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Bhattiprolu AK, Kollipara S, Boddu R, Arumugam A, Khan SM, Ahmed T. A Semi-Mechanistic Physiologically Based Biopharmaceutics Model to Describe Complex and Saturable Absorption of Metformin: Justification of Dissolution Specifications for Extended Release Formulation. AAPS PharmSciTech 2024; 25:193. [PMID: 39168956 DOI: 10.1208/s12249-024-02904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 07/26/2024] [Indexed: 08/23/2024] Open
Abstract
Physiologically based pharmacokinetic (PBPK) or physiologically based biopharmaceutics models (PBBM) demonstrated plethora of applications in both new drugs and generic product development. Justification of dissolution specifications and establishment of dissolution safe space is an important application of such modeling approaches. In case of molecules exhibiting saturable absorption behavior, justification of dissolution specifications requires development of a model that incorporates effects of transporters is critical to simulate in vivo scenario. In the present case, we have developed a semi-mechanistic PBBM to describe the non-linearity of BCS class III molecule metformin for justification of dissolution specifications of extended release formulation at strengths 500 mg and 1000 mg. Semi-mechanistic PBBM was built using physicochemical properties, dissolution and non-linearity was accounted through incorporation of multiple transporter kinetics at absorption level. The model was extensively validated using literature reported intravenous, oral (immediate & extended release) formulations and further validated using in-house bioequivalence data in fasting and fed conditions. Virtual dissolution profiles at lower and upper specifications were generated to justify the dissolution specifications. The model predicted literature as well as in-house clinical study data with acceptable prediction errors. Further, virtual bioequivalence trials predicted the bioequivalence outcome that matched with clinical study data. The model predicted bioequivalence when lower and upper specifications were compared against pivotal test formulations thereby justifying dissolution specifications. Overall, complex and saturable absorption pathway of metformin was successfully simulated and this work resulted in regulatory acceptance of dissolution specifications which has ability to reduce multiple dissolution testing.
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Affiliation(s)
- Adithya Karthik Bhattiprolu
- Biopharmaceutics Group, Global Clinical Management, Dr. Reddy's Laboratories Ltd., Integrated Product Development Organization (IPDO), BachupallyMedchal Malkajgiri District, Hyderabad, Telangana, 500 090, India
| | - Sivacharan Kollipara
- Biopharmaceutics Group, Global Clinical Management, Dr. Reddy's Laboratories Ltd., Integrated Product Development Organization (IPDO), BachupallyMedchal Malkajgiri District, Hyderabad, Telangana, 500 090, India
| | - Rajkumar Boddu
- Biopharmaceutics Group, Global Clinical Management, Dr. Reddy's Laboratories Ltd., Integrated Product Development Organization (IPDO), BachupallyMedchal Malkajgiri District, Hyderabad, Telangana, 500 090, India
| | - Anand Arumugam
- Clinical Pharmacokinetics, Global Clinical Management, Dr. Reddy's Laboratories Ltd., Integrated Product Development Organization (IPDO), BachupallyMedchal Malkajgiri District, Hyderabad, Telangana, 500 090, India
| | - Sohel Mohammed Khan
- Clinical Pharmacokinetics, Global Clinical Management, Dr. Reddy's Laboratories Ltd., Integrated Product Development Organization (IPDO), BachupallyMedchal Malkajgiri District, Hyderabad, Telangana, 500 090, India
| | - Tausif Ahmed
- Biopharmaceutics Group, Global Clinical Management, Dr. Reddy's Laboratories Ltd., Integrated Product Development Organization (IPDO), BachupallyMedchal Malkajgiri District, Hyderabad, Telangana, 500 090, India.
- Clinical Pharmacokinetics, Global Clinical Management, Dr. Reddy's Laboratories Ltd., Integrated Product Development Organization (IPDO), BachupallyMedchal Malkajgiri District, Hyderabad, Telangana, 500 090, India.
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2
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Lockwood TD. Coordination chemistry suggests that independently observed benefits of metformin and Zn 2+ against COVID-19 are not independent. Biometals 2024; 37:983-1022. [PMID: 38578560 PMCID: PMC11255062 DOI: 10.1007/s10534-024-00590-5] [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: 11/24/2023] [Accepted: 02/12/2024] [Indexed: 04/06/2024]
Abstract
Independent trials indicate that either oral Zn2+ or metformin can separately improve COVID-19 outcomes by approximately 40%. Coordination chemistry predicts a mechanistic relationship and therapeutic synergy. Zn2+ deficit is a known risk factor for both COVID-19 and non-infectious inflammation. Most dietary Zn2+ is not absorbed. Metformin is a naked ligand that presumably increases intestinal Zn2+ bioavailability and active absorption by cation transporters known to transport metformin. Intracellular Zn2+ provides a natural buffer of many protease reactions; the variable "set point" is determined by Zn2+ regulation or availability. A Zn2+-interactive protease network is suggested here. The two viral cysteine proteases are therapeutic targets against COVID-19. Viral and many host proteases are submaximally inhibited by exchangeable cell Zn2+. Inhibition of cysteine proteases can improve COVID-19 outcomes and non-infectious inflammation. Metformin reportedly enhances the natural moderating effect of Zn2+ on bioassayed proteome degradation. Firstly, the dissociable metformin-Zn2+ complex could be actively transported by intestinal cation transporters; thereby creating artificial pathways of absorption and increased body Zn2+ content. Secondly, metformin Zn2+ coordination can create a non-natural protease inhibitor independent of cell Zn2+ content. Moderation of peptidolytic reactions by either or both mechanisms could slow (a) viral multiplication (b) viral invasion and (c) the pathogenic host inflammatory response. These combined actions could allow development of acquired immunity to clear the infection before life-threatening inflammation. Nirmatrelvir (Paxlovid®) opposes COVID-19 by selective inhibition the viral main protease by a Zn2+-independent mechanism. Pending safety evaluation, predictable synergistic benefits of metformin and Zn2+, and perhaps metformin/Zn2+/Paxlovid® co-administration should be investigated.
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Affiliation(s)
- Thomas D Lockwood
- Department Pharmacology and Toxicology, School of Medicine, Wright State University, Dayton, OH, 45435, USA.
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3
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Wang Y, Jia X, Cong B. Advances in the mechanism of metformin with wide-ranging effects on regulation of the intestinal microbiota. Front Microbiol 2024; 15:1396031. [PMID: 38855769 PMCID: PMC11157079 DOI: 10.3389/fmicb.2024.1396031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/29/2024] [Indexed: 06/11/2024] Open
Abstract
Metformin is of great focus because of its high safety, low side effects, and various effects other than lowering blood sugar, such as anti-inflammation, anti-tumor, and anti-aging. Studies have shown that metformin has a modulating effect on the composition and function of the intestinal microbiota other than acting on the liver. However, the composition of microbiota is complex and varies to some extent between species and individuals, and the experimental design of each study is also different. Multiple factors present a major obstacle to better comprehending the effects of metformin on the gut microbiota. This paper reviews the regulatory effects of metformin on the gut microbiota, such as increasing the abundance of genus Akkermansia, enriching short-chain fatty acids (SCFAs)-producing bacterial genus, and regulating gene expression of certain genera. The intestinal microbiota is a large and vital ecosystem in the human body and is considered to be the equivalent of an "organ" of the human body, which is highly relevant to human health and disease status. There are a lot of evidences that the gut microbiota is responsible for metformin's widespread effects. However, there are only a few systematic studies on this mechanism, and the specific mechanism is still unclear. This paper aims to summarize the possible mechanism of metformin in relation to gut microbiota.
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Affiliation(s)
- Yue Wang
- College of Forensic Medicine, Hebei Key Laboratory of Forensic Medicine, Hebei Medical University, Shijiazhuang, China
- Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, Beijing, China
| | - Xianxian Jia
- College of Forensic Medicine, Hebei Key Laboratory of Forensic Medicine, Hebei Medical University, Shijiazhuang, China
- Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, Beijing, China
- Department of Pathogen Biology, Institute of Basic Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Bin Cong
- College of Forensic Medicine, Hebei Key Laboratory of Forensic Medicine, Hebei Medical University, Shijiazhuang, China
- Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, Beijing, China
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4
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Sugiyama K, Shimano H, Takahashi M, Shimura Y, Shimura A, Furuya T, Tomabechi R, Shirasaka Y, Higuchi K, Kishimoto H, Inoue K. The Use of Carboxyfluorescein Reveals the Transport Function of MCT6/SLC16A5 Associated with CD147 as a Chloride-Sensitive Organic Anion Transporter in Mammalian Cells. J Pharm Sci 2024; 113:1113-1120. [PMID: 38160712 DOI: 10.1016/j.xphs.2023.12.023] [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: 10/07/2023] [Revised: 12/25/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
Oral drug absorption involves drug permeation across the apical and basolateral membranes of enterocytes. Although transporters mediating the influx of anionic drugs in the apical membranes have been identified, transporters responsible for efflux in the basolateral membranes remain unclear. Monocarboxylate transporter 6 (MCT6/SLC16A5) has been reported to localize to the apical and basolateral membranes of human enterocytes and to transport organic anions such as bumetanide and nateglinide in the Xenopus oocyte expression system; however, its transport functions have not been elucidated in detail. In this study, we characterized the function of MCT6 expressed in HEK293T cells and explored fluorescent probes to more easily evaluate MCT6 function. The results illustrated that MCT6 interacts with CD147 to localize at the plasma membrane. When the uptake of various fluorescein derivatives was examined in NaCl-free uptake buffer (pH 5.5), the uptake of 5-carboxyfluorescein (5-CF) was significantly greater in MCT6 and CD147-expressing cells. MCT6-mediated 5-CF uptake was saturable with a Km of 1.07 mM and inhibited by several substrates/inhibitors of organic anion transporters and extracellular Cl ion with an IC50 of 53.7 mM. These results suggest that MCT6 is a chloride-sensitive organic anion transporter that can be characterized using 5-CF as a fluorescent probe.
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Affiliation(s)
- Koki Sugiyama
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hiroe Shimano
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Masaki Takahashi
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Yuta Shimura
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Asuka Shimura
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Takahito Furuya
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Ryuto Tomabechi
- Laboratory of Pharmaceutics, Kitasato University School of Pharmacy, Tokyo, Japan
| | - Yoshiyuki Shirasaka
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Kei Higuchi
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hisanao Kishimoto
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Katsuhisa Inoue
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
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5
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Zhang H, Lai J, Zhang L, Zhang W, Liu X, Gong Q, Tian H, Yang M, Yang T, Zhao R, Li D, Huang H, Zhao Y, Yan S, Yu M, Xiyang Y, Shi L, Yang L, Wang L, Chen W, Cao X. The co-regulation of the gut microbiome and host genes might play essential roles in metformin gastrointestinal intolerance. Toxicol Appl Pharmacol 2023; 481:116732. [PMID: 37871735 DOI: 10.1016/j.taap.2023.116732] [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: 07/18/2023] [Revised: 09/14/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
Metformin is commonly used, but approximately 20% of patients experience gastrointestinal intolerance, leading to medication discontinuation for unclear reasons and a lack of effective management strategies. In this study, the 18 fecal and blood samples were analyzed using 16S rRNA and mRNA transcriptome, respectively. These samples included 3 fecal and 4 blood from metformin-tolerant T2D patients before and after metformin treatment (T and Ta), 3 fecal and 5 blood from metformin-intolerant T2D patients before and after treatment (TS and TSa), and 6 fecal samples from healthy controls. The results showed that certain anti-inflammatory gut bacteria and gene, such as Barnesiella (p = 0.046), Parabacteroides goldsteinii (p = 0.016), and the gene JUND (p = 0.0002), exhibited higher levels in metformin-intolerant patients, and which decreased after metformin treatment (p < 0.05). This potentially invalidates patients' anti-inflammatory effect and intestinal mucus barrier protection, which may lead to alterations in intestinal permeability, decreased gut barrier function, and gastrointestinal symptoms, including diarrhea, bloating, and nausea. After metformin treatment, primary bile acids (PBAs) production species: Weissella confusa, Weissella paramesenteroides, Lactobacillus brevis, and Lactobacillus plantarum increased (p < 0.05). The species converting PBAs to secondary bile acids (SBAs): Parabacteroides distasonis decreased (p < 0.05). This might result in accumulation of PBAs, which also may lead to anti-inflammatory gene JUND and SQSTM1 downregulated. In conclusion, this study suggests that metformin intolerance may be attributed to a decrease in anti-inflammatory-related flora and genes, and also alterations in PBAs accumulation-related flora. These findings open up possibilities for future research targeting gut flora and host genes to prevent metformin intolerance.
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Affiliation(s)
- Huixiang Zhang
- Institute of Neuroscience, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China; Department of Laboratory Animal Science, Kunming Medical University, Kunming, Yunnan, China
| | - Jiao Lai
- Department of Endocrinology, Qujing NO.1 Hospital of Yunnan Province, Qujing, Yunnan, China
| | - Lihuan Zhang
- Department of Laboratory Animal Science, Kunming Medical University, Kunming, Yunnan, China
| | - Wei Zhang
- Department of Endocrinology, Qujing NO.1 Hospital of Yunnan Province, Qujing, Yunnan, China
| | - Xun Liu
- Institute of Neuroscience, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China
| | - Qilin Gong
- Department of Endocrinology, Qujing NO.1 Hospital of Yunnan Province, Qujing, Yunnan, China
| | - Hongxi Tian
- Institute of Neuroscience, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China
| | - Mingzhi Yang
- Institute of Neuroscience, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China
| | - Tao Yang
- Institute of Neuroscience, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China
| | - Rui Zhao
- Department of Endocrinology, Qujing NO.1 Hospital of Yunnan Province, Qujing, Yunnan, China
| | - Dongqing Li
- Department of Endocrinology, Qujing NO.1 Hospital of Yunnan Province, Qujing, Yunnan, China
| | - Hehua Huang
- Department of Endocrinology, Qujing NO.1 Hospital of Yunnan Province, Qujing, Yunnan, China
| | - Ya Zhao
- Department of Endocrinology, Qujing NO.1 Hospital of Yunnan Province, Qujing, Yunnan, China
| | - Shan Yan
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Bioengineering Centre, Kunming Medical University, Kunming, Yunnan, China
| | - Ming Yu
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Bioengineering Centre, Kunming Medical University, Kunming, Yunnan, China
| | - Yanbin Xiyang
- Institute of Neuroscience, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China
| | - Lanlan Shi
- Department of Anatomy, Histology and Embryology, Basic Medical College, Kunming Medical University, Kunming, Yunnan, China
| | - Lirong Yang
- Institute of Neuroscience, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China; No.1 School of Clinical Medicine, Kunming Medical University, Kunming, Yunnan, China
| | - Limei Wang
- Department of Laboratory Animal Science, Kunming Medical University, Kunming, Yunnan, China.
| | - Weiwen Chen
- Qujing Second People's Hospital of Yunnan Province, Qujing, Yunnan, China.
| | - Xue Cao
- Department of Laboratory Animal Science, Kunming Medical University, Kunming, Yunnan, China; State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Yunnan University, Kunming, Yunnan, China.
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6
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Isop LM, Neculau AE, Necula RD, Kakucs C, Moga MA, Dima L. Metformin: The Winding Path from Understanding Its Molecular Mechanisms to Proving Therapeutic Benefits in Neurodegenerative Disorders. Pharmaceuticals (Basel) 2023; 16:1714. [PMID: 38139841 PMCID: PMC10748332 DOI: 10.3390/ph16121714] [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: 09/12/2023] [Revised: 11/25/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Metformin, a widely prescribed medication for type 2 diabetes, has garnered increasing attention for its potential neuroprotective properties due to the growing demand for treatments for Alzheimer's, Parkinson's, and motor neuron diseases. This review synthesizes experimental and clinical studies on metformin's mechanisms of action and potential therapeutic benefits for neurodegenerative disorders. A comprehensive search of electronic databases, including PubMed, MEDLINE, Embase, and Cochrane library, focused on key phrases such as "metformin", "neuroprotection", and "neurodegenerative diseases", with data up to September 2023. Recent research on metformin's glucoregulatory mechanisms reveals new molecular targets, including the activation of the LKB1-AMPK signaling pathway, which is crucial for chronic administration of metformin. The pleiotropic impact may involve other stress kinases that are acutely activated. The precise role of respiratory chain complexes (I and IV), of the mitochondrial targets, or of the lysosomes in metformin effects remains to be established by further research. Research on extrahepatic targets like the gut and microbiota, as well as its antioxidant and immunomodulatory properties, is crucial for understanding neurodegenerative disorders. Experimental data on animal models shows promising results, but clinical studies are inconclusive. Understanding the molecular targets and mechanisms of its effects could help design clinical trials to explore and, hopefully, prove its therapeutic effects in neurodegenerative conditions.
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Affiliation(s)
- Laura Mihaela Isop
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania; (L.M.I.)
| | - Andrea Elena Neculau
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania; (L.M.I.)
| | - Radu Dan Necula
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania
| | - Cristian Kakucs
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania
| | - Marius Alexandru Moga
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania
| | - Lorena Dima
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania; (L.M.I.)
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7
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Oyanna VO, Garcia-Torres KY, Bechtold BJ, Lynch KD, Call MR, Horváth M, Manwill PK, Graf TN, Cech NB, Oberlies NH, Paine MF, Clarke JD. Goldenseal-Mediated Inhibition of Intestinal Uptake Transporters Decreases Metformin Systemic Exposure in Mice. Drug Metab Dispos 2023; 51:1483-1489. [PMID: 37562957 PMCID: PMC10586506 DOI: 10.1124/dmd.123.001360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/08/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023] Open
Abstract
Goldenseal is a perennial plant native to eastern North America. A recent clinical study reported goldenseal decreased metformin Cmax and area under the blood concentration versus time curve (AUC) by 27% and 23%, respectively, but half-life and renal clearance were unchanged. These observations suggested goldenseal altered processes involved in metformin absorption. The underlying mechanism(s) remain(s) unknown. One mechanism for the decreased metformin systemic exposure is inhibition by goldenseal of intestinal uptake transporters involved in metformin absorption. Goldenseal extract and three goldenseal alkaloids (berberine, (-)-β-hydrastine, hydrastinine) were tested as inhibitors of organic cation transporter (OCT) 3, plasma membrane monoamine transporter (PMAT), and thiamine transporter (THTR) 2 using human embryonic kidney 293 cells overexpressing each transporter. The goldenseal extract, normalized to berberine content, was the strongest inhibitor of each transporter (IC50: 4.9, 13.1, and 5.8 μM for OCT3, PMAT, and THTR2, respectively). A pharmacokinetic study in mice compared the effects of berberine, (-)-β-hydrastine, goldenseal extract, and imatinib (OCT inhibitor) on orally administered metformin. Goldenseal extract and imatinib significantly decreased metformin Cmax by 31% and 25%, respectively, and had no effect on half-life. Berberine and (-)-β-hydrastine had no effect on metformin pharmacokinetics, indicating neither alkaloid alone precipitated the interaction in vivo. A follow-up murine study involving intravenous metformin and oral inhibitors examined the contributions of basolateral enteric/hepatic uptake transporters to the goldenseal-metformin interaction. Goldenseal extract and imatinib had no effect on metformin AUC and half-life, suggesting lack of inhibition of basolateral enteric/hepatic uptake transporters. Results may have implications for patients taking goldenseal with drugs that are substrates for OCT3 and THTR2. SIGNIFICANCE STATEMENT: Goldenseal is used to self-treat respiratory infections and digestive disorders. We investigated potential mechanisms for the clinical pharmacokinetic interaction observed between goldenseal and metformin, specifically inhibition by goldenseal of intestinal uptake transporters (OCT3, PMAT, THTR2) involved in metformin absorption. Goldenseal extract inhibited all three transporters in vitro and decreased metformin systemic exposure in mice. These data may have broader implications for patients co-consuming goldenseal with other drugs that are substrates for these transporters.
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Affiliation(s)
- Victoria O Oyanna
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Kenisha Y Garcia-Torres
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Baron J Bechtold
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Katherine D Lynch
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - M Ridge Call
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Miklós Horváth
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Preston K Manwill
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Tyler N Graf
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Nadja B Cech
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Nicholas H Oberlies
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Mary F Paine
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - John D Clarke
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
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8
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Regu VPR, Behera D, Sunkara SP, Gohel V, Tripathy S, Swain RP, Subudhi BB. Ocular Delivery of Metformin for Sustained Release and in Vivo Efficacy. J Pharm Sci 2023; 112:2494-2505. [PMID: 37031863 DOI: 10.1016/j.xphs.2023.04.002] [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: 02/17/2023] [Revised: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
Metformin is known to lower inflammation, independent of its anti-diabetic action. Thus, topical metformin can be a therapeutic strategy for managing ocular inflammation associated with diabetes. To achieve this and address the issues of ocular retention and controlled release an in situ gel of metformin was developed. The formulations were prepared using sodium hyaluronate, hypromellose, and gellan gum. The composition was optimized by monitoring gelling time/capacity, viscosity, and mucoadhesion. MF5 was selected as the optimized formulation. It showed both chemical and physiological compatibility. It was found to be sterile and stable. MF5 exhibited sustained release of metformin for 8h that fitted best with zero-order kinetics. Further, the release mode was found to be close to the Korsmeyer-Peppas model. Supported by an ex vivo permeation study, it showed potential for prolonged action. It showed a significant reduction in ocular inflammation that was comparable to that of the standard drug. MF5 shows translational potential as a safe alternative to steroids for managing ocular inflammation.
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Affiliation(s)
- Vara Prasada Rao Regu
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Dhananjay Behera
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Sai Prathyusha Sunkara
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Vinit Gohel
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India; ProCyto Labs Pvt Ltd., KIIT-TBI, Bhubaneswar, Odisha 751024, India
| | - Shyamalendu Tripathy
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Ranjit Prasad Swain
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Bharat Bhusan Subudhi
- Drug Development and Analysis Laboratory, School of Pharmaceutical Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India.
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9
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Foretz M, Guigas B, Viollet B. Metformin: update on mechanisms of action and repurposing potential. Nat Rev Endocrinol 2023:10.1038/s41574-023-00833-4. [PMID: 37130947 PMCID: PMC10153049 DOI: 10.1038/s41574-023-00833-4] [Citation(s) in RCA: 133] [Impact Index Per Article: 133.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/04/2023]
Abstract
Currently, metformin is the first-line medication to treat type 2 diabetes mellitus (T2DM) in most guidelines and is used daily by >200 million patients. Surprisingly, the mechanisms underlying its therapeutic action are complex and are still not fully understood. Early evidence highlighted the liver as the major organ involved in the effect of metformin on reducing blood levels of glucose. However, increasing evidence points towards other sites of action that might also have an important role, including the gastrointestinal tract, the gut microbial communities and the tissue-resident immune cells. At the molecular level, it seems that the mechanisms of action vary depending on the dose of metformin used and duration of treatment. Initial studies have shown that metformin targets hepatic mitochondria; however, the identification of a novel target at low concentrations of metformin at the lysosome surface might reveal a new mechanism of action. Based on the efficacy and safety records in T2DM, attention has been given to the repurposing of metformin as part of adjunct therapy for the treatment of cancer, age-related diseases, inflammatory diseases and COVID-19. In this Review, we highlight the latest advances in our understanding of the mechanisms of action of metformin and discuss potential emerging novel therapeutic uses.
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Affiliation(s)
- Marc Foretz
- Université Paris Cité, CNRS, Inserm, Institut Cochin, Paris, France
| | - Bruno Guigas
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Benoit Viollet
- Université Paris Cité, CNRS, Inserm, Institut Cochin, Paris, France.
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Metabolic Action of Metformin. Pharmaceuticals (Basel) 2022; 15:ph15070810. [PMID: 35890109 PMCID: PMC9317619 DOI: 10.3390/ph15070810] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/14/2022] [Accepted: 06/26/2022] [Indexed: 12/12/2022] Open
Abstract
Metformin, a cheap and safe biguanide derivative, due to its ability to influence metabolism, is widely used as a first-line drug for type 2 diabetes (T2DM) treatment. Therefore, the aim of this review was to present the updated biochemical and molecular effects exerted by the drug. It has been well explored that metformin suppresses hepatic glucose production in both AMPK-independent and AMPK-dependent manners. Substantial scientific evidence also revealed that its action is related to decreased secretion of lipids from intestinal epithelial cells, as well as strengthened oxidation of fatty acids in adipose tissue and muscles. It was recognized that metformin’s supra-therapeutic doses suppress mitochondrial respiration in intestinal epithelial cells, whereas its therapeutic doses elevate cellular respiration in the liver. The drug is also suggested to improve systemic insulin sensitivity as a result of alteration in gut microbiota composition, maintenance of intestinal barrier integrity, and alleviation of low-grade inflammation.
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