MyoKardia, South San Francisco, CA, USA.
J Food Drug Anal. 2018 Apr;26(2S):S32-S44. doi: 10.1016/j.jfda.2017.11.008. Epub 2017 Dec 19.
The growing use of natural products in cardiovascular (CV) patients has been greatly raising the concerns about potential natural product-CV drug interactions. Some of these may lead to unexpected cardiovascular adverse effects and it is, therefore, essential to identify or predict potential natural product-CV drug interactions, and to understand the underlying mechanisms. Drug transporters are important determinants for the pharmacokinetics of drugs and alterations of drug transport has been recognized as one of the major causes of natural product-drug interactions. In last two decades, many CV drugs (e.g., angiotensin II receptor blockers, beta-blockers and statins) have been identified to be substrates and inhibitors of the solute carrier (SLC) transporters and the ATP-binding cassette (ABC) transporters, which are two major transporter superfamilies. Meanwhile, in vitro and in vivo studies indicate that a growing number of natural products showed cardioprotective effects (e.g., gingko biloba, danshen and their active ingredients) are also substrates and inhibitors of drug transporters. Thus, to understand transporter-mediated natural product-CV drug interactions is important and some transporter-mediated interactions have already shown to have clinical relevance. In this review, we review the current knowledge on the role of ABC and SLC transporters in CV therapy, as well as transporter modulation by natural products used in CV diseases and their induced natural product-CV drug interactions through alterations of drug transport. We hope our review will aid in a comprehensive summary of transporter-mediated natural product-CV drug interactions and help public and physicians understand these type of interactions.
天然产物在心血管（CV）患者中的应用日益增多，这使得人们对潜在的天然产物与 CV 药物相互作用的关注大大增加。其中一些可能导致意想不到的心血管不良事件，因此，识别或预测潜在的天然产物与 CV 药物相互作用，并了解其潜在机制至关重要。药物转运体是药物药代动力学的重要决定因素，药物转运的改变已被认为是天然产物-药物相互作用的主要原因之一。在过去的二十年中，许多 CV 药物（如血管紧张素 II 受体阻滞剂、β受体阻滞剂和他汀类药物）已被确定为溶质载体（SLC）转运体和三磷酸腺苷结合盒（ABC）转运体的底物和抑制剂，这两种转运体是两个主要的转运体超家族。同时，体外和体内研究表明，越来越多的具有心脏保护作用的天然产物（如银杏叶、丹参及其有效成分）也是药物转运体的底物和抑制剂。因此，了解转运体介导的天然产物与 CV 药物相互作用非常重要，一些转运体介导的相互作用已经显示出临床相关性。在这篇综述中，我们回顾了 ABC 和 SLC 转运体在 CV 治疗中的作用，以及天然产物对 CV 疾病中使用的天然产物的转运体调节作用，以及它们通过改变药物转运诱导的天然产物与 CV 药物相互作用。我们希望我们的综述将有助于对转运体介导的天然产物与 CV 药物相互作用进行全面总结，并帮助公众和医生了解这类相互作用。
