St John's Wort increases expression of P-glycoprotein: Implications for drug interactions
Martina Hennessy,Dermot Kelleher,J P Spiers,Michael J. Barry,Pierce V. Kavanagh,David Back,Fiona Mulcahy,John Feely +7 more
TLDR
SJW increased expression and enhanced the drug efflux function of the multi drug transporter P-glycoprotein in PBMCs of healthy volunteers and may represent a second mechanism for the drug-herb interactions seen in clinical practice and account for the discrepancies between in vitro and in vivo data.Abstract:
Aims
St John's Wort (SJW) is widely used in the treatment of depression but concerns have been raised about its potential to interact with other drugs. Co-administration with SJW has resulted in significant reductions in trough plasma concentrations of indinavir and cyclosporin [1, 2]. Induction of cytochrome P450 3A4 (CYP3A4) has been implicated as the most likely interaction mechanism. However, the magnitude of the interaction seen in clinical practice is greater than that predicted by in vitro studies suggesting additional interaction mechanisms may exist. As indinavir and cyclosporin are substrates for both CYP3A4 and the multi drug transporter P-glycoprotein we hypothesized that modulation of P-glycoprotein expression and function by SJW may contribute to the development of potentially harmful drug–drug interactions.read more
Citations
More filters
PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder
Journal ArticleDOI
Herb-drug interactions: a literature review.
Zeping Hu,Xiaoxia Yang,Paul C. Ho,Sui Yung Chan,Paul Wan Sia Heng,Eli Chan,Wei Duan,Hwee-Ling Koh,Shu-Feng Zhou +8 more
TL;DR: An extensive review of the literature identified reported herb-drug interactions with clinical significance, although the underlying mechanisms for the altered drug effects and/or concentrations by concomitant herbal medicines are yet to be determined.
Journal ArticleDOI
Structure, function and regulation of P-glycoprotein and its clinical relevance in drug disposition
TL;DR: Altered P-gp/MDR1 activity due to induction and/or inhibition can cause drug–drug interactions with altered drug pharmacokinetics and response, and is of great clinical importance in non-cancer-related drug therapy due to its wide-ranging effects on the absorption and excretion of a variety of drugs.
Journal ArticleDOI
Herbal Remedies in the United States: Potential Adverse Interactions With Anticancer Agents
TL;DR: It is suggested that health care professionals and consumers should be aware of the potential for adverse interactions with these herbs, question their patients on their use of them, and urge patients to avoid herbs that could confound their cancer care.
Journal ArticleDOI
ABC transporters as multidrug resistance mechanisms and the development of chemosensitizers for their reversal.
TL;DR: In this review, the physiological functions and structures of ABC transporters, and the development of chemosensitizers are described focusing on well-known proteins including P-glycoprotein, multidrug resistance associated protein, and breast cancer resistance protein.
References
More filters
Journal ArticleDOI
Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction
TL;DR: A new method of total RNA isolation by a single extraction with an acid guanidinium thiocyanate-phenol-chloroform mixture is described, providing a pure preparation of undegraded RNA in high yield and can be completed within 4 h.
Journal ArticleDOI
Trends in Alternative Medicine Use in the United States, 1990-1997 Results of a Follow-up National Survey
David Eisenberg,Roger B. Davis,Susan L. Ettner,Scott Appel,Sonja Wilkey,Maria I. Van Rompay,Ronald C. Kessler +6 more
TL;DR: Alternative medicine use and expenditures increased substantially between 1990 and 1997, attributable primarily to an increase in the proportion of the population seeking alternative therapies, rather than increased visits per patient.
Journal ArticleDOI
Biochemical, cellular, and pharmacological aspects of the multidrug transporter
Suresh V. Ambudkar,Saibal Dey,Christine A. Hrycyna,Murali Ramachandra,Ira Pastan,Michael M. Gottesman +5 more
TL;DR: This review summarizes current research on the structure-function analysis of P-glycoprotein, its mechanism of action, and facts and speculations about its normal physiological role.
Biochemical, cellular, and pharmacological aspects of the multidrug
Suresh V. Ambudkar,Saibal Dey,Christine A. Hrycyna,Murali Ramachandra,Ira Pastan,Michael M. Gottesman +5 more
TL;DR: In this paper, a review summarizes current research on the structure-function analysis of P-glycoprotein, its mechanism of action, and facts and speculations about its normal physiological role.
Journal ArticleDOI
The human orphan nuclear receptor PXR is activated by compounds that regulate CYP3A4 gene expression and cause drug interactions.
Jürgen M. Lehmann,David D. McKee,Michael A. Watson,Timothy M. Willson,John T. Moore,Steven A. Kliewer +5 more
TL;DR: The identification of a human (h) orphan nuclear receptor, termed the pregnane X receptor (PXR), that binds to a response element in the CYP3A4 promoter and is activated by a range of drugs known to induce CYP 3A4 expression is reported.