Differential inhibition of human CYP3A4 and Candida albicans CYP51 with azole antifungal agents.

Abstract The inhibition by azole antifungals of human cytochrome CYP3A4, the major form of drug metabolising enzyme within the liver, was compared with their inhibitory activity against their target enzyme, Candida albicans sterol 14α-demethylase (CYP51), following heterologous expression in Saccharomyces cerevisiae . IC 50 values for ketoconazole and itraconazole CYP3A4 inhibition were 0.25 and 0.2 μM. These values compared with much lower doses required for the complete inhibition of C. albicans CYP51, where IC 50 values of 0.008 and 0.0076 μM were observed for ketoconazole and itraconazole, respectively. Additionally, stereoselective inhibition of CYP3A4 and CYP51 was observed with enantiomers of the azole antifungal compounds diclobutrazol and SCH39304. In both instances, the RR (+) configuration at their asymmetric carbon centres was most active. Interestingly, the SS (−) enantiomeric form of SCH39304 was inactive and failed to bind CYP3A4, as demonstrable by Type II binding spectra.