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Cellular targets of sn-38 in the blood and intestinal tissues. Excessive accumulation of SN-38 can lead to bone marrow toxicities such as leukopenia and neutropenia, as well as damage to the intestinal epithelium. These toxicities are pronounced in individuals that have reduced capacity to form the SN-38 glucuronide, such as patients with Gilbert's syndrome. Note the different body compartments and cell types involved (Reproduced with permission from Tukey RH et al. Pharmacogenetics of human UDP-glucuronosyltransferases and irinotecan toxicity. Mol Pharmacol, 2002, 62:446–450. Copyright © 2002 The American Society for Pharmacology and Experimental Therapeutics.) Source: Drug Metabolism, Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 12e Citation: Brunton LL, Chabner BA, Knollmann BC. Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 12e; 2011 Available at: http://mhmedical.com/ Accessed: May 11, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved
