The flavin-containing monooxygenase (FMO)
protein family specializes in the
oxidation of
xeno-substrates in order to facilitate the excretion of these compounds from living organisms.
These
enzymes can oxidize a wide array of
heteroatoms
In chemistry, a heteroatom () is, strictly, any atom that is not carbon or hydrogen.
Organic chemistry
In practice, the term is usually used more specifically to indicate that non-carbon atoms have replaced carbon in the backbone of the molecula ...
, particularly
soft nucleophiles, such as
amines,
sulfides
Sulfide (British English also sulphide) is an inorganic anion of sulfur with the chemical formula S2− or a compound containing one or more S2− ions. Solutions of sulfide salts are corrosive. ''Sulfide'' also refers to chemical compounds la ...
, and
phosphites. This reaction requires an oxygen, an
NADPH
Nicotinamide adenine dinucleotide phosphate, abbreviated NADP or, in older notation, TPN (triphosphopyridine nucleotide), is a cofactor used in anabolic reactions, such as the Calvin cycle and lipid and nucleic acid syntheses, which require NAD ...
cofactor, and an
FAD prosthetic group.
FMOs share several structural features, such as a
NADPH
Nicotinamide adenine dinucleotide phosphate, abbreviated NADP or, in older notation, TPN (triphosphopyridine nucleotide), is a cofactor used in anabolic reactions, such as the Calvin cycle and lipid and nucleic acid syntheses, which require NAD ...
binding domain,
FAD binding domain, and a conserved arginine residue present in the active site. Recently, FMO enzymes have received a great deal of attention from the pharmaceutical industry both as a
drug target for various diseases and as a means to
metabolize pro-drug compounds into active pharmaceuticals.
These
monooxygenases are often misclassified because they share activity profiles similar to those of
cytochrome P450
Cytochromes P450 (CYPs) are a Protein superfamily, superfamily of enzymes containing heme as a cofactor (biochemistry), cofactor that functions as monooxygenases. In mammals, these proteins oxidize steroids, fatty acids, and xenobiotics, and are ...
(CYP450), which is the major contributor to oxidative xenobiotic
metabolism. However, a key difference between the two enzymes lies in how they proceed to oxidize their respective substrates; CYP enzymes make use of an oxygenated
heme prosthetic group, while the FMO family utilizes FAD to oxidize its substrates.
History
Prior to the 1960s, the
oxidation of
xenotoxic materials was thought to be completely accomplished by
CYP450. However, in the early 1970s, Dr. Daniel Ziegler from the University of Texas at Austin discovered a
hepatic flavoprotein isolated from pig liver that was found to oxidize a vast array of various
amines to their corresponding
nitro state. This flavoprotein named "Ziegler's enzyme" exhibited unusual chemical and spectrometric properties. Upon further spectroscopic characterization and investigation of the substrate pool of this enzyme, Dr. Ziegler discovered that this enzyme solely bound FAD molecule that could form a C4a-hydroxyperoxyflavin intermediate, and that this enzyme could oxidize a wide variety of substrates with no common structural features, including
phosphines,
sulfides
Sulfide (British English also sulphide) is an inorganic anion of sulfur with the chemical formula S2− or a compound containing one or more S2− ions. Solutions of sulfide salts are corrosive. ''Sulfide'' also refers to chemical compounds la ...
,
selenium compounds, amongst others. Once this was noticed, Dr. Ziegler's enzyme was reclassified as a broadband flavin
monooxygenase.
In 1984, the first evidence for multiple forms of FMOs was elucidated by two different laboratories when two distinct FMOs were isolated from rabbit lungs. Since then, over 150 different FMO enzymes have been successfully isolated from a wide variety of organisms. Up until 2002, only 5 FMO enzymes were successfully isolated from mammals. However, a group of researchers found a sixth FMO gene located on
human chromosome 1
Chromosome 1 is the designation for the largest human chromosome. Humans have two copies of chromosome 1, as they do with all of the autosomes, which are the non-sex chromosomes. Chromosome 1 spans about 249 million nucleotide base pairs, which ...
. In addition to the sixth FMO discovered as of 2002, the laboratories of Dr. Ian Philips and Elizabeth Sheppard discovered a second gene cluster in humans that consists of 5 additional pseudogenes for FMO on human chromosome 1.
Evolution of FMO gene family
The FMO family of
genes
In biology, the word gene (from , ; "...Wilhelm Johannsen coined the word gene to describe the Mendelian units of heredity..." meaning ''generation'' or ''birth'' or ''gender'') can have several different meanings. The Mendelian gene is a ba ...
is
conserved across all
phyla Phyla, the plural of ''phylum'', may refer to:
* Phylum, a biological taxon between Kingdom and Class
* by analogy, in linguistics, a large division of possibly related languages, or a major language family which is not subordinate to another
Phyl ...
that have been studied so far, therefore some form of the FMO gene family can be found in all studied
eukaryotes
Eukaryotes () are organisms whose cells have a nucleus. All animals, plants, fungi, and many unicellular organisms, are Eukaryotes. They belong to the group of organisms Eukaryota or Eukarya, which is one of the three domains of life. Bacte ...
. FMO genes are characterized by specific structural and functional constraints, which led to the evolution of different types of FMO's in order to perform a variety of functions.
Divergence between the functional types of FMO's (FMO 1–5) occurred before the
amphibians
Amphibians are four-limbed and ectothermic vertebrates of the class Amphibia. All living amphibians belong to the group Lissamphibia. They inhabit a wide variety of habitats, with most species living within terrestrial, fossorial, arbore ...
and
mammals diverged into separate
classes. FMO5 found in
vertebrates appears to be evolutionarily older than other types of FMO's, making FMO5 the first functionally distinct member of the FMO family.
Phylogenetic studies suggest that FMO1 and FMO3 are the most recent FMO's to evolve into enzymes with distinct functions. Although FMO5 was the first distinct FMO, it is not clear what function it serves since it does not
oxygenate the typical FMO substrates involved in
first-pass metabolism.
Analyses of FMO genes across several species have shown extensive
silent DNA mutations, which indicate that the current FMO gene family exists because of selective pressure at the
protein level rather than the
nucleotide level. FMO's found in
invertebrates are found to have originated
polyphyletically; meaning that a
phenotypically similar gene evolved in invertebrates which was not inherited from a common ancestor.
Classification and characterization
FMOs are one
subfamily
In biological classification, a subfamily (Latin: ', plural ') is an auxiliary (intermediate) taxonomic rank, next below family but more inclusive than genus. Standard nomenclature rules end subfamily botanical names with "-oideae", and zoologi ...
of class B external flavoprotein
monooxygenases (EC 1.14.13), which belong to the family of monooxygenase
oxidoreductases, along with the other subfamilies
Baeyer-Villiger monooxygenases and microbial N-hydroxylating monooxygenases.
FMO's are found in fungi, yeast, plants, mammals, and bacteria.
Mammals
Developmental and tissue specific
expression has been studied in several mammalian species, including humans, mice, rats, and rabbits.
However, because FMO expression is unique to each animal species, it is difficult to make conclusions about human FMO regulation and activity based on other mammalian studies.
It is likely that species-specific expression of FMO's contributes to differences in susceptibility to
toxins
A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. Toxins occur especially as a protein or conjugated protein. The term toxin was first used by organic chemist Ludwig Brieger (1849–1 ...
and
xenobiotics as well as the efficiency with excreting among different mammals.
Six functional forms of human FMO genes have been reported. However, FMO6 is considered to be a
pseudogene
Pseudogenes are nonfunctional segments of DNA that resemble functional genes. Most arise as superfluous copies of functional genes, either directly by DNA duplication or indirectly by Reverse transcriptase, reverse transcription of an mRNA trans ...
.
FMOs 1–5 share between 50–58% amino acid identity across the different species.
Recently, five more human FMO genes were discovered, although they fall in the category of pseudogenes.
*
FMO1,
FMO2
Dimethylaniline monooxygenase -oxide-forming2 is an enzyme that in humans is encoded by the ''FMO2'' gene
In biology, the word gene (from , ; "... Wilhelm Johannsen coined the word gene to describe the Mendelian units of heredity..." mean ...
,
FMO3,
FMO4,
FMO5
Dimethylaniline monooxygenase -oxide-forming5 is an enzyme that in humans is encoded by the ''FMO5'' gene.
Metabolic N-oxidation of the diet-derived amino-trimethylamine (TMA) is mediated by flavin-containing monooxygenase and is subject to an i ...
,
FMO6
Yeast
Unlike mammals, yeast (''
Saccharomyces cerevisiae'') do not have several
isoforms of FMO, but instead only have one called yFMO. This enzyme does not accept
xenobiotic compounds. Instead, yFMO helps to fold proteins that contain
disulfide bonds by catalyzing O
2 and
NADPH-dependent oxidations of biological
thiols, just like mammalian FMO's.
An example is the oxidation of
glutathione to
glutathione disulfide
Glutathione disulfide (GSSG) is a disulfide derived from two glutathione molecules.
In living cells, glutathione disulfide is reduced into two molecules of glutathione with reducing equivalents from the coenzyme NADPH. This reaction is catalyzed ...
, both of which form a
redox buffering system in the cell between the
endoplasmic reticulum
The endoplasmic reticulum (ER) is, in essence, the transportation system of the eukaryotic cell, and has many other important functions such as protein folding. It is a type of organelle made up of two subunits – rough endoplasmic reticulum ( ...
and the
cytoplasm. yFMO is localized in the cytoplasm in order to maintain the optimum redox buffer ratio necessary for proteins containing disulfide bonds to fold properly.
This non-xenobiotic role of yFMO may represent the original role of the FMO's before the rise of the modern FMO family of enzymes found in mammals.
Plants
Plant FMO's play a role in defending against
pathogens and catalyze specific steps in the
biosynthesis
Biosynthesis is a multi-step, enzyme-catalyzed process where substrates are converted into more complex products in living organisms. In biosynthesis, simple compounds are modified, converted into other compounds, or joined to form macromolecules. ...
of
auxin
Auxins (plural of auxin ) are a class of plant hormones (or plant-growth regulators) with some morphogen-like characteristics. Auxins play a cardinal role in coordination of many growth and behavioral processes in plant life cycles and are essenti ...
, a
plant hormone
Plant hormone (or phytohormones) are signal molecules, produced within plants, that occur in extremely low concentrations. Plant hormones control all aspects of plant growth and development, from embryogenesis, the regulation of organ size, pa ...
. Plant FMO's also play a role in the metabolism of
glucosinolates. These non-xenobiotic roles of plant FMO's suggest that other FMO functions could be identified in non-plant organisms.
Structure
Crystal structures have been determined for yeast (''
Schizosaccharomyces pombe'') FMO
PDB: 1VQW and bacterial (''
Methylophaga aminisulfidivorans
The genus ''Methylophaga'' consists of halophilic methylotrophic members of the ''Gammaproteobacteria'', all of which were isolated from marine or otherwise low water activity environments, such as the surface of marble or hypersaline lakes. ...
'') FMO
PDB: 2XVH.
The crystal structures are similar to each other and they share 27% sequence identity.
These enzymes share 22% and 31%
sequence identity with human FMOs, respectively.

FMOs have a tightly bound
FAD prosthetic group and a binding
NADPH
Nicotinamide adenine dinucleotide phosphate, abbreviated NADP or, in older notation, TPN (triphosphopyridine nucleotide), is a cofactor used in anabolic reactions, such as the Calvin cycle and lipid and nucleic acid syntheses, which require NAD ...
cofactor.
Both
dinucleotide binding motifs form
Rossmann folds. The yeast FMO and bacterial FMO are
dimers, with each
monomer consisting of two structural
domains: the smaller NADPH binding domain and the larger FAD-binding domain. The two domains are connected by a double linker. A channel between the two domains leads to the active site where NADPH binds both domains and occupies a cleft that blocks access to the
flavin group of FAD, which is bound to the large domain along the channel together with a water molecule.
The
nicotinamide group of NADPH interacts with the flavin group of FAD, and the NADPH binding site overlaps with the substrate
binding site on the flavin group.
FMOs contain several
sequence motifs that are conserved across all
domains:
* FAD-binding motif (GXGXXG)
* FMO identifying motif (FXGXXXHXXXF/Y)
* NADPH-binding motif (GXSXXA)
* F/LATGY motif
*
arginine
Arginine is the amino acid with the formula (H2N)(HN)CN(H)(CH2)3CH(NH2)CO2H. The molecule features a guanidino group appended to a standard amino acid framework. At physiological pH, the carboxylic acid is deprotonated (−CO2−) and both the am ...
residue in the active site
The FMO identifying motif interacts with the flavin of FAD.
The F/LATGY motif is a sequence motif common in ''N''-hydroxylating enzymes.
The arginine residue interacts with the
phosphate group of NADPH.
Function

The general function of these enzymes is to
metabolise xenobiotics.
Hence, they are considered to be xenobiotic detoxication
catalysts. These proteins catalyze the
oxygenation
Oxygenation may refer to:
* Oxygenation (environmental), a measurement of dissolved oxygen concentration in soil or water
* Oxygen saturation (medicine), the process by which concentrations of oxygen increase within a tissue
* Water oxygenation, t ...
of multiple
heteroatom-containing compounds that are present in our diet, such as
amine-,
sulfide
Sulfide (British English also sulphide) is an inorganic anion of sulfur with the chemical formula S2− or a compound containing one or more S2− ions. Solutions of sulfide salts are corrosive. ''Sulfide'' also refers to chemical compounds lar ...
-,
phosphorus-, and other
nucleophilic heteroatom-containing compounds. FMOs have been implicated in the metabolism of a number of pharmaceuticals, pesticides and toxicants, by converting the
lipophilic xenobiotics into
polar, oxygenated, and readily excreted metabolites.
Substrate diversity
FMO substrates are structurally diverse compounds. However, they all share similar characteristics:
*
Soft nucleophiles (basic amines, sulfides, Se- or P-containing compounds)
* Neutral or single-positively charged
Zwitterions,
anions and
dications
A dication is any cation, of general formula X2+, formed by the removal of two electrons from a neutral species.
Diatomic dications corresponding to stable neutral species (e.g. formed by removal of two electrons from H2) often decay quickly into ...
are considered to be unfavorable substrates. There are several drugs reported to be typical substrates for FMOs.
The majority of drugs function as alternate
substrate
Substrate may refer to:
Physical layers
*Substrate (biology), the natural environment in which an organism lives, or the surface or medium on which an organism grows or is attached
** Substrate (locomotion), the surface over which an organism lo ...
competitive inhibitors
Competitive inhibition is interruption of a chemical pathway owing to one chemical substance inhibiting the effect of another by competing with it for binding or bonding. Any metabolic or chemical messenger system can potentially be affected ...
to FMOs (i.e. good nucleophiles that compete with the drug for FMO
oxygenation
Oxygenation may refer to:
* Oxygenation (environmental), a measurement of dissolved oxygen concentration in soil or water
* Oxygen saturation (medicine), the process by which concentrations of oxygen increase within a tissue
* Water oxygenation, t ...
), since they are not likely to serve as FMO substrates.
Only a few true FMO competitive inhibitors have been reported. Those include indole-3-carbinol and ''N'',''N''-dimethylamino stilbene carboxylates. A well-known FMO inhibitor is
methimazole
Thiamazole, also known as methimazole, is a medication used to treat hyperthyroidism. This includes Graves disease, toxic multinodular goiter, and thyrotoxic crisis. It is taken by mouth. Full effects may take a few weeks to occur.
Common s ...
(MMI).
Mechanism

The FMO
catalytic cycle proceeds as follows:
# The
cofactor NADPH binds to the
oxidized state of the
FAD prosthetic group, reducing it to FADH
2.
# Molecular
oxygen binds to the formed NADP
+-FADH
2-enzyme complex and is reduced, resulting in 4a-hydroperoxyflavin (4a-HPF or FADH-OOH). This species is stabilized by NADP
+ in the
catalytic site of the enzyme. These first two steps in the cycle are fast.
# In the presence of a substrate (S), a
nucleophilic attack occurs on the distal O-atom of the prosthetic group. The substrate is oxygenated to SO, forming the 4a-hydroxyflavin (FADH-OH). Only when the flavin is in the hydroperoxy form is when the xenobiotic substrate will react.
# The flavin product then breaks down with release of water to reform FAD.
# Due to the low
dissociation constant
In chemistry, biochemistry, and pharmacology, a dissociation constant (K_D) is a specific type of equilibrium constant that measures the propensity of a larger object to separate (dissociate) reversibly into smaller components, as when a complex fa ...
of the NADP
+-enzyme complex, NADP
+ is released by the end of the cycle and the enzyme returns to its original state. The
rate-limiting step involves either the breakdown of FADH-OH to water or the release of NADP
+.
#
Quantum mechanics simulations showed the N-hydroxylation catalyzed by flavin-containing monooxygenases initiated by
homolysis of the O-O bond in the C4a-hydroperoxyflavin intermediate resulting in the formation of an internal hydrogen bonded hydroxyl radical.
Cellular expression in humans
Expression of each type of FMO relies on several factors including,
cofactor supply, physiological & environmental factors, as well as
diet. Because of these factors, each type of FMO is expressed differently depending on the species and tissue. In humans, expression of FMO's is mainly concentrated to the human liver, lungs, and kidneys, where most of the metabolism of
xenobiotics occur. However, FMO's can also be found in the human brain and small intestine. While FMO1-5 can be found in the brain, liver, kidneys, lungs, and small intestine, the distribution of each type of FMO differs depending on the tissue and the developmental stage of the person.
Expression in adult tissues
In an adult, FMO1 is predominately expressed in the
kidneys and to a lesser extent in the
lungs and
small intestine
The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the p ...
. FMO2 is the most abundant of the FMO's and is mostly expressed in the lungs and kidneys, with lower expression in the
liver and small intestine. FMO3 is highly concentrated in the liver, but is also expressed in the lungs. FMO4 is expressed mostly in the liver and kidneys. FMO5 is highly expressed in the liver, but also has substantial expression in the lungs and small intestine. Though FMO2 is the most expressed FMO in the
brain, it only constitutes about 1% of that found in the lungs, making FMO expression in the brain fairly low.
Expression in fetal Tissues
The distribution of FMO's in various types of tissues changes as a person continues to develop, making the fetal distribution of FMO's quite different than adult distribution of FMO's. While the adult liver is dominated by the expression of FMO3 and FMO5, the fetal liver is dominated by the expression of FMO1 and FMO5. Another difference is in the brain, where adults mostly express FMO2 and fetuses mostly express FMO1.
Clinical significance
Drug development
Drug metabolism is one of the most important factors to consider when developing new drugs for
therapeutic applications. The degradation rate of these new drugs in an organism's system determines the duration and intensity of their
pharmacological action. During the past few years, FMOs have gained a lot of attention in
drug development since these enzymes are not readily induced or
inhibited by the chemicals or drugs surrounding their environment.
CYPs are the primary enzymes involved in drug metabolism. However, recent efforts have been directed towards the development of drug candidates that incorporate
functional groups that can be metabolized by FMOs. By doing this, the number of potential adverse
drug-drug interactions is minimized and the reliance on CYP450 metabolism is decreased. Several approaches have been made to screen potential drug interactions. One of them includes human FMO3 (hFMO3), which is described as the most vital FMO regarding drug interactions. In order to successfully screen hFMO3 in a high throughput fashion hFMO3 was successfully fixed to
graphene oxide
An oxide () is a chemical compound that contains at least one oxygen atom and one other element in its chemical formula. "Oxide" itself is the dianion of oxygen, an O2– (molecular) ion. with oxygen in the oxidation state of −2. Most of ...
chips in order to measure the change in
electrical potential generated as a result of the drug being oxidized when it interacts with the
enzyme.
Hypertension
There is evidence that FMOs are associated to the
regulation of
blood pressure
Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...
. FMO3 is involved in the formation of
TMA N-oxides (TMAO). Some studies indicate that
hypertension
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
can develop when there are no organic
osmolytes
Osmolytes are low-molecular weight organic compounds that influence the properties of biological fluids. Their primary role is to maintain the integrity of cells by affecting the viscosity, melting point, and ionic strength of the aqueous solution. ...
(i.e. TMAO) that can counteract an increase in
osmotic pressure
Osmotic pressure is the minimum pressure which needs to be applied to a solution to prevent the inward flow of its pure solvent across a semipermeable membrane.
It is also defined as the measure of the tendency of a solution to take in a pure ...
and
peripheral resistance. Individuals with deficient FMO3 activity have a higher prevalence of hypertension and other
cardiovascular diseases, since there is a decrease in formation of TMA N-oxides to counterbalance the effects of a higher osmotic pressure and peripheral resistance.
Fish odor syndrome
The
trimethylaminuria disorder, also known as fish odor syndrome, causes abnormal FMO3-mediated metabolism or a deficiency of this enzyme in an individual. A person with this disorder has a low capacity to oxidize the
trimethylamine (TMA) that comes from their diet to its odourless metabolite TMAO. When this happens, large amounts of TMA are excreted through the individual's urine, sweat, and breath, with a strong fish-like odor. As of today, there is no known cure or treatment for this disorder. However, doctors recommend patients to avoid foods containing
choline,
carnitine
Carnitine is a quaternary ammonium compound involved in metabolism in most mammals, plants, and some bacteria. In support of energy metabolism, carnitine transports long-chain fatty acids into mitochondria to be oxidized for energy production, an ...
,
nitrogen,
sulfur
Sulfur (or sulphur in British English) is a chemical element with the symbol S and atomic number 16. It is abundant, multivalent and nonmetallic. Under normal conditions, sulfur atoms form cyclic octatomic molecules with a chemical formula ...
and
lecithin
Lecithin (, from the Greek ''lekithos'' "yolk") is a generic term to designate any group of yellow-brownish fatty substances occurring in animal and plant tissues which are amphiphilic – they attract both water and fatty substances (and so ar ...
.
Other diseases
FMOs have also been associated with other diseases, such as
cancer and
diabetes.
Yet, additional studies are imperative to elucidate what is the relationship between FMO function and these diseases, as well as to define these enzymes’ clinical relevance.
References
External links
*
*
Research information on FMO1 (WikiGenes)
{{Portal bar, Biology, border=no
EC 1.14.13
Oxidoreductases