PXR mediated induction of CYP3A4, CYP1A2, and P-gp by Mitragyna speciosa and its alkaloids

Phytother Res. 2017 Dec;31(12):1935-1945. doi: 10.1002/ptr.5942. Epub 2017 Oct 26.

Abstract

Kratom (Mitragyna speciosa), a native herb of Southeast Asia, is widely known for its psychoactive properties. Recent increase in the use of kratom as a recreational drug has increased the risk of its interaction with conventional drugs if taken concomitantly. A few reports are available related to the effects of kratom on the activity of cytochrome P450 enzymes (CYPs), but there are no reports of its effects on pregnane X receptor (PXR), a transcription factor that regulates the expression of CYPs and P-glycoprotein (P-gp). This study was carried out to evaluate the effects of a methanolic extract of kratom leaves, an alkaloid rich fraction and its 5 indole and 4 oxindole alkaloids on PXR activation and the resulting changes in the mRNA expression of PXR target genes (CYP3A4, CYP1A2, and P-gp). A significant activation of PXR was observed by the extract (3-fold), alkaloidal fraction (4-fold) and all 9 alkaloids (4- to 6-fold) that was associated with an increased mRNA expression which resulted into an increase in the activity of CYP3A4, CYP1A2, and P-gp. These results indicate that high consumption of Mitragyna speciosa extract along with the conventional drugs may lead to potential herb-drug interactions due to its effects on PXR.

Keywords: Cytochrome P450; Drug interactions; Kratom; Mitragyna speciosa; P-gp; PXR.

MeSH terms

  • Alkaloids
  • Cytochrome P-450 CYP1A2 / metabolism*
  • Cytochrome P-450 CYP3A / metabolism*
  • Humans
  • Mitragyna / chemistry*
  • Plant Extracts / pharmacology
  • Plant Extracts / therapeutic use*
  • Pregnane X Receptor
  • Receptors, Steroid / metabolism*

Substances

  • Alkaloids
  • Plant Extracts
  • Pregnane X Receptor
  • Receptors, Steroid
  • Cytochrome P-450 CYP1A2
  • Cytochrome P-450 CYP3A