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The Caco-2 Model: Modifications and enhancements to improve efficiency and predictive performance. Int J Pharm 2022; 624:122004. [PMID: 35820514 DOI: 10.1016/j.ijpharm.2022.122004] [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: 04/28/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/20/2022]
Abstract
The Caco-2 cell model has been widely used to assess the permeability of drug candidates. It has provided a high throughput in vitro platform, functionally resembling the enterocytes. Since the oral route is the most preferred for drug administration, the Caco-2 cell model acts as a very important tool to elucidate the oral "druggability" of a molecule by providing a fairly reliable estimate of its permeability through the intestinal membrane. Despite its shortcomings (the lack of a mucus layer, long cultivation period, inter-lab variability, and differences in expression of enzymes, transporters, and tight junction complexes) it remains heavily used due to its reliability, predictive performance, and wide acceptance. Various modifications have been made: co-culturing with other intestinal cells, applying biosimilar mucus, reducing culturing time, combining Caco-2 monolayer with the dissolution apparatus, enhancing protein expression, and redesigning the sampling apparatus. These modifications are intended to overcome some of the shortcomings of the Caco-2 model in order to make its use easier, quicker, economical, and more representative of the intestine. The aim of this review is to discuss such modifications to enhance this model's utility, predictive performance, and reproducibility.
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Włodarczyk M, Gleńsk M. An in-depth look into a well-known herbal drug: Fingerprinting, isolation, identification, and content estimation of saponins in different Strophanthus seeds. PLANTA MEDICA 2022; 88:576-586. [PMID: 34474491 DOI: 10.1055/a-1586-1915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Seeds of Strophanthus species are known as a source of rapid-acting cardenolides. These water-soluble glycosides are listed as the sole critical constituents of this raw herbal drug. A non-standard cardioprotective medication with ouabain-containing oral remedies has become popular in Europe as a result of the withdrawal of corresponding registered drugs from the market. However, the bioequivalence of pure ouabain solutions, tinctures, and home-made extracts from Strophanthus seeds is unknown. Thus, this study aimed to update the information on the composition of Strophanthus seeds used for this purpose. The distribution of two main saponins and about 90 previously unreported compounds, tentatively identified as saponins in eleven Strophanthus species, was systematically evaluated by ultra-high-performance liquid chromatography mass spectrometry (UHPLC-MS) and -MS/MS. Seeds of S. gratus were selected to isolate the dominant unreported triterpenoids, bidesmosides of echinocystic and oleanolic acid. Their structures were established by HRMS, MS/MS, as well as by NMR techniques. The total saponin content, estimated by UHPLC-MS, was up to 1%. The detected saponins could influence the peroral bioavailability of hardly absorbable Strophanthus cardenolides and exhibit their own activity. This finding may be relevant when Strophanthus preparations (containing both saponins and cardiac glycosides) are used, particularly when homemade preparations are administered.
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Affiliation(s)
- Maciej Włodarczyk
- Department of Pharmacognosy and Herbal Medicines, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Michał Gleńsk
- Department of Pharmacognosy and Herbal Medicines, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
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Yagiz Y, Wang GP, Gu L. Emulsification by vitamin E TPGS or Quillaja extract enhanced absorption of berberine without affecting its metabolism in humans. Food Funct 2022; 13:12135-12143. [DOI: 10.1039/d2fo02288e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Berberine is widely used for the prevention of cancers and diabetes.
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Affiliation(s)
- Yavuz Yagiz
- Food Science and Human Nutrition Department, College of Agricultural and Life Sciences, USA
| | - Gary P. Wang
- Division of Infectious Diseases and Global Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida 32610, USA
| | - Liwei Gu
- Food Science and Human Nutrition Department, College of Agricultural and Life Sciences, USA
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Zhang Q, Song X, Chen X, Jiang R, Peng K, Tang X, Liu Z. Antiosteoporotic effect of hesperidin against ovariectomy-induced osteoporosis in rats via reduction of oxidative stress and inflammation. J Biochem Mol Toxicol 2021; 35:e22832. [PMID: 34028927 DOI: 10.1002/jbt.22832] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/03/2021] [Accepted: 05/18/2021] [Indexed: 01/15/2023]
Abstract
Osteoporosis is a serious health problem, especially in geriatric patients. Worldwide, it affects 8.9 million people every year. Oxidative stress and inflammation expand the osteoporosis reaction. Hesperidin supplement helps to decrease inflammation and oxidative stress. In this study, we estimated the antiosteoporotic effect of hesperidin against the ovariectomized (OVX) rat model of osteoporosis. Hesperidin was orally administered at 5, 10, and 20 mg/kg to OVX rats for 10 weeks. Different biochemical parameters, such as alkaline phosphatase (ALP), osteocalcin (OC), phosphorus (P), calcium (Ca), and antioxidant parameters, were also estimated. The three-point bending test, bone mineral density (BMD), and histomorphometric features of the femoral bone were also scrutinized. Hesperidin significantly decreased body weight and increased uterine weight. Hesperidin significantly reduced the ALP, OC, acid phosphatase, and β-isomerized C-terminal telopeptides levels in OVX rats. Hesperidin considerably increased BMD and dose-dependently reduced the pixel density. Hesperidin considerably increased the maximum load, energy, stiffness, maximum stress, and young modulus. Hesperidin significantly (p < 0.001) reduced the levels of thiobarbituric acid reactive substance and increased the level of superoxide dismutase, glutathione, glutathione peroxidase, catalase in OVX-induced rats. Hesperidin significantly diminishes the cytokine levels, such as tumor necrosis factor-α, interleukin-6 (IL-6), and IL-1β, and inflammatory mediators such as nuclear factor-kappa B. It significantly reduced the level of Ca, P, and increased the level of vitamin D in OVX rats. Hesperidin significantly (p < 0.001) reduced the expression of sirtuin 1. Collectively, we can conclude that hesperidin exhibited better protection against osteoporosis by enhancing the bone density and bone mineral content in addition to biomechanical parameters.
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Affiliation(s)
- Qiang Zhang
- Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Xiaoxia Song
- Department of Respiratory Medicine, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Xiaoming Chen
- Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Ruizhong Jiang
- Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Ke Peng
- Department of Spine Surgery, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Xinqiao Tang
- Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Zhong Liu
- Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China
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Linz G, Djeljadini S, Steinbeck L, Köse G, Kiessling F, Wessling M. Cell barrier characterization in transwell inserts by electrical impedance spectroscopy. Biosens Bioelectron 2020; 165:112345. [PMID: 32513645 DOI: 10.1016/j.bios.2020.112345] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/12/2020] [Accepted: 05/31/2020] [Indexed: 11/19/2022]
Abstract
We describe an impedance-based method for cell barrier integrity testing. A four-electrode electrical impedance spectroscopy (EIS) setup can be realized by simply connecting a commercial chopstick-like electrode (STX-1) to a potentiostat allowing monitoring cell barriers cultivated in transwell inserts. Subsequent electric circuit modeling of the electrical impedance results the capacitive properties of the barrier next to the well-known transepithelial electrical resistance (TEER). The versatility of the new method was analyzed by the EIS analysis of a Caco-2 monolayer in response to (a) different membrane coating materials, (b) two different permeability enhancers ethylene glycol-bis(2-aminoethylether)-N,N,N',N'-tetraacetic acid (EGTA) and saponin, and (c) sonoporation. For the different membrane coating materials, the TEERs of the standard and new protocol coincide and increase during cultivation, while the capacitance shows a distinct maximum for three different surface materials (no coating, Matrigel®, and collagen I). The permeability enhancers cause a decline in the TEER value, but only saponin alters the capacitance of the cell layer by two orders of magnitude. Hence, cell layer capacitance and TEER represent two independent properties characterizing the monolayer. The use of commercial chopstick-like electrodes to access the impedance of a barrier cultivated in transwell inserts enables remarkable insight into the behavior of the cellular barrier with no extra work for the researcher. This simple method could evolve into a standard protocol used in cell barrier research.
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Affiliation(s)
- Georg Linz
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstr. 50, 52074 Aachen, Germany; RWTH Aachen University, Aachener Verfahrenstechnik-Chemical Process Engineering, Forckenbeckstrasse 51, 52074, Aachen, Germany
| | - Suzana Djeljadini
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstr. 50, 52074 Aachen, Germany; RWTH Aachen University, Aachener Verfahrenstechnik-Chemical Process Engineering, Forckenbeckstrasse 51, 52074, Aachen, Germany
| | - Lea Steinbeck
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstr. 50, 52074 Aachen, Germany; RWTH Aachen University, Aachener Verfahrenstechnik-Chemical Process Engineering, Forckenbeckstrasse 51, 52074, Aachen, Germany
| | - Gurbet Köse
- Institute for Experimental Molecular Imaging, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany
| | - Matthias Wessling
- DWI - Leibniz Institute for Interactive Materials, Forckenbeckstr. 50, 52074 Aachen, Germany; RWTH Aachen University, Aachener Verfahrenstechnik-Chemical Process Engineering, Forckenbeckstrasse 51, 52074, Aachen, Germany.
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Chakuleska L, Michailova R, Shkondrov A, Manov V, Zlateva-Panayotova N, Marinov G, Petrova R, Atanasova M, Krasteva I, Danchev N, Doytchinova I, Simeonova R. Bone protective effects of purified extract from Ruscus aculeatus on ovariectomy-induced osteoporosis in rats. Food Chem Toxicol 2019; 132:110668. [PMID: 31299293 DOI: 10.1016/j.fct.2019.110668] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 02/07/2023]
Abstract
Ruscus aculeatus is a source of steroidal saponins that could mimic sex hormones and could help alleviate the risk of fracture in osteoporotic patients. The aim of the present study was to evaluate the in vitro effects of an extract from R. aculeatus (ERA) on the proliferation of human osteoblast-like SaOS-2 cell line and to investigate the effects of the ERA administered orally for 10 weeks at three doses (50, 100 and 200 mg/kg) on the bone structure of rats with estrogen deficiency induced by bilateral ovariectomy. Bone turnover markers, hormones, histopathological and radiological disturbances were evidenced in the ovariectomized rats. ERA recovered most of the affected parameters in a dose-dependent manner similar to diosgenin and alendronate used as positive comparators. The main active compounds of ERA (ruscogenin and neoruscogenin) were docked into the Vit. D receptor and oestrogen receptors alpha and beta, and stable complexes were found with binding scores equal to those of estradiol and diosgenin. The findings of this study provide for the first time an insight into the effects of ERA on bone structure and suggest that ERA could be developed as a potential candidate for the prevention of postmenopausal osteoporotic complications.
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Affiliation(s)
- Lidija Chakuleska
- Department of Pharmacology, Pharmacotherapy, and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
| | - Rositza Michailova
- Department of Pharmacology, Pharmacotherapy, and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
| | - Aleksandar Shkondrov
- Department of Pharmacognosy, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
| | - Vassil Manov
- Department of Internal Non-infectious Diseases, Pathology, and Pharmacology, Faculty of Veterinary Medicine, University of Forestry, 10, Kliment Ochridsky Blvd, 1756, Sofia, Bulgaria.
| | - Nadya Zlateva-Panayotova
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Forestry, 10, Kliment Ochridsky Blvd, 1756, Sofia, Bulgaria.
| | - Georgi Marinov
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Forestry, 10, Kliment Ochridsky Blvd, 1756, Sofia, Bulgaria.
| | - Reneta Petrova
- National Diagnostic and Research Veterinary Institute, Sofia, Bulgaria, Department: National Center of Animal Health.
| | - Mariyana Atanasova
- Department of Chemistry, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
| | - Ilina Krasteva
- Department of Pharmacognosy, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
| | - Nikolay Danchev
- Department of Pharmacology, Pharmacotherapy, and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
| | - Irini Doytchinova
- Department of Chemistry, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
| | - Rumyana Simeonova
- Department of Pharmacology, Pharmacotherapy, and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 2, Dunav St, 1000, Sofia, Bulgaria.
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Tagousop CN, Tamokou JDD, Kengne IC, Ngnokam D, Voutquenne-Nazabadioko L. Antimicrobial activities of saponins from Melanthera elliptica and their synergistic effects with antibiotics against pathogenic phenotypes. Chem Cent J 2018; 12:97. [PMID: 30238231 PMCID: PMC6768134 DOI: 10.1186/s13065-018-0466-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Resistance of bacteria and fungi to antibiotics is one of the biggest problems that faces public health. The present work was designated to evaluate the antimicrobial activities of saponins from Melanthera elliptica and their synergistic effects with standard antibiotics against pathogenic phenotypes. The plant extract was prepared by maceration in methanol. The methanol extract was partitioned into ethyl acetate and n-butanol extracts. Column chromatography of the n-butanol extract followed by purification of different fractions led to the isolation of four saponins. Their structures were elucidated on the basis of spectra analysis, and by comparison with those from the literature. The antimicrobial activities of the extracts/compounds alone and their combinations with tetracycline and fluconazole were evaluated using the broth microdilution method through the determination of minimum inhibitory concentration (MIC) and minimum microbicidal concentration. RESULTS Four compounds: 3-O-β-D-glucuronopyranosyl-oleanolic acid (1), 3-O-β-D-glucuronopyranosyloleanolic acid 28-O-β-D-glucopyranosyl ester (2), 3-O-β-D-glucopyranosyl(1 → 2)-β-D-glucuronopyranosyl oleanolic acid (3) and 3-O-β-D-glucopyranosyl(1 → 2)-β-D-glucuronopyranosyl oleanolic acid 28-O-β-D-glucopyranosyl ester (4) were isolated. Compounds 1, 2 and 3 showed the largest antibacterial activities (MIC = 8-128 μg/mL) whereas compound 4 displayed the highest antifungal activities (MIC = 8-16 μg/mL). The antibacterial activities of compounds 1 and 2 (MIC = 16-32 μg/mL) against multi-drug-resistant Escherichia coli S2 (1) and Shigella flexneri SDINT are equal to those of vancomycin (MIC = 16-32 μg/mL) used as reference antibiotic. CONCLUSIONS The present study showed significant antimicrobial activity of compounds 1, 2, 3 and 4 against the tested microorganisms. The saponins act in synergy with the tested standard antibiotics. This synergy could lead to new options for the treatment of infectious diseases and emerging drug resistance.
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Affiliation(s)
- Cyrille Ngoufack Tagousop
- Research Unit of Environmental and Applied Chemistry, Department of Chemistry, Faculty of Science, University of Dschang, P.O. Box 67, Dschang, Cameroon
| | - Jean-de-Dieu Tamokou
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, P.O. Box 67, Dschang, Cameroon.
| | - Irene Chinda Kengne
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, P.O. Box 67, Dschang, Cameroon
| | - David Ngnokam
- Research Unit of Environmental and Applied Chemistry, Department of Chemistry, Faculty of Science, University of Dschang, P.O. Box 67, Dschang, Cameroon.
| | - Laurence Voutquenne-Nazabadioko
- Groupe Isolement et Structure, Institut de Chimie Moléculaire de Reims (ICMR), CNRS, UMR 7312, Bat. 18, BP.1039, 51687, Reims cedex 2, France
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Maher S, Mrsny RJ, Brayden DJ. Intestinal permeation enhancers for oral peptide delivery. Adv Drug Deliv Rev 2016; 106:277-319. [PMID: 27320643 DOI: 10.1016/j.addr.2016.06.005] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 12/15/2022]
Abstract
Intestinal permeation enhancers (PEs) are one of the most widely tested strategies to improve oral delivery of therapeutic peptides. This article assesses the intestinal permeation enhancement action of over 250 PEs that have been tested in intestinal delivery models. In depth analysis of pre-clinical data is presented for PEs as components of proprietary delivery systems that have progressed to clinical trials. Given the importance of co-presentation of sufficiently high concentrations of PE and peptide at the small intestinal epithelium, there is an emphasis on studies where PEs have been formulated with poorly permeable molecules in solid dosage forms and lipoidal dispersions.
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Plant extracts as supplements for lactating sows: effects on piglet performance, sow food intake and diet digestibility. ACTA ACUST UNITED AC 2016. [DOI: 10.1017/s1357729800058987] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe objective of this study was to evaluate the ability of the plant extracts Yucca shidigera, Quillaja saponaria and a combination (a blend of capsicum, carvacrol and cinnamaldehyde) to stimulate piglet and sow performance when used as supplements in the diets of lactating sows. These extracts were selected for their potential benefits to health, appetite and digestion. Eighty hybrid sows were housed in conventional indoor farrowing crates from day 107 of gestation until weaning. Sows were allocated according to parity, live weight, fatness and past reproductive performance, to one of four dietary treatments: control (C), combination (COM, 100 g/t food), yucca (Y, 200 g/t), quillaja (Q, 250 g/t). Between days 107 to 114 of gestation, sows received 2·5 kg food per day of their respective diet. During lactation food was offered ad libitum with sow food intake (FI) recorded daily. Faecal samples were obtained from sows daily in order to measure diet digestibility using titanium dioxide as an external marker. Piglet live weight and sow P2 backfat were recorded on days 1, 7, 14 and 21 and at weaning on day 23 (s.e.2·5). Piglet live weight and rectal temperature were measured at birth and 24 h of age. Piglet growth between birth and 24 h was significantly affected by sow treatment. Litters from COM sows held the greatest advantage (117 v. C 99, Q 77, Y 107 g per pig per day, P < 0·01, s.e. = 7·9). Piglet body temperature at birth was also higher in COM litters when compared with treatment C (38·58 v. 37·95oC, P < 0·05)). Q and Y piglets were intermediate between the two. Sow treatment had no effect on piglet performance between day 1 and 14 of lactation. However, between days 15 and 21, piglets from COM sows again significantly outperformed all other treatments (COM 290, C 246, Q 235, Y 255 g per pig per day, P < 0·001, s.e. = 9·3). Piglet weights on day 21 were also significantly greater for the COM sows (6878 g v. C 6584 g, Q 6330 g, Y 6498 g, P < 0·05 s.e. = 132). No benefit was seen from supplementation with either yucca or quillaja extracts on piglet growth. Sow FI and P2 backfat loss between parturition and weaning were unaffected by treatment. However, diet digestibility was enhanced by all supplements during week 1 of lactation in terms of dry matter, organic matter and crude protein. It is concluded that some plant extracts may enhance piglet and sow performance prior to weaning.
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Mine T, Miyamoto H, Yoshikawa N, Fumoto S, Sasaki H, Nakamura J, Nishida K. Effect of absorption enhancers on the absorption of FD-4 as a poorly absorbable marker macromolecule from the liver surface in rats. J Drug Deliv Sci Technol 2014. [DOI: 10.1016/s1773-2247(14)50078-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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A permeation enhancer for increasing transport of therapeutic macromolecules across the intestine. J Control Release 2013; 172:541-9. [PMID: 23680288 DOI: 10.1016/j.jconrel.2013.05.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 04/29/2013] [Accepted: 05/06/2013] [Indexed: 01/03/2023]
Abstract
Delivery of therapeutic macromolecules is limited by the physiological limitations of the gastrointestinal tract including poor intestinal permeability, low pH and enzymatic activity. Several permeation enhancers have been proposed to enhance intestinal permeability of macromolecules; however their utility is often hindered by toxicity and limited potency. Here, we report on a novel permeation enhancer, Dimethyl palmitoyl ammonio propanesulfonate (PPS), with excellent enhancement potential and minimal toxicity. PPS was tested for dose- and time-dependent cytotoxicity, delivery of two model fluorescent molecules, sulforhodamine-B and FITC-insulin in vitro, and absorption enhancement of salmon calcitonin (sCT) in vivo. Caco-2 studies revealed that PPS is an effective enhancer of macromolecular transport while being minimally toxic. TEER measurements in Caco-2 monolayers confirmed the reversibility of the effect of PPS. Confocal microscopy studies revealed that molecules permeate via both paracellular and transcellular pathways in the presence of PPS. In vivo studies in rats showed that PPS enhanced relative bioavailability of sCT by 45-fold after intestinal administration. Histological studies showed that PPS does not induce damage to the intestine. PPS is an excellent permeation enhancer which provides new opportunities for developing efficacious oral/intestinal delivery systems for therapeutic macromolecules.
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12
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Use of 'natural' products as alternatives to antibiotic feed additives in ruminant production. Animal 2012; 1:1443-66. [PMID: 22444918 DOI: 10.1017/s1751731107000742] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The banning in 2006 of the use of antibiotics as animal growth promoters in the European Union has increased demand from producers for alternative feed additives that can be used to improve animal production. This review gives an overview of the most common non-antibiotic feed additives already being used or that could potentially be used in ruminant nutrition. Probiotics, dicarboxylic acids, enzymes and plant-derived products including saponins, tannins and essential oils are presented. The known modes of action and effects of these additives on feed digestion and more especially on rumen fermentations are described. Their utility and limitations in field conditions for modern ruminant production systems and their compliance with the current legislation are also discussed.
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13
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Chen JL, Bahna SL. Spice allergy. Ann Allergy Asthma Immunol 2011; 107:191-9; quiz 199, 265. [PMID: 21875536 DOI: 10.1016/j.anai.2011.06.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 06/24/2011] [Accepted: 06/25/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To provide a review on spice allergy and its implementation in clinical practice. DATA SOURCES PubMed searches were performed using spice allergy as the keyword for original and review articles. Selected references were also procured from the reviewed articles' references list. STUDY SELECTION Articles were selected based on their relevance to the topic. RESULTS Spices are available in a large variety and are widely used, often as blends. Spice allergy seems to be rare, reportedly affecting between 4 and 13 of 10,000 adults and occurring more often in women because of cosmetic use. No figures were available on children. Most spice allergens are degraded by digestion; therefore, IgE sensitization is mostly through inhalation of cross-reacting pollens, particularly mugwort and birch. The symptoms are more likely to be respiratory when exposure is by inhalation and cutaneous if by contact. Studies on skin testing and specific IgE assays are limited and showed low reliability. The diagnosis primarily depends on a good history taking and confirmation with oral challenge. The common use of spice blends makes identifying the particular offending component difficult, particularly because their components are inconsistent. CONCLUSION Spices are widely used and contain multiple allergens, yet spice allergy is probably markedly underdiagnosed. There is a need for reliable skin testing extracts and serum specific IgE assays. Currently, the diagnosis depends on a good history taking and well-designed titrated challenge testing. Until immunotherapy becomes developed, treatment is strict avoidance, which may be difficult because of incomplete or vague labeling.
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Affiliation(s)
- James L Chen
- Allergy and Immunology Section, Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
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14
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Carlson D, Fernandez JA, Poulsen HD, Nielsen B, Jacobsen SE. Effects of quinoa hull meal on piglet performance and intestinal epithelial physiology. J Anim Physiol Anim Nutr (Berl) 2011; 96:198-205. [DOI: 10.1111/j.1439-0396.2011.01138.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Weng A, Jenett-Siems K, Görick C, Melzig MF. Enhancement of cytotoxicity of ribosome-inactivating-protein type I by saponinum album is not based on stimulation of phagocytosis. J Pharm Pharmacol 2010; 60:925-30. [DOI: 10.1211/jpp.60.7.0015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Saponinum album, a mixture of triterpenoic saponins derived from Gypsophila species, led to an increased internalization of agrostin, a ribosome-inactivating-protein (RIP) type I in U-937 cells differentiated with interferon-γ or phorbol myristate acetate. Treatment with agrostin only showed no cytotoxicity. It was hypothesized that saponinum album stimulated phagocytosis and by that the uptake of agrostin. For this purpose phagocytosis experiments with Alexa-Fluor-488-labelled 1-μm amino-latex beads and FITC-labelled Escherichia coli (K-12 strain) were performed. The results indicated no stimulation of phagocytosis by treatment with saponinum album.
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Affiliation(s)
- A Weng
- Institute of Pharmacy, Free University Berlin, Königin-Luise-Str. 2 + 4, D-14195 Berlin, Germany
| | - K Jenett-Siems
- Institute of Pharmacy, Free University Berlin, Königin-Luise-Str. 2 + 4, D-14195 Berlin, Germany
| | - C Görick
- Institute of Pharmacy, Free University Berlin, Königin-Luise-Str. 2 + 4, D-14195 Berlin, Germany
| | - M F Melzig
- Institute of Pharmacy, Free University Berlin, Königin-Luise-Str. 2 + 4, D-14195 Berlin, Germany
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Knudsen D, Jutfelt F, Sundh H, Sundell K, Koppe W, Frøkiaer H. Dietary soya saponins increase gut permeability and play a key role in the onset of soyabean-induced enteritis in Atlantic salmon ( Salmo salar L.). Br J Nutr 2008; 100:120-9. [PMID: 18167174 DOI: 10.1017/s0007114507886338] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Saponins are naturally occurring amphiphilic molecules and have been associated with many biological activities. The aim of the present study was to investigate whether soya saponins trigger the onset of soyabean-induced enteritis in Atlantic salmon (Salmo salar L.), and to examine if dietary soya saponins increase the epithelial permeability of the distal intestine in Atlantic salmon. Seven experimental diets containing different levels of soya saponins were fed to seawater-adapted Atlantic salmon for 53 d. The diets included a fishmeal-based control diet, two fishmeal-based diets with different levels of added soya saponins, one diet containing 25% lupin kernel meal, two diets based on 25% lupin kernel meal with different levels of added soya saponins, and one diet containing 25% defatted soyabean meal. The effect on intestinal morphology, intestinal epithelial permeability and faecal DM content was examined. Fish fed 25% defatted soyabean meal displayed severe enteritis, whereas fish fed 25% lupin kernel meal had normal intestinal morphology. The combination of soya saponins and fishmeal did not induce morphological changes but fish fed soya saponins in combination with lupin kernel meal displayed significant enteritis. Increased epithelial permeability was observed in fish fed 25% defatted soyabean meal and in fish fed soya saponin concentrate independent of the protein source in the feed. The study demonstrates that soya saponins, in combination with one or several unidentified components present in legumes, induce an inflammatory reaction in the distal intestine of Atlantic salmon. Soya saponins increase the intestinal epithelial permeability but do not, per se, induce enteritis.
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Affiliation(s)
- David Knudsen
- BioCentrum-DTU, Nutritional Immunology Group, Centre of Biological Sequence Analysis, Technical University of Denmark, Lyngby DK-2800, Denmark.
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17
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Whitehead K, Mitragotri S. Mechanistic Analysis of Chemical Permeation Enhancers for Oral Drug Delivery. Pharm Res 2008; 25:1412-9. [DOI: 10.1007/s11095-008-9542-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 01/22/2008] [Indexed: 11/29/2022]
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18
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Pavei C, Guzatto P, Ros Petrovick P, Gosmann G, González‐Ortega G. Development and Validation of an HPLC Method for the Characterization and Assay of the Saponins from Ilex paraguariensis A. St.‐Hil (Mate) Fruits. J LIQ CHROMATOGR R T 2007. [DOI: 10.1080/10826070601034311] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Cabral Pavei
- a Faculdade de Farmácia, PPGCF , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, R.S., Brazil
| | - Paula Guzatto
- a Faculdade de Farmácia, PPGCF , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, R.S., Brazil
| | - Pedro Ros Petrovick
- a Faculdade de Farmácia, PPGCF , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, R.S., Brazil
| | - Grace Gosmann
- a Faculdade de Farmácia, PPGCF , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, R.S., Brazil
| | - George González‐Ortega
- a Faculdade de Farmácia, PPGCF , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, R.S., Brazil
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19
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Sim JS, Zhao HL, Li DW, Cho SY, Jeong CS, Lee EB, Kim YS. Effects of Saponins from the Root Bark of Aralia elata on the Transport of Chondroitin Sulfate in Caco-2 Cell Monolayers and Rats. Biol Pharm Bull 2005; 28:1043-8. [PMID: 15930742 DOI: 10.1248/bpb.28.1043] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We investigated the intestinal absorption enhancing effect of the saponins from the root bark of Aralia elata (SRBAE) in Caco-2 cell monolayers and rats. SRBAE at concentrations of 0.04% and 0.08% (w/v) decreased the transepithelial electrical resistance (TEER) values and increased the paracellular uptake of chondroitin sulfates (CSs) having different molecular weights (MW 500, 4500, and 18000) in a dose-dependent manner. We also evaluated the cytotoxicity of SRBAE to determine its proper concentration as an absorption enhancer. MTT assay and trypan blue exclusion test indicated that the cytotoxicity of SRBAE at concentrations of 0.04% and 0.08% was negligible. CS (MW 18000) was orally administered with or without SRBAE to rats. The oral administration of SRBAE (250 mg/kg) in 1 h increased the intestinal absorption of CS, by 4.9-fold versus the control (CS alone). Histological examination of the gastrointestinal tissues showed that SRBAE did not cause any damage to tissues. In conclusion, our results suggest that SRBAE acts as an efficient absorption enhancer and makes it easier for hydrophilic molecules to penetrate the intestinal epithelium.
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Affiliation(s)
- Joon-Soo Sim
- Natural Products Research Institute, College of Pharmacy, Seoul National University, Korea
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20
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Ilsley SE, Miller HM, Kamel C. Effects of dietary quillaja saponin and curcumin on the performance and immune status of weaned piglets1. J Anim Sci 2005; 83:82-8. [DOI: 10.2527/2005.83182x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Schöll I, Jensen-Jarolim E. Allergenic potency of spices: hot, medium hot, or very hot. Int Arch Allergy Immunol 2004; 135:247-61. [PMID: 15528928 DOI: 10.1159/000081950] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Spices are the most attractive ingredients to confer an authentic taste to food. As they are derived from plants, they harbour allergenic potency and can induce symptoms ranging from mild local to severe systemic reactions. Due to the content of pharmacologically active substances of spices, the diagnosis of allergy and the differentiation from intolerance reactions may be difficult. Association with inhalative allergies via IgE cross-reactivity, but also direct gastrointestinal sensitization plays a role. This article is a botanical and allergological overview of the most important spices and molecules responsible for eliciting IgE-mediated reactions or cross-reactions. As no curative treatments are known at present, strict avoidance is recommended and, therefore, accurate labelling of pre-packed food is necessary.
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Affiliation(s)
- Isabella Schöll
- Institute of Pathophysiology, Medical University of Vienna, Vienna, Austria
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22
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Hu J, Reddy MB, Hendrich S, Murphy PA. Soyasaponin I and sapongenol B have limited absorption by Caco-2 intestinal cells and limited bioavailability in women. J Nutr 2004; 134:1867-73. [PMID: 15284368 DOI: 10.1093/jn/134.8.1867] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A human study was conducted to evaluate soyasaponin bioavailability in humans. Eight healthy women ingested a single dose of concentrated soy extract containing 434 micromol of group B soyasaponins, the predominant form of soyasaponins in soybeans. Neither soyasaponins nor their metabolites were detected in a 24-h urine collection. Soyasapogenol B, a major metabolite of group B soyasaponins, was found (36.3 +/- 10.2 micromol) in a 5-d fecal collection but no group B soyasaponins were detected. A human colon cancer Caco-2 cell model was used to evaluate the absorbability of soyasaponins at the mucosal level. The mucosal transfers of soyasaponin I and soyasapogenol B were 0.5-2.9 and 0.2-0.8%, respectively, after 4-h incubation on the Caco-2 monolayer. The apical to basolateral absorptions of soyasaponin I and soyasapogenol B were low with P(app) of 0.9 to 3.6 x 10(-6) and 0.3 to 0.6 x 10(-6) cm/s, respectively. The transport rate and cell uptake of soyasaponin I were saturable and concentration-independent. In contrast, soyasapogenol B was taken up by Caco-2 cells in a concentration-dependent manner. Soyasaponin I had no apparent cytotoxic effect on Caco-2 cells at concentrations up to 3 mmol/L, whereas soyasapogenol B at 1 mmol/L or more significantly reduced cell viability. Therefore, ingested soyasaponins have low absorbability in human intestinal cells and seem to be metabolized to soyasapogenol B by human intestinal microorganisms in vivo and excreted in the feces.
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Affiliation(s)
- Jiang Hu
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011, USA
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Cho SY, Sim JS, Kang SS, Jeong CS, Linhardt RJ, Kim YS. Enhancement of heparin and heparin disaccharide absorption by thePhytolacca americana saponins. Arch Pharm Res 2003; 26:1102-8. [PMID: 14723347 DOI: 10.1007/bf02994765] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We studied the effects of phytolaccosides, saponins from Phytolacca americana, on the intestinal absorption of heparin in vitro and in vivo. The absorption enhancing activity of these compounds (phytolaccosides B, D2, E, F, G and I) was determined by changes in transepithelial electrical resistance (TEER) and the transport amount of heparin disaccharide, the major repeating unit of heparin, across Caco-2 cell monolayers. With the exception of phytolaccoside G, all of them decreased TEER values and increased the permeability in a dose-dependent and time-dependent manner. In vitro, phytolaccosides B, D2, and E showed significant absorption enhancing activities, while effects by phytolaccoside F and I were mild. In vivo, phytolaccoside E increased the activated partial thromboplastin time (APTT) and thrombin time, indicating that phytolaccoside E modulated the transport of heparin in intestinal route. Our results suggest that a series of phytolaccosides from Phytolacca americana can be applied as pharmaceutical excipients to improve the permeability of macromolecules and hydrophilic drugs having difficulty in absorption across the intestinal epithelium.
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Affiliation(s)
- So Yean Cho
- Natural Products Research Institute, College of Pharmacy Seoul National University, Seoul 110-460, Korea
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Abstract
The rapid integration of new technologies by the pharmaceutical industry has resulted in numerous breakthroughs in the discovery, development and manufacturing of pharmaceutical products. In particular, the commercial-scale production of high-purity recombinant proteins has resulted in important additions to treatment options for many large therapeutic areas. In addition to proteins, other macromolecules, such as the animal-derived mucopolysaccharide heparins, have also seen dramatic growth as injectable pharmaceutical products. To date, macromolecules have been limited as therapeutics by the fact that they cannot be orally delivered. This article will address the current status and future possibilities of oral macromolecular drug delivery.
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Affiliation(s)
- Michael Goldberg
- Emisphere Technologies Inc, 765 Old Saw Mill River Road Tarrytown, New York 10591, USA.
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Francis G, Kerem Z, Makkar HPS, Becker K. The biological action of saponins in animal systems: a review. Br J Nutr 2002; 88:587-605. [PMID: 12493081 DOI: 10.1079/bjn2002725] [Citation(s) in RCA: 705] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Saponins are steroid or triterpenoid glycosides, common in a large number of plants and plant products that are important in human and animal nutrition. Several biological effects have been ascribed to saponins. Extensive research has been carried out into the membrane-permeabilising, immunostimulant, hypocholesterolaemic and anticarcinogenic properties of saponins and they have also been found to significantly affect growth, feed intake and reproduction in animals. These structurally diverse compounds have also been observed to kill protozoans and molluscs, to be antioxidants, to impair the digestion of protein and the uptake of vitamins and minerals in the gut, to cause hypoglycaemia, and to act as antifungal and antiviral agents. These compounds can thus affect animals in a host of different ways both positive and negative.
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Affiliation(s)
- George Francis
- Department of Aquaculture Systems and Animal Nutrition, Institute for Animal Production in the Tropics and Subtropics, University of Hohenheim (480), D 70593 Stuttgart, Germany
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Lentz KA, Hayashi J, Lucisano LJ, Polli JE. Development of a more rapid, reduced serum culture system for Caco-2 monolayers and application to the biopharmaceutics classification system. Int J Pharm 2000; 200:41-51. [PMID: 10845684 DOI: 10.1016/s0378-5173(00)00334-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The objectives were: (1) to develop a more rapid, reduced serum culture system for Caco-2 monolayers, relative to the traditional 21-day, 10% fetal bovine serum (FBS) system; and (2) to determine the biopharmaceutical drug classification of an oral therapeutic agent using this new system. Caco-2 cells were grown in the six well format on polycarbonate filters, in medium containing 2% iron supplemented calf serum (sCS) and a combination of growth factors and hormones. After 4 days in culture, permeabilities of three marker compounds (metoprolol, mannitol, and taurocholate) across monolayers were determined, and compared to permeabilities from the traditional 21-day, 10% FBS system, using cells at similar passage number. Cell morphology, degree of cell differentiation, and the presence of two efflux pumps were assessed. The 2% sCS model was also used to classify the permeability of an oral therapeutic agent as high or low. No difference in permeability was observed for metoprolol transport (P = 0.38) between the two culture methods, and the values obtained were independent of passage number of the cells. Mannitol permeability was about 2-fold higher from the 2% sCS system, as compared to the 10% FBS system. Taurocholate permeability was low indicating the 2% sCS culture at 4 days lacked this particular active transporter capability. Electron micrographs of cells grown in the 2% sCS system at 4 days revealed the presence of microvilli and tight junctions. P-glycoprotein and an efflux pump for furosemide were functionally present. The 2% sCS system indicated the oral therapeutic agent as highly permeable, which agreed with the 10% FBS system. This new system provides a rapid, accurate, and economical option for passive permeability determination, and appears to be applicable to the proposed Biopharmaceutics Classification System (BCS).
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Affiliation(s)
- K A Lentz
- School of Pharmacy, University of Maryland, Baltimore 21201, USA
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27
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Abstract
This review addresses the field of improving oral bioavailability through the use of excipients that increase intestinal membrane permeability. The critical issues to consider in evaluating these approaches are 1) the extent of bioavailability enhancement achieved, 2) the influence of formulation and physiological variables, 3) toxicity associated with permeation enhancement, and 4) the mechanism of permeation enhancement. The categories of permeation enhancers discussed are surfactants, fatty acids, medium chain glycerides, steroidal detergents, acyl carnitine and alkanoylcholines, N-acetylated alpha-amino acids and N-acetylated non-alpha-amino acids, and chitosans and other mucoadhesive polymers. Some of these approaches have been developed to the stage of initial clinical trials. Several seem to have potential to improve oral bioavailabilities of poorly absorbed compounds without causing significant intestinal damage. In addition, the possible use of excipients that inhibit secretory transport is reviewed.
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Affiliation(s)
- B J Aungst
- DuPont Pharmaceuticals Co., P. O. Box 80400, Wilmington, DE 19880-0400, USA.
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28
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Chao AC, Nguyen JV, Broughall M, Griffin A, Fix JA, Daddona PE. In vitro and in vivo evaluation of effects of sodium caprate on enteral peptide absorption and on mucosal morphology. Int J Pharm 1999; 191:15-24. [PMID: 10556736 DOI: 10.1016/s0378-5173(99)00213-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sodium salts of medium-chain fatty acids, sodium caprate (C10) in particular, have been used as absorption-enhancing agents to promote transmucosal drug absorption. In this study, we conducted both in vitro and in vivo experiments to investigate the effects of C10 on intestinal permeabilities and mucosal morphology. Mucosal addition of C10 (13-25 mM) reduced the transepithelial electric resistance (TEER) of cultured monolayers of the human intestinal cell line Caco-2 by 40-65% and, upon removal of C10, a marked tendency of TEER recovery was recorded. C10 added mucosally at 13-50 mM increased the transports of mannitol and polyethylene glycol (PEG) 900 across Caco-2 in a dose-dependent manner. In contrast, the transport of a model D-decapeptide was maximally enhanced with 20-25 mM C10. No noticeable morphological alteration of the Caco-2 monolayers was observed after a 1-h mucosal pretreatment with C10. Co-delivery with C10 (0.05-0.5 mmol/kg) into the rat terminal ileum increased the D-decapeptide bioavailability (BA) dose-dependently. With 0.5 mmol/kg C10 co-administered, D-decapeptide percent BA was elevated from 2 to 11%. Following a 1-h incubation with 0.5 mmol/kg C10 (in liquid or powder form) non-invasively delivered into the rectal lumen, no signs of histological change in the rectal mucosa were detected. These results demonstrate that C10 can promote intestinal absorption of a small peptide without causing detrimental alterations of the intestinal mucosa. C10 thus seems to be a good candidate as an enhancing agent for improving the oral BA of small therapeutic peptides.
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Affiliation(s)
- A C Chao
- Biological Sciences, ALZA Corporation, 950 Page Mill Road, Palo Alto, CA 94303-0802, USA
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