RESUMO
Erythrina mulungu Benth. (Fabaceae), Cordia verbenacea A. DC. (Boraginaceae), Solanum paniculatum L. (Solanaceae) and Lippia sidoides Cham. (Verbenaceae) are medicinal plant species native to Brazil shortlisted by the Brazilian National Health System for future clinical use. However, nothing is known about their effects in metabolic and transporter proteins, which could potentially lead to herb-drug interactions (HDI). In this work, we assess non-toxic concentrations (100 µg/mL) of the plant infusions for their in vitro ability to modulate CYP3A4 mRNA gene expression and intracellular glutathione levels in HepG2 cells, as well as P-glycoprotein (P-gp) activity in vincristine-resistant Caco-2 cells (Caco-2 VCR). Their mechanisms of action were further studied by measuring the activation of human pregnane X receptor (hPXR) in transiently co-transfected HeLa cells and the inhibition of γ-glutamyl transferase (GGT) in HepG2 cells. Our results show that P-gp activity was not affected in any case and that only Solanum paniculatum was able to significantly change CYP3A4 mRNA gene expression (twofold decrease, p < 0.05), this being correlated with an antagonist effect upon hPXR (EC50 = 0.38 mg/mL). Total intracellular glutathione levels were significantly depleted by exposure to Solanum paniculatum (-44%, p < 0.001), Lippia sidoides (-12%, p < 0.05) and Cordia verbenacea (-47%, p < 0.001). The latter plant extract was able to decrease GGT activity (-48%, p < 0.01). In conclusion, this preclinical study shows that the administration of some of these herbal medicines may be able to cause disturbances to metabolic mechanisms in vitro. Although Erythrina mulungu appears safe in our tests, active pharmacovigilance is recommended for the other three species, especially in the case of Solanum paniculatum.
RESUMO
The use of medicinal plants in Brazil is widespread and is supported by public policies; it has the objective of providing the population with safe and effective herbal medicines of adequate quality. An action in these policies is to develop medicinal plant monographs to gather published information and decide which medicinal plants should be financed by the Brazilian government and distributed by the public health system. Currently, the monographs published worldwide do not present unified information regarding medicinal plants, and generally, they do not cover enough requirements for herbal medicine registration. The aim of this study is to develop a monograph model with standardized information not only about botany, agronomy, quality control, safety, and efficacy but also about relating regulatory aspects that support herbal medicine regulation. The development of standardized monographs favors the fast authorization and distribution of herbal medicines in the public system. The model also points out the lacking studies that should be carried out to supplement the necessary regulatory information of medicinal plants.
RESUMO
Fitoterápico é uma classe de medicamento largamente utilizada no país e constitui um mercado em potencial expansão. Este artigo busca traçar um panorama sobre os medicamentos fitoterápicos registrados no país e as espécies vegetais que lhe deram origem, enfocando o papel regulador da Anvisa. Realizou-se uma pesquisa nas seguintes bases de dados: Visalegis e site da Anvisa para verificar os medicamentos fitoterápicos registrados na Anvisa, obtendo-se os seguintes dados: há 432 fitoterápicos simples registrados e 80 compostos, as espécies vegetais com maior número de derivados registrados são o Ginkgo (Ginkgo biloba) e a Castanha da Índia (Aesculus hippocastanum), com 33 e 29 registros, respectivamente. O artigo traz ainda uma tabela com as espécies vegetais que possuem derivados registrados como fitoterápicos simples, sua classificação terapêutica, lista as espécies registradas em associação, as principais formas farmacêuticas registradas e os percentuais de registro e empresas por região do país, fornecendo assim um panorama da atuação da Anvisano setor de fitoterápicos.
Herbal medicines are widely used in Brazil and constitute a market in potential expansion. This article explains the situation on herbal medicines registration in Brazil plant species, focusing on the regulatory role of Anvisa. The research was realized in the Visalegis and site of Anvisa databases to verify the herbal medicines registered in Anvisa, resulting in the following data: there are 432 simple herbal medicines (composed by one medicinal plant) registered and 80 compound herbal medicine (more than one plant), the plants species with the largest number of registered derivatives are the Ginkgo (Ginkgo biloba) and the Castanha da Índia (Aesculus hippocastanum), with 33 and 29 records, respectively. The article also brings a table with the plant species registered as simple herbal medicines, the main pharmaceutical forms registered and data about companies that produces herbal medicines.
