Potential Influence of Centrally Acting Herbal Drugs on Transporters at the Blood–Cerebrospinal Fluid Barrier and Blood–Brain Barrier

Lilian W. Kibathi, So Hyun Bae, Scott Robert Penzak, Parag Kumar

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Complementary and alternative medications (CAM) with known or suspected pharmacologic activity in the central nervous system (CNS) are common. These herbal preparations may cause clinically significant drug–drug interactions (DDIs) when coadministered with medications that act in the CNS. This can result in negative outcomes such as toxicity or loss of efficacy. Most drug interaction reports with CAM focus on cytochrome P450 (CYP) modulation. However, drug interactions between CAM and conventional medications may occur via mechanisms other than CYP inhibition or induction; in particular, modulation of drug transport proteins represents an important mechanism by which such interactions may occur. This article provides an updated review of transporter-mediated mechanisms by which herbal products may theoretically interact with centrally acting medications at the blood–brain barrier and blood–cerebrospinal fluid (CSF) barrier. Further research is required before the true clinical impact of interactions involving modulation of centrally located membrane transporters can be fully understood.

Original languageEnglish
Pages (from-to)619-635
Number of pages17
JournalEuropean Journal of Drug Metabolism and Pharmacokinetics
Volume43
Issue number6
DOIs
StatePublished - 1 Dec 2018

Fingerprint

Drug Interactions
Cytochrome P-450 Enzyme System
Central Nervous System
Plant Preparations
Membrane Transport Proteins
Pharmaceutical Preparations
Carrier Proteins
Research

Cite this

@article{add0d603090d498c873eee7e6f00f503,
title = "Potential Influence of Centrally Acting Herbal Drugs on Transporters at the Blood–Cerebrospinal Fluid Barrier and Blood–Brain Barrier",
abstract = "Complementary and alternative medications (CAM) with known or suspected pharmacologic activity in the central nervous system (CNS) are common. These herbal preparations may cause clinically significant drug–drug interactions (DDIs) when coadministered with medications that act in the CNS. This can result in negative outcomes such as toxicity or loss of efficacy. Most drug interaction reports with CAM focus on cytochrome P450 (CYP) modulation. However, drug interactions between CAM and conventional medications may occur via mechanisms other than CYP inhibition or induction; in particular, modulation of drug transport proteins represents an important mechanism by which such interactions may occur. This article provides an updated review of transporter-mediated mechanisms by which herbal products may theoretically interact with centrally acting medications at the blood–brain barrier and blood–cerebrospinal fluid (CSF) barrier. Further research is required before the true clinical impact of interactions involving modulation of centrally located membrane transporters can be fully understood.",
author = "Kibathi, {Lilian W.} and Bae, {So Hyun} and Penzak, {Scott Robert} and Parag Kumar",
year = "2018",
month = "12",
day = "1",
doi = "10.1007/s13318-018-0486-6",
language = "English",
volume = "43",
pages = "619--635",
journal = "European Journal of Drug Metabolism and Pharmacokinetics",
issn = "0378-7966",
publisher = "Springer Paris",
number = "6",

}

Potential Influence of Centrally Acting Herbal Drugs on Transporters at the Blood–Cerebrospinal Fluid Barrier and Blood–Brain Barrier. / Kibathi, Lilian W.; Bae, So Hyun; Penzak, Scott Robert; Kumar, Parag.

In: European Journal of Drug Metabolism and Pharmacokinetics, Vol. 43, No. 6, 01.12.2018, p. 619-635.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Potential Influence of Centrally Acting Herbal Drugs on Transporters at the Blood–Cerebrospinal Fluid Barrier and Blood–Brain Barrier

AU - Kibathi, Lilian W.

AU - Bae, So Hyun

AU - Penzak, Scott Robert

AU - Kumar, Parag

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Complementary and alternative medications (CAM) with known or suspected pharmacologic activity in the central nervous system (CNS) are common. These herbal preparations may cause clinically significant drug–drug interactions (DDIs) when coadministered with medications that act in the CNS. This can result in negative outcomes such as toxicity or loss of efficacy. Most drug interaction reports with CAM focus on cytochrome P450 (CYP) modulation. However, drug interactions between CAM and conventional medications may occur via mechanisms other than CYP inhibition or induction; in particular, modulation of drug transport proteins represents an important mechanism by which such interactions may occur. This article provides an updated review of transporter-mediated mechanisms by which herbal products may theoretically interact with centrally acting medications at the blood–brain barrier and blood–cerebrospinal fluid (CSF) barrier. Further research is required before the true clinical impact of interactions involving modulation of centrally located membrane transporters can be fully understood.

AB - Complementary and alternative medications (CAM) with known or suspected pharmacologic activity in the central nervous system (CNS) are common. These herbal preparations may cause clinically significant drug–drug interactions (DDIs) when coadministered with medications that act in the CNS. This can result in negative outcomes such as toxicity or loss of efficacy. Most drug interaction reports with CAM focus on cytochrome P450 (CYP) modulation. However, drug interactions between CAM and conventional medications may occur via mechanisms other than CYP inhibition or induction; in particular, modulation of drug transport proteins represents an important mechanism by which such interactions may occur. This article provides an updated review of transporter-mediated mechanisms by which herbal products may theoretically interact with centrally acting medications at the blood–brain barrier and blood–cerebrospinal fluid (CSF) barrier. Further research is required before the true clinical impact of interactions involving modulation of centrally located membrane transporters can be fully understood.

UR - http://www.scopus.com/inward/record.url?scp=85047950436&partnerID=8YFLogxK

U2 - 10.1007/s13318-018-0486-6

DO - 10.1007/s13318-018-0486-6

M3 - Review article

AN - SCOPUS:85047950436

VL - 43

SP - 619

EP - 635

JO - European Journal of Drug Metabolism and Pharmacokinetics

JF - European Journal of Drug Metabolism and Pharmacokinetics

SN - 0378-7966

IS - 6

ER -