Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.
Division of Gastrointestinal Surgery, Department of Surgery, Ren-Ai Branch, Taipei City Hospital, Taipei, 106, Taiwan.
J Ethnopharmacol. 2021 Oct 5;278:114276. doi: 10.1016/j.jep.2021.114276. Epub 2021 Jun 1.
Valproic acid (VPA) is primarily used as a medicine for the treatment of seizures. Gastrodia elata (G. elata) extract has been used as an alternative medicine for epilepsy patients. Cotreatment with VPA and G. elata extract is commonly prescribed in Taiwan and mainland China. Nevertheless, the mechanism of the blood-brain barrier (BBB) transportation effect of G. elata extract on VPA has not been characterized.
Our hypothesis is that G. elata extract modulates the BBB penetration of VPA through specific transporter transfer.
A validated liquid chromatography-tandem mass spectrometry and multiple microdialysis method was developed to simultaneously monitor VPA in the blood and brain of rats. To investigate the mechanism of BBB modulation by the G. elata extract on VPA in the brain, cyclosporin A, a P-glycoprotein (P-gp) inhibitor and organic anion transporting polypeptide (OATP) inhibitor, was coadministered with the G. elata extract and VPA.
The pharmacokinetic results demonstrated that the VPA penetration ratio of the BBB, determined by the area under the concentration curve (AUC) ratio of VPA (AUC/AUC), was approximately 0.36. After treatment with the G. elata extract (1 and 3 g/kg, p.o. for 5 consecutive days), the VPA penetration ratios were significantly enhanced to 1.47 and 1.02, respectively. However, in the experimental group coadministered cyclosporin A, the G. elata extract was unable to enhance the BBB transportation of VPA. Instead, the VPA penetration ratio in the brain was suppressed back to 0.38.
The present study reveals that the enhancement effect of the transporter mechanism of G. elata extract on VPA transport into the brain occurs through the OATP transporter but not the P-gp transporter.
标题
丙戊酸(VPA)主要用作治疗癫痫的药物。天麻提取物已被用作癫痫患者的替代药物。在台湾和中国大陆,通常会联合使用 VPA 和天麻提取物进行治疗。然而,天麻提取物对 VPA 通过血脑屏障(BBB)的转运作用的机制尚未得到阐明。
我们的假设是,天麻提取物通过特定的转运体转运来调节 BBB 对 VPA 的穿透。
建立了一种经验证的液相色谱-串联质谱和多微透析方法,以同时监测大鼠血液和大脑中的 VPA。为了研究天麻提取物对 VPA 在大脑中 BBB 调节的机制,环孢素 A(一种 P-糖蛋白(P-gp)抑制剂和有机阴离子转运多肽(OATP)抑制剂)与天麻提取物和 VPA 一起给药。
药代动力学结果表明,通过 VPA 的 AUC 比值(AUC/AUC)来确定 BBB 对 VPA 的穿透率,约为 0.36。在用天麻提取物(1 和 3 g/kg,口服连续 5 天)治疗后,VPA 的穿透率分别显著增强至 1.47 和 1.02。然而,在环孢素 A 实验组中,天麻提取物无法增强 VPA 对 BBB 的转运。相反,VPA 在大脑中的穿透率被抑制回 0.38。
本研究揭示了天麻提取物对 VPA 向大脑转运的转运体机制的增强作用是通过 OATP 转运体而不是 P-gp 转运体发生的。