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Oyanna VO, Garcia-Torres KY, Bechtold BJ, Lynch KD, Call MR, Horváth M, Manwill PK, Graf TN, Cech NB, Oberlies NH, Paine MF, Clarke JD. Goldenseal-Mediated Inhibition of Intestinal Uptake Transporters Decreases Metformin Systemic Exposure in Mice. Drug Metab Dispos 2023; 51:1483-1489. [PMID: 37562957 PMCID: PMC10586506 DOI: 10.1124/dmd.123.001360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/08/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023] Open
Abstract
Goldenseal is a perennial plant native to eastern North America. A recent clinical study reported goldenseal decreased metformin Cmax and area under the blood concentration versus time curve (AUC) by 27% and 23%, respectively, but half-life and renal clearance were unchanged. These observations suggested goldenseal altered processes involved in metformin absorption. The underlying mechanism(s) remain(s) unknown. One mechanism for the decreased metformin systemic exposure is inhibition by goldenseal of intestinal uptake transporters involved in metformin absorption. Goldenseal extract and three goldenseal alkaloids (berberine, (-)-β-hydrastine, hydrastinine) were tested as inhibitors of organic cation transporter (OCT) 3, plasma membrane monoamine transporter (PMAT), and thiamine transporter (THTR) 2 using human embryonic kidney 293 cells overexpressing each transporter. The goldenseal extract, normalized to berberine content, was the strongest inhibitor of each transporter (IC50: 4.9, 13.1, and 5.8 μM for OCT3, PMAT, and THTR2, respectively). A pharmacokinetic study in mice compared the effects of berberine, (-)-β-hydrastine, goldenseal extract, and imatinib (OCT inhibitor) on orally administered metformin. Goldenseal extract and imatinib significantly decreased metformin Cmax by 31% and 25%, respectively, and had no effect on half-life. Berberine and (-)-β-hydrastine had no effect on metformin pharmacokinetics, indicating neither alkaloid alone precipitated the interaction in vivo. A follow-up murine study involving intravenous metformin and oral inhibitors examined the contributions of basolateral enteric/hepatic uptake transporters to the goldenseal-metformin interaction. Goldenseal extract and imatinib had no effect on metformin AUC and half-life, suggesting lack of inhibition of basolateral enteric/hepatic uptake transporters. Results may have implications for patients taking goldenseal with drugs that are substrates for OCT3 and THTR2. SIGNIFICANCE STATEMENT: Goldenseal is used to self-treat respiratory infections and digestive disorders. We investigated potential mechanisms for the clinical pharmacokinetic interaction observed between goldenseal and metformin, specifically inhibition by goldenseal of intestinal uptake transporters (OCT3, PMAT, THTR2) involved in metformin absorption. Goldenseal extract inhibited all three transporters in vitro and decreased metformin systemic exposure in mice. These data may have broader implications for patients co-consuming goldenseal with other drugs that are substrates for these transporters.
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Affiliation(s)
- Victoria O Oyanna
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Kenisha Y Garcia-Torres
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Baron J Bechtold
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Katherine D Lynch
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - M Ridge Call
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Miklós Horváth
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Preston K Manwill
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Tyler N Graf
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Nadja B Cech
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Nicholas H Oberlies
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - Mary F Paine
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
| | - John D Clarke
- Department of Pharmaceutical Sciences, Washington State University, Spokane, Washington (V.O.O., K.Y.G.-T., B.J.B., K.D.L., M.R.C., M.F.P., J.D.C.); Department of Chemistry and Biochemistry, University of North Carolina at Greensboro, North Carolina (P.K.M., T.N.G., N.B.C., N.H.O.); SOLVO Biotechnology, Szeged, Hungary (M.H.); and Center of Excellence for Natural Product Drug Interaction Research, Spokane, Washington (N.B.C., N.H.O., M.F.P., J.D.C.)
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Miners JO, Polasek TM, Hulin JA, Rowland A, Meech R. Drug-drug interactions that alter the exposure of glucuronidated drugs: Scope, UDP-glucuronosyltransferase (UGT) enzyme selectivity, mechanisms (inhibition and induction), and clinical significance. Pharmacol Ther 2023:108459. [PMID: 37263383 DOI: 10.1016/j.pharmthera.2023.108459] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
Drug-drug interactions (DDIs) arising from the perturbation of drug metabolising enzyme activities represent both a clinical problem and a potential economic loss for the pharmaceutical industry. DDIs involving glucuronidated drugs have historically attracted little attention and there is a perception that interactions are of minor clinical relevance. This review critically examines the scope and aetiology of DDIs that result in altered exposure of glucuronidated drugs. Interaction mechanisms, namely inhibition and induction of UDP-glucuronosyltransferase (UGT) enzymes and the potential interplay with drug transporters, are reviewed in detail, as is the clinical significance of known DDIs. Altered victim drug exposure arising from modulation of UGT enzyme activities is relatively common and, notably, the incidence and importance of UGT induction as a DDI mechanism is greater than generally believed. Numerous DDIs are clinically relevant, resulting in either loss of efficacy or an increased risk of adverse effects, necessitating dose individualisation. Several generalisations relating to the likelihood of DDIs can be drawn from the known substrate and inhibitor selectivities of UGT enzymes, highlighting the importance of comprehensive reaction phenotyping studies at an early stage of drug development. Further, rigorous assessment of the DDI liability of new chemical entities that undergo glucuronidation to a significant extent has been recommended recently by regulatory guidance. Although evidence-based approaches exist for the in vitro characterisation of UGT enzyme inhibition and induction, the availability of drugs considered appropriate for use as 'probe' substrates in clinical DDI studies is limited and this should be research priority.
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Affiliation(s)
- John O Miners
- Discipline of Clinical Pharmacology and Flinders Centre for Innovation in Cancer, Flinders University College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Thomas M Polasek
- Certara, Princeton, NJ, USA; Centre for Medicines Use and Safety, Monash University, Melbourne, Australia
| | - Julie-Ann Hulin
- Discipline of Clinical Pharmacology and Flinders Centre for Innovation in Cancer, Flinders University College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Andrew Rowland
- Discipline of Clinical Pharmacology and Flinders Centre for Innovation in Cancer, Flinders University College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Robyn Meech
- Discipline of Clinical Pharmacology and Flinders Centre for Innovation in Cancer, Flinders University College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Hong S, Li S, Meng X, Li P, Wang X, Su M, Liu X, Liu L. Bile duct ligation differently regulates protein expressions of organic cation transporters in intestine, liver and kidney of rats through activation of farnesoid X receptor by cholate and bilirubin. Acta Pharm Sin B 2023; 13:227-245. [PMID: 36815051 PMCID: PMC9939304 DOI: 10.1016/j.apsb.2022.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/17/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Abstract
Body is equipped with organic cation transporters (OCTs). These OCTs mediate drug transport and are also involved in some disease process. We aimed to investigate whether liver failure alters intestinal, hepatic and renal Oct expressions using bile duct ligation (BDL) rats. Pharmacokinetic analysis demonstrates that BDL decreases plasma metformin exposure, associated with decreased intestinal absorption and increased urinary excretion. Western blot shows that BDL significantly downregulates intestinal Oct2 and hepatic Oct1 but upregulates renal and hepatic Oct2. In vitro cell experiments show that chenodeoxycholic acid (CDCA), bilirubin and farnesoid X receptor (FXR) agonist GW4064 increase OCT2/Oct2 but decrease OCT1/Oct1, which are remarkably attenuated by glycine-β-muricholic acid and silencing FXR. Significantly lowered intestinal CDCA and increased plasma bilirubin levels contribute to different Octs regulation by BDL, which are confirmed using CDCA-treated and bilirubin-treated rats. A disease-based physiologically based pharmacokinetic model characterizing intestinal, hepatic and renal Octs was successfully developed to predict metformin pharmacokinetics in rats. In conclusion, BDL remarkably downregulates expressions of intestinal Oct2 and hepatic Oct1 protein while upregulates expressions of renal and hepatic Oct2 protein in rats, finally, decreasing plasma exposure and impairing hypoglycemic effects of metformin. BDL differently regulates Oct expressions via Fxr activation by CDCA and bilirubin.
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Affiliation(s)
- Shijin Hong
- Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing 210098, China
| | - Shuai Li
- Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing 210098, China
| | - Xiaoyan Meng
- Tianjin Institutes of Pharmaceutical Research, Tianjin 300301, China
| | - Ping Li
- Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing 210098, China
| | - Xun Wang
- Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing 210098, China
| | - Mengxiang Su
- Departments of Pharmaceutical Analysis, School of Pharmacy, China Pharmaceutical University, Nanjing 210098, China
| | - Xiaodong Liu
- Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing 210098, China,Corresponding author. Tel./fax: +86 25 83271060.
| | - Li Liu
- Center of Drug Metabolism and Pharmacokinetics, School of Pharmacy, China Pharmaceutical University, Nanjing 210098, China,Corresponding author. Tel./fax: +86 25 83271060.
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Wegler C, Wiśniewski JR, Robertsen I, Christensen H, Hertel JK, Hjelmesaeth J, Jansson-Löfmark R, Åsberg A, Andersson TB, Artursson P. Drug disposition protein quantification in matched human jejunum and liver from donors with obesity. Clin Pharmacol Ther 2022; 111:1142-1154. [PMID: 35158408 PMCID: PMC9310776 DOI: 10.1002/cpt.2558] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
Mathematical models, such as physiologically‐based pharmacokinetic models, are used to predict, for example, drug disposition and toxicity. However, populations differ in the abundance of proteins involved in these processes. To improve the building and refinement of such models, they must take into account these interindividual variabilities. In this study, we used global proteomics to characterize the protein composition of jejunum and liver from 37 donors with obesity enrolled in the COCKTAIL study. Liver protein levels from the 37 donors were further compared with those from donors without obesity. We quantified thousands of proteins and could present the expression of several drug‐metabolizing enzymes, for the first time, in jejunum, many of which belong to the cytochrome P450 (CYP) (e.g., CYP2U1) and the amine oxidase (flavin‐containing) (e.g., monoamine oxidase A (MAOA)) families. Although we show that many metabolizing enzymes had greater expression in liver, others had higher expression in jejunum (such as, MAOA and CES2), indicating the role of the small intestine in extrahepatic drug metabolism. We further show that proteins involved in drug disposition are not correlated in the two donor‐matched tissues. These proteins also do not correlate with physiological factors such as body mass index, age, and inflammation status in either tissue. Furthermore, the majority of these proteins are not differently expressed in donors with or without obesity. Nonetheless, interindividual differences were considerable, with implications for personalized prediction models and systems pharmacology.
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Affiliation(s)
- Christine Wegler
- Department of Pharmacy, Uppsala University, SE-75123, Uppsala, Sweden.,DMPK, Research and Early Development Cardiovascular, Renal and Metabolism, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, Sweden
| | - Jacek R Wiśniewski
- Biochemical Proteomics Group, Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, D-82152, Martinsried, Germany
| | - Ida Robertsen
- Department of Pharmacy, Section for Pharmacology, Pharmaceutical Biosciences, University of Oslo, Oslo, Norway
| | - Hege Christensen
- Department of Pharmacy, Section for Pharmacology, Pharmaceutical Biosciences, University of Oslo, Oslo, Norway
| | - Jens Kristoffer Hertel
- Morbid Obesity Centre, Department of Medicine, Vestfold Hospital Trust, Boks, 2168, 3103, Tønsberg, Norway
| | - Jøran Hjelmesaeth
- Morbid Obesity Centre, Department of Medicine, Vestfold Hospital Trust, Boks, 2168, 3103, Tønsberg, Norway.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rasmus Jansson-Löfmark
- DMPK, Research and Early Development Cardiovascular, Renal and Metabolism, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, Sweden
| | - Anders Åsberg
- Department of Pharmacy, Section for Pharmacology, Pharmaceutical Biosciences, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Tommy B Andersson
- DMPK, Research and Early Development Cardiovascular, Renal and Metabolism, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, Sweden
| | - Per Artursson
- Department of Pharmacy, Uppsala University, SE-75123, Uppsala, Sweden
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