Secondary Fish-Odor Syndrome Can be Acquired by Nitric Oxide-mediated Impairment of Flavin-containing Monooxygenase in Hepatitis B Virus-Infected Patients

  • Yi, Hyeon-Gyu (Department of Pharmacology, Medicinal Toxicology Research Center, CDIR, Department of Internal Medicine, College of Medicine, Inha University) ;
  • Lee, Jung-Nam (Department of General Surgery, Gachon Medical School, Ghil Medical Center) ;
  • Ryu, Seung-Duk (Department of Pharmacology, Medicinal Toxicology Research Center, CDIR, College of Medicine, Inha University) ;
  • Kang, Ju-Hee (Department of Pharmacology, Medicinal Toxicology Research Center, CDIR, College of Medicine, Inha University) ;
  • Cha, Young-Nam (Department of Pharmacology, Medicinal Toxicology Research Center, CDIR, College of Medicine, Inha University) ;
  • Park, Chang-Shin (Department of Pharmacology, Medicinal Toxicology Research Center, CDIR, College of Medicine, Inha University)
  • Published : 2004.08.21

Abstract

Primary fish-odor syndrome (FOS) is a genetic disorder caused by defective flavin-containing mono-oxygenase 3 gene (FMO3) with deficient N-oxidation of trimethylamine (TMA), causing trimethylaminuria (TMAU). By contrast, secondary FOS can be acquired by decreased FMO activities in patients with chronic liver diseases, but the underlying mechanisms are unknown. In the present study, we examined plasma NOx concentrations and viral DNA contents as well as in vivo FMO activities and their correlations in chronic viral hepatitis (CVH) patients. Plasma concentration of NOx was significantly increased by 2.1 fold $(56.2{\pm}26.5\;vs.\;26.6{\pm}5.4\;{\mu}M,\;p<0.01)$, and it was positively correlated with plasma hepatitis B virus (HBV) DNA contents $(r^2=0.2838,\;p=0.0107)$. Furthermore, the elevated plasma NOx values were inversely and significantly correlated with in vivo FMO activities detected by ranitidine-challenged test $(8.3%\;vs.\;20.0%,\;r^2=0.2109,\;p=\0.0315)$. TMA N-oxidation activities determined in CVH patients without challenge test were also significantly low (73.6% vs. 95.7%, p< 0.05). In conclusion, these results suggested that secondary FOS could be acquired by the endogenously elevated NO in patients with CVH.

Keywords

References

  1. Akaike T, Maeda H. Nitric oxide and virus infection. Immunology 101: 300-308, 2000 https://doi.org/10.1046/j.1365-2567.2000.00142.x
  2. Al-Waiz M, Ayesh R, Mitchell SC, Idle JR, Smith RL. A genetic polymorphism of the N-oxidation of trimethylamine in humans. Clin Pharmacol Ther 42: 588-594, 1987a https://doi.org/10.1038/clpt.1987.201
  3. Al-Waiz M, Ayesh R, Mitchell SC, Idle JR, Smith RL. Trimethylaminuria (fish-odour syndrome): an inborn error of oxidative metabolism. Lancet 1: 634-635, 1987b
  4. Al-Waiz M, Ayesh R, Mitchell SC, Idle JR, Smith RL. Trimethylaminuria ('fish-odour syndrome'): a study of an affected family. Clin Sci 74: 231-236, 1988
  5. Al-Waiz M, Mitchell SC, Idle JR, Smith RL. The relative importance of N-oxidation and N-demethylation in the metabolism of trimethylamine in man. Toxicology 43: 117-121, 1987c https://doi.org/10.1016/0300-483X(87)90001-1
  6. Ayesh R, Mitchell SC, Zhang A, Smith RL. The fish odour syndrome: biochemical, familial, and clinical aspects. BMJ 307: 655- 657, 1993 https://doi.org/10.1136/bmj.307.6905.655
  7. Cashman JR. Structural and catalytic properties of the mammalian flavin-containing monooxygenase. Chem Res Toxicol 8: 166- 181, 1995
  8. Chisari FV, Ferrari C. Hepatitis B virus immunopathogenesis. Annu Rev Immunol 13: 29-60, 1995 https://doi.org/10.1146/annurev.iy.13.040195.000333
  9. Chung WG, Kang JH, Park CS, Cho MH, Cha YN. Effect of age and smoking on in vivo CYP1A2, flavin-containing monooxygenase, and xanthine oxidase activities in Koreans: determination by caffeine metabolism. Clin Pharmacol Ther 67: 258-266, 2000 https://doi.org/10.1067/mcp.2000.104617
  10. Craig PI, Mehta I, Murray M, McDonald D, Astrom A, van der Meide PH, Farrell GC. Interferon down regulates the malespecific cytochrome P450IIIA2 in rat liver. Mol Pharmacol 38: 313-318, 1990
  11. Dolphin CT, Janmohamed A, Smith RL, Shephard EA, Phillips IR. Missense mutation in flavin-containing mono-oxygenase 3 gene, FMO3, underlies fish-odour syndrome. Nat Genet 17: 491-494, 1997 https://doi.org/10.1038/ng1297-491
  12. Geller DA, Di Silvio M, Nussler AK, Wang SC, Shapiro RA, Simmons RL, Billiar TR. Nitric oxide synthase expression is induced in hepatocytes in vivo during hepatic inflammation. J Surg Res 55: 427-432, 1993 https://doi.org/10.1006/jsre.1993.1164
  13. Green LC, Wagner DA, Glogowski J, Skipper PL, Wishnok JS, Tannenbaum SR. Analysis of nitrate, nitrite, and $[^{15}H]$nitrate in biological fluids. Anal Biochem 126: 131-138, 1982 https://doi.org/10.1016/0003-2697(82)90118-X
  14. Kang JH, Chung WG, Lee KH, Park CS, Kang JS, Shin IC, Roh HK, et al. Phenotypes of flavin-containing monooxygenase activity determined by ranitidine N-oxidation are positively correlated with genotypes of linked FM03 gene mutations in a Korean population. Pharmacogenetics 10: 67-78, 2000 https://doi.org/10.1097/00008571-200002000-00009
  15. Khatsenko OG, Gross SS, Rifkind AB, Vane JR. Nitric oxide is a mediator of the decrease in cytochrome P450-dependent metabolism caused by immunostimulants. Proc Natl Acad Sci USA 90: 11147-11151, 1993 https://doi.org/10.1073/pnas.90.23.11147
  16. Kim YM, Bergonia HA, Muller C, Pitt BR, Watkins WD, Lancaster JR Jr. Loss and degradation of enzyme-bound heme induced by cellular nitric oxide synthesis. J Biol Chem 270: 5710-5713, 1995 https://doi.org/10.1074/jbc.270.11.5710
  17. Koukouritaki SB, Simpson P, Yeung CK, Rettie AE, Hines RN. Human hepatic flavin-containing monooxygenases 1 (FMO1) and 3 (FMO3) developmental expression. Pediatr Res 51: 236-243, 2002 https://doi.org/10.1203/00006450-200202000-00018
  18. Majano PL, Garcia-Monzon C, Lopez-Cabrera M, Lara-Pezzi E, Fernandez-Ruiz E, Garcia-Iglesias C, Borque MJ, et al. Inducible nitric oxide synthase expression in chronic viral hepatitis. Evidence for a virus-induced gene upregulation. J Clin Invest 101: 1343-1352, 1998 https://doi.org/10.1172/JCI774
  19. Marks R, Dudley F, Wan A. Trimethylamine metabolism in liver disease. Lancet 1: 1106-1107, 1978
  20. Mayatepek E, Kohlmuller D. Transient trimethylaminuria in childhood. Acta Paediatr 87: 1205-1207, 1998 https://doi.org/10.1080/080352598750031257
  21. Minamiyama Y, Takemura S, Imaoka S, Funae Y, Tanimoto Y, Inoue M. Irreversible inhibition of cytochrome P450 by nitric oxide. J Pharmacol Exp Ther 283: 1479-1485, 1997
  22. Mitchell SC, Ayesh R, Barrett T, Smith R. Trimethylamine and foetor hepaticus. Scand J Gastroenterol 34: 524-528, 1999 https://doi.org/10.1080/003655299750026281
  23. Mitchell SC, Smith RL. Trimethylaminuria: the fish malodor syndrome. Drug Metab Dispos 29: 517-521, 2001
  24. Monshouwer M, Witkamp RF, Nujmeijer SM, Van Amsterdam JG, Van Miert AS. Suppression of cytochrome P450- and UDP glucuronosyl transferase-dependent enzyme activities by proinflammatory cytokines and possible role of nitric oxide in primary cultures of pig hepatocytes. Toxicol Appl Pharmacol 137: 237- 244, 1996 https://doi.org/10.1006/taap.1996.0077
  25. Morgan ET. Down-regulation of multiple cytochrome P450 gene products by inflammatory mediators in vivo. Independence from the hypothalamo-pituitary axis. Biochem Pharmacol 45: 415- 419, 1993 https://doi.org/10.1016/0006-2952(93)90078-B
  26. Morgan ET, Ullrich V, Daiber A, Schmidt P, Takaya N, Shoun H, McGiff JC, Oyekan A, Hanke CJ, Campbell WB, Park CS, Kang JS, Yi HG, Cha YN, Mansuy D, Boucher JL. Cytochromes P450 and flavin monooxygenases-targets and sources of nitric oxide. Drug Metab Dispos 29: 1366-1376, 2001
  27. Muriel P. Regulation of nitric oxide synthesis in the liver. J Appl Toxicol 20: 189-195, 2000 https://doi.org/10.1002/(SICI)1099-1263(200005/06)20:3<189::AID-JAT632>3.0.CO;2-8
  28. Nakajima M, Iwata K, Yamamoto T, Funae Y, Yoshida T, Kuroiwa Y. Nicotine metabolism in liver microsomes from rats with acute hepatitis or cirrhosis. Drug Metab Dispos 26: 36-41, 1998
  29. Park CS, Baek HM, Chung WG, Lee KH, Ryu SD, Cha YN. Suppression of flavin-containing monooxygenase by overproduced nitric oxide in rat liver. Mol Pharmacol 56: 507-514, 1999
  30. Park CS, Kang JH, Chung WG, Yi HG, Pie JE, Park DK, Hines RN, et al. Ethnic differences in allelic frequency of two flavincontaining monooxygenase 3 (FMO3) polymorphisms: linkage and effects on in vivo and in vitro FMO activities. Pharmacogenetics 12: 77-80, 2002 https://doi.org/10.1097/00008571-200201000-00011
  31. Ryu SD, Yi HG, Cha YN, Kang JH, Kang JS, Jeon YC, Park HK, Yu TM, Lee JN, Park CS. Flavin-containing monooxygenase activity can be inhibited by nitric oxide-mediated S-nitrosylation. Life Sci, in press, 2004
  32. Salkowski CA, Detore G, McNally R, van Rooijen N, Vogel SN. Regulation of inducible nitric oxide synthase messenger RNA expression and nitric oxide production by lipopolysaccharide in vivo: the roles of macrophages, endogenous IFN-gamma, and TNF receptor-1-mediated signaling. J Immunol 158: 905-912, 1997
  33. Sewer MB, Morgan ET. Nitric oxide-independent suppression of P450 2C11 expression by interleukin-1beta and endotoxin in primary rat hepatocytes. Biochem Pharmacol 54: 729-737, 1997 https://doi.org/10.1016/S0006-2952(97)00226-8
  34. Sewer MB, Morgan ET. Down-regulation of the expression of three major rat liver cytochrome P450S by endotoxin in vivo occurs independently of nitric oxide production. J Pharmacol Exp Ther 287: 352-358, 1998
  35. Sewer MB, Barclay TB, Morgan ET. Down-regulation of cytochrome P450 mRNAs and proteins in mice lacking a functional NOS2 gene. Mol Pharmacol 54: 273-279, 1998
  36. Simenhoff ML, Ginn HE, Teschan PE. Toxicity of aliphatic amines in uremia.Trans Am Soc Artif Intern Organs 23: 560-565, 1977 https://doi.org/10.1097/00002480-197700230-00150
  37. Stadler J, Trockfeld J, Schmalix WA, Brill T, Siewert JR, Greim H, Doehmer J. Inhibition of cytochromes P4501A by nitric oxide. Proc Natl Acad Sci USA 91: 3559-3563, 1994 https://doi.org/10.1073/pnas.91.9.3559
  38. Stamler JS, Simon DI, Osborne JA, Mullins ME, Jaraki O, Michel T, Singel DJ, et al. S-nitrosylation of proteins with nitric oxide: synthesis and characterization of biologically active compounds. Proc Natl Acad Sci USA 89: 444-448, 1992 https://doi.org/10.1073/pnas.89.1.444
  39. Stanley LA, Adams DJ, Balkwill FR, Griffin D, Wolf CR. Differential effects of recombinant interferon alpha on constitutive and inducible cytochrome P450 isozymes in mouse liver. Biochem Pharmacol 42: 311-320, 1991 https://doi.org/10.1016/0006-2952(91)90718-K
  40. Treacy EP, Akerman BR, Chow LM, Youil R, Bibeau C, Lin J, Bruce AG, et al. Mutations of the flavin-containing monooxygenase gene (FMO3) cause trimethylaminuria, a defect in detoxication. Hum Mol Genet 7: 839-845, 1998 https://doi.org/10.1093/hmg/7.5.839
  41. Wink DA, Mitchell JB. Chemical biology of nitric oxide: Insights into regulatory, cytotoxic, and cytoprotective mechanisms of nitric oxide. Free Radic Biol Med 25: 434-456, 1998 https://doi.org/10.1016/S0891-5849(98)00092-6
  42. Wink DA, Osawa Y, Darbyshire JF, Jones CR, Eshenaur SC, Nims RW. Inhibition of cytochromes P450 by nitric oxide and a nitric oxide-releasing agent. Arch Biochem Biophys 300: 115-123, 1993 https://doi.org/10.1006/abbi.1993.1016
  43. Wright K, Morgan ET. Transcriptional and post-transcriptional suppression of P450IIC11 and P450IIC12 by inflammation. FEBS Lett 271: 59-61, 1990 https://doi.org/10.1016/0014-5793(90)80371-O
  44. Wright K, Morgan ET. Regulation of cytochrome P450IIC12 expression by interleukin-1 alpha, interleukin-6, and dexamethasone. Mol Pharmacol 39: 468-474, 1991
  45. Zhang AQ, Mitchell SC, Ayesh R, Smith RL. Determination of trimethylamine and related aliphatic amines in human urine by head-space gas chromatography. J Chromatogr 584: 141-145, 1992 https://doi.org/10.1016/0378-4347(92)80569-C
  46. Zhang AQ, Mitchell SC, Smith RL. Dietary precursors of trimethylamine in man: a pilot study. Food Chem Toxicol 37: 515-520, 1999 https://doi.org/10.1016/S0278-6915(99)00028-9
  47. Ziegler DM. Flavin-containing monooxygenases: catalytic mechanism and substrate specificities. Drug Metab Rev 19: 1-32, 1988 https://doi.org/10.3109/03602538809049617
  48. Zschocke J, Kohlmueller D, Quak E, Meissner T, Hoffmann GF, Mayatepek E. Mild trimethylaminuria caused by common variants in FMO3 gene. Lancet 354: 834-835, 1999