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Drug interactions.

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R F Palmer. 1971. Drug interactions.. https://doi.org/10.1016/s0025-7125(16)32535-4

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Synergistic antimycobacterial activities of sesquiterpene lactones from Laurus spp.

OBJECTIVES: The aim of this study was to determine the antimycobacterial potential of laurel oil, its fractions and its two sesquiterpene lactones against several mycobacterial strains and clinical isolates, and to establish the possibility of occurrence of some synergistic effects between those lactones using a modification of the fluorometric Alamar Blue microassay (FMABA). METHODS: The in vitro antimycobacterial activity of whole oil and its fractions and pure active compounds were determined by FMABA. A bioassay-guided fractionation of the traditional preparation of laurel oil from Madeira Islands was performed, yielding pure compounds chemically identified by standard procedures. Synergism of pure compounds was established by X/Y quotient analysis adapted to FMABA. RESULTS: Sesquiterpene lactones, costunolide and dehydrocostuslactone, were the compounds responsible for the antimycobacterial activity against Mycobacterium tuberculosis H37Rv with MICs of 6.25 and 12.5 mg/L, respectively. Antimycobacterial activity against drug-resistant M. tuberculosis clinical isolates was better for the mixture than for pure compounds. CONCLUSIONS: Both lactones presented synergistic activity, i.e. analysis of relative fluorescence units presented an X/Y value <0.5 at a concentration of 1/8 MIC of each compound in the combination. Establishment of synergism by FMABA represents another application of the microplate Alamar Blue assay.

Drug Synergism↗

Application of the "-Omic-" technologies in phytomedicine.

The proof of efficacy of phytopreparations and the determination of their mode of action are permanent challenges for an evidence-based phytotherapy. The technology platform of genomics, proteomics and metabolomics ("-omic-" technologies) are high-throughput technologies. They increase substantially the number of proteins/genes that can be detected simultaneously and have the potential to relate complex mixtures to complex effects in the form of gene/protein expression profiles. Provided that phytopreparation-specific signatures in the form of gene/protein expression profiles can be developed, these technologies will be useful for the chemical and pharmacological standardization and the proof of the toxicological potential of a plant extract. Over a long-term perspective they may economize the proof of efficacy, the determination of the mode of action of phytomedicines and allow to investigate herbal extracts without prominent active principle(s). The application of this genomics revealed already that gene expression profiles induced by single drugs and the ones induced by the combination of the same drugs can be entirely different. These results make the information of the mode of action of isolated "active principles/lead substances" of phytopreparations questionable. The application of the "-omic-" technologies may lead to a change of paradigms towards the application of complex mixtures in medicine and open the new field of phytogenomics, -proteomics and -metabolomics.

Drug Synergism↗

High glucose and homocysteine synergistically affect the metalloproteinases-tissue inhibitors of metalloproteinases pattern, but not TGFB expression, in human fibroblasts.

AIMS/HYPOTHESIS: Atherosclerosis is particularly aggressive in patients with diabetes. Hyperhomocysteinaemia causes oxidative stress and cytokine secretion: its atherogenic effect is mediated by an enhanced inflammatory response. Matrix metalloproteinases (MMPs) regulate extracellular matrix degradation and remodelling, and contribute to the vulnerability of the atherosclerotic lesion. Fibroblasts contribute to collagen biosynthesis and participate in plaque remodelling via expression and release of MMP2 and MMP9. To explore the role of hyperhomocysteinaemia in cellular pathways involved in plaque growth and stability in diabetic patients, we studied the effect of hyperhomocysteinaemia in human fibroblasts grown in the presence of normal or high glucose concentrations. MATERIALS AND METHODS: In fibroblasts of five normal subjects, grown at 5.5 or 22 mmol/l glucose and treated with homocysteine, we determined: (1) MMP2, MMP9 and tissue inhibitor of metalloproteinases (TIMP)-1 (an MMP inhibitor) production by western blot analysis; (2) their activity by zymography; (3) TGFB1 expression by real-time PCR; and (4) TGFB, fibronectin and IL6 release by ELISA. RESULTS: Hyperhomocysteinaemia increased the production and enzymatic activity of MMP2 and MMP9, the effect being more pronounced in high glucose. Conversely, TIMP1 production was reduced by hyperhomocysteinaemia in both conditions, especially in high glucose. Hyperhomocysteinaemia also stimulated IL6 release, at least in part through nuclear factor-kappaB activation. TGFB1 expression was not affected by hyperhomocysteinaemia either in normal or in high glucose. CONCLUSIONS/INTERPRETATION: Homocysteine upregulates the MMP-TIMP pathway and IL6 release, the effect being stronger in the presence of high glucose. These actions of homocysteine may contribute to the increased atherogenesis observed in diabetic patients with poor metabolic control.

Drug Synergism↗