Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Programa de Pós-Graduação em Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Chem Biol Interact. 2019 Dec 1;314:108825. doi: 10.1016/j.cbi.2019.108825. Epub 2019 Sep 22.
The World Health Organization (WHO) and other worldwide health agencies have recently taken initiatives to encourage the use of traditional medicine and/or complementary/alternative medicine in order to promote well-being and public health. In this way, one of the WHO's concerns is the safe use of these therapies. Phytotherapy is a strategy consisting of the use of medicinal plants (MP) and/or herbal medicinal products (HMP) for medicinal purposes. The use of phytotherapy concomitantly with drugs may cause interactions compromising the expected pharmacological action or generating toxic effects. These interactions are complex processes that may occur with multiple medications targeting different metabolic pathways, and involving different compounds present in MP and HMP. Thus, the aim of this review was to summarize the main MP- and HMP-drug interactions that involve specific transporters (P-glycoprotein and BCRP) and CYP450 enzymes (CYP3A4 and CYP2D6), which play relevant roles in the mechanisms of interactions. Firstly, multiple databases were used to search studies describing in vitro or in vivo MP and HMP-drug interactions and, after that, a systematic note-taking and appraisal of the literature was conducted. It was observed that several MP and HMP, metabolic pathways and transcription factors are involved in the transporters and enzymes expression or in the modulation of their activity having the potential to provide such interactions. Thus, the knowledge of MP- and HMP-drug interaction mechanisms could contribute to prevent harmful interactions and can ensure the safe use of these products to help the establishment of the therapeutic planning in order to certify the best treatment strategy to be used.
世界卫生组织（WHO）和其他全球卫生机构最近采取了主动行动，鼓励使用传统医学和/或补充/替代医学，以促进健康和公共卫生。这样，WHO 的关注点之一就是这些疗法的安全使用。植物疗法是一种策略，包括使用药用植物（MP）和/或草药药物（HMP）进行药用。同时使用植物疗法和药物可能会引起相互作用，从而影响预期的药理作用或产生毒性作用。这些相互作用是复杂的过程，可能涉及针对不同代谢途径的多种药物，并且涉及 MP 和 HMP 中存在的不同化合物。因此，本综述的目的是总结涉及特定转运蛋白（P-糖蛋白和 BCRP）和 CYP450 酶（CYP3A4 和 CYP2D6）的主要 MP 和 HMP-药物相互作用，这些转运蛋白和酶在相互作用机制中起着重要作用。首先，使用多个数据库搜索描述 MP 和 HMP 与药物相互作用的体内和体外研究，然后对文献进行系统的笔记记录和评估。观察到几种 MP 和 HMP、代谢途径和转录因子参与转运蛋白和酶的表达或其活性的调节，从而具有提供此类相互作用的潜力。因此，了解 MP 和 HMP-药物相互作用机制有助于预防有害的相互作用，并可以确保安全使用这些产品，以帮助制定治疗计划，以确保使用最佳的治疗策略。
