Herb-drug interaction: A case study of effects and involved mechanisms of cisplatin on the pharmacokinetics of ginsenoside Rb1 in tumor-bearing mice

Biomed Pharmacother. 2019 Feb:110:95-104. doi: 10.1016/j.biopha.2018.11.021. Epub 2018 Nov 19.

Abstract

Ginseng is often prescribed together with cisplatin for treatment of cancer, but the interaction between ginseng and cisplatin is still unknown. This study employed ginsenoside Rb1 (Rb1), one of the major components in ginseng, to explore the effects and involved mechanisms of cisplatin on the pharmacokinetics of ginseng. The effects of cisplatin on the pharmacokinetics of Rb1 and its bioactive metabolites Rd, Rg3, and F2 were investigated by using A549-bearing mice with and without cisplatin intervention. Our data showed that cisplatin could significantly decrease the AUC(0-t) and Cmax of Rd, Rg3, and F2, except Rb1. To evaluate the involved mechanisms, feces and intestinal mucosa were collected to explore the effects of cisplatin on the gut metabolism of Rb1 in vitro; meanwhile, Caco-2 cell model and small intestine histological characters were examined to evaluate the effects of cisplatin on the gut absorptive areas and permeability. The mechanisms involved may be mainly related to the comprehensive contributions of inhibited intestinal bacteria and mucosa metabolisms, narrowed intestinal absorptive area, increased efflux ratio of intestinal absorption and enhanced intestinal permeability. All these findings suggested that the dosage of ginseng traditionally used for health protection should be adjusted when it was prescribed together with cisplatin in the treatment of cancer.

Keywords: Cisplatin; Ginsenoside Rb1; Interactions.

MeSH terms

  • A549 Cells
  • Animals
  • Antineoplastic Agents / pharmacokinetics*
  • Caco-2 Cells
  • Cisplatin / pharmacokinetics*
  • Ginsenosides / pharmacokinetics*
  • Herb-Drug Interactions / physiology*
  • Humans
  • Intestinal Absorption / drug effects
  • Intestinal Absorption / physiology*
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Mice, Nude
  • Random Allocation
  • Xenograft Model Antitumor Assays* / methods

Substances

  • Antineoplastic Agents
  • Ginsenosides
  • ginsenoside Rb1
  • Cisplatin