Semisolid Enteral Nutrients Alter the Pharmacokinetics of Orally Administered Levetiracetam in Rats.

Enteral nutrients (ENs) affect the plasma drug concentration of orally co-administered drugs, particularly those of antiepileptic drugs, such as phenytoin and carbamazepine. However, few studies have reported the interactions of levetiracetam (LEV), an upcoming antiepileptic drug, with ENs. In this study we aimed to investigate the pharmacokinetics of LEV in 55 rats after oral co-administration of LEV with liquid or semisolid ENs. Compared with the control group, co-administration with Terumeal ® Soft significantly decreased the plasma LEV concentration at 0.5, 1, and 2 h and area under the plasma concentration-time curve from 0 to 3 h (AUC0→3h) (P < 0.01). However, the AUC0→3h of LEV remained unchanged following the administration of Terumeal ® Soft 2 h after the initial LEV administration. Moreover, co-administration with semisolid Racol® NF delayed the absorption of LEV without decreasing the AUC0→3h, whereas liquid Racol ® NF did not alter LEV pharmacokinetics. Thus, co-administration of LEV with Terumeal® Soft reduced the absorption of LEV from the gastrointestinal tract, which was prevented by administering Terumeal ® Soft 2 h after LEV administration. Semisolid Racol ® NF altered LEV pharmacokinetics without decreasing its gastrointestinal absorption. Our findings suggested that careful monitoring of the plasma LEV levels is necessary when co-administering LEV with Terumeal ® Soft, semisolid Racol ® NF, or any other semisolid ENs, to prevent the inadvertent effects of the interaction between LEV and ENs.

Influence of concurrent and staggered dosing of semi-solid nutrients on the pharmacokinetics of orally administered carbamazepine in rats.

In the present study, we examined the effects of concurrent and staggered dosing of PG-soft ace-MP TM (PG), novel semi-solid enteral nutrients, on the pharmacokinetics of orally administered carbamazepine (CBZ) in rats due to the high possibility of drug interaction during the absorption process. The pharmacokinetic behavior of CBZ was considerably altered when administered concurrently with PG. The maximum serum CBZ concentration (Cmax) significantly decreased and the mean residence time (MRT) significantly increased. The elimination constant (ke) also significantly increased, but there were no significant changes in the area under the serum CBZ concentration versus time curve (AUC) and the time to reach Cmax (Tmax). However, these changes in the pharmacokinetic parameters were eliminated by waiting 20 min, the time interval equivalent to the Tmax described above, between CBZ administration and PG dosing. This study suggested that PG interferes with CBZ absorption from the digestive tract, although staggered administration of CBZ and PG prevented their interaction.

Interaction between phenytoin and enteral nutrients and its influence on gastrointestinal absorption.

The gastrointestinal absorption of phenytoin (PHT), an antiepileptic drug, is often affected by its interaction with co-administered enteral nutrients through a nasogastric (NG) tube, resulting in decreased plasma PHT concentration. In this study, we measured the recovery rate (%) of PHT (Aleviatin® powder) passed through an NG tube when co-administered with distilled water or enteral nutrients (F2α®, Racol® NF, Ensure Liquid® and Renalen® LP). We also measured plasma PHT levels in rats, after oral co-administration of PHT with enteral nutrients. We demonstrate that PHT recovery rate was close to 100 % in all cases after passage through the NG tube. In the rat study, the AUC0→∞ of PHT concentration after oral administration significantly decreased when it was co-administered with F2α® and Racol® NF compared to distilled water. However, the AUC0→∞ of PHT was unchanged when co-administered with F2α® 2 h after initial PHT administration. We therefore conclude that the co-administration of PHT with F2α® and Racol® NF caused a reduction in the absorption of PHT from the gastrointestinal tract to the blood, without adsorption to the NG tube. The administration of enteral nutrients 2 h after PHT is one clear way to prevent a decrease in plasma PHT concentration.

Downregulation of organic cation transporter 1 and breast cancer resistance protein with the induction of Pregnane X receptor in rat kidney impaired by doxorubicin.

Transporters expressed in the kidney play an important role in the excretion of endogenous substances and chemical drugs. The Pregnane X receptor (PXR) has been reported to be involved in regulating the expression of numerous transporters. In the present study, we examined the alteration in expression level of PXR, organic cation transporter 1 (OCT1) and breast cancer resistance protein (BCRP) in renal cell lines of rat origin and the kidney of rats when damaged by doxorubicin (DOX). The expression level of PXR in renal tubular epithelium NRK-52E cells was significantly increased by DOX at a concentration confirmed to cause cellular damage. The expression levels of OCT1 and BCRP were significantly lower in the DOX-treated cells than in the untreated cells. In model rats with DOX-induced nephrotoxicity, the alterations in renal expression of PXR, OCT1 and BCRP were similar to those in NRK-52E cells, although there was a difference in the degree of the changes.

Effects of Gosha-jinki-gan (Chinese herbal medicine: Niu-Che-Sen-Qi-Wan) on hyperinsulinemia and hypertriglyceridemia in prediabetic Zucker fatty rats.

The Chinese herbal medicine, Goshajinki-gan (GJ) (Niu-Che-Sen-Qi-Wan), has been widely used for treating patients with melalgia, lower back pain, numbness, and diabetic neuropathy. We investigated the effects of GJ on the regulation of serum insulin and triglyceride levels in obese Zucker fatty rats (fa/fa; ZFR). We administrated GJ to 6-week-old ZFR and non-obese lean rats (LR) for 12 weeks. Body weight and serum glucose, insulin, total cholesterol, and triglyceride levels were significantly increased at 18 weeks in ZFR as compared to the LR. GJ treatment in ZFR significantly suppressed elevation in serum glucose, insulin, and triglyceride levels, but no significant differences were observed in body weight and serum cholesterol levels in the ZFR group with GJ treatment compared to the ZFR group without GJ treatment. These results suggest that GJ may improve hyperinsulinemia and hypertriglyceridemia in ZFR and that GJ may be useful for preventing or delaying the onset of diabetes mellitus in a pre-diabetic state.

Efflux transporter mRNA expression profiles in differentiating JEG-3 human choriocarcinoma cells as a placental transport model.

The kinetics of drug transport across the trophoblast layer is determined by several factors. Human choriocarcinoma cell lines like BeWo and JEG-3 have been used as models of the trophoblast layer to examine the placental transport of drugs. Previously, the drugs examined in these models have been readily transported across the trophoblast layer via cellular gap junctions. These backgrounds enabled us to establish the differentiating JEG-3 cell (DJEG) layer model, which suppresses paracellular drug transport, as an evaluation system of placental drug transport. The efflux transporters on the trophoblast layer assume the meaningful role of protecting the fetus from xenobiotic substances. In order to clarify the usefulness of our DJEG placental drug transport model, this study examined the mRNA expression profiles of the efflux transporters MRPs, MDR1, and BCRP in JEG-3 cells and compared them with those of BeWo cells and their known placental expression. We suggest that the mRNA of efflux transporters MRP 1-8 and BCRP are expressed widely in JEG-3 cells; however, expression levels of MDR1 mRNA were undetectable. It was also indicated that polymorphisms of BCRP C421A in both the BeWo and JEG-3 cells are of the wild-type. We demonstrated the efflux transporters' expression profiles, as well as those of the BeWo cells, was demonstrated in the DJEG placental drug transport evaluating model as well as the BeWo cells, in the DJEG placental drug transport evaluation model. Based on these findings, we hope that the DJEG model will be adequate for use in evaluating placental drug transport in relation to the transporter proteins.

Effects of Gosha-jinki-gan (Chinese herbal medicine: Niu-Che-Sen-Qi-Wan) on hyperinsulinemia induced in rats fed a sucrose-rich diet.

We investigated the effects of a Chinese herbal medicine, Gosha-jinki-gan (GJG), on the regulation of insulin levels in rats fed a sucrose-rich diet (SRD). Normal Wistar rats in the SRD group were fed an SRD for 4 weeks. Increased dietary sucrose did not alter plasma glucose levels but it increased plasma insulin levels at 2 and 4 weeks in the SRD-fed rats relative to control rats that were fed standard chow. GJG treatment significantly suppressed the SRD-induced elevation in plasma insulin levels. These results suggest that GJG improves hyperinsulinemia caused by an SRD.

Effects of the herbal medicine Hachimi-jio-gan (Ba-Wei-Di-Huang-Wan) on insulin secretion and glucose tolerance in type 2 diabetic Goto-Kakizaki rats.

Hachimi-jio-gan (HJ) is a Chinese medicine that has been widely used for the treatment of nephrotic syndromes, hypertension, and diabetes mellitus. We reported that HJ lowers plasma glucose in type 1 diabetic rats. We investigated the effects of HJ on diabetic hyperglycemia and insulin secretion in type 2 diabetic Goto-Kakizaki (GK) rats. Eight-week-old diabetic GK rats were given free access to pellets containing 1% HJ extract powder for 14 weeks. HJ consumption increased the food intake and body weight of these rats in comparison to control rats. HJ may control the body weight loss observed in GK rats. HJ also reduced hyperglycemia in diabetic GK rats, and it significantly increased insulin secretion in non-fasting GK rats over the experimental period. In oral glucose tolerance tests, HJ significantly improved the insulin response at 30 min and reduced the plasma glucose level at 60 min after glucose administration (p < 0.05). Ten weeks after administration, the plasma leptin levels significantly increased in the HJ group rats. These results demonstrate that in diabetic GK rats, HJ decreased the level of postprandial glucose via enhanced insulin secretion coupled with the regulation of food intake by leptin.

Characterization of multidrug resistance-associated protein mRNAs expression profiles in Caco-2 and HT-1080 cell lines induced by methotrexate.

An efflux function induced by multidrug resistance-associated proteins (MRPs) contributes to the mechanisms of resistance to methotrexate (MTX). Since it has been reported that the human Caucasian colon adenocarcinoma cell line (Caco-2) shows high MRPs expression, it is assumed that Caco-2 cells are resistant to MTX. Alternatively, the human fibrosarcoma cell line (HT-1080) has been reported to be highly sensitive to MTX. In this study, the difference in the growth-inhibitory activity of MTX in these cell lines was compared as a characteristic of sensitivity. Subsequently, the characterization of MRP (1-8) mRNAs expression profiles before and after MTX exposure in these cell types was examined with the multiplex reverse-transcription-polymerase chain reaction (RT-PCR) method. It was demonstrated that the expressions of MRP2, MRP3, MRP6, and MRP8 mRNAs in the HT-1080 cells were lower than those in the Caco-2 cells and that only MRP5 mRNA expression was induced in the Caco-2 cells after MTX treatment. The MRP mRNAs expression profiles between these two cell lines could be differentiated widely. The characterization of MRPs profiles might be associated with resistance to MTX in cells. Additionally, this multiplex RT-PCR method would be beneficial for further time-dependence investigations of the MRP mRNAs expression profiles.

Localization of glucagon-like peptide-2 receptor mRNA expression at different sites in the small intestine of rats.

Preproglucagon is known to be processed into glucagon-like peptide (GLP)-1, GLP-2, and glicentin in the L cells of the intestinal tract. GLP-2 has been shown to possess intestinotrophic activity in rodents. However, the ligand-binding mechanisms of GLP-2 receptor (GLP-2R) have not been extensively investigated. The present study sought to determine the localization of GLP-2R in the small intestine by analyzing GLP-2R mRNA expression using the reverse transcriptase-polymerase chain reaction (RT-PCR) method. GLP-2R mRNA expression was detected at all sites in the small intestine; its expression levels were particularly high in the jejunum. Moreover, GLP-2R mRNA expression was detected in both non-mucosal intestinal tissues and intestinal mucosa. These findings suggest that in addition to the intestinal mucosa, the functional sites of GLP-2 may be present in the non-mucosal tissues. These results imply that GLP-2 peptide acts as an intestinotrophic factor that may affect the intestines from outside the mucosa. The intestinotrophic effect of GLP-2 from outside the mucosa may be a function of the enteric neurons transmitting several growth signals to mucosal cells.