|Year : 2009 | Volume
| 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 Publication||12-Feb-2010|
Department of Pharmacology, Government Medical College, Surat - 395 001, Gujarat
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jaykaran. Is cytochrome modulation the new frontier for decreasing the risk of cataract?. Indian J Pharmacol 2009;41:289
I read the interesting article by Nair et al.,.  "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. 
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). These and some other studies suggest that pioglitazone either does not induce the hepatic CYP3A4 enzyme system or is a weak inducer. ,
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|| |
|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. |
|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. |
|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. |
|4.||Nowak SN, Edwards DJ, Clarke A, Anderson GD, Jaber LA. Pioglitazone: effect on CYP3A4 activity. J Clin Pharmacol 2002;42:1299-302. [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. [PUBMED] [FULLTEXT] |