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Zhang M, Shi L, Chen L, Liu Z, Zhao T, Zhu C, Yang L. A water mediated multicomponent reaction for the synthesis of novel spirooxindole derivatives and their antifungal activity. Org Biomol Chem 2024; 22:3459-3467. [PMID: 38597668 DOI: 10.1039/d4ob00256c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
A water mediated three-component reaction of isatin, 4-aminocoumarin, and 1,3-cyclodicarbonyl compounds is reported for the synthesis of spiro[chromeno[4,3-b]cyclopenta[e]pyridine-7,3'-indoline]trione and the spiro[chromeno[4,3-b]quinoline 7,3'-indoline]trione. Up to 27 different spirooxindole derivatives were synthesized by this method. The bioactivity of these spirooxindole derivatives was evaluated and they were found to show antifungal activity against Cercospora arachidicola, Physalospora piricola, Rhizoctonia cerealis, and Fusarium moniliforme.
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Affiliation(s)
- Min Zhang
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013, PR China.
| | - Liang Shi
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013, PR China.
| | - Li Chen
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013, PR China.
| | - Zhengyu Liu
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013, PR China.
| | - Ting Zhao
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013, PR China.
| | - Chunyin Zhu
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013, PR China.
| | - Liuqing Yang
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013, PR China.
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Annuar NAK, Azlan UK, Mediani A, Tong X, Han R, Al-Olayan E, Baharum SN, Bunawan H, Sarian MN, Hamezah HS, Jantan I. An insight review on the neuropharmacological effects, mechanisms of action, pharmacokinetics and toxicity of mitragynine. Biomed Pharmacother 2024; 171:116134. [PMID: 38219389 DOI: 10.1016/j.biopha.2024.116134] [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: 10/25/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024] Open
Abstract
Mitragynine is one of the main psychoactive alkaloids in Mitragyna speciosa Korth. (kratom). It has opium-like effects by acting on μ-, δ-, and κ-opioid receptors in the brain. The compound also interacts with other receptors, such as adrenergic and serotonergic receptors and neuronal Ca2+ channels in the central nervous system to have its neuropharmacological effects. Mitragynine has the potential to treat diseases related to neurodegeneration such as Alzheimer's disease and Parkinson's disease, as its modulation on the opioid receptors has been reported extensively. This review aimed to provide an up-to-date and critical overview on the neuropharmacological effects, mechanisms of action, pharmacokinetics and safety of mitragynine as a prospective psychotropic agent. Its multiple neuropharmacological effects on the brain include antinociceptive, anti-inflammatory, antidepressant, sedative, stimulant, cognitive, and anxiolytic activities. The potential of mitragynine to manage opioid withdrawal symptoms related to opioid dependence, its pharmacokinetics and toxic effects were also discussed. The interaction of mitragynine with various receptors in the brain produce diverse neuropharmacological effects, which have beneficial properties in neurological disorders. However, further studies need to be carried out on mitragynine to uncover its complex mechanisms of action, pharmacokinetics, pharmacodynamic profiles, addictive potential, and safe dosage to prevent harmful side effects.
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Affiliation(s)
- Nur Aisyah Khairul Annuar
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Ummi Kalthum Azlan
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Ahmed Mediani
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Xiaohui Tong
- School of Life Sciences, Anhui University of Chinese Medicine, Hefei, China
| | - Rongchun Han
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, China
| | - Ebtesam Al-Olayan
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Syarul Nataqain Baharum
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Hamidun Bunawan
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Murni Nazira Sarian
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
| | - Hamizah Shahirah Hamezah
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia.
| | - Ibrahim Jantan
- Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia
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Bowe A, Kerr PL. Endogenous Opioid Activity as the Mechanism of Action for Mitragyna speciosa (Kratom): The Current State of the Evidence. ADVANCES IN NEUROBIOLOGY 2024; 35:287-313. [PMID: 38874729 DOI: 10.1007/978-3-031-45493-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Kratom (Mitragyna speciosa) is a substance derived from botanical compounds native to Southeast Asia. This substance has been cultivated predominantly in Thailand, Malaysia, Vietnam, and Myanmar, where it has historically been used in traditional medicine as a near panacea for several health problems. Such ritualistic use of kratom has been present for centuries; however, recreational use appears to have increased globally, especially in the United States. Pharmacodynamic and pharmacokinetic studies have found that kratom demonstrates a unique parabolic, dose-dependent pattern of effects ranging from stimulation to opioid and analgesic effects. Pharmacological research indicates that kratom is both a mu opioid receptor (μ-OR; MOR) and a kappa opioid receptor (κ-OR; KOR) agonist, which mediates its analgesic effects. Other research suggests that kratom may simultaneously act on dopaminergic and serotonergic receptors, which mediate its stimulant effects. This chapter reviews the literature related to the structural, functional, and cultural characteristics of kratom use. We begin with an overview of current and historical patterns of kratom, followed by a review of data on the pharmacodynamics and pharmacokinetics of kratom thus far.
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MESH Headings
- Mitragyna
- Humans
- Plant Extracts/pharmacology
- Animals
- Receptors, Opioid, kappa/metabolism
- Receptors, Opioid, kappa/agonists
- Analgesics, Opioid/pharmacology
- Analgesics, Opioid/therapeutic use
- Receptors, Opioid, mu/metabolism
- Receptors, Opioid, mu/agonists
- Asia, Southeastern
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Affiliation(s)
- Adina Bowe
- West Virginia University School of Medicine-Charleston, Charleston, WV, USA.
| | - Patrick L Kerr
- West Virginia University School of Medicine-Charleston, Charleston, WV, USA
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Basheer M, Khudhair Jasim R, Harn GL. Controversial usages of kratom ( Mitragyna speciosa): For good or for evil. World J Pharmacol 2022; 11:16-26. [DOI: 10.5497/wjp.v11.i3.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/04/2022] [Accepted: 11/23/2022] [Indexed: 11/28/2022] Open
Abstract
Kratom (Mitragyna speciosa) is a plant that grows well in tropical climates such as in Southeast Asia. Traditionally, people discovered it possessed a stimulating effect that relieved tiredness. Furthermore, it contains analgesic and medicinal properties for the treatment of pain, diarrhea, muscle discomfort, and blood pressure and to enhance stamina. Nevertheless, long term or regular consumption of kratom leads to addiction. This is because the main alkaloid of kratom, mitragynine, binds to opioid receptors and exerts a euphoric effect similar to that of morphine, which may lead to death. Due to this reason, kratom has been listed as a regulated substance in many countries including the United States, Thailand, Malaysia, Bhutan, Finland, Lithuania, Denmark, Poland, Sweden, Australia, and Myanmar. Usages of kratom carry two pharmacological effects depending on dosage. Low-dose kratom exerts a stimulating effect that refreshes the user. High-dose kratom exerts sedative effects that can lead to addiction similar to that of morphine. Despite the euphoric effect of kratom, the beneficial values of kratom to human health is indisputable. Therefore, a complete banning of kratom may cause a loss to pharmaceutical industry. Rather, a controlled or selective usage of kratom will be a better choice.
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Affiliation(s)
- Murtadha Basheer
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
| | - Rana Khudhair Jasim
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
| | - Gam Lay Harn
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
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Berthold EC, Kamble SH, Raju KS, Kuntz MA, Senetra AS, Mottinelli M, León F, Restrepo LF, Patel A, Ho NP, Hiranita T, Sharma A, McMahon LR, McCurdy CR. The Lack of Contribution of 7-Hydroxymitragynine to the Antinociceptive Effects of Mitragynine in Mice: A Pharmacokinetic and Pharmacodynamic Study. Drug Metab Dispos 2022; 50:158-167. [PMID: 34759012 PMCID: PMC8969138 DOI: 10.1124/dmd.121.000640] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/05/2021] [Indexed: 02/03/2023] Open
Abstract
Kratom (Mitragyna speciosa), a Southeast Asian tree, has been used for centuries in pain relief and mitigation of opium withdrawal symptoms. Mitragynine (MTG), the major kratom alkaloid, is being investigated for its potential to provide analgesia without the deleterious effects associated with typical opioids. Concerns have been raised regarding the active metabolite of MTG, 7-hydroxymitragynine (7HMG), which has higher affinity and efficacy at µ-opioid receptors than MTG. Here we investigated the hotplate antinociception, pharmacokinetics, and tissue distribution of MTG and 7HMG at equianalgesic oral doses in male and female C57BL/6 mice to determine the extent to which 7HMG metabolized from MTG accounts for the antinociceptive effects of MTG and investigate any sex differences. The mechanism of action was examined by performing studies with the opioid receptor antagonist naltrexone. A population pharmacokinetic/pharmacodynamic model was developed to predict the behavioral effects after administration of various doses of MTG and 7HMG. When administered alone, 7HMG was 2.8-fold more potent than MTG to produce antinociception. At equivalent effective doses of MTG and 7HMG, there was a marked difference in the maximum brain concentration of 7HMG achieved, i.e., 11-fold lower as a metabolite of MTG. The brain concentration of 7HMG observed 4 hours post administration, producing an analgesic effect <10%, was still 1.5-fold higher than the maximum concentration of 7HMG as a metabolite of MTG. These results provide strong evidence that 7HMG has a negligible role in the antinociceptive effects of MTG in mice. SIGNIFICANCE STATEMENT: Mitragynine (MTG) is being investigated for its potential to aid in pain relief, opioid withdrawal syndrome, and opioid use disorder. The active metabolite of MTG, 7-hydroxymitragynine (7HMG), has been shown to have abuse potential and has been implicated in the opioid-like analgesic effect after MTG administration. The results of this study suggest a lack of involvement of 7HMG in the antinociceptive effects of MTG in mice.
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Affiliation(s)
- Erin C Berthold
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Shyam H Kamble
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Kanumuri S Raju
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Michelle A Kuntz
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Alexandria S Senetra
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Marco Mottinelli
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Francisco León
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Luis F Restrepo
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Avi Patel
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Nicholas P Ho
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Takato Hiranita
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Lance R McMahon
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Christopher R McCurdy
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
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Hiranita T, Obeng S, Sharma A, Wilkerson JL, McCurdy CR, McMahon LR. In vitro and in vivo pharmacology of kratom. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 93:35-76. [PMID: 35341571 DOI: 10.1016/bs.apha.2021.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Kratom products have been historically and anecdotally used in south Asian countries for centuries to manage pain and opioid withdrawal. The use of kratom products has dramatically increased in the United States. More than 45 kratom alkaloids have been isolated, yet the overall pharmacology of the individual alkaloids is still not well characterized. The purpose of this chapter is to summarize in vitro and in vivo opioid activities of the primary kratom alkaloid mitragynine and its more potent metabolite 7-hydroxymitragynine. Following are experimental procedures described to characterize opioid receptor activity; receptor binding and functional assays, antinociceptive assays, operant conditioning assays, and respiratory plethysmography. The capacity of kratom alkaloids to confer tolerance and physical dependence as well as their pharmacokinetic properties are also summarized. The data reviewed here suggest that kratom products and mitragynine possess low efficacy agonist activity at the mu-opioid receptor in vivo. In addition, kratom products and mitragynine have been demonstrated to antagonize the effects of high efficacy mu-opioid agonists. The data further suggest that 7-hydroxymitragynine formed in vivo by metabolism of mitragynine may be minimally involved in the overall behavioral profile of mitragynine and kratom, whereas 7-hydroxymitragynine itself, at sufficiently high doses administered exogenously, shares many of the same abuse- and dependence-related behavioral effects associated with traditional opioid agonists. The apparent low efficacy of kratom products and mitragynine at mu-opioid receptors supports the development of these ligands as effective and potentially safe medications for opioid use disorder.
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Affiliation(s)
- Takato Hiranita
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Samuel Obeng
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Translational Drug Development Core, Clinical and Translational Sciences Institute, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Jenny L Wilkerson
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, United States; Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, United States; Translational Drug Development Core, Clinical and Translational Sciences Institute, College of Pharmacy, University of Florida, Gainesville, FL, United States
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, United States.
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Hanapi NA, Chear NJY, Azizi J, Yusof SR. Kratom Alkaloids: Interactions With Enzymes, Receptors, and Cellular Barriers. Front Pharmacol 2021; 12:751656. [PMID: 34867362 PMCID: PMC8637859 DOI: 10.3389/fphar.2021.751656] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/26/2021] [Indexed: 01/11/2023] Open
Abstract
Parallel to the growing use of kratom, there is a wealth of evidence from self-report, preclinical, and early clinical studies on therapeutic benefits of its alkaloids in particular for treating pain, managing substance use disorder, and coping with emotional or mental health conditions. On the other hand, there are also reports on potential health risks concerning kratom use. These two aspects are often discussed in reviews on kratom. Here, we aim to highlight specific areas that are of importance to give insights into the mechanistic of kratom alkaloids pharmacological actions. This includes their interactions with drug-metabolizing enzymes and predictions of clinical drug-drug interactions, receptor-binding properties, interactions with cellular barriers in regards to barrier permeability, involvement of membrane transporters, and alteration of barrier function when exposed to the alkaloids.
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Affiliation(s)
- Nur Aziah Hanapi
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia
| | | | - Juzaili Azizi
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia
| | - Siti R Yusof
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia
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Omar F, Tareq AM, Alqahtani AM, Dhama K, Sayeed MA, Emran TB, Simal-Gandara J. Plant-Based Indole Alkaloids: A Comprehensive Overview from a Pharmacological Perspective. Molecules 2021; 26:molecules26082297. [PMID: 33921093 PMCID: PMC8071433 DOI: 10.3390/molecules26082297] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
Plant-based indole alkaloids are very rich in pharmacological activities, and the indole nucleus is considered to contribute greatly to these activities. This review's fundamental objective is to summarize the pharmacological potential of indole alkaloids that have been derived from plants and provide a detailed evaluation of their established pharmacological activities, which may contribute to identifying new lead compounds. The study was performed by searching various scientific databases, including Springer, Elsevier, ACS Publications, Taylor and Francis, Thieme, Wiley Online Library, ProQuest, MDPI, and online scientific books. A total of 100 indole compounds were identified and reviewed. The most active compounds possessed a variety of pharmacological activities, including anticancer, antibacterial, antiviral, antimalarial, antifungal, anti-inflammatory, antidepressant, analgesic, hypotensive, anticholinesterase, antiplatelet, antidiarrheal, spasmolytic, antileishmanial, lipid-lowering, antimycobacterial, and antidiabetic activities. Although some compounds have potent activity, some only have mild-to-moderate activity. The pharmacokinetic profiles of some of the identified compounds, such as brucine, mitragynine, 7-hydroxymitragynine, vindoline, and harmane, were also reviewed. Most of these compounds showed promising pharmacological activity. An in-depth pharmacological evaluation of these compounds should be performed to determine whether any of these indoles may serve as new leads.
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Affiliation(s)
- Faisal Omar
- Department of Pharmacy, International Islamic University Chittagong, Chittagong 4318, Bangladesh; (F.O.); (A.M.T.)
| | - Abu Montakim Tareq
- Department of Pharmacy, International Islamic University Chittagong, Chittagong 4318, Bangladesh; (F.O.); (A.M.T.)
| | - Ali M. Alqahtani
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia;
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Mohammed Abu Sayeed
- Department of Pharmacy, International Islamic University Chittagong, Chittagong 4318, Bangladesh; (F.O.); (A.M.T.)
- Correspondence: (M.A.S.); (T.B.E.); (J.S.-G.); Tel.: +88-0-167-041-9435 (M.A.S.); +88-0-181-994-2214 (T.B.E.); +34-988-387000 (J.S.-G.)
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh
- Correspondence: (M.A.S.); (T.B.E.); (J.S.-G.); Tel.: +88-0-167-041-9435 (M.A.S.); +88-0-181-994-2214 (T.B.E.); +34-988-387000 (J.S.-G.)
| | - Jesus Simal-Gandara
- Nutrition and Bromatology Group, Department of Analytical and Food Chemistry, Faculty of Food Science and Technology, University of Vigo—Ourense Campus, E32004 Ourense, Spain
- Correspondence: (M.A.S.); (T.B.E.); (J.S.-G.); Tel.: +88-0-167-041-9435 (M.A.S.); +88-0-181-994-2214 (T.B.E.); +34-988-387000 (J.S.-G.)
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9
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Maxwell EA, King TI, Kamble SH, Raju KSR, Berthold EC, León F, Hampson A, McMahon LR, McCurdy CR, Sharma A. Oral Pharmacokinetics in Beagle Dogs of the Mitragynine Metabolite, 7-Hydroxymitragynine. Eur J Drug Metab Pharmacokinet 2021; 46:459-463. [PMID: 33847897 DOI: 10.1007/s13318-021-00684-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES 7-Hydroxymitragynine (7-HMG) is an oxidative metabolite of mitragynine, the most abundant alkaloid in the leaves of Mitragyna speciosa (otherwise known as kratom). While mitragynine is a weak partial µ-opioid receptor (MOR) agonist, 7-HMG is a potent and full MOR agonist. It is produced from mitragynine by cytochrome P450 (CYP) 3A, a drug-metabolizing CYP isoform predominate in the liver that is also highly expressed in the intestine. Given the opioidergic potency of 7-HMG, a single oral dose pharmacokinetic and safety study of 7-HMG was performed in beagle dogs. METHODS Following a single oral dose (1 mg/kg) of 7-HMG, plasma samples were obtained from healthy female beagle dogs. Concentrations of 7-HMG were determined using ultra-performance liquid chromatography coupled with a tandem mass spectrometer (UPLC-MS/MS). Pharmacokinetic parameters were calculated using a model-independent non-compartmental analysis of plasma concentration-time data. RESULTS Absorption of 7-HMG was rapid, with a peak plasma concentration (Cmax, 56.4 ± 1.6 ng/ml) observed within 15 min post-dose. In contrast, 7-HMG elimination was slow, exhibiting a mono-exponential distribution and mean elimination half-life of 3.6 ± 0.5 h. Oral dosing of 1 mg/kg 7-HMG was well tolerated with no observed adverse events or significant changes to clinical laboratory tests. CONCLUSIONS These results provide the first pharmacokinetic and safety data for 7-HMG in the dog and therefore contribute to the understanding of the putative pharmacologic role of 7-HMG resulting from an oral delivery of mitragynine from kratom.
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Affiliation(s)
- Elizabeth A Maxwell
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Tamara I King
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Shyam H Kamble
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USA.,Translational Drug Development Core, Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA
| | - Kanumuri Siva Rama Raju
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USA.,Translational Drug Development Core, Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA
| | - Erin C Berthold
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Francisco León
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Aidan Hampson
- Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Christopher R McCurdy
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USA. .,Translational Drug Development Core, Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA. .,Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA.
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL, USA. .,Translational Drug Development Core, Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.
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10
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Abstract
Abstract
Purpose
This paper examines the scope of anorectics in counterfeit weight-reducing formulations and provides insight into the present state of research in determining such adulterants. Analytical techniques utilised in profiling adulterants found in slimming products, including limitations and mitigation steps of these conventional methods are also discussed. The current legal status of the anorectics and analogues routinely encountered in non-prescription slimming formulations is also explored.
Methods
All reviewed literature was extracted from Scopus, Web of Science, PubMed, and Google Scholar databases using relevant search terms, such as, ‘counterfeit drugs’, ‘weight loss drugs’, ‘weight-reducing drugs’, ‘slimming drugs’, ‘anorectic agents’, and ‘counterfeit anorexics’. Legislation related to anorectics was obtained from the portals of various government and international agencies.
Results
Anorectics frequently profiled in counterfeit slimming formulations are mostly amphetamine derivatives or its analogues. Five routinely reported pharmacological classes of adulterants, namely anxiolytics, diuretics, antidepressants, laxatives, and stimulants, are mainly utilised as coadjuvants in fake weigh-reducing formulations to increase bioavailability or to minimise anticipated side effects. Liquid and gas chromatography coupled with mass spectrometric detectors are predominantly used techniques for anorectic analysis due to the possibility of obtaining detailed information of adulterants. However, interference from the complex sample matrices of these fake products limits the accuracy of these methods and requires robust sample preparation methods for enhanced sensitivity and selectivity. The most common anorectics found in counterfeit slimming medicines are either completely banned or available by prescription only, in many countries.
Conclusions
Slimming formulations doped with anorectic cocktails to boost their weight-reducing efficacy are not uncommon. Liquid chromatography combined with mass spectrometry remains the gold standard for counterfeit drug analysis, and requires improved preconcentration methods for rapid and quantitative identification of specific chemical constituents. Extensive method development and validation, targeted at refining existing techniques while developing new ones, is expected to improve the analytical profiling of counterfeit anorectics significantly.
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11
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Hu Y, Zeng H, Huang J, Jiang L, Chen J, Zeng Q. Traditional Asian Herbs in Skin Whitening: The Current Development and Limitations. Front Pharmacol 2020; 11:982. [PMID: 32733239 PMCID: PMC7358643 DOI: 10.3389/fphar.2020.00982] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/17/2020] [Indexed: 12/13/2022] Open
Abstract
In Asia, the market for whitening cosmetics is expanding rapidly, more and more people prefer to use natural products. Driven by natural product demand and technical advances, herbal research is also developing fast. Lots of studies reported that Asian herbal reagents can reduce melanogenesis, these findings provide evidence for the whitening application of Asian herbs. However, the current development status and challenges of herbal research need attention too. By reviewing these studies, different problems in studying herbal formulas, extracts, and active ingredients were presented. One of the most influential troubles is that the components of herbs are too complex to obtain reliable results. Thus, an understanding of the overall quality of herbal research is necessary. Further, 90 most cited Asian herbal studies on whitening were collected, which were conducted between 2017 and 2020, then statistical analysis was carried out. This work provided a comprehensive understanding of Asian herbal research in skin whitening, including the overall status and quality, as well as the focuses and limitations of these studies. By proactively confronting and analyzing these issues, it is suggested that the focus of herbal medicine research needs to shift from quantity to quality, and the new stage of development should emphasize transformation from research findings to whitening products.
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Affiliation(s)
- Yibo Hu
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Hongliang Zeng
- Institute of Chinese Materia Medica, Hunan Academy of Chinese Medicine, Changsha, China
| | - Jinhua Huang
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ling Jiang
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jing Chen
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Qinghai Zeng
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
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12
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Birer-Williams C, Gufford BT, Chou E, Alilio M, VanAlstine S, Morley RE, McCune JS, Paine MF, Boyce RD. A New Data Repository for Pharmacokinetic Natural Product-Drug Interactions: From Chemical Characterization to Clinical Studies. Drug Metab Dispos 2020; 48:1104-1112. [PMID: 32601103 PMCID: PMC7543481 DOI: 10.1124/dmd.120.000054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022] Open
Abstract
There are many gaps in scientific knowledge about the clinical significance of pharmacokinetic natural product–drug interactions (NPDIs) in which the natural product (NP) is the precipitant and a conventional drug is the object. The National Center for Complimentary and Integrative Health created the Center of Excellence for NPDI Research (NaPDI Center) (www.napdi.org) to provide leadership and guidance on the study of pharmacokinetic NPDIs. A key contribution of the Center is the first user-friendly online repository that stores and links pharmacokinetic NPDI data across chemical characterization, metabolomics analyses, and pharmacokinetic in vitro and clinical experiments (repo.napdi.org). The design is expected to help researchers more easily arrive at a complete understanding of pharmacokinetic NPDI research on a particular NP. The repository will also facilitate multidisciplinary collaborations, as the repository links all of the experimental data for a given NP across the study types. The current work describes the design of the repository, standard operating procedures used to enter data, and pharmacokinetic NPDI data that have been entered to date. To illustrate the usefulness of the NaPDI Center repository, more details on two high-priority NPs, cannabis and kratom, are provided as case studies.
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Affiliation(s)
- Caroline Birer-Williams
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Brandon T Gufford
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Eric Chou
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Marijanel Alilio
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Sidney VanAlstine
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Rachael E Morley
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Jeannine S McCune
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Mary F Paine
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
| | - Richard D Boyce
- Department of Biomedical Informatics (C.B.-W., E.C., R.D.B.) and School of Pharmacy (M.A.), University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania; School of Pharmacy, University of Utah, Salt Lake City, Utah (S.V., R.E.M.); Covance Inc., Clinical Pharmacology, Madison, Wisconsin (B.T.G.); Department of Population Sciences and Department of Hematology & HCT, City of Hope Comprehensive Cancer Center, Duarte, California (J.S.M.); Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington (M.F.P.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (J.S.M., M.F.P., R.D.B.)
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13
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Eastlack SC, Cornett EM, Kaye AD. Kratom-Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review. Pain Ther 2020; 9:55-69. [PMID: 31994019 PMCID: PMC7203303 DOI: 10.1007/s40122-020-00151-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Indexed: 02/06/2023] Open
Abstract
Kratom, or Mitragyna, is a tropical plant indigenous to Southeast Asia, with unique pharmacological properties. It is commonly consumed by preparing the leaves into decoction or tea, or by grinding them into a powder. Recent evidence has revealed that kratom has physiological effects similar to opioids, including pain relief and euphoria, as well as stimulant properties, which together raise potential concern for dependence and addiction. Moreover, growing evidence suggests that the prevalence of kratom use is increasing in many parts of the world, raising important considerations for healthcare providers. This manuscript will discuss the most current epidemiology, pharmacology, toxicity, and management related to kratom, while seeking to provide a contemporary perspective on the issue and its role in the greater context of the opioid epidemic.
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Affiliation(s)
- Steven C Eastlack
- LSU Health Sciences Center School of Medicine, 1901 Perdido Street, New Orleans, LA, 70112, USA
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA, 71103, USA
- Department of Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA, 71103, USA
- Tulane School of Medicine, New Orleans, LA, 70112, USA
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14
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Meier U, Mercer-Chalmers-Bender K, Scheurer E, Dussy F. Development, validation, and application of an LC-MS/MS method for mitragynine and 7-hydroxymitragynine analysis in hair. Drug Test Anal 2020; 12:280-284. [PMID: 31833662 DOI: 10.1002/dta.2746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 11/08/2022]
Abstract
The entire scalp hair of a self-declared Kratom consumer of 3 grams per day was acquired during an ethical committee approved study. As no values of the concentration in hair of the two Kratom alkaloids mitragynine or 7-hydroxymitragynine were found in the literature, an already established method for the analysis of benzodiazepines/z-substances was extended for the detection of mitragynine and 7-hydroxymitragynine with LC-MS/MS, and successfully validated. The limits of detection and quantification for mitragynine were 2 pg/mg and 4 pg/mg, respectively. Those of 7-hydroxymitragynine were 20 pg/mg and 30 pg/mg, respectively. The method was applied to the entire scalp hair, divided in 91 regions, of the study participant. A narrow mitragynine concentration distribution with values between 1054 pg/mg and 2244 ng/mg (mean 1517 ng/mg) and no clear scalp region associated distribution pattern was obtained. 7-Hydroxymitragynine was not detected in any hair sample. After validation, the method was established as routine and subsequently 300 samples (mainly abstinence controls for drugs of abuse) were analyzed, allowing the investigation of the prevalence of Kratom consumption in our population. None of the analyzed routine hair samples were positive for mitragynine or 7-hydroxymitragynine, providing no evidence that Kratom consumption is prevalent in the investigated population.
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Affiliation(s)
- Ulf Meier
- Department of Biomedical Engineering, University of Basel Institute of Forensic Medicine, Switzerland
| | | | - Eva Scheurer
- Department of Biomedical Engineering, University of Basel Institute of Forensic Medicine, Switzerland
| | - Franz Dussy
- Department of Biomedical Engineering, University of Basel Institute of Forensic Medicine, Switzerland
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15
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Abstract
The psychoactive plant kratom is a native plant to Southeast Asia, and its major bioactive alkaloid is mitragynine. Mitragynine exerts its analgesic properties by acting on the opioid receptors. One of its active metabolites, 7-hydroxymytraginine, is found to be 40 times more potent than mitragynine and 10 times more potent than morphine. Interestingly, current research suggests that mitragynine behaves as an atypical opioid agonist, possessing analgesic activity with less severe side effects than those of typical opioids. Although Thailand and Malaysia have criminalized the use, possession, growing, or selling of kratom due to its abuse potential, kratom still remains unregulated in the United States. The U.S. Drug Enforcement Agency (DEA) listed kratom as a "drug of concern" in 2008 with the intent to temporarily place mitragynine and 7-hydroxymitragynine onto Schedule I of the Controlled Substances Act. However, responses from the general public, U.S. Congress, and Kratom Alliances had the DEA retract their intent. Kratom is currently marketed in the United States as a dietary or herbal supplement used to treat chronic pain, anxiety, and depression with over $207 million in annual sales in the United States alone. Here, we will review the traditional and medicinal uses of kratom along with the synthesis of its bioactive ingredients and their pharmacology, metabolism, and structure-activity relationships. The importance in society of this currently controversial substance will also be discussed.
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Affiliation(s)
- Changho Han
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
| | - Joza Schmitt
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
| | - Kristen M Gilliland
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
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16
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Obeng S, Kamble SH, Reeves ME, Restrepo LF, Patel A, Behnke M, Chear NJY, Ramanathan S, Sharma A, León F, Hiranita T, Avery BA, McMahon LR, McCurdy CR. Investigation of the Adrenergic and Opioid Binding Affinities, Metabolic Stability, Plasma Protein Binding Properties, and Functional Effects of Selected Indole-Based Kratom Alkaloids. J Med Chem 2019; 63:433-439. [PMID: 31834797 DOI: 10.1021/acs.jmedchem.9b01465] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Selected indole-based kratom alkaloids were evaluated for their opioid and adrenergic receptor binding and functional effects, in vivo antinociceptive effects, plasma protein binding, and metabolic stability. Mitragynine, the major alkaloid in Mitragyna speciosa (kratom), had higher affinity at opioid receptors than at adrenergic receptors while the vice versa was observed for corynantheidine. The observed polypharmacology of kratom alkaloids may support its utilization to treat opioid use disorder and withdrawal.
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Affiliation(s)
- Samuel Obeng
- Department of Pharmacodynamics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States.,Department of Medicinal Chemistry , College of Pharmacy, University of Florida , Gainesville , Florida 32610 , United States
| | - Shyam H Kamble
- Department of Pharmaceutics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States.,Translational Drug Development Core, Clinical and Translational Sciences Institute , University of Florida , Gainesville , Florida 32610 , United States
| | - Morgan E Reeves
- Department of Pharmacodynamics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States
| | - Luis F Restrepo
- Department of Pharmacodynamics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States
| | - Avi Patel
- Department of Pharmacodynamics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States
| | - Mira Behnke
- Department of Pharmacodynamics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States
| | - Nelson J-Y Chear
- Centre for Drug Research , Universiti Sains Malaysia , 11800 Minden , Penang , Malaysia
| | - Surash Ramanathan
- Centre for Drug Research , Universiti Sains Malaysia , 11800 Minden , Penang , Malaysia
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States.,Translational Drug Development Core, Clinical and Translational Sciences Institute , University of Florida , Gainesville , Florida 32610 , United States
| | - Francisco León
- Department of Medicinal Chemistry , College of Pharmacy, University of Florida , Gainesville , Florida 32610 , United States
| | - Takato Hiranita
- Department of Pharmacodynamics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States
| | - Bonnie A Avery
- Department of Pharmaceutics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy , University of Florida , Gainesville , Florida 32610 , United States
| | - Christopher R McCurdy
- Department of Medicinal Chemistry , College of Pharmacy, University of Florida , Gainesville , Florida 32610 , United States.,Translational Drug Development Core, Clinical and Translational Sciences Institute , University of Florida , Gainesville , Florida 32610 , United States
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17
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Ramachandram DS, Damodaran T, Zainal H, Murugaiyah V, Ramanathan S. Pharmacokinetics and pharmacodynamics of mitragynine, the principle alkaloid of Mitragyna speciosa: present knowledge and future directions in perspective of pain. J Basic Clin Physiol Pharmacol 2019; 31:jbcpp-2019-0138. [PMID: 31665120 DOI: 10.1515/jbcpp-2019-0138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Mitragyna speciosa, commonly known as Ketum or Biak in Malaysia and Kratom in Thailand, is a native plant to Southeast Asia and has various pharmacological benefits. Mitragynine (MG) is the principal alkaloid found in the leaves of Mitragyna speciosa and has been reported to be responsible for the plant's therapeutic actions. Traditionally, local communities use Kratom preparations for relief from different types of pain. The potential analgesic effects of MG using rodent models have been reported in literatures. We have reviewed the published analgesic and pharmacokinetic studies and all of these findings showed the routes of drug administration, doses employed, and type of vehicles used to solubilize the drug, varied considerably; hence this posted difficulties in predicting the drug's pharmacokinetic-response relationship. A rational approach is warranted for accurate prediction of dose-response relationship; as this is essential for the development of MG as an alternative medicinal drug for pain management. PKPD modeling would serve as a better method to understand the dose-response relationship in future MG preclinical and clinical studies.
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Affiliation(s)
| | | | - Hadzliana Zainal
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Surash Ramanathan
- Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
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18
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Kruegel A, Uprety R, Grinnell SG, Langreck C, Pekarskaya EA, Le Rouzic V, Ansonoff M, Gassaway MM, Pintar JE, Pasternak GW, Javitch JA, Majumdar S, Sames D. 7-Hydroxymitragynine Is an Active Metabolite of Mitragynine and a Key Mediator of Its Analgesic Effects. ACS CENTRAL SCIENCE 2019; 5:992-1001. [PMID: 31263758 PMCID: PMC6598159 DOI: 10.1021/acscentsci.9b00141] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Indexed: 05/17/2023]
Abstract
Mitragyna speciosa, more commonly known as kratom, is a plant native to Southeast Asia, the leaves of which have been used traditionally as a stimulant, analgesic, and treatment for opioid addiction. Recently, growing use of the plant in the United States and concerns that kratom represents an uncontrolled drug with potential abuse liability, have highlighted the need for more careful study of its pharmacological activity. The major active alkaloid found in kratom, mitragynine, has been reported to have opioid agonist and analgesic activity in vitro and in animal models, consistent with the purported effects of kratom leaf in humans. However, preliminary research has provided some evidence that mitragynine and related compounds may act as atypical opioid agonists, inducing therapeutic effects such as analgesia, while limiting the negative side effects typical of classical opioids. Here we report evidence that an active metabolite plays an important role in mediating the analgesic effects of mitragynine. We find that mitragynine is converted in vitro in both mouse and human liver preparations to the much more potent mu-opioid receptor agonist 7-hydroxymitragynine and that this conversion is mediated by cytochrome P450 3A isoforms. Further, we show that 7-hydroxymitragynine is formed from mitragynine in mice and that brain concentrations of this metabolite are sufficient to explain most or all of the opioid-receptor-mediated analgesic activity of mitragynine. At the same time, mitragynine is found in the brains of mice at very high concentrations relative to its opioid receptor binding affinity, suggesting that it does not directly activate opioid receptors. The results presented here provide a metabolism-dependent mechanism for the analgesic effects of mitragynine and clarify the importance of route of administration for determining the activity of this compound. Further, they raise important questions about the interpretation of existing data on mitragynine and highlight critical areas for further research in animals and humans.
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Affiliation(s)
- Andrew
C. Kruegel
- Department
of Chemistry, Department of Psychiatry, Department of Pharmacology, Department of Neuroscience, Columbia University, New York, New York 10027, United States
| | - Rajendra Uprety
- Department
of Neurology and Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, United States
| | - Steven G. Grinnell
- Department
of Chemistry, Department of Psychiatry, Department of Pharmacology, Department of Neuroscience, Columbia University, New York, New York 10027, United States
| | - Cory Langreck
- Department
of Chemistry, Department of Psychiatry, Department of Pharmacology, Department of Neuroscience, Columbia University, New York, New York 10027, United States
| | - Elizabeth A. Pekarskaya
- Department
of Chemistry, Department of Psychiatry, Department of Pharmacology, Department of Neuroscience, Columbia University, New York, New York 10027, United States
| | - Valerie Le Rouzic
- Department
of Neurology and Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, United States
| | - Michael Ansonoff
- Department
of Neuroscience and Cell Biology, Rutgers
Robert Wood Johnson Medical School, Piscataway, New Jersey 08854, United States
| | - Madalee M. Gassaway
- Department
of Chemistry, Department of Psychiatry, Department of Pharmacology, Department of Neuroscience, Columbia University, New York, New York 10027, United States
| | - John E. Pintar
- Department
of Neuroscience and Cell Biology, Rutgers
Robert Wood Johnson Medical School, Piscataway, New Jersey 08854, United States
| | - Gavril W. Pasternak
- Department
of Neurology and Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, United States
| | - Jonathan A. Javitch
- Department
of Chemistry, Department of Psychiatry, Department of Pharmacology, Department of Neuroscience, Columbia University, New York, New York 10027, United States
- Division
of Molecular Therapeutics, New York State
Psychiatric Institute, New York, New York 10032, United States
| | - Susruta Majumdar
- Department
of Neurology and Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, United States
- Center
for Clinical Pharmacology, St. Louis College
of Pharmacy and Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Dalibor Sames
- Department
of Chemistry, Department of Psychiatry, Department of Pharmacology, Department of Neuroscience, Columbia University, New York, New York 10027, United States
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19
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Prozialeck WC, Avery BA, Boyer EW, Grundmann O, Henningfield JE, Kruegel AC, McMahon LR, McCurdy CR, Swogger MT, Veltri CA, Singh D. Kratom policy: The challenge of balancing therapeutic potential with public safety. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 70:70-77. [PMID: 31103778 PMCID: PMC7881941 DOI: 10.1016/j.drugpo.2019.05.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/01/2019] [Accepted: 05/03/2019] [Indexed: 02/07/2023]
Abstract
Kratom (Mitragyna speciosa) is a tree-like plant indigenous to Southeast Asia. Its leaves, and the teas brewed from them have long been used by people in that region to stave off fatigue and to manage pain and opioid withdrawal. Evidence suggests kratom is being increasingly used by people in the United States and Europe for the self-management of opioid withdrawal and treatment of pain. Recent studies have confirmed that kratom and its chemical constituents have potentially useful pharmacological actions. However, there have also been increasing numbers of reports of adverse effects resulting from use of kratom products. In August 2016, the US Drug Enforcement Administration announced plans to classify kratom and its mitragynine constituents as Schedule I Controlled Substances, a move that triggered a massive response from pro-kratom advocates. The debate regarding the risks, and benefits and safety of kratom continues to intensify. Kratom proponents tout kratom as a safer and less addictive alternative to opioids for the management of pain and opioid addiction. The anti-kratom faction argues that kratom, itself, is a dangerous and addictive drug that ought to be banned. Given the widespread use of kratom and the extensive media attention it is receiving, it is important for physicians, scientists and policy makers to be knowledgeable about the subject. The purpose of this commentary is to update readers about recent developments and controversies in this rapidly evolving area. All of the authors are engaged in various aspects of kratom research and it is our intention to provide a fair and balanced overview that can form the basis for informed decisions on kratom policy. Our conclusions from these analyses are: (a) User reports and results of preclinical studies in animals strongly suggest that kratom and its main constituent alkaloid, mitragynine may have useful activity in alleviating pain and managing symptoms of opioid withdrawal, even though well-controlled clinical trials have yet to be done. (b) Even though kratom lacks many of the toxicities of classic opioids, there are legitimate concerns about the safety and lack of quality control of purported "kratom" products that are being sold in the US. (c) The issues regarding the safety and efficacy of kratom and its mitragynine constituent can only be resolved by additional research. Classification of the Mitragyna alkaloids as Schedule I controlled substances would substantially impede this important research on kratom.
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Affiliation(s)
- Walter C Prozialeck
- Department of Pharmacology, Midwestern University, 555 31st Street, Downers Grove, IL 60515, USA.
| | - Bonnie A Avery
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Edward W Boyer
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Oliver Grundmann
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.
| | - Jack E Henningfield
- Research, Health Policy and Abuse, Liability, Pinney Associates And Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 4800 Montgomery Lane, Suite 400, Bethesda, MD 20814, USA.
| | - Andrew C Kruegel
- Department of Chemistry, Columbia University, 3000 Broadway, New York, NY 10027, USA.
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.
| | - Marc T Swogger
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14682, USA.
| | - Charles A Veltri
- Department of Pharmaceutical Sciences, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308, USA.
| | - Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia.
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20
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Fantoukh OI, Dale OR, Parveen A, Hawwal MF, Ali Z, Manda VK, Khan SI, Chittiboyina AG, Viljoen A, Khan IA. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea ( Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2019; 67:4967-4975. [PMID: 30955332 DOI: 10.1021/acs.jafc.9b00846] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Rooibos tea ( Aspalathus linearis) is a well-known South African herbal tea enjoyed worldwide. Limited reports indicate the potential of rooibos tea to alter the activity of certain cytochrome P450 (CYP450) isozymes. In this study, the phytochemical investigation of MeOH extract of A. linearis (leaves and stems) resulted in the isolation and characterization of 11 phenolic compounds. The MeOH extract exhibited significant inhibition of the major human CYP450 isozymes (CYP3A4, CYP1A2, CYP2D6, CYP2C9, and CYP2C19). The strongest inhibition was observed by the extract for CYP3A4 (IC50 1.7 ± 0.1 μg/mL) followed by CYP2C19 (IC50 4.0 ± 0.3 μg/mL). Among the tested phytochemicals, the most potent inhibitors were isovitexin on CYP3A4 (IC50 3.4 ± 0.2 μM), vitexin on CYP2C9 (IC50 8.0 ± 0.2 μM), and thermopsoside on CYP2C19 (IC50 9.5 ± 0.2 μM). The two major, structurally related compounds aspalathin and nothofagin exhibited a moderate pregnane-X receptor (PXR) activation, which was associated with increased mRNA expression of CYP3A4 and CYP1A2, respectively. These results indicate that a high intake of nutraceuticals containing rooibos extracts may pose a risk of herb-drug interactions when consumed concomitantly with clinical drugs that are substrates of CYP enzymes.
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Affiliation(s)
- Omer I Fantoukh
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
- Department of Pharmacognosy, College of Pharmacy , King Saud University , Riyadh 4545 , Saudi Arabia
| | - Olivia R Dale
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Abidah Parveen
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
| | - Mohammed F Hawwal
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
- Department of Pharmacognosy, College of Pharmacy , King Saud University , Riyadh 4545 , Saudi Arabia
| | - Zulfiqar Ali
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Vamshi K Manda
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Shabana I Khan
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
| | - Amar G Chittiboyina
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Alvaro Viljoen
- Department of Pharmaceutical Sciences and SAMRC Herbal Drugs Research Unit , Tshwane University of Technology , Pretoria 0183 , South Africa
| | - Ikhlas A Khan
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
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21
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Jagabalan JDY, Murugaiyah V, Zainal H, Mansor SM, Ramanathan S. Intestinal permeability of mitragynine in rats using in situ absorption model. JOURNAL OF ASIAN NATURAL PRODUCTS RESEARCH 2019; 21:351-363. [PMID: 29667422 DOI: 10.1080/10286020.2018.1461088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
The intestinal permeability of mitragynine was investigated in situ using a single pass intestinal perfusion (SPIP) absorption model, in small intestine of rat using mitragynine in the absence/presence of the permeability markers, P-gp and/or CYP3A4 inhibitors. Mitragynine demonstrated high intestinal permeability (Peff of 1.11 × 10-4 cm/s) that is in the range of highly permeable drugs such as propranolol (Peff of 1.27 × 10-4 cm/s) indicating that it readily crosses the intestine. The addition of azithromycin (P-glycoprotein inhibitor) and ciprofloxacin (CYP3A4 inhibitor) or combination of both has no effect on intestinal permeability of mitragynine across the rat small intestine.
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Affiliation(s)
| | - Vikneswaran Murugaiyah
- b School of Pharmaceutical Sciences , Universiti Sains Malaysia , Penang 11800 , Malaysia
| | - Hadzliana Zainal
- b School of Pharmaceutical Sciences , Universiti Sains Malaysia , Penang 11800 , Malaysia
| | | | - Surash Ramanathan
- a Centre for Drug Research , Universiti Sains Malaysia , Penang 11800 , Malaysia
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22
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Meireles V, Rosado T, Barroso M, Soares S, Gonçalves J, Luís Â, Caramelo D, Simão AY, Fernández N, Duarte AP, Gallardo E. Mitragyna speciosa: Clinical, Toxicological Aspects and Analysis in Biological and Non-Biological Samples. MEDICINES 2019; 6:medicines6010035. [PMID: 30836609 PMCID: PMC6473843 DOI: 10.3390/medicines6010035] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/24/2019] [Accepted: 02/27/2019] [Indexed: 02/07/2023]
Abstract
The abuse of psychotropic substances is a well-known phenomenon, and many of them are usually associated with ancestral traditions and home remedies. This is the case of Mitragyna speciosa (kratom), a tropical tree used to improve work performance and to withstand great heat. According to several published studies, the main reasons for kratom consumption involve improving sexual performance and endurance, but also social and recreational uses for the feeling of happiness and euphoria; it is also used for medical purposes as a pain reliever, and in the treatment of diarrhea, fever, diabetes, and hypertension. However, this plant has gained more popularity amongst young people over the last years. Since it is available on the internet for purchase, its use is now widely as a drug of abuse, namely as a new psychoactive substance, being a cheaper alternative to opioids that does not require medical prescription in most countries. According to internet surveys by the European Monitoring Centre for Drugs and Drug Addiction in 2008 and 2011, kratom was one of the most widely supplied new psychoactive substances. The composition of kratom is complex; in fact, more than 40 different alkaloids have been identified in Mitragyna speciosa so far, the major constituent being mitragynine, which is exclusive to this plant. Besides mitragynine, alkaloids such as corynantheidine and 7-hydroxamitragynine also present pharmacological effects, a feature that may be attributed to the remaining constituents as well. The main goal of this review is not only to understand the origin, chemistry, consumption, and analytical methodologies for analysis and mechanism of action, but also the use of secondary metabolites of kratom as therapeutic drugs and the assessment of potential risks associated with its consumption, in order to aid health professionals, toxicologists, and police authorities in cases where this plant is present.
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Affiliation(s)
- Vânia Meireles
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Tiago Rosado
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Mário Barroso
- Serviço de Química e Toxicologia Forenses, Instituto de Medicina Legal e Ciências Forenses-Delegação do Sul, 1169-201 Lisboa, Portugal.
| | - Sofia Soares
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Joana Gonçalves
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Ângelo Luís
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Débora Caramelo
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Ana Y Simão
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Nicolás Fernández
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Toxicología y Química Legal, Laboratorio de Asesoramiento Toxicológico Analítico (CENATOXA). Junín 956 7mo piso. Ciudad Autónoma de Buenos Aires (CABA), Buenos Aires C1113AAD, Argentina.
| | - Ana Paula Duarte
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde, Faculdade de Ciências da Saúde da Universidade da Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal.
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23
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Stanciu CN, Gnanasegaram SA, Ahmed S, Penders T. Kratom Withdrawal: A Systematic Review with Case Series. J Psychoactive Drugs 2019; 51:12-18. [DOI: 10.1080/02791072.2018.1562133] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Cornel N. Stanciu
- Psychiatry Department, Dartmouth’s Geisel School of Medicine, Hanover, NH, USA
- Addiction Services, New Hampshire Hospital, Concord, NH, USA
| | - Samantha A. Gnanasegaram
- Psychiatry Department, Dartmouth’s Geisel School of Medicine, Hanover, NH, USA
- Psychiatric Physician, New Hampshire Hospital, Concord, NH, USA
| | - Saeed Ahmed
- Psychiatric Resident Physician, Nassau University Medical Center, East Meadow, NY, USA
| | - Thomas Penders
- Psychiatry Department, Brody School of Medicine at East Carolina University, Greenville, NC, USA
- Psychiatric Physician, Walter B. Jones Addiction Treatment Center, Greenville, NC, USA
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24
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Rusli N, Amanah A, Kaur G, Adenan MI, Sulaiman SF, Wahab HA, Tan ML. The inhibitory effects of mitragynine on P-glycoprotein in vitro. Naunyn Schmiedebergs Arch Pharmacol 2019; 392:481-496. [DOI: 10.1007/s00210-018-01605-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/14/2018] [Indexed: 12/13/2022]
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25
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Smith LC, Lin L, Hwang CS, Zhou B, Kubitz DM, Wang H, Janda KD. Lateral Flow Assessment and Unanticipated Toxicity of Kratom. Chem Res Toxicol 2018; 32:113-121. [PMID: 30380840 DOI: 10.1021/acs.chemrestox.8b00218] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The leaves of the Mitragynine speciosia tree (also known as Kratom) have long been chewed, smoked, or brewed into a tea by people in Southeastern Asian countries, such as Malaysia and Thailand. Just this past year, the plant Kratom gained popularity in the United States as a "legal opioid" and scheduling it as a drug of abuse is currently pending. The primary alkaloid found in Kratom is a μ-opioid receptor agonist, mitragynine, whose structure contains a promising scaffold for immunopharmacological use. Although Kratom is regarded as a safe opioid alternative, here we report the LD50 values determined for its two main psychoactive alkaloids, mitragynine and 7-hydroxymitragynine, as comparable to heroin in mice when administered intravenously. Given Kratom's recent emergence in the U.S., there is currently no diagnostic test available for law enforcement or health professionals, so we sought to design such an assay. Mitragynine was used as a starting point for hapten design, resulting in a hapten with an ether linker extending from the C9 position of the alkaloid. Bacterial flagellin (FliC) was chosen as a carrier protein for active immunization in mice, yielding 32 potential monoclonal antibodies (mAbs) for assay development. Antimitragynine mAbs in the range of micro- to nanomolar affinities were uncovered and their utility in producing a convenient lateral flow detection assay of human fluid samples was examined. Antibodies were screened for binding to mitragynine, 7-hydroxymitragynine, and performance in lateral flow assays. Two monoclonal antibodies were subcloned and further purified with 93 and 362 nM affinity to mitragynine. Test strip assays were optimized with a detection cut off of 0.5 μg/mL for mitragynine in buffer and urine (reflecting projected clinically relevant levels of drug in urine), which could be beneficial to law enforcement agencies and health professionals as the opioid epidemic in America continues to evolve.
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Affiliation(s)
| | | | | | | | | | - Huiying Wang
- ABiox Company, 720 East First Street , Newberg , Oregon 97132 , United States
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26
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Abstract
Neonatal abstinence syndrome (NAS) secondary to maternal drug use is a well-recognized clinical entity. We present a novel case of moderately severe NAS in a term infant whose mother was self-medicating with kratom tea. The baby required oral morphine for NAS. After 12 days in neonatal intensive care unit, she was discharged on oral morphine which was discontinued after 2 months. Kratom, a psychoactive herb with opioid activity, has traditionally been used as a stimulant to boost energy, cure cough, depression, pain, sickness and a substitute for opium. Although well known in South East Asia and Africa, this drug is less familiar to physicians in North America. It is undetectable by standard urine drug screening and is being sold as a legal herbal remedy. This is the first report of a newborn developing significant NAS after maternal use of kratom tea. We believe physicians should be aware of this 'new' risk to newborns.
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Affiliation(s)
- Prashanth Murthy
- Department of Pediatrics, Rockyview General Hospital Calgary, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Deborah Clark
- Department of Pediatrics, Rockyview General Hospital Calgary, Cumming School of Medicine, University of Calgary, Calgary, Alberta
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27
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Assessing Herb–Drug Interactions of Herbal Products With Therapeutic Agents for Metabolic Diseases: Analytical and Regulatory Perspectives. STUDIES IN NATURAL PRODUCTS CHEMISTRY 2018. [DOI: 10.1016/b978-0-444-64179-3.00009-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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28
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Fasinu PS, Manda VK, Dale OR, Egiebor NO, Walker LA, Khan SI. Modulation of Cytochrome P450, P-glycoprotein and Pregnane X Receptor by Selected Antimalarial Herbs-Implication for Herb-Drug Interaction. Molecules 2017; 22:molecules22122049. [PMID: 29168799 PMCID: PMC6150001 DOI: 10.3390/molecules22122049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/20/2017] [Indexed: 11/17/2022] Open
Abstract
Seven medicinal plants popularly used for treating malaria in West Africa were selected to assess herb-drug interaction potential through a series of in vitro methods. Fluorescent cytochrome P450 (CYP) assays were conducted using the recombinant CYP enzymes for CYP1A2, CYP2A6, CYP2B6, CYP2C9, CYP2C19, CYP2D6 and CYP3A4 to assess the effect of the methanolic extracts on the metabolic activity of CYPs. Secondly, the inhibitory effect of the extracts was evaluated on P-glycoproteins (P-gp) using calcein-AM, a fluorescent substrate, in MDCK-II and hMDR1-MDCK-II cells. The inhibition of P-gp activity was determined as a reflection of increase in calcein-AM uptake. Additionally, the enzyme induction potential of the extracts was assessed through the modulation of PXR activity in HepG2 cells transiently transfected with pSG5-PXR and PCR5 plasmid DNA. Significant inhibition of CYP activity (IC50 < 10 µg/mL) was observed with the following herbs: A. muricata [CYP2C9, 3A4 and CYP2D6]; M. indica [CYP2C9]; M. charantia [CYP2C9 and CYP2C19]; P. amarus [CYP2C19, CYP2C9 and CYP3A4]; T. diversifolia [CYP2C19 and CYP3A4]. Extracts of four herbs (P. amarus, M. charantia, T. diversifolia and A. muricata) exhibited significant inhibition of P-gp with IC50 values (µg/mL) of 17 ± 1, 16 ± 0.4, 26 ± 1, and 24 ± 1, respectively. In addition, four herbs (A. mexicana, M. charantia, P. amarus and T. diversifolia) showed a >two-fold increase in induction in PXR activity. These findings suggest that these herbs may be capable of eliciting herb-drug interactions if consumed in high quantities with concomitant use of conventional therapies.
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Affiliation(s)
- Pius S Fasinu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC 27506, USA.
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA.
| | - Vamshi K Manda
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA.
| | - Olivia R Dale
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA.
| | - Nosa O Egiebor
- Department of Environmental Resources Engineering, State University of New York College of Environmental Science and Forestry, Syracuse, NY 13210, USA.
| | - Larry A Walker
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA.
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA.
| | - Shabana I Khan
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA.
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA.
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Manda VK, Avula B, Dale OR, Ali Z, Khan IA, Walker LA, Khan SI. PXR mediated induction of CYP3A4, CYP1A2, and P-gp byMitragyna speciosaand its alkaloids. Phytother Res 2017; 31:1935-1945. [DOI: 10.1002/ptr.5942] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/24/2017] [Accepted: 09/06/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Vamshi K. Manda
- National Center for Natural Products Research, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
| | - Bharathi Avula
- National Center for Natural Products Research, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
| | - Olivia R. Dale
- National Center for Natural Products Research, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
| | - Zulfiqar Ali
- National Center for Natural Products Research, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
| | - Ikhlas A. Khan
- National Center for Natural Products Research, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
- Department of Biomolecular Sciences, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
| | - Larry A. Walker
- National Center for Natural Products Research, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
- Department of Biomolecular Sciences, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
| | - Shabana I. Khan
- National Center for Natural Products Research, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
- Department of Biomolecular Sciences, School of Pharmacy; University of Mississippi; University Oxford MS 38677 USA
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Loperamide-Related Deaths in North Carolina. J Anal Toxicol 2016; 40:677-686. [DOI: 10.1093/jat/bkw069] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 05/05/2016] [Indexed: 01/16/2023] Open
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Wu N, Xu W, Cao GY, Yang YF, Yang XB, Yang XW. The Blood-Brain Barrier Permeability of Lignans and Malabaricones from the Seeds of Myristica fragrans in the MDCK-pHaMDR Cell Monolayer Model. Molecules 2016; 21:134. [PMID: 26805808 PMCID: PMC6274353 DOI: 10.3390/molecules21020134] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 01/15/2016] [Accepted: 01/19/2016] [Indexed: 11/16/2022] Open
Abstract
The blood-brain barrier (BBB) permeability of twelve lignans and three phenolic malabaricones from the seeds of Myristica fragrans (nutmeg) were studied with the MDCK-pHaMDR cell monolayer model. The samples were measured by high-performance liquid chromatography and the apparent permeability coefficients (Papp) were calculated. Among the fifteen test compounds, benzonfuran-type, dibenzylbutane-type and arylnaphthalene-type lignans showed poor to moderate permeabilities with Papp values at 10−8–10−6 cm/s; those of 8-O-4′-neolignan and tetrahydrofuran-lignan were at 10−6–10−5 cm/s, meaning that their permeabilities are moderate to high; the permeabilities of malabaricones were poor as their Papp values were at 10−8–10−7 cm/s. To 5-methoxy-dehydrodiisoeugenol (2), erythro-2-(4-allyl-2,6-dimethoxyphenoxy)-1-(3,4-dimethoxyphenyl)-propan-1-ol acetate (6), verrucosin (8), and nectandrin B (9), an efflux way was involved and the main transporter for 6, 8 and 9 was demonstrated to be P-glycoprotein. The time and concentration dependency experiments indicated the main transport mechanism for neolignans dehydrodiisoeugenol (1), myrislignan (7) and 8 was passive diffusion. This study summarized the relationship between the BBB permeability and structure parameters of the test compounds, which could be used to preliminarily predict the transport of a compound through BBB. The results provide a significant molecular basis for better understanding the potential central nervous system effects of nutmeg.
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Affiliation(s)
- Ni Wu
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Wei Xu
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Gui-Yun Cao
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Yan-Fang Yang
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Xin-Bao Yang
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Xiu-Wei Yang
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.
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Following "the Roots" of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BIOMED RESEARCH INTERNATIONAL 2015; 2015:968786. [PMID: 26640804 PMCID: PMC4657101 DOI: 10.1155/2015/968786] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 12/17/2022]
Abstract
The use of substances to enhance human abilities is a constant and cross-cultural feature in the evolution of humanity. Although much has changed over time, the availability on the Internet, often supported by misleading marketing strategies, has made their use even more likely and risky. This paper will explore the case of Mitragyna speciosa Korth. (kratom), a tropical tree used traditionally to combat fatigue and improve work productivity among farm populations in Southeast Asia, which has recently become popular as novel psychoactive substance in Western countries. Specifically, it (i) reviews the state of the art on kratom pharmacology and identification; (ii) provides a comprehensive overview of kratom use cross-culturally; (iii) explores the subjective experiences of users; (iv) identifies potential risks and side-effects related to its consumption. Finally, it concludes that the use of kratom is not negligible, especially for self-medication, and more clinical, pharmacological, and socioanthropological studies as well as a better international collaboration are needed to tackle this marginally explored phenomenon.
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Manda VK, Avula B, Chittiboyina AG, Khan IA, Walker LA, Khan SI. Inhibition of CYP3A4 and CYP1A2 byAegle marmelosand its constituents. Xenobiotica 2015; 46:117-25. [DOI: 10.3109/00498254.2015.1053006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Manda VK, Avula B, Dale OR, Chittiboyina AG, Khan IA, Walker LA, Khan SI. Studies on Pharmacokinetic Drug Interaction Potential of Vinpocetine. MEDICINES 2015; 2:93-105. [PMID: 28930203 PMCID: PMC5533163 DOI: 10.3390/medicines2020093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/26/2015] [Accepted: 06/02/2015] [Indexed: 01/17/2023]
Abstract
Background Vinpocetine, a semi-synthetic derivative of vincamine, is a popular dietary supplement used for the treatment of several central nervous system related disorders. Despite its wide use, no pharmacokinetic drug interaction studies are reported in the literature. Due to increasing use of dietary supplements in combination with conventional drugs, the risk of adverse effects is on the rise. As a preliminary step to predict a possibility of drug interaction during concomitant use of vinpocetine and conventional drugs, this study was carried out to evaluate the effects of vinpocetine on three main regulators of pharmacokinetic drug interactions namely, cytochromes P450 (CYPs), P-glycoprotein (P-gp), and Pregnane X receptor (PXR). Methods Inhibition of CYPs was evaluated by employing recombinant enzymes. The inhibition of P-gp was determined by calcein-AM uptake method in transfected and wild type MDCKII cells. Modulation of PXR activity was monitored through a reporter gene assay in HepG2 cells. Results Vinpocetine showed a strong inhibition of P-gp (EC50 8 μM) and a moderate inhibition of recombinant CYP3A4 and CYP2D6 (IC50 2.8 and 6.5 μM) with no activity towards CYP2C9, CYP2C19 and CYP1A2 enzymes. In HLM, competitive inhibition of CYP3A4 (IC50 54 and Ki 19 μM) and non-competitive inhibition of CYP2D6 (IC50 19 and Ki 26 μM) was observed. Activation of PXR was observed only at the highest tested concentration of vinpocetine (30 μM) while lower doses were ineffective. Conclusion Strong inhibition of P-gp by vinpocetine is indicative of a possibility of drug interactions by altering the pharmacokinetics of drugs, which are the substrates of P-gp. However, the effects on CYPs and PXR indicate that vinpocetine may not affect CYP-mediated metabolism of drugs, as the inhibitory concentrations are much greater than the expected plasma concentrations in humans.
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Affiliation(s)
- Vamshi K Manda
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - Bharathi Avula
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - Olivia R Dale
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - Amar G Chittiboyina
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - Ikhlas A Khan
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
- Department of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
- Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia.
| | - Larry A Walker
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
- Department of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
| | - Shabana I Khan
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
- Department of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, University, MS 38677, USA.
- Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia.
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Trakulsrichai S, Sathirakul K, Auparakkitanon S, Krongvorakul J, Sueajai J, Noumjad N, Sukasem C, Wananukul W. Pharmacokinetics of mitragynine in man. Drug Des Devel Ther 2015; 9:2421-9. [PMID: 25995615 PMCID: PMC4425236 DOI: 10.2147/dddt.s79658] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Kratom, known botanically as Mitragyna speciosa (Korth.), is an indigenous tree in Southeast Asia. Kratom is currently easily available worldwide via special shops and the Internet to use as a drug of abuse, opioid alternative, or pain killer. So far, the pharmacokinetics of this plant has been studied only in animals, and there is no such study in humans. The major abundant active alkaloid in Kratom, mitragynine, is one of the promising new chemical substances to be developed as a new drug. The aim of this study was to examine the pharmacokinetics of mitragynine and assess the linearity in pharmacokinetics in chronic users. METHODS Since Kratom is illegal in Thailand, studies in healthy subjects would be unethical. We therefore conducted a prospective study by enrolling ten chronic, regular, healthy users. We adjusted the steady state in each subject by giving a known amount of Kratom tea for 7 days before commencement of the experiment. We admitted and gave different oral doses to subjects to confirm linearity in pharmacokinetics. The mitragynine blood concentrations at 17 times points and the urine concentrations during the 24-hour period were collected and measured by liquid chromatography-tandem mass spectrometry method. RESULTS Ten male subjects completed the study without adverse reactions. The median duration of abuse was 1.75 years. We analyzed one subject separately due to the abnormal behavior of blood concentration. From data of nine subjects, the pharmacokinetic parameters established were time to reach the maximum plasma concentration (0.83±0.35 hour), terminal half-life (23.24±16.07 hours), and the apparent volume of distribution (38.04±24.32 L/kg). The urine excretion of unchanged form was 0.14%. The pharmacokinetics were observed to be oral two-compartment model. CONCLUSION This was the first pharmacokinetic study in humans, which demonstrated linearity and was consistent with the oral two-compartment model with a terminal half-life of about 1 day. The pharmacokinetic linearity and parameters reported are necessary pharmacological information of Kratom, and there is a possibility for it to be developed medically as a pain killer or better opioid substitute in the future.
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Affiliation(s)
- Satariya Trakulsrichai
- Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Korbtham Sathirakul
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Center for Drug Research Discovery and Development, Thammasat Univerisity, Prathumthani, Thailand
| | - Saranya Auparakkitanon
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jatupon Krongvorakul
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jetjamnong Sueajai
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nantida Noumjad
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chonlaphat Sukasem
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Winai Wananukul
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Ramanathan S, Parthasarathy S, Murugaiyah V, Magosso E, Tan SC, Mansor SM. Understanding the physicochemical properties of mitragynine, a principal alkaloid of Mitragyna speciosa, for preclinical evaluation. Molecules 2015; 20:4915-27. [PMID: 25793541 PMCID: PMC6272646 DOI: 10.3390/molecules20034915] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 02/27/2015] [Indexed: 12/17/2022] Open
Abstract
Varied pharmacological responses have been reported for mitragynine in the literature, but no supportive scientific explanations have been given for this. These studies have been undertaken without a sufficient understanding of the physicochemical properties of mitragynine. In this work a UV spectrophotometer approach and HPLC-UV method were employed to ascertain the physicochemical properties of mitragynine. The pKa of mitragynine measured by conventional UV (8.11 ± 0.11) was in agreement with the microplate reader determination (8.08 ± 0.04). Mitragynine is a lipophilic alkaloid, as indicated by a logP value of 1.73. Mitragynine had poor solubility in water and basic media, and conversely in acidic environments, but it is acid labile. In an in vitro dissolution the total drug release was higher for the simulated gastric fluid but was prolonged and incomplete for the simulated intestinal fluid. The hydrophobicity, poor water solubility, high variability of drug release in simulated biological fluids and acid degradable characteristics of mitragynine probably explain the large variability of its pharmacological responses reported in the literature. The determined physicochemical properties of mitragynine will provide a basis for developing a suitable formulation to further improve its solubility, stability and oral absorption for better assessment of this compound in preclinical studies.
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Affiliation(s)
- Surash Ramanathan
- Centre for Drug Research, Universiti Sains Malaysia, Penang 11800, Malaysia
| | | | | | - Enrico Magosso
- Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, Kepala Batas, Penang 13200, Malaysia
| | - Soo Choon Tan
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang 11800, Malaysia
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Manda VK, Dale OR, Awortwe C, Ali Z, Khan IA, Walker LA, Khan SI. Evaluation of drug interaction potential of Labisia pumila (Kacip Fatimah) and its constituents. Front Pharmacol 2014; 5:178. [PMID: 25152732 PMCID: PMC4126480 DOI: 10.3389/fphar.2014.00178] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/11/2014] [Indexed: 11/13/2022] Open
Abstract
Labisia pumila (Kacip Fatimah) is a popular herb in Malaysia that has been traditionally used in a number of women's health applications such as to improve libido, relieve postmenopausal symptoms, and to facilitate or hasten delivery in childbirth. In addition, the constituents of this plant have been reported to possess anticancer, antioxidant, and anti-inflammatory properties. Clinical studies have indicated that cytochrome P450s (CYPs), P-glycoprotein (P-gp), and Pregnane X receptor (PXR) are the three main modulators of drug-drug interactions which alter the absorption, distribution, and metabolism of drugs. Given the widespread use of Kacip Fatimah in dietary supplements, the current study focuses on determining the potential of its constituents to affect the activities of CYPs, P-gp, or PXR using in vitro assays which may provide useful information toward the risk of herb-drug interaction with concomitantly used drugs. Six compounds isolated from the roots of L. pumila (2 saponins and 4 alkyl phenols) were tested, in addition to the methanolic extract. The extract of L. pumila showed a significant time dependent inhibition (TDI) of CYP3A4, reversible inhibition of CYP2C9 and 2C19 and a weak inhibition of 1A2 and 2D6 as well as an inhibition of P-gp and rifampicin-induced PXR activation. The alkyl phenols inhibited CYP3A4 (TDI), CYP2C9, and 2C19 (reversible) while saponins inhibited P-gp and PXR. In conclusion, L. pumila and its constituents showed significant modulation of all three regulatory proteins (CYPs, P-gp, and PXR) suggesting a potential to alter the pharmacokinetic and pharmacodynamic properties of conventional drugs if used concomitantly.
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Affiliation(s)
- Vamshi K Manda
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi Oxford, MS, USA
| | - Olivia R Dale
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi Oxford, MS, USA
| | - Charles Awortwe
- Division of Clinical Pharmacology, University of Stellenbosch Cape Town, South Africa
| | - Zulfiqar Ali
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi Oxford, MS, USA
| | - Ikhlas A Khan
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi Oxford, MS, USA ; Division of Pharmacognosy, Department of Biomolecular Sciences, School of Pharmacy, The University of Mississippi Oxford, MS, USA
| | - Larry A Walker
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi Oxford, MS, USA ; Division of Pharmacology, Department of Biomolecular Sciences, School of Pharmacy, The University of Mississippi Oxford, MS, USA
| | - Shabana I Khan
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi Oxford, MS, USA ; Division of Pharmacognosy, Department of Biomolecular Sciences, School of Pharmacy, The University of Mississippi Oxford, MS, USA
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