Department of Pharmaceutics, College of Pharmacy, King Saud University, 11451, Riyadh, Saudi Arabia.
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, 11451, Riyadh, Saudi Arabia.
Eur J Drug Metab Pharmacokinet. 2024 Mar;49(2):239-247. doi: 10.1007/s13318-024-00881-9. Epub 2024 Feb 20.
BACKGROUND AND OBJECTIVES: The novel tyrosine kinase inhibitor (TKI) dasatinib, a multitarget inhibitor of Bcr-Abl and Src family kinases, has been licensed for the treatment of Ph+ acute lymphoblastic leukemia and chronic myeloid leukemia. Many citrus-based foods include the flavonoid naringenin, which is commonly available. Dasatinib is a Cyp3a4, P-gp, and Bcrp1 substrate, which makes it sensitive to potential food-drug interactions. The concurrent use of naringenin may change the pharmacokinetics of dasatinib, which could result in adverse effects and toxicity. The present investigation examined the impact of naringenin on the pharmacokinetics interactions of DAS and proposes a possible interaction mechanism in Wistar rats. METHODS: Rats were provided with a single oral dose of dasatinib (25 mg/kg) with or without naringenin pretreatment (150 mg/kg p.o. daily for 7 days, n = 6 in each group). Dasatinib was quantified in plasma by UHPLC MS/MS assay. Noncompartmental analysis was used to compute the pharmacokinetic parameters, and immunoblot was used to assess the protein expression in the hepatic and intestinal tissues. RESULTS: Following 7 days of naringenin pretreatment, the plasma mean concentration of dasatinib was enhanced compared with without pretreatment. In rats that were pretreated with naringenin, the pharmacokinetics of the orally administered dasatinib (25 mg/kg) was shown to be significantly different from that of dasatinib given without pretreatment (p < 0.05). There was a significant enhancement in pharmacokinetic parameters elimination half-life (T), time to maximum concentration ( T), maximum concentration )C), area under the concentration-time curve (AUC), area under the moment curve (AUMC), and mean residence time (MRT) by 28.41%, 50%, 103.54%, 72.64%, 115.08%, and 15.19%, respectively (p < 0.05) and suppression in elimination rate constant (K), volume of distribution (V), and clearance (CL) by 21.09%, 31.13%, and 46.25%, respectively, in comparison with dasatinib alone group (p < 0.05). The enhancement in dasatinib bioavailability and systemic exposure resulted from the significant inhibition of Cyp3a2, Mdr1/P-gp, and Bcrp1 expression and suppression of the dasatinib hepatic and intestinal metabolism, which enhanced the rate of dasatinib absorption and decreased its elimination. CONCLUSION: Concurrent use of naringenin-containing supplements, herbs, or foods with dasatinib may cause serious and potentially life-threatening drug interactions. Further studies are necessary to determine the clinical significance of these findings.
背景与目的:新型酪氨酸激酶抑制剂(TKI)达沙替尼是一种 Bcr-Abl 和Src 家族激酶的多靶点抑制剂,已获准用于治疗 Ph+急性淋巴细胞白血病和慢性髓性白血病。许多柑橘类食物都含有常见的类黄酮柚皮苷。达沙替尼是 Cyp3a4、P-糖蛋白和 Bcrp1 的底物,这使其易受潜在的食物-药物相互作用的影响。柚皮苷的同时使用可能会改变达沙替尼的药代动力学,从而导致不良反应和毒性。本研究旨在探讨柚皮苷对达沙替尼药代动力学相互作用的影响,并在 Wistar 大鼠中提出一种可能的相互作用机制。
方法:大鼠给予单次口服达沙替尼(25mg/kg),并用或不用柚皮苷预处理(每天 150mg/kg,po,连续 7 天,每组 6 只)。采用 UHPLC-MS/MS 测定法检测血浆中的达沙替尼浓度。采用非房室分析计算药代动力学参数,并采用免疫印迹法检测肝和肠组织中的蛋白表达。
结果:柚皮苷预处理 7 天后,与未预处理相比,达沙替尼的血浆平均浓度升高。与未预处理相比,预先给予柚皮苷的大鼠口服给予达沙替尼(25mg/kg)的药代动力学明显不同(p<0.05)。药代动力学参数消除半衰期(T)、最大浓度时间(T)、最大浓度(C)、浓度-时间曲线下面积(AUC)、浓度-时间曲线下矩面积(AUMC)和平均驻留时间(MRT)分别显著增加 28.41%、50%、103.54%、72.64%、115.08%和 15.19%(p<0.05),而消除率常数(K)、分布容积(V)和清除率(CL)分别显著降低 21.09%、31.13%和 46.25%(p<0.05),与达沙替尼单独组相比。达沙替尼生物利用度和全身暴露的增加是由于 Cyp3a2、Mdr1/P-糖蛋白和 Bcrp1 表达的显著抑制以及达沙替尼肝肠代谢的抑制,这增强了达沙替尼的吸收速率,降低了其消除速率。
结论:达沙替尼与含柚皮苷的补充剂、草药或食物同时使用可能会导致严重且潜在危及生命的药物相互作用。需要进一步研究以确定这些发现的临床意义。
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