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CORRESPONDENCE
Year : 2009  |  Volume : 41  |  Issue : 6  |  Page : 289
 

Is cytochrome modulation the new frontier for decreasing the risk of cataract?


Department of Pharmacology, Government Medical College, Surat - 395 001, Gujarat, India

Date of Web Publication12-Feb-2010

Correspondence Address:
Jaykaran
Department of Pharmacology, Government Medical College, Surat - 395 001, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7613.59931

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How to cite this article:
Jaykaran. Is cytochrome modulation the new frontier for decreasing the risk of cataract?. Indian J Pharmacol 2009;41:289

How to cite this URL:
Jaykaran. Is cytochrome modulation the new frontier for decreasing the risk of cataract?. Indian J Pharmacol [serial online] 2009 [cited 2019 Oct 22];41:289. Available from: http://www.ijp-online.com/text.asp?2009/41/6/289/59931


Sir,

I read the interesting article by Nair et al.,. [1] "Is cytochrome modulation the new frontier for decreasing the risk of cataract?," wherein:

1. The authors used "Pioglitazone" as a tool for enzyme induction and "Diltiazem" for enzyme inhibition. I believe that instead of pioglitazone some other agents could have been used as the enzyme-inducing capacity of pioglitazone is questionable.

Ishida et al. evaluated the relation between the therapeutic effects of troglitazone and pioglitazone in steroid-induced diabetes. They measured the urinary excretion of 6[Beta]-hydroxycortisol and the ratio of 6[Beta]-hydroxycortisol to the cortisol marker of CYP3A4 induction. There was a significant increase in 6[Beta]-hydroxycortisol with troglitazone but it remained unchanged with pioglitazone. [2]

In a similar clinical study, the authors investigated the 6b-hydroxycortisol/free cortisol urinary ratio as a specific marker of CYP3A4 induction. In this study, six healthy subjects received pioglitazone 45 mg once daily on day 1 and from day 3 to day 12. The 6b-hydroxycortisol/free cortisol ratio in the urine was evaluated on day 1 and day 12. The mean (±SD) 6b-hydroxycortisol/free cortisol ratios in day 1 urine samples and day 12 urine samples were 4.99 ± 1.92 and 5.11 ± 2.01, respectively, indicating no ratio difference between day 12 versus day 1 (P = 0.29).[3] These and some other studies suggest that pioglitazone either does not induce the hepatic CYP3A4 enzyme system or is a weak inducer. [4],[5]

2. The authors used ANOVA and the post hoc Tuckey for the analysis of data. Data are expressed as the percentage of total number of lenses affected. I believe that this data is nominal data and thus the "Chi-square test" could have been a better choice instead of ANOVA in this study.

 
  References Top

1.Nair KS, Patel KV, Gandhi TR. Is cytochrome modulation the new frontier for decreasing the risk of cataract? Indian J Pharmacol 2009;41:72-4.   Back to cited text no. 1    Medknow Journal  
2.Ishida T, Hosokawa H, Murao K, Tada T, Taminato T, Taka- hara J. The effect of troglitazone and pioglitazone on urinary excretion of 6b-hydroxycortisol in steroid induced diabetes. Diabetes 2000;49:115-8.  Back to cited text no. 2      
3.Ged C, Rouillon JM, Pichard L, Combalbert J, Bressot N, Bories P, et al. The increase in urinary excretion of 6b-hydroxycortisol as a marker of human hepatic cytochrome P450 IIIA induction. Br J Clin Pharmacol 1989;28:373-87.   Back to cited text no. 3      
4.Nowak SN, Edwards DJ, Clarke A, Anderson GD, Jaber LA. Pioglitazone: effect on CYP3A4 activity. J Clin Pharmacol 2002;42:1299-302.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  
5.Prueksaritanont T, Vega JM, Zhao J, Gagliano K, Kuznetsova O, Musser B, et al. Interactions between simvastatin and troglitazone or pioglitazone in healthy subjects. J Clin Pharmacol 2001;41:573-81.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]  




 

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