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KEY WORDS: aged garlic extract Cytochromes P450 in vitro metabolism drug interaction
1
Published in a supplement to The Journal of Nutrition. Presented at the
symposium Signicance of Garlic and Its Constituents in Cancer and Cardiovascular Disease held April 911, 2005 at Georgetown University, Washington, DC.
The symposium was sponsored by Strang Cancer Prevention Center, afliated
with Weill Medical College of Cornell University, and Harbor-UCLA Medical Center,
and co-sponsored by American Botanical Council, American Institute for Cancer
Research, American Society for Nutrition, Life Extension Foundation, General
Nutrition Centers, National Nutritional Foods Association, Society of Atherosclerosis Imaging, Susan Samueli Center for Integrative Medicine at the University of
California, Irvine. The symposium was supported by Alan James Group, LLC,
Agencias Motta, S.A., Antistress AG, Armal, Birger Ledin AB, Ecolandia Internacional, Essential Sterolin Products (PTY) Ltd., Grand Quality LLC, IC Vietnam,
Intervec Ltd., Jenn Health, Kernpharm BV, Laboratori Mizar SAS, Magna Trade,
Manavita B.V.B.A., MaxiPharm A/S, Natures Farm, Naturkost S. Rui a.s., Nichea
Company Limited, Nutra-Life Health & Fitness Ltd., Oy Valioravinto Ab, Panax, PT.
Nutriprima Jayasakti, Purity Life Health Products Limited, Quest Vitamins, Ltd.,
Sabinco S.A., The AIM Companies, Valosun Ltd., Wakunaga of America Co. Ltd.,
and Wakunaga Pharmaceutical Co., Ltd. Guest editors for the supplement
publication were Richard Rivlin, Matthew Budoff, and Harunobu Amagase. Guest
Editor Disclosure: R. Rivlin has been awarded research grants from Wakunaga
of America, Ltd. and received an honorarium for serving as co-chair of the
conference; M. Budoff has been awarded research grants from Wakunaga of
America, Ltd. and received an honorarium for serving as co-chair of the
conference; and Harunobu Amagase is employed by Wakunaga of America, Ltd.
2
Author disclosure: No relationships to disclose.
3
This work was supported in part by grants AT-01381, AI-55412, MH-58435,
DA-13209, DK/AI-58496, DA-13834, AG-17880, AI-58784, and RR-00054 from the
U.S. Department of Health and Human Services.
4
To whom correspondence should be addressed: E-mail: dj.greenblatt@
tufts.edu.
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ABSTRACT Eight water-soluble components of aged garlic extract were evaluated to assess their potential to inhibit the activity of human cytochrome-P450 (CYP) enzymes. The in vitro model consisted of human liver microsomes
with index reactions chosen to prole the activity of the following six CYP isoforms: CYP1A2, 2B6, 2C9, 2C19, 2D6,
and 3A. With only 2 exceptions, none of the 8 garlic components produced .50% inhibition even at high concentrations
(100 mmol/L). S-methyl-L-cysteine and S-allyl-L-cysteine at 100 mmol/L produced modest inhibition of CYP3A, reducing activity to 2040% of control. However available clinical evidence does not indicate CYP3A inhibition in vivo.
The ndings suggest that drug interactions involving inhibition of CYP3A enzymes by aged garlic extract are very
unlikely. J. Nutr. 136: 806S809S, 2006.
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TABLE 1
Experimental conditions for inhibition studies
CYP isoform
Substrate (concentration,
mmol/L)
1A2
2B6
2C9
2C19
2D6
3A
Phenacetin (100)
Bupropion (250)
Flurbiprofen (5)
S-mephenytoin (25)
Dextromethorphan (25)
Triazolam (250)
Product(s)
Mobile phase
composition*, %
Detection
mode, nm
Acetaminophen
OH-bupropion
4-OH-urbiprofen
49-OH-mephenytoin
Dextrorphan
a-OH-triazolam, 4-OH-triazolam
CH3CN:buffer 15:85
CH3CN:buffer 21:79
CH3CN:Na acetate (10 mM) 30:70
CH3CN:buffer 42:58
CH3CN:buffer 30:70
CH3CN:CH3OH:buffer 22.5:10:67.5
U.V. 254
U.V. 214
U.V. 230
Fluorescence: excit. 260 emis. 320
Fluorescence: excit. 250 emis. 310
U.V. 220
TABLE 2
Effect of aged garlic extract components on activity of human
Cytochrome P450 isoforms in vitro
Inhibitory effect vs. Cytochrome P450 isoforms
Garlic component*
Alliin
Cycloalliin
Methylin
S-Methyl-L-cysteine
SAC
N-Acetyl-SAC
S-Allomercapto-L-cysteine
Gamma-glutamyl-SAC
CYP3A
CYP2C9
CYP2C19
CYP2D6
CYP1A2
CYP2B6
1
1
SUPPLEMENT
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RESULTS
The outcome of in vitro studies is shown in Table 2. A minus
sign () indicates ,50% inhibition of the index reaction
velocity; a plus sign (1) indicates .50% inhibition. The concentrations of garlic components in the incubation mixtures
(100 mmol/L) are very high, probably exceeding by an order of
magnitude or more the in vivo exposure that would be
anticipated. Therefore the anticipated levels of clinical exposure confer a very low risk of pharmacokinetic drug interactions
including metabolic inhibition of any of the indicated CYP
isoforms.
In only 2 instances, inhibition of CYP3A exceeded 50%.
S-allyl-L-cysteine, an important component in terms of biologic
effects of aged garlic extract, reduced CYP3A activity to 40%
of the control (Fig. 1). An evaluation of the concentration
dependence of the inhibitory action did not demonstrate clear
evidence of classical concentration effect. Furthermore, inhibition of the 2 parallel pathways of triazolam hydroxylation
(a-OH- and 4-OH-triazolam formation) revealed differential
inhibition of the 2 pathways (Fig. 2). There was no evidence
that the character of inhibition was mechanism based.
DISCUSSION
Benefits and limitations of in vitro systems have been
extensively discussed (4347). Of importance is that human
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