Multidirectional vector pathways of vitamin D metabolism as modifiers of its interaction with drugs
Background. The comorbid pathology characteristic of the elderly and senile people may lead to polypharmacy. The leading role in the metabolism of drugs is played by the cytochrome (CY) P450 system. The use of vitamin D in geriatric patients is of particular importance taking into account their age-specific features of metabolism. The purpose of the review was to analyse the international contemporary information content on the interaction of vitamin D with the system of metabolism of the drugs. Materials and methods. Analysis of American and European scientific sources was performed. Results. More than 11,500 proteins of the CYP system are currently described. In the metabolism of medicines, the following six are involved: CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP2E1, CYP3A4, which provide biotransformation of drugs through oxidation. CYP450 is a hemoprotein that provides binding of the substrate molecules with activation of oxygens, resulting in the formation of oxidation, a more hydrophilic product and water molecule. The insufficiency of hydroxylation capacity of the liver and kidneys can lead to D-hypovitaminosis in the body of patients. CYP11A1, СYР27А1, СYР27В1, СYР24А1 are responsible for vitamin D metabolism. Conducted studies have shown that these cytochromes metabolize a number of other drugs that can act as their inhibitors and inducers. Conclusions. The system of cytochrome P450 influences the formation of vitamin D metabolites. Taking into account the physiological ways of its metabolism, multidirectional results of interaction are formed.
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