U. Kristina Walle

HIGH ABSORPTION BUT VERY LOW BIOAVAILABILITY OF ORAL RESVERATROL IN HUMANS

The dietary polyphenol resveratrol has been shown to have chemopreventive activity against cardiovascular disease and a variety of cancers in model systems, but it is not clear whether the drug reaches the proposed sites of action in vivo after oral ingestion, especially in humans. In this study, we examined the absorption, bioavailability, and metabolism of 14C-resveratrol after oral and i.v. doses in six human volunteers. The absorption of a dietary relevant 25-mg oral dose was at least 70%, with peak plasma levels of resveratrol and metabolites of 491 ± 90 ng/ml (about 2 μM) and a plasma half-life of 9.2 ± 0.6 h. However, only trace amounts of unchanged resveratrol (<5 ng/ml) could be detected in plasma. Most of the oral dose was recovered in urine, and liquid chromatography/mass spectrometry analysis identified three metabolic pathways, i.e., sulfate and glucuronic acid conjugation of the phenolic groups and, interestingly, hydrogenation of the aliphatic double bond, the latter likely produced by the intestinal microflora. Extremely rapid sulfate conjugation by the intestine/liver appears to be the rate-limiting step in resveratrols bioavailability. Although the systemic bioavailability of resveratrol is very low, accumulation of resveratrol in epithelial cells along the aerodigestive tract and potentially active resveratrol metabolites may still produce cancer-preventive and other effects.

Transport of the flavonoid chrysin and its conjugated metabolites by the human intestinal cell line Caco-2.

Chrysin (5,7-dihydroxyflavone), a natural product present in our daily diet, is a potent inhibitor of drug-metabolizing enzymes. However, its oral bioavailability is not known. This study examined the intestinal epithelial transport of chrysin (20 microM), using the human colonic cell line Caco-2 as a model of human intestinal absorption. The apical to basolateral flux of chrysin, with an apparent permeability coefficient (P(app)) during the first hour of 6.9 +/- 1.6 x 10(-6) cm x sec(-1) (mean +/- SEM), was more than 10-fold higher than for the paracellular transport marker mannitol, 0.42 +/- 0.12 x 10(-6) cm x sec(-1). Interestingly, the reverse, basolateral to apical flux of chrysin, P(app) = 14.1 +/- 1.6 x 10(-6) cm x sec(-1), was about 2-fold higher than the apical to basolateral flux (P < 0.01). In transport studies beyond 1 hr, there was a rapid decline in P(app). This correlated with the appearance of two metabolites, M1 (chrysin glucuronide) and M2 (chrysin sulfate), identified by enzymatic hydrolysis procedures and HPLC. Following apical loading of chrysin, as much as 90% of M1 + M2 appeared on the apical side, thus indicating clear efflux of the chrysin metabolites. The addition of the anion transport inhibitor MK-571 (50 microM) on the apical side produced a 71% (P < 0.0001) and 20% (P < 0.05) inhibition of the efflux of M1 and M2, respectively, suggesting the involvement of the multidrug resistance protein MRP2 pump. Indeed, using specific antibodies, MRP2 was in fact detected by western blotting in Caco-2 plasma membranes, whereas MRP1 was not. These observations suggest that chrysin has favorable membrane transport properties but that its intestinal absorption may be seriously limited by surprisingly efficient glucuronidation and sulfation by the enterocytes and almost quantitative efflux by MRP2 of the metabolites formed.

Extensive binding of the bioflavonoid quercetin to human plasma proteins

Although the bioflavonoids, a large group of polyphenolic natural products, exert chemopreventive effects in cardiovascular disease and cancer, there is little information about the disposition of these dietary components in man. The objective of this study was to investigate the plasma‐protein binding of the most abundant bioflavonoid, quercetin, using 14C‐labelled quercetin.

Stereoselective delivery and actions of beta receptor antagonists

These studies have revealed that the delivery and actions of beta receptor antagonist drugs are controlled by a cascade of stereoselective processes involving multiple enzymes, transport proteins and receptors. In essence, the free concentration of the pharmacologically active (-)-enantiomer species of these drugs presented to cell surface beta receptors appears to be a function of the stereoselective clearance by hepatic cytochrome P-450 isoenzymes, enantiomer selective binding to alpha 1-acid glycoprotein and albumin and perhaps predominantly by stereoselective sequestration (and release) by the vesicular amine transport protein within adrenergic neurons. Stereoselectivity in the clearance of beta blocking drugs, which can favor either the (+)- or (-)-enantiomer, only appears to be important for the lipophilic drugs which are cleared by hepatic metabolism. Such stereoselectivity is due to differential stereochemical substrate requirements of individual hepatic cytochrome P-450 isoenzymes. Interindividual variations in the stereoselectivity can occur as a result of differences in the amount and expression of cytochrome P-450 isoenzymes due to genetic predisposition or other factors. In the same context, we have observed a significant correlation between the extent and stereoselectivity of binding of beta blocking drugs to plasma proteins. This is another finding which suggests that variability in the expression of individual proteins involved in the beta blocking drug-protein cascade determines the free concentration of the pharmacologically active enantiomer. However, since most observations have been made in young normal subjects, the extent of stereoselectivity in metabolism, binding and other processes is unknown in the general population where steady-state plasma concentrations can vary widely due to multiple biological factors. The observations from neural studies support the concept that adrenergic nerve endings provide a depot for the stereoselective storage and release of the active enantiomer of beta receptor antagonists. The mechanism of this release appears to involve exocytotic secretion of drug that has been stereoselectively accumulated by the neurotransmitter storage vesicles. In terms of this idea, beta receptor antagonists released during nerve stimulation may achieve concentrations of the (-)-enantiomer within the adrenergic synapse greatly in excess of those found in plasma. Such a mechanism could significantly influence both the intensity and duration of beta receptor blockade in the heart, blood vessels, brain and other target tissues.(ABSTRACT TRUNCATED AT 400 WORDS)

Resveratrol transport and metabolism by human intestinal Caco-2 cells

Resveratrol is a dietary constituent suggested to have protective effects against cancer as well as cardiovascular disease. The purpose of the study was to learn whether this agent could be absorbed in man and enter the systemic circulation. This was examined by measuring transport and metabolism of resveratrol (5–40 μM) by the human intestinal epithelial cell line Caco‐2 cultured in Transwells. Transport across the Caco‐2 monolayer occurred in a direction‐independent manner with Papp values of ≅ 7 times 10−6 cm s−1, much higher than for the paracellular transport marker mannitol (≅ 0.4 times 10−6 cms−1), suggesting efficient absorption in‐vivo. At the highest resveratrol concentration, the absorption increased, possibly due to saturation of metabolism. In sharp contrast to previous findings in the rat, the metabolism of resveratrol in Caco‐2 cells involved mainly sulfation and, to a minor extent, glucuronidation. At low resveratrol concentrations, most of the sulfate conjugate was exported to the apical side, presumably by MRP2, which is well expressed in these cells. At high concentrations, there was a shift towards the basolateral side, possibly involving MRP3, which was recently shown also to be expressed in Caco‐2 cells. These results indicate that absorption of resveratrol in‐vivo may be high but with limited bioavailability due to efficient sulfate conjugation. Extensive accumulation of resveratrol in the Caco‐2 cells, demonstrated in additional experiments, suggests enterocytes as a major target site for this cancer preventive agent.

Evidence of covalent binding of the dietary flavonoid quercetin to DNA and protein in human intestinal and hepatic cells

Quercetin-rich foods have the potential to prevent human disease. However, knowledge of its biological fate and mechanism of action is limited. This study extends previous observations of the oxidation of quercetin by peroxidases to quinone/quinone methide intermediates and, for the first time, demonstrates covalent binding of [14C]quercetin to macromolecules. This was first demonstrated using horseradish peroxidase and hydrogen peroxide with human liver microsomal protein to trap the intermediates. To extend this observation to the cellular level, human intestinal Caco-2 cells and hepatic Hep G2 cells were incubated for up to 2hr with [14C]quercetin, and cellular DNA and protein were isolated. The cellular uptake of [14C]quercetin was rapid, and the covalent binding of [14C]quercetin to DNA and protein was determined by liquid scintillation spectrometry after extensive purification. Both cell types demonstrated DNA binding with a maximum level of 5-15pmol/mg DNA. The level of covalent binding to protein was considerably higher in both cell types, 75-125pmol/mg protein. To determine potential specificity in the protein binding, Hep G2 cells were treated with [14C]quercetin, and the cell lysate was subjected to SDS-PAGE followed by staining and autoradiography. Several distinct radiolabeled protein bands did not correspond to the major Coomassie blue stained cellular proteins. We propose that this specific binding may mediate part of the antiproliferative and other cellular actions of quercetin.

The predictable relationship between plasma levels and dose during chronic propranolol therapy.

The present study has examined the relationship between plasma propranolol concentrations and dose during chronic propranolol therapy and the between‐patient variation in this relationship under rigorously controlled conditions. Peak (2 hr) and trough (6 hr) plasma concentrations were measured at carefully established steady‐state conditions in 46 patients with hypertension or coronary artery disease. All patients were hospitalized in a clinical research unit. Propranolol doses ranged from 40 to 960 mg/day (every 6 hr). Propranolol was measured by gas chromatography‐mass spectrometry using a stable isotope‐labeled internal standard. Peak plasma propranolol (ng/ml) was linearly related to dose over the range 160 to 960 mg (y = 1.11x − 111; correlation coefficient = 0.96); a non linear relationship exists over the range 40 to 160 mg. Trough plasma concentrations were 51 ± 9% (mean ± SD) of the peak concentrations over the entire dose range. Between‐patient variation in plasma propranolol was much smaller than has previously been reported in spite of the fact that the patient population studied was quite heterogeneous and that numerous other drugs were concomitantly used with propranolol. A maximum, 3‐fold, variation was observed at the 40‐mg dose level and decreased linearly with dose to an only 1.3‐fold variation at doses exceeding 600 mg/day. The fact that the oral dose of propranolol can be used to predict a very narrow plasma concentration range indicates a very uniform pattern in the way patients handle propranolol, a pattern that could prove useful as an aid in dose selection as well as a basis for an evaluation of patient compliance.

Induction of UDP-glucuronosyltransferase UGT1A1 by the flavonoid chrysin in Caco-2 cells--potential role in carcinogen bioinactivation.

AbstractPurpose. Dietary flavonoids, present in fruits, vegetables and beverages have been demonstrated to be protective in cancer. Recently, we showed that the flavonoid chrysin induced UDP-glucuronosyl- transferase (UGT) activity and expression in the human intestinal cell line Caco-2. In the present study, we determined the specific UGT isoform(s) induced and whether this induction facilitates glucuronidation and potential detoxification of the colon carcinogen 2-hydroxyamino-1-methyl-6-phenylimidazo[4,5-b]pyridine (N-hydroxy-PhIP). Methods. The induction was studied by immunoblot analysis with UGT isoform-specific antibodies, by Northern blot analysis and using quercetin as an isoform-specific catalytic probe. Glucuronidation of N-hydroxy-PhIP was characterized using both recombinant UGTs and control and chrysin-treated microsomes. Results. Western blot analysis showed that pretreatment of Caco-2 cells with 25 μM chrysin induced UGT1A1 without affecting the expression of UGTs 1A6, 1A9 and 2B7. Northern blot analysis showed markedly increased expression of UGT1A1 mRNA after chrysin treatment. Similarly, glucuronidation of quercetin was greatly increased in a UGT1A1-specific way. The induction of UGT1A1 in the Caco-2 cells resulted in a 10-fold increase in the glucuronidation of N-hydroxy-PhIP. Conclusion. Dietary flavonoid-mediated induction of intestinal UGT1A1 may be important for the glucuronidation and detoxification of colon and other carcinogens as well as for the presystemic metabolism of therapeutic drugs.

Pathway-selective sex differences in the metabolic clearance of propranolol in human subjects

This study determined the total clearance of propranolol and the partial clearances through each of its three primary metabolic pathways after administration of an 80 mg single oral dose in 28 young, white subjects (13 women; 15 men). The oral clearance of propranolol was significantly higher (63%, p < 0.02) in the men (65.7 ± 7.7 ml/min/kg; mean ± SE) than in the women (40.2 ± 6.2 ml/min/kg). This sex difference was mainly attributable to a 137% higher clearance through the P‐450‐mediated side‐chain oxidation in the men (p < 0.001). There was also a 52% higher clearance through glucuronidation in the men (p < 0.02). In contrast, the clearance through the P‐450–mediated ring oxidation was not different between men and women. After administration of simultaneous intravenous doses of hexadeuterium‐labeled drug (0.1 mg/kg) to 11 of the subjects, there were no differences between men and women in volume of distribution or half‐life. Moreover, there were no sex differences in plasma and blood binding of propranolol. This study thus demonstrates that higher plasma levels of propranolol occur in women than in men after oral doses and suggests that some drug metabolizing enzymes, but not others, are regulated by sex hormones in human beings.

Quercetin, a potent and specific inhibitor of the human P-form phenolsulfotransferase

The natural product quercetin was a potent inhibitor of the human P-form phenolsulfo-transferase with an IC50 value of 0.10 +/- 0.03 microM (mean +/- SEM; N = 5), which was three to four orders of magnitude more potent than its inhibition of other human sulfotransferases. The inhibition was noncompetitive with a Ki value of 0.10 microM. The potency and mechanism of this inhibition appear similar to those of the current standard P-form inhibitor, 2,6-dichloro-4-nitrophenol. Among other flavonoids examined, kaempferol was found to have an IC50 value of 0.39 +/- 0.07 microM, naringenin 10.6 +/- 1.6 microM and naringin 265 +/- 90 microM (N = 3). These observations suggest the potential for clinically important pharmacologic and toxicologic interactions by flavonoid-containing foods and beverages.