Marked decrease of cyclosporin bioavailability caused by coadministration of ginkgo and onion in rats.

Quercetin was reported to modulate CYP isoenzymes and P-glycoprotein (Pgp), a drug efflux transporter. Our previous study reported that quercetin significantly decreased the bioavailability of cyclosporin, a substrate for CYP3A4 and Pgp, in rats and pigs. Ginkgo and onion contain quercetin and its glycosides as St. John's Wort. The coadministration of cyclosporin with ginkgo or onion may be subject to clinically relevant interactions as St. John's Wort. Therefore, this study aimed to investigate the influences of ginkgo and onion on the absorption and disposition of cyclosporin in rats. Cyclosporin was administered orally and intravenously to rats with and without an oral dose of ginkgo or onion in crossover designs. Blood samples were collected via cardiopuncture and blood cyclosporin concentration was assayed by a specific monoclonal fluorescence polarization immunoassay. Everted gut sac was used to investigate the effects of ginkgo and onion on the function of intestinal Pgp. Oral coadministration of ginkgo and onion significantly decreased the Cmax of cyclosporin by 62% and 60%, and reduced the AUC0-t by 51% and 68%, respectively, whereas no influence was observed when cyclosporin was given intravenously. This indicates that the interactions between cyclosporin and ginkgo or onion occurred mainly at the absorption site. In conclusion, ginkgo and onion markedly decreased the oral bioavailability of cyclosporin. We suggest that concurrent intake of quercetin-rich herbs or foods with cyclosporin are better avoided in order to ensure the efficacy of cyclosporin.

Effects of glucose, fructose and 5-hydroxymethyl-2-furaldehyde on the presystemic metabolism and absorption of glycyrrhizin in rabbits.

Our previous study reported that co-administration of honey significantly increased the serum levels of glycyrrhetic acid (GA) after oral administration of glycyrrhizin (GZ) in rabbits. The components of honey are sucrose, glucose, fructose and 5-hydroxymethyl-furaldehyde (HMF). To clarify the causative component(s) in honey that altered the metabolic pharmacokinetics of GZ, rabbits were given GZ (150 mg kg(-1)) with and without glucose (5 g/rabbit), fructose (5 g/rabbit) and HMF (1 mg kg(-1)), respectively, in crossover designs. An HPLC method was used to determine concentrations of GZ and GA in serum as well as GA and 3-dehydroglycyrrhetic acid (3-dehydroGA) in faeces suspension. A noncompartment model was used to calculate the pharmacokinetic parameters and analysis of variance was used for statistical comparison. Our results indicated that the area under curve (AUC) of GA was significantly increased by 29% when HMF was coadministered, whereas the pharmacokinetics of GZ and GA were not significantly altered by coadministration of glucose or fructose. An in-vitro study, using faeces to incubate GZ and GA individually, indicated that HMF significantly inhibited the oxidation of GA to 3-dehydroGA and this may explain the enhanced GA absorption in-vivo. It was concluded that HMF is the causative component in honey that affects the presystemic metabolism and pharmacokinetics of GZ in-vivo.

Profound difference in pharmacokinetics between morin and its isomer quercetin in rats.

Morin and quercetin are isomeric antioxidant flavonols widely distributed in plant foods and herbs. The pharmacokinetics of both flavonols at two doses were investigated and compared in rats. Parent forms and their glucuronides and sulfates in serum were determined by HPLC before and after enzymatic hydrolysis, respectively. After oral dosing of morin, both the parent form, morin, and its glucuronides and sulfates were present in the bloodstream. The conjugated metabolites predominated at the dose of 25 mg kg(-1), whereas the parent form was predominant at the dose of 50 mg kg(-1). Moreover, the AUC of morin parent form increased by a factor of 37 when the dose doubled, indicating that morin showed nonlinear pharmacokinetics. On the other hand, quercetin presented only as glucuronides and sulfates in the blood, indicating negligible bioavailability of quercetin, and the metabolites showed linear pharmacokinetics at the two doses studied. When considering the total AUC of parent form with conjugated metabolites, the extent of absorption of morin was 3 fold that of quercetin at the dose of 50 mg kg(-1). The results indicated that the difference in hydroxylation pattern on B-ring of flavonol markedly affected their fates in rats.

Effect of honey and sugars on the metabolism and disposition of naringin in rabbits.

To investigate the effect of honey and sugars on the metabolism and disposition of naringin, rabbits were administered naringin alone and naringin with honey or its component sugars - fructose, glucose and sucrose in crossover designs. An HPLC method was developed to determine naringenin in serum after enzymatic hydrolysis. Our results indicate that honey, fructose and sucrose significantly reduced AUC(0-t) of naringenin by 41 %, 61 % and 45 %, respectively. In vitro studies using a rabbit feces suspension to incubate naringin without or with honey or the respective sugars were employed to investigate the mechanism of this interaction. The results indicated that honey and its component sugars did not affect the rate and extent of naringin hydrolysis, whereas the degradation of naringenin was significantly enhanced in the presence of honey and fructose. It could be concluded that concomitant intake of honey, fructose and sucrose resulted in the reduction of naringin absorption which could be attributable in part to the enhanced preabsorption degradation of absorbable naringenin in the large intestine.

Determinations of morin, quercetin and their conjugate metabolites in serum.

Morin and quercetin are isomeric antioxidant flavonols. High-performance liquid chromatographic methods were developed for the quantitation of morin and quercetin in serum. The method employed a Cosmosil RP-18 column, using acetonitrile/0.2% o-phosphoric acid 28/72 and 27/73 (v/v) as mobile phases, with ethyl paraben and 6,7-dimethoxycoumarin used as internal standards for morin and quercetin, respectively. Moreover, a strategy to stabilize morin/quercetin released from their glucuronides/sulfates in serum during hydrolysis was established. The present methods are applicable for determining morin, quercetin, and their glucuronides/sulfates in serum.

Acute intoxication of cyclosporin caused by coadministration of decoctions of the fruits of Citrus aurantium and the Pericarps of Citrus grandis.

In order to investigate the effects of Citrus herbs on cyclosporin absorption and disposition, swine were given cyclosporin (10 mg/kg) with or without decoctions of Citri Aurantii Fructus (CAF) or Citri Grandis Pericarpium (CGP) in a crossover design. FPIA method (fluorescence polarization immunoassay) was used to determine the blood concentration of cyclosporin. The decoctions were characterized by their flavanone contents. Our results indicated that the coadministration of CAF and CGP significantly increased the Cmax of cyclosporin by 64% and 79%, respectively. The AUC of cyclosporin was significantly elevated by 97% when coadministered with CGP. Among the swine, 1/5 and 3/5 exhibited acute toxicity of cyclosporin after concomitant intake of CAF and CGP, respectively. This indicates an interaction of Citrus compounds with a commonly used drug. We suggest when cyclosporin is coadministered with these Citrus decoctions, the blood concentration of cyclosporin should be carefully monitored for dose adjustment to avoid cyclosporin intoxication.

Effect of honey on naringin absorption from a decoction of the pericarps of Citrus grandis.

To measure naringin/naringenin absorption of a decoction prepared from the pericarps of Citrus grandis and to investigate the effect of honey on naringin/naringenin absorption, six healthy males received 200 mL decoctions of untreated and honey-treated Pericarpium Citri Grandis in a randomized crossover design. The absorption was measured by renal recovery of naringenin glucuronides/sulfates over 48 hours. The contents of naringin/naringenin in 200 mL decoctions of untreated and honey-treated Pericarpium Citri Grandis were determined to be 261.5/23.8 mumol and 303.3/11.6 mumol, respectively. The mean cumulated renal excretion of naringenin glucuronides/sulfates after intake of these two decoctions were 74.8 mumol (26.2% of dose) and 49.8 mumol (15.8% of dose), respectively. Paired Student's t-test showed that the difference of the total renal recovery of naringin/naringenin between the two decoctions was significant. The results indicated that honey significantly reduced naringin/naringenin absorption by 33.4% in humans and suggested that honey treatment might alter the efficacy of Pericarpium Citri Grandis.

Emodin pharmacokinetics in rabbits.

Administration of emodin to rabbits by i.v. bolus resulted in a serum profile which could be well described by a two-compartment model. The AUC of emodin was 518 micrograms.min/ml, clearance was 72.3 ml/min, and elimination half life was 227 min which was much longer than that reported in a previous study. Oral administration of emodin resulted in a very low serum concentration. Protein binding of emodin was investigated by the equilibrium dialysis method. Emodin was found to be highly bound (99.6%) to serum protein.