Reduced system exposures of total rhein and baicalin after combinatory oral administration of rhein, baicalin and berberine to beagle dogs and rats

Ethnopharmacological relevance: Rhein (Rh), baicalin (BC) and berberine (Be) are important coexisted constituents of San-Huang-Xie-Xin-Tang, which was widely used in traditional Chinese medicine for the treatment of gastritis, hypertension, gastric bleeding and peptic ulcers, etc. Aim of the study: Based on the extensive phase II conjugation reactions of polyphenols (Rh and BC) in vivo, the aims of the present study were to investigate the effects of combination (Rh, BC and Be) on the system exposures of total Rh and BC involving the phase II conjugates metabolites and its possible mechanism. Materials and methods: A 3 x 3 Latin square single heavy design was used to investigate the pharmacokinetics influence of total Rh and BC after combination of Be by treating plasma samples with beta-glucuronidase/sulfatase both in beagle dogs and Wistar rats. In vitro and in situ experiment models including in situ rat intestinal perfusion, Caco-2 cell monolayer transport and small intestinal flora incubation system were used to discuss the possible mechanism. Results: The results of pharmacokinetic interactions showed that combination significantly reduced the system exposures of total Rh and BG. Compared with Rh or BC alone, the mean area under concentration-time curves (AUC(0-t)) of total Rh and BC reduced by 31% and 77% in beagle dog experiment. In Wistar rat experiment, the AUC(0-t) of total Rh and BC reduced by 22% and 21%. Subsequently, the results of in situ rat intestinal perfusion and small intestinal flora incubation system tests revealed that combination may decrease the absorption and metabolism of BC. However, combination could not affect the transport profile of BC across the Caco-2 cell. Moreover, combination did not affect the absorption or metabolism profile of Rh in all three in situ/in vitro experiments. Conclusions: It was deduced that the possible mechanism of the reduction of the system exposures of total Rh and BC was related to that combination decreased the metabolism of BC to B or the phase II conjugates of Rh/BG excreted from liver/bile duct to their free aglycones in vivo by inhibiting intestinal flora. The potent effects of combination on the phase II conjugates of Rh and B in pharmacokinetics, shown in this paper, indicated that more attention should be paid to the phase II conjugates metabolites of these polyphenols (undergo extensive phase II conjugation reactions in vivo) when applied herbal products composed of these coexist compounds. Crown Copyright (C) 2012 Published by Elsevier Ireland Ltd. All rights reserved.