

Drug-induced torsades de pointes (TdP), a life-threatening arrhythmia associated with prolongation of the QT interval, has been a significant reason for withdrawal of several medicines from the market. Prolongation of the QT interval is considered as the best biomarker for predicting the torsadogenic risk of a new chemical entity. Because of the difficulty assessing the risk for TdP during drug development, we evaluated the metabolic phenotype for predicting QT prolongation induced by sparfloxacin, and elucidated the metabolic pathway related to the QT prolongation. We performed electrocardiography analysis and liquid chromatography-mass spectroscopy-based metabolic profiling of plasma samples obtained from 15 guinea pigs after administration of sparfloxacin at doses of 33.3, 100, and 300 mg/kg. Principal component analysis and partial least squares modelling were conducted to select the metabolites that substantially contributed to the prediction of QT prolongation. QTc increased significantly with increasing dose (r = 0.93). From the PLS analysis, the key metabolites that showed the highest variable importance in the projection values (>1.5) were selected, identified, and used to determine the metabolic network. In particular, cytidine-5'-diphosphate (CDP), deoxycorticosterone, L-aspartic acid and stearic acid were found to be final metabolomic phenotypes for the prediction of QT prolongation. Metabolomic phenotypes for predicting drug-induced QT prolongation of sparfloxacin were developed and can be applied to cardiac toxicity screening of other drugs. In addition, this integrative pharmacometabolomic approach would serve as a good tool for predicting pharmacodynamic or toxicological effects caused by changes in dose.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Electrocardiography / drug effects
  • Fluoroquinolones / administration & dosage
  • Fluoroquinolones / chemistry
  • Fluoroquinolones / pharmacokinetics
  • Guinea Pigs
  • Male
  • Metabolic Networks and Pathways
  • Metabolome
  • Metabolomics / methods
  • Phenotype
  • Prognosis
  • Sotalol / administration & dosage
  • Sotalol / chemistry
  • Sotalol / pharmacokinetics
  • Torsades de Pointes / blood
  • Torsades de Pointes / chemically induced
  • Torsades de Pointes / diagnosis*
  • Torsades de Pointes / metabolism*

Substances

  • Fluoroquinolones
  • Sotalol
  • sparfloxacin

Grants and funding

This research was supported by a grant (09172KFDA662) from the Korea Food & Drug Administration & the National Project for Personalized Genomic Medicine (A111218-PG02), Ministry of Health & Welfare, Republic of Korea, and the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010-0022996), Republic of Korea. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.