Characterization of Interindividual Variability and Differential Tissue Abundance of UGT2B17: Discovery of a Potential Biomarker and Drug Interaction Prediction

Abstract

UGT2B17 is an androgen- and drug-conjugating enzyme with a remarkably high interindividual variability in its hepatic protein expression. Testosterone is one of its main endogenous substrates, and various clinical associations between UGT2B17 and testosterone-related and other pathophysiological outcomes have been reported, along with associations with drug and xenobiotic disposition. UGT2B17 also exhibits relatively high and variable intestinal abundance, compared to the liver, both in absolute abundance and relative to other UGT isoforms, which brings in concern for first pass metabolism and differential drug-drug interactions. Multiple factors, including a common copy number variation (CNV), sex, age, and certain SNPs, contribute to UGT2B17 tissue abundance variability, but only account for a small portion of that variability. Unexplained interindividual differences in UGT2B17 tissue abundance, along with UGT2B17’s unique ontogeny, highlights the need for a phenotypic biomarker to assess in vivo UGT2B17 activity. This dissertation project focuses on characterizing interindividual variability and differential tissue abundance of UGT2B17. Chapter 2 explores UGT2B17’s role in first pass metabolism of testosterone in human in vitro models for the small intestine and liver and explores its role in the disposition of orally administered testosterone. Findings confirm that UGT2B17 drives testosterone glucuronide (TG) formation in liver and intestine, and the higher intestinal abundance may explain oral testosterone’s high and variable first pass metabolism and low bioavailability. In Chapter 3, urinary TG normalized with androsterone glucuronide (TG/AG) is identified as a potential urinary biomarker for UGT2B17 and validated in longitudinal urine samples from 63 pediatric subjects. Significant associations between TG/AG and sex, age, and UGT2B17 CNV were found. Chapter 4 investigates regional enzyme abundance of UGT2B17 and non-CYP enzymes in cryopreserved human intestinal mucosa (CHIM), corroborates proteomic findings with activity assays, and proposes enterocyte marker proteins as normalizers to control for intestinal tissue heterogeneity. Non-CYP enzymes that were quantifiable were carboxylesterase 1 (CES1), CES2, UGT1A1, UGT1A3, UGT1A10, UGT2B7, UGT2B17, sulfotransferase 1A1 (SULT1A1), SULT1A3, SULT1B1, and SULT2A1. We also found good enzyme abundance-activity correlations, demonstrating that CHIMs are functionally active with respect to xenobiotic metabolism. This dissertation improves the understanding of UGT2B17’s role in first pass drug metabolism and potential drug-drug interactions. It also establishes a promising phenotypic urinary biomarker for UGT2B17 for further applications in drug development and disease state associations.