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Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities

BACKGROUND: European mistletoe (Viscum album) products used in cancer therapy are frequently combined with other anti-cancer-drugs. Hence, potential herb-drug interactions have become a major safety concern in mistletoe therapy. METHODS: Three European mistletoe products (Helixor® A, Helixor® M and...

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Autores principales: Schink, Michael, Dehus, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715639/
https://www.ncbi.nlm.nih.gov/pubmed/29202738
http://dx.doi.org/10.1186/s12906-017-2028-1
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author Schink, Michael
Dehus, Oliver
author_facet Schink, Michael
Dehus, Oliver
author_sort Schink, Michael
collection PubMed
description BACKGROUND: European mistletoe (Viscum album) products used in cancer therapy are frequently combined with other anti-cancer-drugs. Hence, potential herb-drug interactions have become a major safety concern in mistletoe therapy. METHODS: Three European mistletoe products (Helixor® A, Helixor® M and Helixor® P from mistletoe grown on firs, apple trees and pines, respectively) were tested for inhibition of nine major cytochrome P450 (CYP) isoenzymes in a test system using pooled human liver microsomes and for induction of five CYP isoforms in human hepatocytes cultivated in vitro according to the relevant guideline. RESULTS: Major inhibition did not occur in any of the CYP marker reactions. For some CYP isoenzymes, a minor or intermediate inhibition could be observed, but without dose effect relationship. Induction activity (≥ 1.5-fold increase) was not found with any of the three mistletoe products. CONCLUSION: Since no induction capacity was found and major inhibition above 50% did not occur even with the highest concentration used, which is approximately 100,000-fold higher than the clinically relevant dose in plasma, a clinically relevant herb-drug interaction is not expected for Helixor® A, M, and P.
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spelling pubmed-57156392017-12-08 Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities Schink, Michael Dehus, Oliver BMC Complement Altern Med Research Article BACKGROUND: European mistletoe (Viscum album) products used in cancer therapy are frequently combined with other anti-cancer-drugs. Hence, potential herb-drug interactions have become a major safety concern in mistletoe therapy. METHODS: Three European mistletoe products (Helixor® A, Helixor® M and Helixor® P from mistletoe grown on firs, apple trees and pines, respectively) were tested for inhibition of nine major cytochrome P450 (CYP) isoenzymes in a test system using pooled human liver microsomes and for induction of five CYP isoforms in human hepatocytes cultivated in vitro according to the relevant guideline. RESULTS: Major inhibition did not occur in any of the CYP marker reactions. For some CYP isoenzymes, a minor or intermediate inhibition could be observed, but without dose effect relationship. Induction activity (≥ 1.5-fold increase) was not found with any of the three mistletoe products. CONCLUSION: Since no induction capacity was found and major inhibition above 50% did not occur even with the highest concentration used, which is approximately 100,000-fold higher than the clinically relevant dose in plasma, a clinically relevant herb-drug interaction is not expected for Helixor® A, M, and P. BioMed Central 2017-12-04 /pmc/articles/PMC5715639/ /pubmed/29202738 http://dx.doi.org/10.1186/s12906-017-2028-1 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Schink, Michael
Dehus, Oliver
Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities
title Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities
title_full Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities
title_fullStr Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities
title_full_unstemmed Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities
title_short Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities
title_sort effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome p450 activities
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715639/
https://www.ncbi.nlm.nih.gov/pubmed/29202738
http://dx.doi.org/10.1186/s12906-017-2028-1
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