Planta Med 2006; 72(8): 685-690
DOI: 10.1055/s-2006-931585
Original Paper
Pharmacology
© Georg Thieme Verlag KG Stuttgart · New York

Hypericum perforatum: Which Constituents may Induce Intestinal MDR1 and CYP3A4 mRNA Expression?

Heike Gutmann1 , Birk Poller1 , Karin Berger Büter2 , Arabelle Pfrunder1 , Willi Schaffner2 , Jürgen Drewe1
  • 1Department of Clinical Pharmacology & Toxicology; University Clinic Basel, Basel, Switzerland
  • 2Institute of Pharmaceutical Biology, University of Basel, Witterswil, Switzerland
Further Information

Publication History

Received: May 31, 2005

Accepted: February 17, 2006

Publication Date:
01 June 2006 (online)

Abstract

In vitro and in vivo studies suggest that extracts of St John’s wort (Hypericum perforatum, L.; SJWE) interact with various drugs, by enhancing their elimination, due to induction of intestinal and hepatic cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp), the gene product of multidrug resistance gene 1 (MDR1/ABCB1). The aim of our study was to identify the major constituents responsible for this induction and their relative importance. Therefore, plant extracts were investigated that vary in these constituents with respect to their effect on mRNA expression of MDR1/CYP3A4. First, different pure constituents of Hypericum perforatum L. were investigated. Secondly, diverse SJWE with different concentrations of hyperforin, quercitrin and hypericin were investigated. The concentrations of hyperforin, hypericin, and quercitrin in the plant extracts were determined by HPLC, and an ”artificial extract” containing the same mixture of these constituents was investigated. Different plant extracts, pure constituents or ”artificial extracts” were applied to the human colon carcinoma-derived cell line (LS180) and the induction of MDR1 and CYP3A4 expression was analyzed by quantitative RT-PCR. MDR1 and CYP3A4 mRNA expression were both induced by single constituents of SJW such as hypericin and hyperforin in a concentration of 10 μM. Additionally, CYP3A4 mRNA expression was induced by quercitrin. SJW extracts containing hyperforin induced significantly MDR1 mRNA expression, whereas no CYP3A4 induction was observed after treatment with any of the investigated SJWE. These effects could be mimicked by ”artificial extracts” containing the same compositions of hyperforin, hypericin and quercitrin as the plant extracts.

References

  • 1 Linde K, Melchart D, Mulrow C D, Berner M. St John’s wort and depression.  JAMS. 2002;  288 447-8; discussion: 48 - 9
  • 2 Ruschitzka F, Meier P J, Turina M, Luscher T F, Noll G. Acute heart transplant rejection due to Saint John’s wort.  Lancet. 2000;  355 548-9
  • 3 Mai I, Kruger H, Budde K, Johne A, Brockmoller J, Neumayer H H. et al . Hazardous pharmacokinetic interaction of Saint John’s wort (Hypericum perforatum) with the immunosuppressant cyclosporin.  Int J Clin Pharmacol Ther. 2000;  38 500-2
  • 4 Barone G W, Gurley B J, Ketel B L, Lightfoot M L, Abul-Ezz S R. Drug interaction between St. John’s wort and cyclosporine.  Ann Pharmacother. 2000;  34 1013-6
  • 5 Johne A, Brockmoller J, Bauer S, Maurer A, Langheinrich M, Roots I. Pharmacokinetic interaction of digoxin with an herbal extract from St John’s wort (Hypericum perforatum).  Clin Pharmacol Ther. 1999;  66 338-45
  • 6 Piscitelli S C, Burstein A H, Chaitt D, Alfaro R M, Falloon J. Indinavir concentrations and St John’s wort.  Lancet. 2000;  355 547-8
  • 7 Johne A, Schmider J, Brockmoller J, Stadelmann A, Stroemer E, Bauer S. et al . Decreased plasma levels of amitriptyline and its metabolites on comedication with an extract from St. John’s wort (Hypericum perforatum).  J Clin Psychopharmacol. 2002;  22 46-54
  • 8 Pfrunder A, Schiesser M, Gerber S, Haschke M, Bitzer J, Drewe J. Interaction of St John’s wort with low-dose oral contraceptive therapy: a randomized controlled trial.  Br J Clin Pharmacol. 2003;  56 683-90
  • 9 Dürr D, Stieger B, Kullak-Ublick G A, Rentsch K M, Steinert H C, Meier P J. et al . St John’s wort induces intestinal P-glycoprotein/MDR1 and intestinal and hepatic CYP3A4.  Clin Pharmacol Ther. 2000;  68 598-604
  • 10 Hennessy M, Kelleher D, Spiers J P, Barry M, Kavanagh P, Back D. et al . St. John’s wort increases expression of P-glycoprotein: implications for drug interactions.  Br J Clin Pharmacol. 2002;  53 75-82
  • 11 Pfrunder A, Gutmann H, Beglinger C, Drewe J. Gene expression of CYP3A4, ABC-transporters (MDR1 and MRP1-MRP5) and hPXR in three different human colon carcinoma cell lines.  J Pharm Pharmacol. 2003;  55 59-66
  • 12 Schuetz E G, Schinkel A H, Relling M V, Schuetz J D. P-glycoprotein: a major determinant of rifampicin-inducible expression of cytochrome P4503A in mice and humans.  Proc Natl Acad Sci USA. 1996;  93 4001-5
  • 13 Skehan P, Storeng R, Scudiero D, Monks A, McMahon J, Vistica D. et al . New colorimetric cytotoxicity assay for anticancer-drug screening.  J Natl Cancer Inst. 1990;  82 1107-12
  • 14 Moore L B, Goodwin B, Jones S A, Wisely G B, Serabjit-Singh C J, Willson T M. et al . St. John’s wort induces hepatic drug metabolism through activation of the pregnane X receptor.  Proc Natl Acad Sci USA. 2000;  97 7500-2
  • 15 Rätz A E, von Moos M, Drewe J. Johanniskraut: ein Phytopharmakon mit potenziell gefährlichen Interaktionen.  Schweiz Rundsch Med Prax. 2001;  90 843-9
  • 16 Kast H R, Goodwin B, Tarr P T, Jones S A, Anisfeld A M, Stoltz C M. et al . Regulation of multidrug resistance-associated protein 2 (ABCC2) by the nuclear receptors pregnane X receptor, farnesoid X-activated receptor, and constitutive androstane receptor.  J Biol Chem. 2002;  277 2908-15
  • 17 Bertilsson G, Heidrich J, Svensson K, Asman M, Jendeberg L, Sydow-Backman M. et al . Identification of a human nuclear receptor defines a new signaling pathway for CYP3A induction.  Proc Natl Acad Sci USA. 1998;  95 12 208-13
  • 18 Goodwin B, Moore L B, Stoltz C M, McKee D D, Kliewer S A. Regulation of the human CYP2B6 gene by the nuclear pregnane X receptor.  Mol Pharmacol. 2001;  60 427-31
  • 19 Geick A, Eichelbaum M, Burk O. Nuclear receptor response elements mediate induction of intestinal MDR1 by rifampin.  J Biol Chem. 2001;  276 14 581-7
  • 20 Schuetz E G, Strom S, Yasuda K, Lecureur V, Assem M, Brimer C. et al . Disrupted bile acid homeostasis reveals an unexpected interaction among nuclear hormone receptors, transporters, and cytochrome P450.  J Biol Chem. 2001;  276 39 411-8
  • 21 Butterweck V, Derendorf H, Gaus W, Nahrstedt A, Schulz V, Unger M. Pharmacokinetic herb-drug interactions: are preventive screenings necessary and appropriate?.  Planta Med. 2004;  70 784-91

Jürgen Drewe MD, MSc

Department of Clinical Pharmacology and Toxicology

University Clinic Basel

Petersgraben 4

4031 Basel

Switzerland

Phone: +41-61-265-3848

Fax: +41-61-265-8581

Email: juergen.drewe@unibas.ch

    >