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Wu F, Zhao T, Zhang Y, Wang Y, Liao G, Zhang B, Wang C, Tian X, Feng L, Fang B, Huo X, Ma X. Beneficial herb-drug interaction of rhein in Jinhongtang and Imipenem/Cilastatin mediated by organic anion transporters. JOURNAL OF ETHNOPHARMACOLOGY 2023; 312:116449. [PMID: 37023835 DOI: 10.1016/j.jep.2023.116449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/12/2023] [Accepted: 03/30/2023] [Indexed: 05/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Jinhongtang as a traditional Chinese medicine (TCM) formula, has been widely used as a clinical adjuvant in the treatment of acute abdominal diseases and sepsis. Clinical benefits of the concurrent use of Jinhongtang and antibiotics have been observed, however, the mechanism has not been fully understood. AIM OF THE STUDY The present study aimed to explore the effect of Jinhongtang on the antibacterial activity of Imipenem/Cilastatin and to clarify the underlying mechanism of herb-drug interaction (HDI). MATERIALS AND METHODS A mouse model of sepsis induced by Staphylococcus aureus (S. aureus) was used to evaluate the pharmacodynamic interaction in vivo. In vitro antibacterial activity of Imipenem/Cilastatin was studied by determining minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Pharmacokinetic interaction was investigated by pharmacokinetic studies in rats and uptake assays using OAT1/3-HEK293 cells. The main constituents ingested into blood of rats were qualitatively identified by UHPLC-Q-TOF-MS. RESULTS Mice treated by Imipenem/Cilastatin and Jinhongtang exhibited higher survival rate, lower bacteria load and less inflammation in blood and lung tissues, compared with those treated by Imipenem/Cilastatin alone after injection of S. aureus. However, MIC and MBC of Imipenem/Cilastatin against S. aureus in vitro were not significantly changed in the presence of Jinhongtang. On the contrary, Jinhongtang increased the plasma concentration of Imipenem and decreased its urinary excretion in rats. CLr of Imipenem was reduced by 58.5%, while its half-life (t1/2) was prolonged for approximate 1.2 times after coadministered Jinhongtang. Furthermore, the extracts of Jinhongtang, single herb in the prescription, and main absorbable constituents inhibited cellular uptake of probe substrates and Imipenem by OAT1/3-HEK293 cells to different extents. Among them, rhein exhibited the strongest inhibition capacity with IC50 values of 0.08 ± 0.01 μM (OAT1) and 2.86 ± 0.28 μM (OAT3). Moreover, coadministration of rhein also significantly enhanced the antibacterial activity of Imipenem/Cilastatin in sepsis mice. CONCLUSION Concomitant administration of Jinhongtang enhanced antibacterial activity of Imipenem/Cilastatin in sepsis mice induced by S. aureus through reducing renal elimination of Imipenem via inhibition of OATs. Our investigation provided the insight of Jinhongtang as an effective supplement to enhance the antibacterial activity of Imipenem/Cilastatin and can be useful for future clinical studies.
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Affiliation(s)
- Fan Wu
- Second Affiliated Hospital, Dalian Medical University, Dalian, 116023, China.
| | - Ting Zhao
- Second Affiliated Hospital, Dalian Medical University, Dalian, 116023, China.
| | - Yu Zhang
- Second Affiliated Hospital, Dalian Medical University, Dalian, 116023, China.
| | - Yan Wang
- Institute of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China.
| | - Guoxin Liao
- Institute of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China.
| | - Baojing Zhang
- Institute of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China.
| | - Chao Wang
- Institute of Integrative Medicine, College of Pharmacy, Dalian Medical University, Dalian, 116044, China.
| | - Xiangge Tian
- Second Affiliated Hospital, Dalian Medical University, Dalian, 116023, China; Department of Pharmacy, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
| | - Lei Feng
- Second Affiliated Hospital, Dalian Medical University, Dalian, 116023, China.
| | - Bangjiang Fang
- Department of Emergency, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
| | - Xiaokui Huo
- Second Affiliated Hospital, Dalian Medical University, Dalian, 116023, China.
| | - Xiaochi Ma
- Second Affiliated Hospital, Dalian Medical University, Dalian, 116023, China.
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