Ankylosing spondylitis manifested by spontaneous anterior atlantoaxial subluxation

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Title:	Ankylosing spondylitis manifested by spontaneous anterior atlantoaxial subluxation
Authors:	Chou, LW;Lo, SF;Kao, MJ;Jim, YF;Cho, DY
Contributors:	附設醫院復健科;China Med Coll Hosp, Dept Phys Med, Taichung, Taiwan;China Med Coll Hosp, Dept Rehabil, Taichung, Taiwan;China Med Coll Hosp, Dept Radiol, Taichung, Taiwan;China Med Coll Hosp, Dept Neurosurg, Taichung, Taiwan;China Med Coll Hosp, Taichung, Taiwan
Date:	2002
Issue Date:	2010-09-24 14:51:35 (UTC+8)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Abstract:	Cyclosporin, an immunosuppressant with a narrow therapeutic window, is a substrate for both CYP3A4 and P-glycoprotein (Pgp). Quercetin is an inhibitor of CYP3A4 and a modulator of Pgp. This study aimed to measure the effect of quercetin on the absorption and disposition of cyclosporin in pigs and rats. Cyclosporin (Sandimmune(R), 10 mg/kg) was orally administered with and without a concomitant dose of quercetin (50 mg/ kg) to pigs and rats. Cyclosporin concentrations in blood samples were determined by a specific monoclonal fluorescence polarization immunoassay. The pharmacokinetic parameters were calculated by noncompartmental analysis using WINNONLIN. A paired Student's t-test was conducted for statistical comparison. A study using the everted intestinal sac was carried out to evaluate the effect of quercetin on the function of intestinal Pgp. The coadministration of quercetin significantly decreased cyclosporin AUC(0-3) (area under the concentration-time curve from time zero to 3 h) by 56% and AUC(0-t) (area under the concentration-time curve from time zero to the last point) by 43% in pigs and rats, respectively, indicating that the coadministration of quercetin significantly decreased cyclosporin oral bioavailability. However, the inverted sac study showed that quercetin significantly inhibited the function of intestinal Pgp. It is suggested that concurrent use of quercetin or quercetin-containing dietary supplement or herbs with cyclosporin or other medications whose absorption and metabolism are mediated by Pgp and/or CYP3A4 should require close monitoring. (C) 2002 Published by Elsevier Science Inc.
Relation:	AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION 81(12):952-955
Appears in Collections:	[China Medical University Hospital] Jurnal articles

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