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The Effects of Cruciferous Vegetable-Enriched Diets on Drug Metabolism: A Systematic Review and Meta-Analysis of Dietary Intervention Trials in Humans.
Clinical Pharmacology & Therapeutics ( IF 6.3 ) Pub Date : 2020-02-22 , DOI: 10.1002/cpt.1811
Shane K Eagles 1, 2 , Annette S Gross 1, 3 , Andrew J McLachlan 1, 2
Affiliation  

Relatively few studies exist in the literature that discuss the effects of diet on drug metabolism and how this can affect interindividual differences in systemic drug exposure. Several studies have investigated the effects of cruciferous vegetables (Cruciferae ) or their constituents on drug‐metabolizing activity, as these vegetables form an important part of many peoples’ diets. In general, the ingestion of cruciferous vegetables is associated with induction of cytochrome P450 (CYP) 1A2 activity in vivo ; however, there is contention between reports, and the clinical significance of potential diet–drug interactions remains unclear. This study reports a systematic review, critical appraisal, and meta‐analysis of the published literature in this area, and discusses the clinical significance of Cruciferae‐enriched diets in the context of diet–drug interactions. Twenty‐three dietary intervention trials with drug metabolism end points were identified across Embase, Medline, and the Cochrane Controlled Register of Trials (CENTRAL). Cruciferous vegetables represented in the literature included broccoli, Brussels sprout, cabbage, cauliflower, radish, and watercress. A range of phase I and II drug‐metabolizing enzymes and phenotyping metrics were represented in the literature. The meta‐analyses performed demonstrated a significant effect on CYP1A2 and glutathione S‐transferase‐alpha (GST‐α), with consumption of Cruciferae increasing the activities of these enzymes by 20–40% and 15–35%, respectively. The results herein suggest that patients undergoing pharmacotherapy with CYP1A2 or GST‐α substrates could have altered drug exposure profiles if they regularly eat large or variable amounts of cruciferous vegetables. Recommendations regarding the design of future randomized, controlled trials to test hypotheses in this area are included.

中文翻译:

十字花科蔬菜丰富的饮食对药物代谢的影响:人类饮食干预试验的系统评价和荟萃分析。

在文献中,很少有研究讨论饮食对药物代谢的影响以及这如何影响全身性药物暴露的个体差异。几项研究调查了十字花科蔬菜(十字花科)或其成分对药物代谢活性的影响,因为这些蔬菜构成了许多人饮食中的重要组成部分。一般而言,十字花科蔬菜的摄入与体内细胞色素P450(CYP)1A2活性的诱导有关; 然而,报告之间存在争议,潜在的饮食-药物相互作用的临床意义仍不清楚。这项研究报告了对该领域已发表文献的系统评价,重要评价和荟萃分析,并讨论了十字花科的临床意义。在饮食与药物相互作用的背景下富含饮食。在Embase,Medline和Cochrane对照试验注册簿(CENTRAL)中确定了23项涉及药物代谢终点的饮食干预试验。文献中的十字花科蔬菜包括西兰花,抱子甘蓝,卷心菜,花椰菜,萝卜和豆瓣菜。文献中介绍了一系列I和II期药物代谢酶和表型指标。进行的荟萃分析显示,对十字花科的食用对CYP1A2和谷胱甘肽S-转移酶-α(GST-α)有显着影响将这些酶的活性分别提高20-40%和15-35%。本文的结果表明,如果接受CYP1A2或GST-α底物的药物治疗的患者经常吃大量或不同量的十字花科蔬菜,则可能会改变药物的暴露状况。包括有关未来随机对照试验设计的建议,以检验该领域的假设。
更新日期:2020-02-22
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