1
|
Gurley BJ. Clinically Relevant Herb-Drug Interactions: A 30-Year Historical Assessment. J Diet Suppl 2024:1-27. [PMID: 38504455 DOI: 10.1080/19390211.2024.2327544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
The Dietary Supplement Health and Education Act, a legislative measure ushering in a novel class of complementary healthcare products known as dietary supplements, will mark its 30th anniversary in October 2024. Over this 30-year period, dietary supplement usage evolved from a few hundred products made up mostly of vitamins, minerals, and select botanical extracts to more than 75,000 single- and multi-ingredient products that are now regular staples in the American healthcare system and used by half of all U.S. consumers. One of the fastest-growing segments of the dietary supplement market during this 3-decade interval has been those products formulated with botanical extracts. Coincident with the growing popularity of botanical dietary supplements (BDS) has been their concomitant ingestion with conventional prescription medications. BDS are complex mixtures of phytochemicals oftentimes exhibiting complex pharmacology. Formulated as concentrated phytochemical extracts, BDS are vehicles for a host of plant secondary metabolites rarely encountered in the typical diet. When taken with prescription drugs, BDS may give rise to clinically significant herb-drug interactions (HDI). Pharmacodynamic HDI describe interactions between phytochemicals and conventional medications at the drug receptor level, while pharmacokinetic HDI stem from phytochemical-mediated induction and/or inhibition of human drug metabolizing enzymes and/or transporters. This review summarizes BDS identified over the last 30 years that pose clinically relevant HDI and whose mechanisms are either pharmacodynamically or pharmacokinetically mediated.
Collapse
Affiliation(s)
- Bill J Gurley
- National Center for Natural Products Research, School of Pharmacy, University of MS, University, MS, USA
| |
Collapse
|
2
|
Patient Assessment. J Oral Maxillofac Surg 2023; 81:E13-34. [PMID: 37833021 DOI: 10.1016/j.joms.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
|
3
|
Jalil B, Naser AY, M Prieto J, Heinrich M. Herbal supplements in Jordan: a cross-sectional survey of pharmacists' perspectives and knowledge. BMJ Open 2022; 12:e057405. [PMID: 35896285 PMCID: PMC9335029 DOI: 10.1136/bmjopen-2021-057405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Pharmacists are ideal partners for engaging with the needs and expectations of patients. They can play a vital role by providing information and supplying herbal medicines. In some community settings, pharmacists are also the main first point of care. This study explored Jordanian community pharmacists' perspectives and knowledge of herbal medicines available in pharmacies. DESIGN A cross-sectional study using an online survey was developed, and it was distributed via social media platforms. The one-way analysis of variance (ANOVA) test was used to compare the mean knowledge scores between different demographic groups. Multiple linear regression analysis was used to identify predictors of herbal medicines knowledge. SETTING Jordanian community pharmacies. PARTICIPANTS 401 Jordanian community pharmacists. RESULTS Herbal supplements are sold in practically all pharmacies (98.5%). Slimming aids (14.7%), followed by sexual and sports enhancements (14%) and maintaining general health (12.1%) were most requested by Jordanian customers. While supplements for maintaining general health (12%), followed by slimming aids (11.4%) and skin conditions (9.3%) were most recommended by Jordanian pharmacists. 63.1% were not aware of potential herb-drug interactions, 95.6% did not receive complaints from customers about herbal medicines and 41.2% would not report adverse reactions to the national pharmacovigilance services. The mean knowledge score for knowledge of use, regulation, adverse reactions, and drug interactions was 3.7 (SD: 0.7), 3.5 (SD: 0.8), 3.6 (SD: 0.8), and 3.6 (SD: 0.8) (out of 5), respectively. ANOVA test showed that total pharmacists' knowledge scores significantly differed based on the length of time practising pharmacy (p<0.05). CONCLUSION This study highlights some key concerns relating to recommendations, awareness and reporting of herbal medicines among Jordanian community pharmacists. Pharmacists need enhanced education to provide objective and evidence-based information on the benefits-risks of herbal medicines. Future studies need to be carried out to confirm whether our findings are transferable to other Middle Eastern countries.
Collapse
Affiliation(s)
- Banaz Jalil
- Pharmacognosy and Phytotherapy, UCL School of Pharmacy, 29 - 39 Brunswick Sq, London, UK
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Isra University, Amman, Jordan
| | - Jose M Prieto
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - Michael Heinrich
- Pharmacognosy and Phytotherapy, UCL School of Pharmacy, 29 - 39 Brunswick Sq, London, UK
| |
Collapse
|
4
|
Abstract
BACKGROUND This review provides a summary of the currently available clinical data on drug-drug interactions (DDIs) involving over-the-counter (OTC) medicines. It aims to educate and increase awareness among health care providers and to support decisions in daily practice. METHODS An extensive literature search was performed using bibliographic databases available through PubMed.gov. An initial structured search was performed using the keywords "drug-drug-interaction AND (over-the-counter OR OTC)," without further restrictions except for the language. The initial results were screened for all described DDIs involving OTC drugs, and further information was gathered specifically on these drugs using dedicated database searches and references found in the bibliography from the initial hits. RESULTS From more than 1200 initial hits (1972-June 2021), 408 relevant publications were screened for DDIs involving OTC drugs, leading to 2 major findings: first, certain types of drug regimens are more prone to DDIs or have more serious DDI-related consequences, such as antiretroviral, anti-infective, and oral anticancer therapies. Second, although most DDIs involve OTC drugs as the perpetrators, some prescription drugs (statins or phosphodiesterase-5 inhibitors) that currently have OTC status can be identified as the victims in DDIs. The following groups were identified to be frequently involved in DDIs: nonsteroidal anti-inflammatory drugs, food supplements, antacids, proton-pump inhibitors, H2 antihistamines, laxatives, antidiarrheal drugs, and herbal drugs. CONCLUSIONS The most significant finding was the lack of high-quality evidence for commonly acknowledged interactions. High-quality interaction studies involving different phenotypes in drug metabolism (cytochrome P450) and distribution (transporters) are urgently needed. This should include modern and critical drugs, such as oral anticancer medications and direct oral anticoagulants.
Collapse
Affiliation(s)
- Oliver Scherf-Clavel
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| |
Collapse
|
5
|
Lippert A, Renner B. Herb-Drug Interaction in Inflammatory Diseases: Review of Phytomedicine and Herbal Supplements. J Clin Med 2022; 11:1567. [PMID: 35329893 PMCID: PMC8951360 DOI: 10.3390/jcm11061567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023] Open
Abstract
Many people worldwide use plant preparations for medicinal purposes. Even in industrialized regions, such as Europe, where conventional therapies are accessible for the majority of patients, there is a growing interest in and usage of phytomedicine. Plant preparations are not only used as alternative treatment, but also combined with conventional drugs. These combinations deserve careful contemplation, as the complex mixtures of bioactive substances in plants show a potential for interactions. Induction of CYP enzymes and pGP by St John's wort may be the most famous example, but there is much more to consider. In this review, we shed light on what is known about the interactions between botanicals and drugs, in order to make practitioners aware of potential drug-related problems. The main focus of the article is the treatment of inflammatory diseases, accompanied by plant preparations used in Europe. Several of the drugs we discuss here, as basal medication in chronic inflammatory diseases (e.g., methotrexate, janus kinase inhibitors), are also used as oral tumor therapeutics.
Collapse
Affiliation(s)
- Annemarie Lippert
- Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, 01069 Dresden, Germany;
| | | |
Collapse
|
6
|
Peterson B, Jacobsz C, Hamman J, Viljoen A, Steyn D. Pharmacokinetic interactions: The effects of selected herbal extracts on permeation of P-glycoprotein substrate drugs across excised pig intestinal tissue. J Herbmed Pharmacol 2021. [DOI: 10.34172/jhp.2022.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: There is growing concern that co-administered herbal medicines may alter the pharmacokinetics and, therefore, the efficacy and toxicity of Western drugs. The aim of this study was to investigate the potential membrane permeation modulating effects of four herbal extracts, i.e., Harpagophytum procumbens, Hoodia gordonii, Leonotis leonurus, and Vitis vinifera on a model compound, Rhodamine 123 (RH-123). Methods: An in vitro permeation model, i.e., excised pig intestinal tissue, mounted to test chambers in a Sweetana-Grass diffusion apparatus, was used to measure the bi-directional transport of RH-123 in the presence and in the absence of four herbal extracts. The concentration of transported RH-123 in each sample was determined by means of fluorescence spectroscopic analysis. The integrity of the mounted jejunum tissue during experimentation was confirmed by measuring the permeation of Lucifer Yellow through these membranes. Trans-epithelial electrical resistance (TEER) of the mounted membranes was also measured at the onset and termination of each experiment to monitor whether tight junction modulation occurred. Results: H. procumbens extract increased the secretory transport of RH-123, indicative of the induction of P-glycoprotein (P-gp) mediated efflux. H. gordonii extract also increased RH-123’s absorptive transport, coupled with a subsequent decrease in its secretory transport, indicating the P-gp related efflux inhibition. Contrary, L. leonurus extract reduced RH-123’s absorptive transport, accompanied by an increase in its secretory transport. V. vinifera seed extract, however, increased both the absorptive and secretory transport of RH-123. A reduction in TEER was observed in the presence of V. vinifera extract, indicating the modulation of tight junction integrity. Conclusion: The ex vivo pharmacokinetics interactions recorded in the current study suggest that the co-administration of herbal medicines could alter the extent of membrane permeation of Western drugs.
Collapse
Affiliation(s)
- Bianca Peterson
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), North-West University, Potchefstroom 2520, South Africa
| | - Corneli Jacobsz
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), North-West University, Potchefstroom 2520, South Africa
| | - Josias Hamman
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), North-West University, Potchefstroom 2520, South Africa
| | - Alvaro Viljoen
- Faculty of Science, Department of Pharmaceutical Sciences and SAMRC Herbal Drugs Research Unit, Tshwane University of Technology, Pretoria, South Africa
| | - Dewald Steyn
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), North-West University, Potchefstroom 2520, South Africa
| |
Collapse
|
7
|
Nowak A, Kojder K, Zielonka-Brzezicka J, Wróbel J, Bosiacki M, Fabiańska M, Wróbel M, Sołek-Pastuszka J, Klimowicz A. The Use of Ginkgo Biloba L. as a Neuroprotective Agent in the Alzheimer's Disease. Front Pharmacol 2021; 12:775034. [PMID: 34803717 PMCID: PMC8599153 DOI: 10.3389/fphar.2021.775034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/22/2021] [Indexed: 12/19/2022] Open
Abstract
Alzheimer's disease, a neurodegenerative disease, is one of the most common causes of dementia if elderly people worldwide. Alzheimer's disease leads to the alienation of individuals and their exclusion from social and professional life. It is characterized mainly by the degradation of memory and disorientation, which occurs as a result of the loss of neuronal structure and function in different brain areas. In recent years, more and more attention has been paid to use in the treatment of natural bioactive compounds that will be effective in neurodegenerative diseases, including Alzheimer's disease. G. biloba L. and its most frequently used standardized extract (EGb 761), have been used for many years in supportive therapy and in the prevention of cognitive disorders. The paper presents an overview of reports on the pathogenesis of Alzheimer's disease, as well as a summary of the properties of G. biloba extract and its effects on the possible pathogenesis of the disease. By exploring more about the pathogenesis of the disease and the benefits of G. biloba extract for patients with Alzheimer's disease, it will be possible to create an individualized therapeutic protocol to optimize the treatment.
Collapse
Affiliation(s)
- Anna Nowak
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Klaudyna Kojder
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Joanna Zielonka-Brzezicka
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jacek Wróbel
- Department of Bioengineering, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Mateusz Bosiacki
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marta Fabiańska
- Institute of Philosophy and Cognitive Science, University of Szczecin, Szczecin, Poland
| | - Mariola Wróbel
- Department of Landscape Architecture, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Joanna Sołek-Pastuszka
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Adam Klimowicz
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| |
Collapse
|
8
|
Leite PM, Martins MAP, Carvalho MDG, Castilho RO. Mechanisms and interactions in concomitant use of herbs and warfarin therapy: An updated review. Biomed Pharmacother 2021; 143:112103. [PMID: 34474338 DOI: 10.1016/j.biopha.2021.112103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 12/19/2022] Open
Abstract
This review is an updated and expanded version published in this journal in 2016. Warfarin pharmacotherapy is extremely complex, since in addition to being a low therapeutic index drug, it does not follow the dose-response pattern and has characteristics that predispose the occurrence of interactions, such as high binding rate to plasma proteins, metabolization by cytochrome P450 enzymes, further to acting in the complex process of blood coagulation, platelet activation, and inflammation. For these reasons, warfarin has great potential for interaction with drugs, foods, and herbal medicines. Herb-warfarin interactions, however, are still not very well studied; thus, the objective of this update is to present new information on the subject aiming to provide a scientific basis to help health professionals in the clinical management of these interactions. A literature review was performed from May to June 2021 in multiple databases and articles published in 2016 to 2021 were included. A total of 59 articles describing 114 herbal medicines were reported to interact with warfarin. Of the plants mentioned, 84% had the potential to increase warfarin effect and the risk of bleeding. Targets possibly involved in these interactions include the processes of blood coagulation, platelet activation, and inflammation, in addition to the pharmacokinetics and pharmacodynamics of warfarin. Despite these alarming numbers, however, the clinical management of interactions is known to be effective. Thus, it is important that the use of these herbal medicines be done with caution in anticoagulated patients and that studies of herb-drug interactions be encouraged in order to generate information to support the clinical management of patients.
Collapse
Affiliation(s)
- Paula Mendonça Leite
- Department of Pharmaceutical Products, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, Minas Gerais, Brazil.
| | - Maria Auxiliadora Parreiras Martins
- Department of Pharmaceutical Products, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, Minas Gerais, Brazil
| | - Maria das Graças Carvalho
- Department of Pharmaceutical Products, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, Minas Gerais, Brazil
| | - Rachel Oliveira Castilho
- Department of Pharmaceutical Products, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, Minas Gerais, Brazil; Consórcio Acadêmico Brasileiro de Saúde Integrativa, CABSIN, Brazil.
| |
Collapse
|
9
|
Babos MB, Heinan M, Redmond L, Moiz F, Souza-Peres JV, Samuels V, Masimukku T, Hamilton D, Khalid M, Herscu P. Herb-Drug Interactions: Worlds Intersect with the Patient at the Center. Medicines (Basel) 2021; 8:44. [PMID: 34436223 PMCID: PMC8401017 DOI: 10.3390/medicines8080044] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
This review examines three bodies of literature related to herb-drug interactions: case reports, clinical studies, evaluations found in six drug interaction checking resources. The aim of the study is to examine the congruity of resources and to assess the degree to which case reports signal for further study. A qualitative review of case reports seeks to determine needs and perspectives of case report authors. Methods: Systematic search of Medline identified clinical studies and case reports of interacting herb-drug combinations. Interacting herb-drug pairs were searched in six drug interaction resources. Case reports were analyzed qualitatively for completeness and to identify underlying themes. Results: Ninety-nine case-report documents detailed 107 cases. Sixty-five clinical studies evaluated 93 mechanisms of interaction relevant to herbs reported in case studies, involving 30 different herbal products; 52.7% of these investigations offered evidence supporting reported reactions. Cohen's kappa found no agreement between any interaction checker and case report corpus. Case reports often lacked full information. Need for further information, attitudes about herbs and herb use, and strategies to reduce risk from interaction were three primary themes in the case report corpus. Conclusions: Reliable herb-drug information is needed, including open and respectful discussion with patients.
Collapse
Affiliation(s)
- Mary Beth Babos
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Michelle Heinan
- School of Medical Sciences, Lincoln Memoria University, Harrogate, TN 37752, USA;
| | - Linda Redmond
- Medical Center Long Term Care, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Fareeha Moiz
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Joao Victor Souza-Peres
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Valerie Samuels
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Tarun Masimukku
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | | | - Myra Khalid
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN 37752, USA; (F.M.); (J.V.S.-P.); (V.S.); (T.M.); (M.K.)
| | - Paul Herscu
- Research Division, Herscu Laboratory, Amherst, MA 01002, USA;
| |
Collapse
|
10
|
Abd-Rabbu HS, Wahba HE, Khalid KA. Pomegranate peel modifies growth, essential oil and certain chemicals of sage (Salvia officinalis L.) herb. Biocatalysis and Agricultural Biotechnology 2021. [DOI: 10.1016/j.bcab.2021.101978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
11
|
Awortwe C, Bruckmueller H, Kaehler M, Cascorbi I. Interaction of Phytocompounds of Echinacea purpurea with ABCB1 and ABCG2 Efflux Transporters. Mol Pharm 2021; 18:1622-1633. [PMID: 33730506 DOI: 10.1021/acs.molpharmaceut.0c01075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Preparations of Echinacea purpurea (E. purpurea) are widely used for the management of upper respiratory infections, influenza, and common cold, often in combination with other conventional drugs. However, the potential of phytochemical constituents of E. purpurea to cause herb-drug interactions via ABCB1 and ABCG2 efflux transporters remains elusive. The purpose of this study was to investigate the impact of E. purpurea-derived caffeic acid derivatives (cichoric acid and echinacoside) and tetraenes on the mRNA and protein expression levels as well as on transport activity of ABCB1 and ABCG2 in intestinal (Caco-2) and liver (HepG2) cell line models. The safety of these compounds was investigated by estimating EC20 values of cell viability assays in both cell lines. Regulation of ABCB1 and ABCG2 protein in these cell lines were analyzed after 24 h exposure to the compounds at 1, 10, and 50 μg/mL. Bidirectional transport of 0.5 μg/mL Hoechst 33342 and 5 μM rhodamine across Caco-2 monolayer and profiling for intracellular concentrations of the fluorophores in both cell lines were conducted to ascertain inhibition effects of the compounds. Cichoric acid showed no cytotoxic effect, while the EC20 values of tetraenes and echinacoside were 45.0 ± 3.0 and 52.0 ± 4.0 μg/mL in Caco-2 cells and 28.0 ± 4.3 and 62.0 ± 9.9 μg/mL in HepG2 cells, respectively. In general, the compounds showed heterogeneous induction of ABCB1 with the strongest 3.6 ± 1.2-fold increase observed for 10 μg/mL tetraenes in Caco-2 cells (p < 0.001). However, the compounds did not induce ABCG2. None of the phytocompounds inhibited significantly net flux of the fluorophores across Caco-2 monolayers. Overall, tetraenes moderately induced ABCB1 but not ABCG2 in Caco-2 and HepG2 cells while no compound significantly inhibited activity of these transporters at clinically relevant concentration to cause herb-drug interactions.
Collapse
Affiliation(s)
- Charles Awortwe
- Institute for Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, 24105 Kiel, Germany.,Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, University of Stellenbosch, 7505 Tygerberg, South Africa
| | - Henrike Bruckmueller
- Institute for Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, 24105 Kiel, Germany.,Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Meike Kaehler
- Institute for Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
| | - Ingolf Cascorbi
- Institute for Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, 24105 Kiel, Germany
| |
Collapse
|
12
|
Iñiguez-Luna MI, Cadena-Iñiguez J, Soto-Hernández RM, Morales-Flores FJ, Cortes-Cruz M, Watanabe KN, Machida-Hirano R, Cadena-Zamudio JD. Bioprospecting of Sechium spp. varieties for the selection of characters with pharmacological activity. Sci Rep 2021; 11:6185. [PMID: 33731771 DOI: 10.1038/s41598-021-85676-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 03/04/2021] [Indexed: 11/08/2022] Open
Abstract
Bioprospecting identifies new sources of compounds with actual or potential economic value that come from biodiversity. An analysis was performed regarding bioprospecting purposes in ten genotypes of Sechium spp., through a meta-analysis of 20 information sources considering different variables: five morphological, 19 biochemical, anti-proliferative activity of extracts on five malignant cell lines, and 188 polymorphic bands of amplified fragment length polymorphisms, were used in order to identify the most relevant variables for the design of genetic interbreeding. Significant relationships between morphological and biochemical characters and anti-proliferative activity in cell lines were obtained, with five principal components for principal component analysis (SAS/ETS); variables were identified with a statistical significance (< 0.7 and Pearson values ≥ 0.7), with 80.81% of the accumulation of genetic variation and 110 genetic bands. Thirty-nine (39) variables were recovered using NTSYSpc software where 30 showed a Pearson correlation (> 0.5) and nine variables (< 0.05), Finally, using a cladistics analysis approach highlighted 65 genetic bands, in addition to color of the fruit, presence of thorns, bitter flavor, piriform and oblong shape, and also content of chlorophylls a and b, presence of cucurbitacins, and the IC50 effect of chayote extracts on the four cell lines.
Collapse
|
13
|
Khalid KA. Growth sites and their impacts on sour orange ʽCitrus aurantium (Tournef.)ʼ essential oil. Biocatalysis and Agricultural Biotechnology 2021. [DOI: 10.1016/j.bcab.2021.101909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
14
|
Awortwe C, Cascorbi I. Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions. Pharmacol Res 2020; 161:105250. [PMID: 33059010 PMCID: PMC7550259 DOI: 10.1016/j.phrs.2020.105250] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 01/08/2023]
Abstract
Drug-drug interactions (DDI) potentially occurring between medications used in the course of COVID-19 infection and medications prescribed for the management of underlying comorbidities may cause adverse drug reactions (ADRs) contributing to worsening of the clinical outcome in affected patients. First, we conducted a meta-analysis to determine comorbidities observed in the course of COVID-19 disease associated with an increased risk of worsened clinical outcome from 24 published studies. In addition, the potential risk of DDI between medications used in the course of COVID-19 treatment in these studies and those for the management of observed comorbidities was evaluated for possible worsening of the clinical outcome. Our meta-analysis revealed an implication cardiometabolic syndrome (e.g. cardiovascular disease, cerebrovascular disease, hypertension, and diabetes), chronic kidney disease and chronic obstructive pulmonary disease as main co-morbidities associated with worsen the clinical outcomes including mortality (risk difference RD 0.12, 95 %-CI 0.05-0.19, p = 0.001), admission to ICU (RD 0.10, 95 %-CI 0.04-0.16, p = 0.001) and severe infection (RD 0.05, 95 %-CI 0.01-0.09, p = 0.01) in COVID-19 patients. Potential DDI on pharmacokinetic level were identified between the antiviral agents atazanavir and lopinavir/ritonavir and some drugs, used in the treatment of cardiovascular diseases such as antiarrhythmics and anti-coagulants possibly affecting the clinical outcome including cardiac injury or arrest because of QTc-time prolongation or bleeding. Concluding, DDI occurring in the course of anti-Covid-19 treatment and co-morbidities could lead to ADRs, increasing the risk of hospitalization, prolonged time to recovery or death on extreme cases. COVID-19 patients with cardiometabolic diseases, chronic kidney disease and chronic obstructive pulmonary disease should be subjected to particular carefully clinical monitoring of adverse events with a possibility of dose adjustment when necessary.
Collapse
Affiliation(s)
- Charles Awortwe
- Institute for Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, Kiel, Germany; Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, South Africa
| | - Ingolf Cascorbi
- Institute for Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, Kiel, Germany.
| |
Collapse
|
15
|
Feltrin C, Farias IV, Sandjo LP, Reginatto FH, Simões CMO. Effects of Standardized Medicinal Plant Extracts on Drug Metabolism Mediated by CYP3A4 and CYP2D6 Enzymes. Chem Res Toxicol 2020; 33:2408-2419. [DOI: 10.1021/acs.chemrestox.0c00182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Clarissa Feltrin
- Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, 88040-900, Santa Catarina, Brazil
| | - Ingrid Vicente Farias
- Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, 88040-900, Santa Catarina, Brazil
| | - Louis Pergaud Sandjo
- Departamento de Química, Universidade Federal de Santa Catarina, Florianópolis, 88040-900, Santa Catarina, Brazil
| | - Flávio Henrique Reginatto
- Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, 88040-900, Santa Catarina, Brazil
| | - Cláudia Maria Oliveira Simões
- Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, 88040-900, Santa Catarina, Brazil
| |
Collapse
|
16
|
Beik A, Joukar S, Najafipour H. A review on plants and herbal components with antiarrhythmic activities and their interaction with current cardiac drugs. J Tradit Complement Med 2020; 10:275-287. [PMID: 32670823 PMCID: PMC7340875 DOI: 10.1016/j.jtcme.2020.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/06/2020] [Accepted: 03/18/2020] [Indexed: 01/10/2023] Open
Abstract
This paper aimed to compile information on plants or their compounds which have experimentally shown antiarrhythmic effect and to scrutinize the efficacy and potency of them and their potential interaction with conventional cardiac drugs. Literature searches were accomplished by using numerous electronic databases, and the available knowledge on different parts of herbs and their ingredients with antiarrhythmic effects up to 2019 were identified and collected. The results indicate that 36 herbs or their derivatives can be effective in the treatment of arrhythmias, especially in animal and cellular models. They affect various ionic channels in different action potential phases. The alterations in ionic currents lead to changing in the amplitude and duration of the action potential, effective refractory period, maximum velocity, resting membrane potential, channel trafficking, or intracellular calcium concentration. The agents that prolong action potential duration and effective refractory period such as dauricine and sophocarpine seem to be more beneficial if more comprehensive studies confirm their efficacy and safety. It is noteworthy that the consumption of some herbal agents for cardiovascular (e.g. Hawthorn and Ginseng) or other (e.g. Ginseng and Licorice) therapeutic purposes may boost the pro-arrhythmogenic effect of current cardiovascular drugs such as cardiac glycosides. This study accentuates known plants or their derivatives with anti-arrhythmic effects, potential interaction with other cardiac drugs, and the possible mechanisms involved. It can assist clinicians and scientists in research and therapeutic approaches to the management of cardiac arrhythmias.
Collapse
Affiliation(s)
- Ahmad Beik
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Siyavash Joukar
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.,Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.,Neuroscience Research Center, Institute of Neuropharmacology, Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Najafipour
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
17
|
Williamson EM, Liu X, Izzo AA. Trends in use, pharmacology, and clinical applications of emerging herbal nutraceuticals. Br J Pharmacol 2020; 177:1227-1240. [PMID: 31799702 DOI: 10.1111/bph.14943] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/06/2019] [Accepted: 10/09/2019] [Indexed: 12/15/2022] Open
Abstract
The nutraceuticals market is vast, encompassing many different products with inconsistent levels of evidence available to support their use. This overview represents a Western perspective of the nutraceuticals market, with a brief comparison with that in China, as an illustration of how individual health supplements increase and decrease in popularity in regional terms. Recent changes in sales patterns, mainly taken from the US market, are summarized and a selection of five newer products, which have not been subject to extensive recent review are profiled: astaxanthin, a carotenoid found in red algae, seafood, salmon and trout, as an antioxidant; cannabidiol, a non-euphoric marijuana ingredient used as mood enhancer and for painful/inflammatory conditions; modified extracts of ginseng used in new indications including dementia and space travel; monk fruit, a non-sugar high intensity sweetener and nigella seed, a popular food ingredient and Asian medicine, which has experienced an extraordinary rise in sales recently. LINKED ARTICLES: This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc.
Collapse
Affiliation(s)
| | - Xinmin Liu
- Research Centre for Pharmacology and Toxicology, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Angelo A Izzo
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| |
Collapse
|
18
|
Feltrin C, Oliveira Simões CM. Reviewing the mechanisms of natural product-drug interactions involving efflux transporters and metabolic enzymes. Chem Biol Interact 2019; 314:108825. [PMID: 31553897 DOI: 10.1016/j.cbi.2019.108825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/28/2019] [Accepted: 09/19/2019] [Indexed: 12/20/2022]
Abstract
The World Health Organization (WHO) and other worldwide health agencies have recently taken initiatives to encourage the use of traditional medicine and/or complementary/alternative medicine in order to promote well-being and public health. In this way, one of the WHO's concerns is the safe use of these therapies. Phytotherapy is a strategy consisting of the use of medicinal plants (MP) and/or herbal medicinal products (HMP) for medicinal purposes. The use of phytotherapy concomitantly with drugs may cause interactions compromising the expected pharmacological action or generating toxic effects. These interactions are complex processes that may occur with multiple medications targeting different metabolic pathways, and involving different compounds present in MP and HMP. Thus, the aim of this review was to summarize the main MP- and HMP-drug interactions that involve specific transporters (P-glycoprotein and BCRP) and CYP450 enzymes (CYP3A4 and CYP2D6), which play relevant roles in the mechanisms of interactions. Firstly, multiple databases were used to search studies describing in vitro or in vivo MP and HMP-drug interactions and, after that, a systematic note-taking and appraisal of the literature was conducted. It was observed that several MP and HMP, metabolic pathways and transcription factors are involved in the transporters and enzymes expression or in the modulation of their activity having the potential to provide such interactions. Thus, the knowledge of MP- and HMP-drug interaction mechanisms could contribute to prevent harmful interactions and can ensure the safe use of these products to help the establishment of the therapeutic planning in order to certify the best treatment strategy to be used.
Collapse
Affiliation(s)
- Clarissa Feltrin
- Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Cláudia Maria Oliveira Simões
- Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| |
Collapse
|
19
|
Šadibolová M, Zárybnický T, Smutný T, Pávek P, Šubrt Z, Matoušková P, Skálová L, Boušová I. Sesquiterpenes Are Agonists of the Pregnane X Receptor but Do Not Induce the Expression of Phase I Drug-Metabolizing Enzymes in the Human Liver. Int J Mol Sci 2019; 20:ijms20184562. [PMID: 31540101 PMCID: PMC6769599 DOI: 10.3390/ijms20184562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 02/07/2023] Open
Abstract
Sesquiterpenes, the main components of plant essential oils, are bioactive compounds with numerous health-beneficial activities. Sesquiterpenes can interact with concomitantly administered drugs due to the modulation of drug-metabolizing enzymes (DMEs). The aim of this study was to evaluate the modulatory effects of six sesquiterpenes (farnesol, cis-nerolidol, trans-nerolidol, α-humulene, β-caryophyllene, and caryophyllene oxide) on the expression of four phase I DMEs (cytochrome P450 3A4 and 2C, carbonyl reductase 1, and aldo-keto reductase 1C) at both the mRNA and protein levels. For this purpose, human precision-cut liver slices (PCLS) prepared from 10 patients and transfected HepG2 cells were used. Western blotting, quantitative real-time PCR and reporter gene assays were employed in the analyses. In the reporter gene assays, all sesquiterpenes significantly induced cytochrome P450 3A4 expression via pregnane X receptor interaction. However in PCLS, their effects on the expression of all the tested DMEs at the mRNA and protein levels were mild or none. High inter-individual variabilities in the basal levels as well as in modulatory efficacy of the tested sesquiterpenes were observed, indicating a high probability of marked differences in the effects of these compounds among the general population. Nevertheless, it seems unlikely that the studied sesquiterpenes would remarkably influence the bioavailability and efficacy of concomitantly administered drugs.
Collapse
Affiliation(s)
- Michaela Šadibolová
- Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic (T.Z.); (P.M.); (L.S.)
| | - Tomáš Zárybnický
- Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic (T.Z.); (P.M.); (L.S.)
| | - Tomáš Smutný
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic; (T.S.); (P.P.)
| | - Petr Pávek
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic; (T.S.); (P.P.)
| | - Zdeněk Šubrt
- Department of General Surgery, Third Faculty of Medicine and University Hospital Královské Vinohrady, Charles University, 100 34 Prague, Czech Republic;
- Department of Surgery, University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic
| | - Petra Matoušková
- Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic (T.Z.); (P.M.); (L.S.)
| | - Lenka Skálová
- Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic (T.Z.); (P.M.); (L.S.)
| | - Iva Boušová
- Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic (T.Z.); (P.M.); (L.S.)
- Correspondence: ; Tel.: +420-495-067-406
| |
Collapse
|
20
|
Costache II, Miron A, Hăncianu M, Aursulesei V, Costache AD, Aprotosoaie AC. Pharmacokinetic Interactions between Cardiovascular Medicines and Plant Products. Cardiovasc Ther 2019; 2019:9402781. [PMID: 32089733 PMCID: PMC7012273 DOI: 10.1155/2019/9402781] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/25/2019] [Indexed: 12/22/2022] Open
Abstract
The growing use of plant products among patients with cardiovascular pharmacotherapy raises the concerns about their potential interactions with conventional cardiovascular medicines. Plant products can influence pharmacokinetics or/and pharmacological activity of coadministered drugs and some of these interactions may lead to unexpected clinical outcomes. Numerous studies and case reports showed various pharmacokinetic interactions that are characterized by a high degree of unpredictability. This review highlights the pharmacokinetic clinically relevant interactions between major conventional cardiovascular medicines and plant products with an emphasis on their putative mechanisms, drawbacks of herbal products use, and the perspectives for further well-designed studies.
Collapse
Affiliation(s)
- Irina-Iuliana Costache
- Faculty of Medicine, Grigore T.Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- “Sf. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Anca Miron
- Faculty of Pharmacy, Grigore T.Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Monica Hăncianu
- Faculty of Pharmacy, Grigore T.Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Viviana Aursulesei
- Faculty of Medicine, Grigore T.Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- “Sf. Spiridon” University Hospital, 700111 Iasi, Romania
| | - Alexandru Dan Costache
- Faculty of Medicine, Grigore T.Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Ana Clara Aprotosoaie
- Faculty of Pharmacy, Grigore T.Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| |
Collapse
|
21
|
Amer HM, Marrez DA, Salama AB, Wahba HE, Khalid KA. Growth and chemical constituents of cardoon plant in response to foliar application of various algal extracts. Biocatalysis and Agricultural Biotechnology 2019; 21:101336. [DOI: 10.1016/j.bcab.2019.101336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
22
|
Zengin G, Paksoy MY, Aumeeruddy MZ, Glamocilja J, Sokovic M, Diuzheva A, Jekő J, Cziáky Z, Rodrigues MJ, Custodio L, Mahomoodally MF. New insights into the chemical profiling, cytotoxicity and bioactivity of four Bunium species. Food Res Int 2019; 123:414-424. [DOI: 10.1016/j.foodres.2019.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 05/05/2019] [Accepted: 05/08/2019] [Indexed: 01/04/2023]
|
23
|
Hou FJ, Guo LX, Zheng KY, Song JN, Wang Q, Zheng YG. Chelidonine enhances the antitumor effect of lenvatinib on hepatocellular carcinoma cells. Onco Targets Ther 2019; 12:6685-6697. [PMID: 31695406 PMCID: PMC6707434 DOI: 10.2147/ott.s215103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/08/2019] [Indexed: 12/15/2022] Open
Abstract
Background Lenvatinib is a newly approved molecular targeted drug for the treatment of advanced hepatocellular carcinoma (HCC). However, the high cost associated with this treatment poses a huge financial burden on patients and the entire public health system. Therefore, there is an urgent need to develop novel strategies that enhance the antitumor effect of lenvatinib. Methods The antitumor effects of chelidonine or/and lenvatinib on HCC cell lines MHCC97-H and LM-3 were examined using the 3-[4,5-dimethyl-2-thiazolyl]-2,5-diphenyl-2- H-tetrazolium bromide (MTT) assay. For the in-vivo investigation, the effect on subcutaneous or intrahepatic tumor growth in nude mice was also determined. The mRNA levels of epithelial mesenchymal transition (EMT)-related factors were examined through quantitative polymerase chain reaction or Western blot. Results In the present study, we found that treatment with chelidonine enhanced the apoptotic effect of lenvatinib on HCC cells and the in-vivo growth of HCC tumors in nude mice. Mechanistically, treatment with chelidonine increased the expression of epithelial indicator E-cadherin, whereas it decreased the expression of mesenchymal indicators N-cadherin and Vimentin. These findings suggest that chelidonine restricted the EMT in HCC cells. Conclusion Chelidonine inhibits the process of EMT and enhances the antitumor effect of lenvatinib on HCC cells.
Collapse
Affiliation(s)
- Fang-Jie Hou
- Hebei University of Chinese Medicine, Shijiazhuang City, Hebei Province 050200, People's Republic of China
| | - Li-Xiao Guo
- Hebei University of Chinese Medicine, Shijiazhuang City, Hebei Province 050200, People's Republic of China
| | - Kai-Yan Zheng
- Hebei University of Chinese Medicine, Shijiazhuang City, Hebei Province 050200, People's Republic of China
| | - Jun-Na Song
- Hebei University of Chinese Medicine, Shijiazhuang City, Hebei Province 050200, People's Republic of China
| | - Qian Wang
- Hebei University of Chinese Medicine, Shijiazhuang City, Hebei Province 050200, People's Republic of China
| | - Yu-Guang Zheng
- Hebei University of Chinese Medicine, Shijiazhuang City, Hebei Province 050200, People's Republic of China
| |
Collapse
|
24
|
Arruda APN, Zhang Y, Gomaa H, Bergamaschi CDC, Guimaraes CC, Righesso LAR, Paglia MDG, Barberato-Filho S, Lopes LC, Ayala Melendez AP, de Oliveira LD, Paula-Ramos L, Johnston B, El Dib R. Herbal medications for anxiety, depression, pain, nausea and vomiting related to preoperative surgical patients: a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2019; 9:e023729. [PMID: 31129571 PMCID: PMC6538060 DOI: 10.1136/bmjopen-2018-023729] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 04/15/2019] [Accepted: 04/17/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To summarise the effects of herbal medications for the prevention of anxiety, depression, pain, and postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgical procedures. METHODS Searches of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and LILACS up until January 2018 were performed to identify randomised controlled trials (RCTs). We included RCTs or quasi-RCTs evaluating any herbal medication among adults undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgeries. The primary outcomes were anxiety, depression, pain and PONV. We used the Grading of Recommendations Assessment, Development and Evaluation approach to rate overall certainty of the evidence for each outcome. RESULTS Eleven trials including 693 patients were eligible. Results from three RCTs suggested a statistically significant reduction in vomiting (relative risk/risk ratio (RR) 0.57; 95% CI 0.38 to 0.86) and nausea (RR 0.69; 95% CI 0.50 to 0.96) with the use of Zingiber officinale (ginger) compared with placebo in both laparoscopic and obstetrical/gynaecological surgeries. Results suggested a non-statistically significantly reduction in the need for rescue medication for pain (RR 0.52; 95% CI 0.13 to 2.13) with Rosa damascena (damask rose) and ginger compared with placebo in laparoscopic and obstetrical/gynaecological surgery. None of the included studies reported on adverse events (AEs). CONCLUSIONS There is very low-certainty evidence regarding the efficacy of both Zingiber officinale and Rosa damascena in reducing vomiting (200 fewer cases per 1000; 288 fewer to 205 fewer), nausea (207 fewer cases per 1000; 333 fewer to 27 fewer) and the need for rescue medication for pain (666 fewer cases per 1000; 580 fewer to 752 more) in patients undergoing either laparoscopic or obstetrical/gynaecological surgeries. Among our eligible studies, there was no reported evidence on AEs. PROSPERO REGISTRATION NUMBER CRD42016042838.
Collapse
Affiliation(s)
- Ana Paula Nappi Arruda
- Department of Surgery and Orthopedics, UNESP - Universidade Estadual Paulista, Faculty of Medicine, Botucatu, São Paulo, Brazil
| | - Yuchen Zhang
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Huda Gomaa
- Department of Pharmacy, Tanta Chest Hospital, Tanta, Egypt
| | | | | | | | | | | | - Luciane Cruz Lopes
- Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo, Brazil
| | | | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, UNESP - Universidade Estadual Paulista, Institute of Science and Technology, São José dos Campos, Brazil
| | - Lucas Paula-Ramos
- Department of Biosciences and Oral Diagnosis, UNESP - Universidade Estadual Paulista, Institute of Science and Technology, São José dos Campos, Brazil
| | - Bradley Johnston
- Community Health and Epidemiology, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
| | - Regina El Dib
- Department of Biosciences and Oral Diagnosis, UNESP - Universidade Estadual Paulista, Institute of Science and Technology, São José dos Campos, Brazil
- St. Joseph's Healthcare, McMaster University, Institute of Urology, Hamilton, Ontario, Canada
| |
Collapse
|
25
|
Begas E, Bounitsi M, Kilindris T, Kouvaras E, Makaritsis K, Kouretas D, Asprodini EK. Effects of short-term saffron (Crocus sativus L.) intake on the in vivo activities of xenobiotic metabolizing enzymes in healthy volunteers. Food Chem Toxicol 2019; 130:32-43. [PMID: 31082462 DOI: 10.1016/j.fct.2019.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 12/30/2022]
Abstract
Crocus sativus L., a perennial plant grown mainly around the Mediterranean and Iran, has many medicinal properties including anti-inflammatory, anti-depressive and cancer preventing properties. Aqueous herbal extracts may affect the activity of Phase I and II enzymes involved in xenobiotic metabolism. The present study was designed to determine whether C. sativus infusion alters the activity of CYP1A2, CYP2A6, XO and NAT2 enzymes in humans. Thirty-four healthy volunteers consumed infusion prepared from C. sativus stigmata for six days. Enzyme phenotyping was assessed in saliva and urine using caffeine metabolite ratios as follows: CYP1A2: 17X/137Χ (saliva) and CYP1A2: (AFMU+1U+1X)/17U, CYP2A6: 17U/(17U + 17X), XO: 1U/(1U+1X) and NAT2: AFMU/(AFMU+1U+1X) (urine). Following C. sativus intake, CYP1A2 index was reduced by ∼13.7% in saliva (before: 0.51 ± 0.22, after: 0.44 ± 0.14; p = 0.002) and ∼6.0% in urine (before: 3.81 ± 1.20, after: 3.58 ± 0.92; p = 0.054). CYP1A2 index was significantly reduced only in males (saliva, before: 0.65 ± 0.22, after: 0.51 ± 0.16; p = 0.0001; urine, before: 4.53 ± 1.19, after: 4.03 ± 0.87; p = 0.017) suggesting sexual dimorphism in CYP1A2 inhibition. There was no effect of C. sativus intake on CYP2A6, XO or NAT2 indices. Short-term consumption of C. sativus infusion is unlikely to result in significant herb-drug interactions involving the enzymes studied, with the exception of potential herb-CYP1A2 substrate interaction in males.
Collapse
Affiliation(s)
- Elias Begas
- Laboratory of Pharmacology, University of Thessaly, 41500, Biopolis, Larissa, Greece.
| | - Maria Bounitsi
- Laboratory of Pharmacology, University of Thessaly, 41500, Biopolis, Larissa, Greece.
| | - Thomas Kilindris
- Laboratory of Medical Informatics, University of Thessaly, 41500, Biopolis, Larissa, Greece.
| | - Evangelos Kouvaras
- Laboratory of Pharmacology, University of Thessaly, 41500, Biopolis, Larissa, Greece.
| | - Konstantinos Makaritsis
- Department of Internal Medicine, Faculty of Medicine, University of Thessaly, 41500, Biopolis, Larissa, Greece.
| | - Demetrios Kouretas
- Laboratory of Animal Physiology - Toxicology, Department of Biochemistry-Biotechnology, University of Thessaly, 41500, Biopolis, Larissa, Greece.
| | - Eftihia K Asprodini
- Laboratory of Pharmacology, University of Thessaly, 41500, Biopolis, Larissa, Greece.
| |
Collapse
|