Li Yanyan, Yang Ke, Zhao Linxian, Xu Chunyi, Zhou Weiling, Wang Zhanguo, Hu Huiling, You Yu
State Key Laboratory of Southwestern Chinese Medicine Resources, Department of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
Holistic Integrative Medicine Industry Collaborative Innovation Research Center, Qiang Medicine Standard Research Promotion Base and Collaborative Innovation Research Center, School of Preclinical Medicine, Chengdu University, Chengdu, 610106, China.
J Ethnopharmacol. 2024 Jan 10;318(Pt B):117057. doi: 10.1016/j.jep.2023.117057. Epub 2023 Aug 17.
Ginseng Radix et Rhizoma (GRR) and Schisandrae Chinensis Fructus (SCF) are frequently used as herb pairs in traditional herbal formulas especially for the synergetic beneficial effects on lung and heart. Shengmai-yin (SMY), a noted formula, was first published in the traditional Chinese medicine classic named Yixue Qiyuan written by Zhang Yuansu in the Jin Dynasty, and has been used for deficiency of both qi and yin, palpitation, shortness of breath and spontaneous sweating. In SMY, GRR, a sovereign herb, plays an essential role in tonifying lung and supplementing qi, and SCF as an adjuvant herb contributes to the effects of nourishing yin and promoting fluid production, both of which are traditionally used as invigorants in China, Korea, Japan, and Russia. However, the underlying compatibility mechanism of GRR-SCF has remained unknown.
In order to explore the impact and underlying mechanism of schisandra chinensis extract (SCE) on the absorption of ginsenosides Rb, Rc, Rb and Rd belonging to protopanaxdiol (PPD)-type and ginsenosides Rg and Re belonging to protopanaxtriol (PPT)-type, pharmacokinetic studies, molecular docking technique and single-pass intestinal perfusion (SPIP) experiment were conducted.
Preliminarily, pharmacokinetic characteristics of ginseng extract (GE) in the presence and absence of SCE were studied. Thereafter, molecular docking was used to predict whether ginsenosides were P-glycoprotein (P-gp) or cytochrome P450 isoenzyme 3A4 (CYP3A4) substrates. Finally, the effects and underlying mechanism of SCE on the absorption of GE were further investigated by in situ SPIP experiment.
Our findings indicated that SCE could increase exposure in vivo and the intestinal absorption of distinct ginsenosides. Additionally, we found that the PPD-type ginsenosides Rb, Rc, Rb, and Rd were substrates for P-gp, and the PPT-type ginsenosides Rg and Re were substrates for CYP3A4 rather than P-gp. SCE, which has been found with extensive inhibitory effects on P-gp and CYP3A4, could remarkably promote the intestinal absorption of ginsenosides Rg, Re, Rb, Rc, Rb, and Rd, obtaining similar effects comparable with ketoconazole known as a classic dual inhibitor of P-gp and CYP3A4.
The study demonstrated that SCE could improve the absorption of GE, and revealed the underlying compatibility mechanism of GRR and SCF from the perspective of P-gp and CYP3A4-mediated interactions to some extent, which provided a certain scientific reference for the compatibility and clinical practice of GRR-SCF as common herb pairs in traditional prescriptions such as SMY. Moreover, this study also furnished a strategy for improving the oral bioavailability of different types of ginsenosides by drug combinations.
人参(GRR)和五味子(SCF)在传统中药配方中常作为药对使用,尤其对肺和心脏具有协同有益作用。生脉饮(SMY)是一个著名的方剂,最早发表于金朝张元素所著的中医经典《医学启源》中,用于治疗气阴两虚、心悸、气短和自汗。在生脉饮中,人参作为君药,在补肺益气方面起关键作用,五味子作为佐药,有助于滋阴生津,二者在中国、韩国、日本和俄罗斯传统上均用作滋补剂。然而,人参 - 五味子的潜在配伍机制尚不清楚。
为了探讨五味子提取物(SCE)对原人参二醇(PPD)型人参皂苷Rb、Rc、Rb和Rd以及原人参三醇(PPT)型人参皂苷Rg和Re吸收的影响及潜在机制,进行了药代动力学研究、分子对接技术和单通道肠道灌注(SPIP)实验。
首先,研究了人参提取物(GE)在有和没有SCE存在时的药代动力学特征。此后,使用分子对接预测人参皂苷是否为P - 糖蛋白(P - gp)或细胞色素P450同工酶3A4(CYP3A4)底物。最后,通过原位SPIP实验进一步研究SCE对GE吸收的影响及其潜在机制。
我们的研究结果表明,SCE可以增加体内暴露量和不同人参皂苷的肠道吸收。此外,我们发现PPD型人参皂苷Rb、Rc、Rb和Rd是P - gp的底物,PPT型人参皂苷Rg和Re是CYP3A4而非P - gp的底物。已发现对P - gp和CYP3A4具有广泛抑制作用的SCE,可以显著促进人参皂苷Rg、Re、Rb、Rc、Rb和Rd的肠道吸收,获得与已知的P - gp和CYP3A4经典双重抑制剂酮康唑相似的效果。
该研究表明SCE可以改善GE的吸收,并在一定程度上从P - gp和CYP3A4介导的相互作用角度揭示了人参和五味子的潜在配伍机制,为像生脉饮这样的传统方剂中人参 - 五味子这一常见药对的配伍及临床应用提供了一定的科学参考。此外,该研究还为通过药物组合提高不同类型人参皂苷的口服生物利用度提供了一种策略。