Induction of intestinal P-glycoprotein by St John's wort reduces the oral bioavailability of talinolol
| Autor: | Ute I. Schwarz, Hartmut Glaeser, Wilhelm Kirch, Eberhard Kuhlisch, George K. Dresser, H. Hanso, Monika Hitzl, Richard B. Kim, Reinhard Oertel, Stephan Miehlke |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Genotype Adrenergic beta-Antagonists Blotting Western Cmax Administration Oral Biological Availability Pharmacology Propanolamines chemistry.chemical_compound Pharmacokinetics In vivo Oral administration Medicine Humans Pharmacology (medical) Drug Interactions ATP Binding Cassette Transporter Subfamily B Member 1 RNA Messenger Intestinal Mucosa P-glycoprotein biology business.industry Microfilament Proteins Hypericum perforatum Endoscopy Exons Bioavailability Intestines chemistry Injections Intravenous biology.protein business Hypericum Talinolol Half-Life |
| Zdroj: | Clinical pharmacology and therapeutics. 81(5) |
| ISSN: | 0009-9236 |
| Popis: | St John's wort (SJW) is known to induce cytochrome P450 (CYP) 3A4 and P-glycoprotein through pregnane X-receptor activation. Our study evaluated the effects of long-term SJW administration on oral and intravenous pharmacokinetics of the nonmetabolized in vivo probe of P-glycoprotein, talinolol, in relation to intestinal P-glycoprotein expression. In a controlled, randomized study (N=9), the pharmacokinetics of oral (50 mg) and intravenous talinolol (30 mg) was determined before and after 12 days SJW (900 mg daily, Jarsin 300®). Duodenal biopsies were taken and MDR1 genotypes assessed. SJW reduced the oral talinolol bioavailability by 25% (P=0.049) compared with water control. A 93% increase in oral clearance (P=0.177) and a 31% reduction in area under the serum concentration time curve (AUC; P=0.030) were observed. Renal and nonrenal clearance (CLNR), elimination half-life, peak serum drug concentration (Cmax), and time to reach Cmax were not significantly altered. After intravenous talinolol, SJW affected only CLNR (35% increase compared with water, P=0.006). SJW increased MDR1 messenger ribonucleic acid (mRNA) as well as P-glycoprotein levels in the duodenal mucosa. Subjects with the combined MDR1 genotype comprising 1236C>T, 2677G>T/A, and 3435C>T polymorphisms had lower intestinal MDR1 mRNA levels and displayed an attenuated inductive response to SJW as assessed by talinolol disposition. Long-term SJW decreased talinolol AUC with a corresponding increase in intestinal MDR1 expression, suggesting that SJW has a major inductive effect on intestinal P-glycoprotein. Interestingly, the magnitude of induction appeared to be affected by MDR1 genotype. Clinical Pharmacology & Therapeutics (2007) 81, 669–678. doi:10.1038/sj.clpt.6100191; published online 28 March 2007 |
| Databáze: | OpenAIRE |
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