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Fine-Shamir N, Dahan A. Ethanol-based solubility-enabling oral drug formulation development: Accounting for the solubility-permeability interplay. Int J Pharm 2024; 653:123893. [PMID: 38346600 DOI: 10.1016/j.ijpharm.2024.123893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
The aim of the current work was to investigate the key factors that govern the success/failure of an ethanol-based solubility-enabling oral drug formulation, including the effects of the ethanol on the solubility of the drug, the permeability across the intestinal membrane, the drug's dissolution in the aqueous milieu of the gastrointestinal tract (GIT), and the resulting solubility-permeability interplay. The concentration-dependent effects of ethanol-based vehicles on the solubility, the in-vitro Caco-2 permeability, the in-vivo rat permeability, and the biorelevant dissolution of the BCS class II antiepileptic drug carbamazepine were studied, and a predictive model describing the solubility-permeability relationship was developed. Significant concentration-dependent solubility increase of CBZ was obtained with increasing ethanol levels, that was accompanied by permeability decrease, both in Caco-2 and in rat perfusion studies, demonstrating a tradeoff between the increased solubility afforded by the ethanol and a concomitant permeability decrease. When ethanol absorption was accounted for, an excellent agreement was achieved between the predicted permeability and the experimental data. Biorelevant dissolution studies revealed that minimal ethanol levels of 30 % and 50 % were needed to fully dissolve 1 and 5 mg CBZ dose respectively, with no drug precipitation.In conclusion, key factors to be accounted for when developing ethanol-based formulation include the drug's solubility, permeability, the solubility-permeability interplay, and the drug dose intended to be delivered. Only the minimal amount of ethanol sufficient to solubilize the drug dose throughout the GIT should be used, and not more than that, to avoid unnecessarily permeability loss, and to maximize overall drug absorption.
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Affiliation(s)
- Noa Fine-Shamir
- Department of Clinical Pharmacology, School of Pharmacy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Arik Dahan
- Department of Clinical Pharmacology, School of Pharmacy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
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Shen M, Zhao H, Han M, Su L, Cui X, Li D, Liu L, Wang C, Yang F. Alcohol-induced gut microbiome dysbiosis enhances the colonization of Klebsiella pneumoniae on the mouse intestinal tract. mSystems 2024; 9:e0005224. [PMID: 38345382 PMCID: PMC10949497 DOI: 10.1128/msystems.00052-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 03/20/2024] Open
Abstract
Chronic alcohol consumption, an important risk factor for diseases and deaths, can cause intestinal microbiota dysbiosis and increase the infection of some opportunistic pathogens. However, the current studies on the effects of alcohol-induced intestinal microbiota dysbiosis on gut colonization of Klebsiella pneumoniae are still scarce. In the present study, we established a binge-on-chronic alcohol model in mice to identify the characteristics of alcohol-induced intestinal microbiome and metabolite dysbiosis using multi-omics and explored the effects and potential mechanisms of these dysbioses on the intestinal colonization of K. pneumoniae. The results show that chronic alcohol consumption alters the diversity and composition of gut microbiota (including bacteria and fungi), decreases the complexity of the interaction between intestinal bacteria and fungi, disturbs the gut metabolites, and promotes the colonization of K. pneumoniae on the gut of mice. The relevance analyses find that alcohol-induced gut microbiome dysbiosis has a strong correlation with the alteration of secondary bile acids. In vitro results suggest that the high concentration of lithocholic acid, a secondary bile acid, could significantly inhibit the proliferation of K. pneumoniae, and the adhesion of K. pneumoniae to Caco-2 cells. Our results indicate that alcohol-induced microbiome dysbiosis contributes to decreased levels of secondary bile acids, which was one of the main reasons affecting the colonization of K. pneumoniae in mice's intestines. Some secondary bile acids (e.g., lithocholic acid) might be a potential drug to prevent the colonization and spread of K. pneumoniae.IMPORTANCEAlcohol is one of the most commonly misused substances in our lives. However, long-term heavy drinking will increase the colonization of some opportunistic pathogens (e.g., Klebsiella pneumoniae) in the body. Here, we revealed that binge-on-chronic alcohol consumption disrupted the balance between gut bacteria and fungi, induced the gut microbiome and metabolites dysbiosis, and promoted the colonization of K. pneumoniae in the intestine of mice. In particular, alcohol-taking disrupted intestinal bile acid metabolism and reduced the lithocholic acid concentration. However, a high concentration of lithocholic acid can protect against intestinal colonization of K. pneumoniae by inhabiting the bacterial growth and adhesion to the host cell. Hence, regulating the balance of gut microbiota and intestinal bile acid metabolism may be a potential strategy for reducing the risk of K. pneumoniae infection and spread.
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Affiliation(s)
- Mengke Shen
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
- Department of Pathogenic Biology and Immunology, Sanquan College of Xinxiang Medical University, Xinxiang, China
| | - Huajie Zhao
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
| | - Meiqing Han
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
| | - Lin Su
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
| | - Xiaojian Cui
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
| | - Duan Li
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
| | - Liang Liu
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
| | - Chuansheng Wang
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Key Laboratory of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Fan Yang
- Department of Pathogenic Biology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, China
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Jung YH, Heo DG, Lee DC, Kwon YM, Seol MJ, Zhang D, Jeong TC, Kim JH. Effect of concomitant oral administration of ethanol on the pharmacokinetics of nicardipine in rats. Biomed Chromatogr 2022; 36:e5425. [PMID: 35696664 DOI: 10.1002/bmc.5425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/09/2022]
Abstract
Ethanol intake can alter pharmacokinetics by increasing the solubility or enhancing the absorption of concomitant drugs. Here, a selective, sensitive and reproducible high-performance liquid chromatography-tandem mass spectrometry method for the quantitative analysis of nicardipine in rat plasma was developed using simple protein precipitation. The calibration curve was linear over a concentration range of 1-2,000 ng/ml (r2 > 0.998). Accuracy ranged from 93.4 to 112.2% and precision was within 12.1% from three independent analytical batches. Stable conditions for the quantification of nicardipine in rat plasma were established in various conditions, including sample storage and handling. The matrix effect was negligible, and recovery was consistent at three different levels of quality control sample. The method was applied to assessment for the effect of ethanol on the pharmacokinetics of nicardipine in rats. The oral bioavailability of nicardipine was increased from 5.4 to 9.4% in Sprague-Dawley rats by concomitant oral administration of ethanol whereas the half-life was not altered. The findings indicated that concomitant ethanol intake can increase systemic drug exposure by increasing gastrointestinal absorption, especially poorly soluble drugs. This study provides an insight for further investigation of the alteration of the pharmacological effect of poorly soluble drugs owing to ethanol intake.
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Affiliation(s)
- Young-Heun Jung
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
| | - Dong-Gyu Heo
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
| | - Dong-Cheol Lee
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
| | - Ye-Min Kwon
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
| | - Mi-Ji Seol
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
| | - Didi Zhang
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
| | - Tae Cheon Jeong
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
| | - Ju-Hyun Kim
- College of Pharmacy, Yeungnam University, Gyeongsan, Republic of Korea
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Yang F, Wei JD, Lu YF, Sun YL, Wang Q, Zhang RL. Galacto-oligosaccharides modulate gut microbiota dysbiosis and intestinal permeability in rats with alcohol withdrawal syndrome. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.103423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Keemink J, Sjögren E, Holm R, Bergström CAS. Does the Intake of Ethanol Affect Oral Absorption of Poorly Soluble Drugs? J Pharm Sci 2018; 108:1765-1771. [PMID: 30562491 DOI: 10.1016/j.xphs.2018.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 11/25/2022]
Abstract
The presence of ethanol in gastrointestinal (GI) fluids may increase the solubility of poorly water-soluble drugs. This suggests that intake of ethanol with such compounds could result in increased drug absorption in the stomach and duodenum because of the greater concentration gradient present. To test this hypothesis, in vitro dissolution of 2 poorly soluble compounds (indomethacin and felodipine) was studied in simulated GI rat fluids in the presence or absence of ethanol. Results were used to predict plasma exposure of the compounds using the software PK-Sim. Finally, in vivo plasma exposure in rats was investigated after oral dosing followed by immediate administration of water or ethanol. Despite increased solubility in GI fluids in the presence of ethanol, simulations predicted a negligible effect on absorption. This was confirmed in the rat study where oral intake of indomethacin or felodipine with ethanol did not increase in vivo plasma exposure. A possible explanation for the lack of an effect may be that dilution, absorption, and transfer of ethanol upon arrival in the stomach resulted in intragastric and intraduodenal ethanol concentrations that did not reach the levels required to affect local solubility.
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Affiliation(s)
- Janneke Keemink
- Department of Pharmacy, Uppsala University, BMC P.O. Box 580, SE-751 23 Uppsala, Sweden.
| | - Erik Sjögren
- Department of Pharmacy, Uppsala University, BMC P.O. Box 580, SE-751 23 Uppsala, Sweden; Pharmeteus, Dag Hammarskjölds Väg 52B, 752 37 Uppsala, Sweden
| | - René Holm
- Drug Product Development, Janssen R&D, Johnson & Johnson, Turnhoutseweg 30, 2340 Beerse, Belgium
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Hillemacher T, Bachmann O, Kahl KG, Frieling H. Alcohol, microbiome, and their effect on psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2018; 85:105-115. [PMID: 29705711 DOI: 10.1016/j.pnpbp.2018.04.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 04/05/2018] [Accepted: 04/25/2018] [Indexed: 12/12/2022]
Abstract
There is accumulating evidence that alcohol consumption and especially alcohol withdrawal increase brain levels of known innate immune signaling molecules and cause neuroinflammation. It has been shown that microbiota play a pivotal role in this process and affect central neurochemistry and behavior. Disruption of or alterations in the intimate cross-talk between microbiome and brain may be a significant factor in many psychiatric disorders. Alterations in the composition of the microbiome, so called dysbiosis, may result in detrimental distortion of microbe-host homeostasis modulating the hypothalamic-pituitary-adrenal axis. A variety of pathologies are associated with changes in the community structure and function of the gut microbiota, suggesting a link between dysbiosis and disease etiology, including irritable bowel syndrome depression, anxiety disorders, schizophrenia, and alcoholism. Despite a paucity of clinical studies in alcohol-dependent humans, emerging data suggests that alcohol induced alterations of the microbiome may explain reward-seeking behaviors as well as anxiety, depression, and craving in withdrawal and increase the risk of developing psychiatric disorders.
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Affiliation(s)
- Thomas Hillemacher
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Germany; Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School (MHH), Germany
| | - Oliver Bachmann
- Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School (MHH), Germany; German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School (MHH), Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School (MHH), Germany.
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Intestinal dysbiosis and permeability: the yin and yang in alcohol dependence and alcoholic liver disease. Clin Sci (Lond) 2018; 132:199-212. [PMID: 29352076 DOI: 10.1042/cs20171055] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/07/2017] [Accepted: 12/19/2017] [Indexed: 02/07/2023]
Abstract
Alcohol dependence and alcoholic liver disease represent a major public health problem with substantial morbidity and mortality. By yet incompletely understood mechanisms, chronic alcohol abuse is associated with increased intestinal permeability and alterations of the gut microbiota composition, allowing bacterial components, bacteria, and metabolites to reach the portal and the systemic circulation. These gut-derived bacterial products are recognized by immune cells circulating in the blood or residing in remote organs such as the liver leading to the release of pro-inflammatory cytokines which are considered important mediators of the liver-gut-brain communication. Although circulating cytokines are likely not the sole factors involved, they can induce liver inflammation/damage and reach the central nervous system where they favor neuroinflammation which is associated with change in mood, cognition, and drinking behavior. In this review, the authors focus on the current evidence describing the changes that occur in the intestinal microbiota with chronic alcohol consumption in conjunction with intestinal barrier breakdown and inflammatory changes sustaining the concept of a gut-liver-brain axis in the pathophysiology of alcohol dependence and alcoholic liver disease.
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Rubbens J, Brouwers J, Wolfs K, Adams E, Tack J, Augustijns P. Ethanol concentrations in the human gastrointestinal tract after intake of alcoholic beverages. Eur J Pharm Sci 2016; 86:91-5. [PMID: 26898927 DOI: 10.1016/j.ejps.2016.02.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 01/19/2016] [Accepted: 02/14/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The goal of this study was to monitor gastric and duodenal ethanol concentrations arising from the consumption of commonly used alcoholic beverages. MATERIALS AND METHODS In a cross-over study, five fasting volunteers were asked to drink two standard consumptions of commercially available alcoholic beverages, including beer (Stella Artois®, 500 mL, 5.2% ethanol), wine (Blanc du Blanc®, 200 mL, 11% ethanol) and whisky (Gallantry Whisky®, 80 mL, 40% ethanol). The volunteers finished drinking beer within 10 min and wine or whisky within 5 min. Ethanol concentrations in gastric and duodenal fluids, aspirated as a function of time, were analyzed by headspace gas chromatography. RESULTS In all three conditions, the average gastric profile shows a maximum ethanol concentration (Cmax) at 7 min, while the mean duodenal profiles have a Tmax at 20, 7 and 12 min for beer, wine and whisky, respectively. The median gastric ethanol Cmax (min-max) for the beer, wine and whisky conditions amounts to 4.1% (3.1-4.1), 4.1% (2.6-7.3) and 11.4% (6.3-21.1), respectively. The mean duodenal profiles follow the same pattern as their corresponding gastric profiles, albeit with lower percentages of ethanol. Median duodenal ethanol Cmax (min-max) for beer, wine and whisky are 1.97% (0.89-4.3), 2.39% (2.02-5.63) and 5.94% (3.55-17.71), respectively. Intraluminal ethanol concentrations appear to decline relatively rapidly in fasting conditions: both stomach and duodenum contained less than 0.05% of ethanol after 120 min. CONCLUSIONS This in vivo study is the first to present intraluminal ethanol concentrations in man after the intake of alcoholic beverages. Relatively low and fast declining gastric ethanol concentrations were observed, contrasting with the current Food and Drug Administration guidelines for the in vitro testing of formulations with respect to ethanol resistance. The presented gastric and duodenal ethanol concentrations and their variation may serve as reference data to design relevant models for predicting (i) ethanol resistance of drug formulations and (ii) ethanol effects on drug solubility and permeability.
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Affiliation(s)
- Jari Rubbens
- KU Leuven, Drug Delivery & Disposition, Gasthuisberg O&N2, Herestraat 49 Box 921, 3000 Leuven, Belgium.
| | - Joachim Brouwers
- KU Leuven, Drug Delivery & Disposition, Gasthuisberg O&N2, Herestraat 49 Box 921, 3000 Leuven, Belgium.
| | - Kris Wolfs
- KU Leuven, Pharmaceutical Analysis, Gasthuisberg O&N2, Herestraat 49 Box 923, 3000 Leuven, Belgium.
| | - Erwin Adams
- KU Leuven, Pharmaceutical Analysis, Gasthuisberg O&N2, Herestraat 49 Box 923, 3000 Leuven, Belgium.
| | - Jan Tack
- KU Leuven, Translational Research Center for Gastrointestinal Disorders (TARGID), Gasthuisberg O&N1, Herestraat 49 Box 701, 3000 Leuven, Belgium.
| | - Patrick Augustijns
- KU Leuven, Drug Delivery & Disposition, Gasthuisberg O&N2, Herestraat 49 Box 921, 3000 Leuven, Belgium.
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Mercuri A, Fares R, Bresciani M, Fotaki N. An in vitro–in vivo correlation study for nifedipine immediate release capsules administered with water, alcoholic and non-alcoholic beverages: Impact of in vitro dissolution media and hydrodynamics. Int J Pharm 2016; 499:330-342. [DOI: 10.1016/j.ijpharm.2015.12.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 12/29/2022]
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10
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Dahlgren D, Roos C, Sjögren E, Lennernäs H. Direct In Vivo Human Intestinal Permeability (Peff ) Determined with Different Clinical Perfusion and Intubation Methods. J Pharm Sci 2014; 104:2702-26. [PMID: 25410736 DOI: 10.1002/jps.24258] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 10/17/2014] [Accepted: 10/17/2014] [Indexed: 12/21/2022]
Abstract
Regional in vivo human intestinal effective permeability (Peff ) is calculated by measuring the disappearance rate of substances during intestinal perfusion. Peff is the most relevant parameter in the prediction of rate and extent of drug absorption from all parts of the intestine. Today, human intestinal perfusions are not performed on a routine basis in drug development. Therefore, it would be beneficial to increase the accuracy of the in vitro and in silico tools used to evaluate the intestinal Peff of novel drugs. This review compiles historical Peff data from 273 individual measurements of 80 substances from 61 studies performed in all parts of the human intestinal tract. These substances include: drugs, monosaccharaides, amino acids, dipeptides, vitamins, steroids, bile acids, ions, fatty acids, and water. The review also discusses the determination and prediction of Peff using in vitro and in silico methods such as quantitative structure-activity relationship, Caco-2, Ussing chamber, animal intestinal perfusion, and physiologically based pharmacokinetic (PBPK) modeling. Finally, we briefly outline how to acquire accurate human intestinal Peff data by deconvolution of plasma concentration-time profiles following regional intestinal bolus dosing.
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Affiliation(s)
- David Dahlgren
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Carl Roos
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Erik Sjögren
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Hans Lennernäs
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
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11
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Varum F, Hatton G, Basit A. Food, physiology and drug delivery. Int J Pharm 2013; 457:446-60. [DOI: 10.1016/j.ijpharm.2013.04.034] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 04/08/2013] [Accepted: 04/12/2013] [Indexed: 02/08/2023]
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12
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Lennernäs H. Ethanol−Drug Absorption Interaction: Potential for a Significant Effect on the Plasma Pharmacokinetics of Ethanol Vulnerable Formulations. Mol Pharm 2009; 6:1429-40. [DOI: 10.1021/mp9000876] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Hans Lennernäs
- Department of Pharmacy, Uppsala University, Se-751 23 Uppsala, Sweden
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13
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Lambert JC, Zhou Z, Wang L, Song Z, McClain CJ, Kang YJ. Preservation of intestinal structural integrity by zinc is independent of metallothionein in alcohol-intoxicated mice. THE AMERICAN JOURNAL OF PATHOLOGY 2004; 164:1959-66. [PMID: 15161632 PMCID: PMC1615750 DOI: 10.1016/s0002-9440(10)63756-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Intestinal-derived endotoxins are importantly involved in alcohol-induced liver injury. Disruption of intestinal barrier function and endotoxemia are common features associated with liver inflammation and injury due to acute ethanol exposure. Zinc has been shown to inhibit acute alcohol-induced liver injury. This study was designed to determine the inhibitory effect of zinc on alcohol-induced endotoxemia and whether the inhibition is mediated by metallothionein (MT) or is independent of MT. MT knockout (MT-KO) mice were administered three oral doses of zinc sulfate (2.5 mg zinc ion/kg body weight) every 12 hours before being administered a single dose of ethanol (6 g/kg body weight) by gavage. Ethanol administration caused liver injury as determined by increased serum transaminases, parenchymal fat accumulation, necrotic foci, and an elevation of tumor necrosis factor (TNF-alpha). Increased plasma endotoxin levels were detected in ethanol-treated animals whose small intestinal structural integrity was compromised as determined by microscopic examination. Zinc supplementation significantly inhibited acute ethanol-induced liver injury and suppressed hepatic TNF-alpha production in association with decreased circulating endotoxin levels and a significant protection of small intestine structure. As expected, MT levels remained undetectable in the MT-KO mice under the zinc treatment. These results thus demonstrate that zinc preservation of intestinal structural integrity is associated with suppression of endotoxemia and liver injury induced by acute exposure to ethanol and the zinc protection is independent of MT.
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Affiliation(s)
- Jason C Lambert
- Department of Pharmacology, University of Louisville School of Medicine, Louisville, Kentucky 40202, USA
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Yang R, Han X, Delude RL, Fink MP. Ethyl pyruvate ameliorates acute alcohol-induced liver injury and inflammation in mice. ACTA ACUST UNITED AC 2004; 142:322-31. [PMID: 14647036 DOI: 10.1016/s0022-2143(03)00138-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ethyl pyruvate dissolved in a calcium-containing balanced salt solution--Ringer's ethyl pyruvate solution (REPS)--ameliorates ileal mucosal hyperpermeability and decreases the expression of several proinflammatory genes when it is used instead of Ringer's lactate solution (RLS) to resuscitate mice from hemorrhagic shock. Herein, we sought to determine whether delayed treatment with REPS would be beneficial in a murine model of acute alcoholic liver injury associated with binge drinking. Mice were gavaged with 3 doses of ethanol (5 g/kg each dose) over a 12-hour period and then randomized to treatment with 3 intraperitoneal doses of REPS or RLS over 12 hours. Compared with sham-treated controls not subjected to alcohol intoxication, RLS-treated mice demonstrated histologic evidence of fatty change and piecemeal necrosis of hepatocytes in the liver, as well as a significant increase in the plasma concentration of alanine aminotransferase. Biochemical changes induced by alcohol administration included increased hepatic lipid peroxidation, nuclear factor-kappaB activation, and tumor necrosis factor-alpha messenger RNA expression. All of these alcohol-induced effects were ameliorated by treatment with REPS instead of RLS. These data support the view that treatment with REPS ameliorates the hepatic inflammatory response and decreases hepatocellular injury in mice subjected to acute alcohol intoxication.
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Affiliation(s)
- Runkuan Yang
- Department of Critical Care Medicine, Pathology, and Surgery, University of Pittsburgh School of Medicine, PA 15261, USA
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15
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Colantoni A, Duffner LA, Maria N, Fontanilla CV, Messingham KAN, Van Thiel DH, Kovacs EJ. Dose-Dependent Effect of Ethanol on Hepatic Oxidative Stress and Interleukin-6 Production After Burn Injury in the Mouse. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb02115.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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16
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Tamai H, Kato S, Horie Y, Ohki E, Yokoyama H, Ishii H. Effect of acute ethanol administration on the intestinal absorption of endotoxin in rats. Alcohol Clin Exp Res 2000. [PMID: 10776683 DOI: 10.1111/j.1530-0277.2000.tb04629.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Endotoxin has been implicated in the pathogenesis and progression of alcoholic liver disease. Not only inactivation of reticuloendothelial function, which reduces clearance of endotoxin, but also an increase in absorption of endotoxin from the intestine may be involved in mechanisms of ethanol-induced endotoxemia. However, it is unclear how ethanol affects absorption of endotoxin from the intestine in vivo. METHODS We gave 10 mg/kg of lipopolysaccharides to rats with water (group 1), 5% ethanol (group 2), or 20% ethanol (group 3) using an intubation tube to the stomach. Blood samples were collected and plasma endotoxin levels were measured. We used fluorescence spectrophotometer to examine permeability of the gut to macromolecules (fluorescein isothiocyanate-dextran; 4,000 Da [FD4] or 20,000 Da [FD20]). RESULTS Plasma endotoxin levels were not different between group 1 (9 +/- 2 pg/ml) and group 2 (14 +/-3 pg/ml), whereas they significantly increased in group 3 with a peak at 60 min (87 +/- 35 pg/ml). Acute ethanol administration did not affect clearance of endotoxin in rats. Hemorrhagic erosions of the proximal small intestine with epithelial cell loss were observed in group 3 at 4 hr, but no significant histological change was observed at 30 min by light microscopy. Acute ethanol administration (20%) increased the permeability of the small intestine to FD4 and FD20 in 30 min when no hemorrhagic erosions of the proximal small intestine with epithelial cell loss were observed. CONCLUSIONS Acute ethanol administration increases intestinal permeability before pathological changes are revealed by light microscopy. Acute ethanol ingestion, especially at high concentrations, facilitates the absorption of endotoxin from rats' small intestine via an increase in intestinal permeability, which may play an important role in endotoxemia observed in alcoholic liver injury.
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Affiliation(s)
- H Tamai
- Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
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17
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Wang E, Spitzer JJ, Chamulitrat W. Differential regulation of inducible nitric oxide synthase gene expression by ethanol in the human intestinal epithelial cell line DLD-1. Nitric Oxide 1999; 3:244-53. [PMID: 10442856 DOI: 10.1006/niox.1999.0230] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have examined the regulation of inducible nitric oxide synthase (iNOS) gene expression by ethanol in monolayers of DLD-1 cells, an epithelial cell line derived from human intestinal adenocarcinoma. Optimum induction of iNOS mRNA in these cells was obtained with IFN-gamma and IL-1beta treatment, while further addition of TNF-alpha did not have significant effect. In a set of experiments to study ethanol effects, DLD-1 monolayers were pretreated with ethanol for 24 h and were then treated with IFN-gamma + IL-1beta for an additional 24 h. Cells pretreated with ethanol showed decreased iNOS mRNA levels, indicating that ethanol may inhibit cytokine-induced iNOS transcription or affect mRNA destabilization. The suppression was ethanol-dose dependent with an IC50 of 50 mM. In another set of experiments to study ethanol effects, DLD-1 monolayers were pretreated with 66 mM ethanol for 24 h. These cells showed significant upregulation of IL-1beta mRNA and protein as detected in the supernatants. Aliquoted supernatants from these cells (i.e., conditioned media) were added to naive DLD-1 monolayers together with IFN-gamma. Conditioned medium from ethanol-treated cells increased the IFN-gamma-induced iNOS mRNA of naive cells by threefold. Two different effects of ethanol are now reported: (a) ethanol inhibits IFN-gamma + IL-1beta-induced iNOS mRNA of the same DLD-1 cells and (b) ethanol induces cellular paracrine signals by releasing IL-1beta into the medium, which in combination with IFN-gamma increases iNOS mRNA levels of the recipient naive DLD-1 cells. Because IFN-gamma and IL-1beta are produced by intestinal immune cells, these findings may have implications for differential in vivo regulation of epithelial iNOS genes by ethanol, depending on the inflammatory and immune status of the host.
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Affiliation(s)
- E Wang
- Department of Physiology and Alcohol Research Center, Louisiana State University Medical Center, New Orleans 70112-1393, USA
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Sun ZW, Wang XD, Deng XM, Wallén R, Gefors L, Hallberg E, Andersson R. The influence of circulatory and gut luminal challenges on bidirectional intestinal barrier permeability in rats. Scand J Gastroenterol 1997; 32:995-1004. [PMID: 9361172 DOI: 10.3109/00365529709011216] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The endothelial and epithelial barriers are important for maintenance of intestinal barrier function. The present study evaluated the response of these barriers after various challenges. METHODS Mucosal endothelial and epithelial barrier integrity was evaluated by the leakage of human serum albumin, labeled with different isotopes, from the circulation to the interstitium and the intestinal lumen, or from the intestinal lumen to the interstitium and the circulation, in rats with endothelial or epithelial challenge. RESULTS Epithelial barrier dysfunction and alterations in epithelial microvillous ultrastructure showed a pattern dependent on the dose of the intraluminal detergents, whereas only higher doses induced an increase in endothelial barrier permeability. Intravenous challenge with CHAPS or Triton caused a dose-dependent increase in both endothelial and epithelial barrier permeability. The development of endothelial barrier dysfunction was related to a decrease in blood pH values. CONCLUSIONS The results indicate that capillary endothelial barrier integrity may play an important role in maintaining intestinal barrier function and that endothelial injury may initiate or at least be involved in the development of intestinal barrier failure.
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Affiliation(s)
- Z W Sun
- Dept. of Surgery, Lund University Hospital, Sweden
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Dinda PK, Kossev P, Beck IT, Buell MG. Role of xanthine oxidase-derived oxidants and leukocytes in ethanol-induced jejunal mucosal injury. Dig Dis Sci 1996; 41:2461-70. [PMID: 9011459 DOI: 10.1007/bf02100144] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Previous reports indicate that intestinal intraluminal ethanol increases mucosal permeability (an index of mucosal injury) and histamine release by mast cells, and that the released histamine plays a role in mediating the increased permeability. In the present study, we investigated whether reactive oxygen metabolites and their major sources (xanthine oxidase and leukocytes) were involved in these ethanol effects. In rabbits, segments of the jejunum were perfused with a control solution or with 6% ethanol. In these segments, mucosal permeability was assessed by determining jejunal clearance of i.v. administered 51Cr-ethylenediaminetetraacetate (51Cr-EDTA) and 125I-bovine serum albumin (125I-BSA), and mast cell histamine release was estimated from the histamine concentration of the gut effluent. Ethanol increased 51Cr-EDTA clearance, 125I-BSA clearance, and histamine release. These ethanol effects decreased when the animals were given superoxide dismutase plus catalase (scavenger of O2- and H2O2, respectively), allopurinol, or oxypurinol (xanthine oxidase inhibitors). Administration of a monoclonal antibody (R15.7) against leukocyte adhesion molecule, CD18, inhibited completely the ethanol-induced increased 51Cr-EDTA and 125I-BSA clearances and histamine release. These and supplementary data suggest that (a) ethanol-induced mucosal injury and mast cell histamine release are mediated primarily by leukocytes, and (b) oxy radicals, especially those generated by xanthine oxidase, mediate these ethanol effects mainly by promoting leukocyte infiltration.
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Affiliation(s)
- P K Dinda
- Gastrointestinal Disease Research Unit, Department of Medicine, Queen's University, Hotel Dieu Hospital, Ontario, Canada
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Dinda PK, Wasan S, Beck IT, Kossev P. Adaptive cytoprotection against ethanol-induced small intestinal mucosal injury. Can J Physiol Pharmacol 1996. [DOI: 10.1139/y96-063] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ahrenstedt O, Hällgren R, Knutson L. Jejunal release of prostaglandin E2 in Crohn's disease: relation to disease activity and first-degree relatives. J Gastroenterol Hepatol 1994; 9:539-43. [PMID: 7865710 DOI: 10.1111/j.1440-1746.1994.tb01557.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Patients with Crohn's disease of the distal ileum show increased permeability to hyaluronan and increased release of histamine and complement components in uninvolved parts of the proximal jejunum. These abnormalities are related to disease activity, and are not found in first-degree relatives. Increased synthesis of prostaglandins has been observed in inflamed areas of the intestine in active Crohn's disease. Our purpose was to measure luminal prostaglandin release in patients with active and inactive Crohn's disease and their first-degree relatives. Twenty-four patients with Crohn's disease of the distal ileum (10 in remission and 12 with inflammatory activity) and 17 of their first-degree relatives were included and compared with healthy control subjects (n = 39). Ten centimetres of the proximal jejunum was isolated between balloons as described previously and perfused with a balanced electrolyte glucose-containing solution. Luminal concentrations of PGE2 and albumin were measured and their luminal release was calculated. Luminal release of PGE2 was significantly higher in patients with Crohn's disease than in control subjects [69.7 +/- 11.5 and 34.0 +/- 4.7 pg/cm per h (3.7 +/- 0.6 and 1.8 +/- 0.3 ng/L), respectively, P < 0.01]. The PGE2 levels, however, were not positively correlated to disease activity. Furthermore, there was a modest, but significant increase in luminal PGE2 in first-degree relatives [53.6 +/- 7.0 pg/cm per h (2.9 +/- 0.4 ng/L), P < 0.05]. These changes were not accompanied by significant changes in luminal permeation of albumin.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- O Ahrenstedt
- Department of Surgery, University Hospital, Uppsala, Sweden
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Actions of sulphasalazine and analogues in animal models of experimental colitis. Inflammopharmacology 1993. [DOI: 10.1007/bf02660614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Pfeiffer A, Schmidt T, Vidon N, Kaess H. Effect of ethanol on absorption of a nutrient solution in the upper human intestine. Scand J Gastroenterol 1993; 28:515-21. [PMID: 8322028 DOI: 10.3109/00365529309098259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The study compares the duodenal and jejunal absorption of an ethanol-containing nutrient solution (4% wt/vol, 4.06 kcal/min = 17.2 kJ/min, 1190 mosmol/kg) with the corresponding ethanol-free solution (2.64 kcal/min = 11.2 kJ/min, 160 mosmol/kg) and with another ethanol-free solution adapted in caloric load and osmolality (4.06 kcal/min = 17.2 kJ/min, 1160 mosmol/kg) by the addition of NaCl and glucose in eight healthy volunteers, using the intestinal perfusion technique. Ethanol added to a nutrient solution did not exert a significant effect on the net absorption of nutrients in the upper intestine. However, duodenal but not jejunal net water (p < 0.05) and sodium (p < 0.02) movements were significantly modified. Compared with the hyperosmolar ethanol-free solution, perfusion of ethanol induced in the duodenum a significantly lower (p < 0.001) net water and sodium secretion and higher absorption rates of total nitrogen and fatty acids (p < 0.001). The importance of the composition of control solutions in studies investigating the effects of ethanol in the gastrointestinal tract is emphasized.
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Affiliation(s)
- A Pfeiffer
- 2nd Medical Dept., Hospital München-Bogenhausen, Germany
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Abstract
BACKGROUND Catechol-O-methyltransferase (COMT) inhibition prevents tissue degradation of catecholamines including dopamine. This study was undertaken to investigate the effect of intraluminal nitecapone, a peripherally acting COMT inhibitor, on duodenal mucosal bicarbonate secretion in humans and to compare the effect with that of the prostaglandin E1 analogue misoprostol. METHODS The duodenal bulb was isolated by means of a three-balloon six-channel tube as previously described. Basal bicarbonate secretion and secretion after intraluminal administration of 30 and 150 mg nitecapone were determined in 11 healthy subjects. In 7 of these subjects, effects of intraluminal administration of 30 and 150 micrograms of misoprostol were studied in a second experiment. RESULTS Even the lower dose of misoprostol increased duodenal bicarbonate secretion from 121 +/- 12 to 221 +/- 36 and the lower dose of nitecapone from 149 +/- 18 to 277 +/- 48 microEq.cm-1 x h-1, respectively (P < 0.05). With 150 micrograms of misoprostol or 150 mg of nitecapone there was a further increase in secretion to 296 +/- 33 (P < 0.01) and 421 +/- 36 (P < 0.001) microEq.cm-1 x h-1, respectively. The rise in bicarbonate secretion in response to nitecapone was associated with some increase in the release of prostaglandin E2 to the luminal perfusate. CONCLUSIONS It seems likely that peripheral COMT inhibition increases duodenal mucosal bicarbonate secretion and protection by inhibition of mucosal degradation of dopamine, an increase similar in magnitude to that obtained by a prostaglandin E1 analogue.
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Affiliation(s)
- L Knutson
- Department of Surgery, University Hospital, Uppsala, Sweden
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