Assessment of Dong Quai Hepatic Metabolism and Potential Interactions when Combined with ChemotherapyXue Zhang1, Anjali Gaikwad1, Lata Mathew2, Larry Coffer2, John Dalrymple3 and Judith A Smith1-3*
- *Corresponding Author:
- Judith A Smith
Department of Obstetrics
Gynecology and Reproductive Sciences
6431 Fannin Street, Houston, Texas 77030, USA
E-mail: [email protected]
Received date October 10, 2013; Accepted date November 16, 2013; Published date November 20, 2013
Citation: Zhang X, Gaikwad A, Mathew L, Coffer L, Dalrymple J, et al. (2013) Assessment of Dong Quai Hepatic Metabolism and Potential Interactions when Combined with Chemotherapy. J Integr Oncol 2:108. doi:10.4172/2329-6771.1000108
Copyright: © 2013 Zhang X, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Dong Quai is a common herbal supplement classified as a “phytoestrogen” used for the improvement of female reproductive function. In the oncology setting, women often seek natural approaches for managing symptoms associated with decreased hormone levels either from surgery or chemotherapy-induced. Clinically, the concern is the safety of phytoestrogens in combination with chemotherapy. The objective of this study was to characterize the hepatic metabolism of Dong Quai to define the potential for drug interactions with selected chemotherapy agents and its impact on alterations in the cytotoxicity in panel of human cancer cell lines.
Methods: In vitro high through-put cytochrome P450 (CYP450) inhibition assay was performed for CYP450 2C9, 2C8, 2D6 and 3A4 isoenzymesto evaluate phase I metabolism of Dong Quai alcohol-free extract. An ex vivo hepatic induction assay with human hepatocytes was used to determine whether Dong Quai is an inducer of CYP450 isoenzymes. The potential cytotoxic effects of Dong Quai alone and its effect when combined with selected chemotherapies were evaluated by a growth inhibition assay in a panel of eight human cancer cell lines.
Results: No inhibition of CYP450 was observed in presence of Dong Quai. At an estimated clinical relevant concentration of 0.86 mg/mL, Dong Quai demonstrated Quai induced CYP3A4, 2C9, 2C8 and 2D6. Dong Quaidid not demonstrated cytotoxicity by itself in the panels of eight human cancer cell lines with 50% growth inhibition was not achieved. The 25% growth inhibition was achieved at concentrations ranging from 0.39 mg/mL to 4.48 mg/mL. Combination growth inhibition assays showed decreased cytotoxic activity of chemotherapy agents.
Conclusion: This data suggests that Dong Quai is an inducer of the CYP450 pathways and also decreased cytotoxic activity of selected chemotherapy. Until confirmatory in vivo information available Dong Quai should be used with caution with chemotherapy.