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Update of green tea interactions with cardiovascular drugs and putative mechanisms
Journal of Food and Drug Analysis ( IF 2.6 ) Pub Date : 2018-04-01 , DOI: 10.1016/j.jfda.2018.01.008
José Pablo Werba 1 , Shingen Misaka 2 , Monica Gianna Giroli 1 , Kenju Shimomura 2 , Manuela Amato 3 , Niccolò Simonelli 1 , Lorenzo Vigo 3 , Elena Tremoli 1
Affiliation  

Many patients treated with cardiovascular (CV) drugs drink green tea (GT), either as a cultural tradition or persuaded of its putative beneficial effects for health. Yet, GT may affect the pharmacokinetics and pharmacodynamics of CV compounds. Novel GT-CV drug interactions were reported for rosuvastatin, sildenafil and tacrolimus. Putative mechanisms involve inhibitory effects of GT catechins at the intestinal level on influx transporters OATP1A2 or OATP2B1 for rosuvastatin, on CYP3A for sildenafil and on both CYP3A and the efflux transporter p-glycoprotein for tacrolimus. These interactions, which add to those previously described with simvastatin, nadolol and warfarin, might lead, in some cases, to reduced drug efficacy or risk of drug toxicity. Oddly, available data on GT interaction with CV compounds with a narrow therapeutic index, such as warfarin and tacrolimus, derive from single case reports. Conversely, GT interactions with simvastatin, rosuvastatin, nadolol and sildenafil were documented through pharmacokinetic studies. In these, the effect of GT or GT derivatives on drug exposure was mild to moderate, but a high inter-individual variability was observed. Further investigations, including studies on the effect of the dose and the time of GT intake are necessary to understand more in depth the clinical relevance of GT-CV drug interactions.

中文翻译:

绿茶与心血管药物相互作用和推定机制的更新

许多接受心血管 (CV) 药物治疗的患者喝绿茶 (GT),要么作为一种文化传统,要么被认为对健康有益。然而,GT 可能会影响 CV 化合物的药代动力学和药效学。瑞舒伐他汀、西地那非和他克莫司报告了新的 GT-CV 药物相互作用。推定的机制涉及 GT 儿茶素在肠道水平对罗苏伐他汀的流入转运蛋白 OATP1A2 或 OATP2B1、西地那非的 CYP3A 以及他克莫司的 CYP3A 和流出转运蛋白 p-糖蛋白的抑制作用。这些相互作用,加上之前描述的辛伐他汀、纳多洛尔和华法林的相互作用,在某些情况下可能导致药物疗效或药物毒性风险降低。奇怪的是,关于 GT 与治疗指数较窄的 CV 化合物相互作用的可用数据,如华法林和他克莫司,来源于单个病例报告。相反,通过药代动力学研究记录了 GT 与辛伐他汀、瑞舒伐他汀、纳多洛尔和西地那非的相互作用。在这些研究中,GT 或 GT 衍生物对药物暴露的影响为轻度至中度,但观察到个体间差异很大。为了更深入地了解 GT-CV 药物相互作用的临床相关性,需要进一步的研究,包括对剂量和 GT 摄入时间影响的研究。
更新日期:2018-04-01
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