Category Archives: Pharmacogenomics

Plantas medicinales con reacciones adversas en Cuba: interacciones potenciales

J Pharm Pharmacogn Res 3(2): 37-44, 2015.

Review | Revisión

Plantas medicinales reportadas con reacciones adversas en Cuba: Potenciales interacciones con fármacos de uso convencional

[Medicinal plant reported with adverse reactions in Cuba: potential interactions with conventional drugs]

Ioanna Martínez 1,*, Ana I. García 1, Idania Rodeiro 2, Francisco Morón 1

1Laboratorio Central de Farmacología “Dr. Francisco Morón In Memoriam”, Facultad de Ciencias Médicas “Dr. Salvador Allende”, Carvajal entre Agua Dulce y A, Cerro, P.O. Box 12000, La Habana, Cuba.2Departamento de Farmacología, Centro de Bioproductos Marinos (CEBIMAR), Loma y 37, Vedado, P.O. Box 10400, La Habana, Cuba.
*E-mail: ioanna@infomed.sld.cu
Abstract

Context: Herbal drugs are a mixture of active compounds and the chemical complexity of each formulation increase with the possibility of interactions between them and conventional drugs. Many mechanisms are implicated in the interactions; scientific community has dedicated the attentions to enzymes as P-gp and CYP450.

Aims: To investigate in the literature the principal plants with suspicions of adverse reactions in Cuba and their potential interactions with conventional drugs.

Methods: PubMed was the database used as source of information until February 2014. Key words: Herb-Drug, Drug-Plant, Herbal–Drug, Interactions with scientific names of plants was used. Information was structured and analysed with EndNote X4.

Analysis and integration of the information: Allium sativum L. (garlic) was the plant with the high number of studies related with CYP450 and P-gp. Plants with great demand as Morinda citrifolia L. (noni), Psidium guajava L. (guayaba), Zingiber officinale Roscoe (ginger) and Eucalyptus spp. (eucalyptus) have a very small number of studies. The professionals of the health should keep in mind the possibility of interactions between herbal products and conventional drugs to increase the effectiveness of phytotherapy.

Conclusions: It is necessary enhance reports and investigations and to put to disposition of the system of health information on the interactions of plants and to stimulate the investigation that offers information for the rational use of our medicinal plants.

Keywords: CYP450; drugs; interactions, medicinal plants; P-gp.

Resumen

Contexto: Los productos herbales constituyen mezclas de principios activos, lo que conlleva a formulaciones químicamente complejas, que incrementan la posibilidad de interacciones con fármacos de uso convencional. Existen varios mecanismos farmacológicos involucrados en las interacciones, los científicos han puesto gran interés en aquellas relacionadas con la modulación de las isoenzimas del sistema CYP450 y los transportadores, particularmente, glicoproteina P (P-gp).

Objetivos: Investigar en la literatura las plantas medicinales con sospechas de reacciones adversas en Cuba y sus potenciales interacciones con fármacos de uso convencional.

Métodos: Se utilizó la base de datos PubMed en la que se usaron las palabras clave: Herb-Drug, Drug-Plant, Herbal-Drug e Interactions y los nombres científicos de las plantas, hasta febrero de 2014. Se estructuró y analizó la información mediante el gestor bibliográfico Sistema EndNote X4.

Análisis e integración de la información: Allium sativum L. (ajo) fue la planta que presentó el mayor número de estudios relacionados con la frecuencia de reportes de aparición de reacciones adversas asociadas a modulaciones de los sistemas CYP450 y P-gp. Se encontraron muy pocos estudios para plantas con elevada demanda como: Morinda citrifolia L. (noni), Psidium guajava L. (guayaba), Zingiber officinale Roscoe (jengibre) y Eucalyptus spp. (eucalipto). Los profesionales de la salud deben tener en cuenta la posibilidad de interacciones entre los productos herbarios y los fármacos convencionales para incrementar la efectividad del tratamiento fitoterapéutico.

Conclusiones: Es necesario incrementar el número de reportes de reacciones adversas y fallos terapéuticos debido a interacciones de plantas medicinales y fármacos de uso convencional, ello permitirá contar con evidencias científicas que contribuirán a mejorar la calidad de la prescripción médica, así como el uso racional de los medicamentos naturales.

Palabras Clave: CYP450; fármacos; interacciones; P-gp; plantas medicinales.

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Citation Format: Ioanna Martínez, Ana I. Garcia, Idania Rodeiro, Francisco Morón (2015) Plantas medicinales reportadas con reacciones adversas en Cuba: Potenciales interacciones con fármacos de uso convencional. [Medicinal plant reported with adverse reactions in Cuba: potential interactions with conventional drugs]. J Pharm Pharmacogn Res 3(2): 37-44.
This article has been cited by:
Maritza Emperatriz Gallegos Zurita (2017) Las plantas medicinales: usos y efectos en el estado de salud de la población rural de Babahoyo – Ecuador – 2015. Tesis para optar al  Grado Académico de Doctor en Ciencias de la Salud. Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Website

© 2015 Journal of Pharmacy & Pharmacognosy Research (JPPRes)

C 026: PHARMACOGENETICS: CLINICAL IMPLICATIONS FOR EATING DISORDERS AND SUICIDE

J Pharm Pharmacogn Res 2(Suppl. 1): S70, 2014

Special supplement with the abstract book of LATINFARMA 2013

Conference

C 026: PHARMACOGENETICS: CLINICAL IMPLICATIONS FOR EATING DISORDERS AND SUICIDE

Llerena A, Naranjo ME; Peñas-Lledo E.

Clinical Research Centre, Extremadura University Hospital and Medical School, Badajoz, Spain. Ibero Latino American Network of Pharmacogenetics (www.ribef.com).
Abstract

Pharmacogenomics Clinical implications. A higher frequency of CYP2D6 UMs has been found among individuals who committed suicide (Zackrisson et al., 2010). One explanation for this relationship could be treatment failure with antidepressant drugs metabolized by CYP2D6 (Llerena et al., 2004) widely used to prevent suicide or to treat mood disorders. A complementary explanation could be via the implication of the polymorphic CYP2D6 in the endogenous metabolism. CYP2D6 has been associated with behavioral and clinical risk factors such as personality and vulnerability to psychopathology (Llerena et al., 1993; 2007; Gonzalez et al., 2008; Peñas-Lledó et al., 2009, 2010). Consistently, we found a relationship between UMs and severity of suicide and lifetime history of suicidal behavior among Eating Disordered patients (Peñas-LLedó et al., 2010, 2011, 2012a). Moreover it seems also been related to antidepressant discontinuation as recently shown (Peñas-LLedó et al., 2012b). Therefore Pharmacogenomics might be useful to prevent relevant side effects such is suicide.

PHARMACOGENETICS IN IBEROAMERICANS AND ITS CLINICAL IMPLICATIONS

J Pharm Pharmacogn Res 2(Suppl. 1): S114, 2014

Special supplement with the abstract book of LATINFARMA 2013

Plenary Lecture

PL 009: CEIBA: PHARMACOGENETICS IN IBEROAMERICANS AND ITS CLINICAL IMPLICATIONS

Llerena A.

Clinical Research Centre, Extremadura University Hospital and Medical School, Badajoz, Spain.
Abstract

Hispanic populations are diverse according to their genetic composition resulting from the inter-ethnic crosses between Amerindians, Europeans and Africans. The frequency of CYP2D6 PMs and UMs in Spain is 7-10% and 4.9%, respectively (Llerena et al., 2009). The CEIBA-RIBEF Network Consortium aimed to evaluate the most relevant CYPs genetic polymorphism in different Ibero-American populations (from Spain, South-, Central-Caribe and North-America in a population of almost 6500 Healthy Volunteers included in the CEIBA consortium. Differences have been found, the frequency of CYP2D6 PMs ranged from 6%-3.9% in Nicaraguans-Cuban-Mestizos. The genetic polymorphism of the most studied cytochrome P450, CYP2D6, is among the major determinants of the interindividual and interethnic variability of pharmacokinetics and drug response. Two CYP2D6 phenotypes have been described: “poor metabolizers” (PM), and “extensive metabolizers” (EM) including a group of Ultra-rapid Metabolizers (UMs). CYP2D6, antidepressants discontinuation and suicide. A higher frequency of UMs has been found among individuals who committed suicide (Zackrisson et al, 2010). One explanation for this relationship could be treatment failure with antidepressant drugs metabolized by CYP2D6 (Llerena et al., 2004) widely used to prevent suicide or to treat mood disorders. A complementary explanation could be via the implication of the polymorphic CYP2D6 in the endogenous metabolism. CYP2D6 has been associated with behavioral and clinical risk factors such as personality and vulnerability to psychopathology (Llerena et al., 1993; 2007; Gonzalez et al., 2008; Peñas-Lledó et al., 2009, 2010). Consistently, we found a relationship between UMs and severity of suicide and lifetime history of suicidal behavior among Eating Disordered patients (Peñas-LLedó et al., 2010, 2011, 2012a). Moreover it seems also been related to antidepressant discontinuation as recently shown in Mexican depressive patients (Peñas-LLedó et al 2012b). The pharmacogenetics of CYP2D6 may be a useful tool to predict unexpected side-effects, interactions, or therapeutic failures of many relevant drugs and may explain the interethnic differences observed not only in the response to psychotropic drugs, but also in the vulnerability to psychopathology including suicide.