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Interações entre agentes antineoplásicos e plantas medicinais
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Resumo(s)
Os doentes oncológicos recorrem com frequência, e cada vez mais, ao uso concomitante de plantas medicinais com medicamentos antineoplásicos. Considerando um conjunto de fatores relativos aos doentes oncológicos, às propriedades dos medicamentos antineoplásicos e à composição das plantas medicinais, está provado existir uma elevada probabilidade de ocorrerem interações planta-medicamento (IPM) com significado clínico relevante. Nos últimos anos, têm surgido várias evidências, resultantes de estudos in vitro e in vivo, que revelam que muitas plantas medicinais interferem com as vias de metabolização enzimática dos fármacos e com os seus transportadores. Como exemplos de IPM mais frequentes e relevantes serão abordadas aquelas que envolvem as seguintes plantas medicinais: Erva de São João (Hypericum perforatum L.), ginkgo biloba (Ginkgo biloba L.), ginseng asiático (Panax ginseng), alho (Allium sativum), chá verde (Camellia sinensis), equinácea (Echinacea purpurea), valeriana (Valeriana officinalis) e cardo mariano (Silybum marianum). Embora sejam diversos os mecanismos envolvidos nestas interações é atribuída especial relevância aos mecanismos que envolvem o citocromo P450 e suas isoenzimas de metabolização, uma vez que estes são os que ocorrem com mais frequência, já que grande parte dos compostos químicos presentes nos extratos de plantas medicinais têm a capacidade de induzir ou inibir uma ou várias isoenzimas deste citocromo.
The combination between medicinal plants and anticancer drugs is becoming more and more used by cancer patients.It has been proven that there is an high probability of occurring herb-drug interactions with clinical relevance caused by factors related with cancer patients, properties of antineoplastic drugs and composition of medicinal plants.Recently, some in vitro and in vivo researches has revealed that many medicinal plants interact with the drug-metabolizing enzymes and drug transporters. As examples of herb-drug interactions will be approached: St John’s wort (Hypericum perforatum L.), ginkgo (Ginkgo biloba L.), ginseng (Panax ginseng), garlic (Allium sativum), green tea (Camellia sinensis), echinacea (Echinacea purpurea), valerian (Valeriana officinalis) and milk thistle (Silybum marianum) because they are the most relevant and frequent. Even though exists many different mechanisms involved in this interactions, futher atention is given to those who are related with cytochrome P450 and their metabolizing enzymes as they are the most frequent, because the most of chemistry compounds present in medicinal plants extracts are able to induce or inhibit one or many enzymes of this cytochrome.
The combination between medicinal plants and anticancer drugs is becoming more and more used by cancer patients.It has been proven that there is an high probability of occurring herb-drug interactions with clinical relevance caused by factors related with cancer patients, properties of antineoplastic drugs and composition of medicinal plants.Recently, some in vitro and in vivo researches has revealed that many medicinal plants interact with the drug-metabolizing enzymes and drug transporters. As examples of herb-drug interactions will be approached: St John’s wort (Hypericum perforatum L.), ginkgo (Ginkgo biloba L.), ginseng (Panax ginseng), garlic (Allium sativum), green tea (Camellia sinensis), echinacea (Echinacea purpurea), valerian (Valeriana officinalis) and milk thistle (Silybum marianum) because they are the most relevant and frequent. Even though exists many different mechanisms involved in this interactions, futher atention is given to those who are related with cytochrome P450 and their metabolizing enzymes as they are the most frequent, because the most of chemistry compounds present in medicinal plants extracts are able to induce or inhibit one or many enzymes of this cytochrome.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2018
Palavras-chave
Cancro Agentes antineoplásicos Interações planta-medicamento Citocromo P450 Plantas medicinais Mestrado Integrado - 2018