转运体介导的食物-药物相互作用

Transporter-mediated food-drug interactions

食物与药物之间的相互作用普遍存在,且作用机制也多种多样。目前,研究较多的是单个食物或食物中的某些营养成分通过调节药物转运体或代谢酶的功能从而影响药物的体内过程。食物对药物体内过程的影响包括吸收、分布、代谢、排泄四个方面,并且主要是调节其中参与的药物转运体和代谢酶的功能。转运体介导的食物对药物体内吸收的影响主要是通过调节肠上皮摄取型和外排型的转运体,从而影响药物的吸收;对分布的影响主要是通过调节体内一些屏障中的转运体;对代谢的影响主要是同时调节药物代谢酶和转运体;对排泄的影响是通过调节肾脏和肝脏胆汁排泄的药物转运体,从而影响药物的清除率。因此,转运体介导的食物与药物相互作用直接影响药物治疗的效果。

The interaction between food and drugs is very common and its mechanism is also rather multitudinous in clinical practice. At present, it has been proven that there are a lot of specific nutrients in food that regulates the function of drug transporters and metabolic enzymes. The main purpose of this review is to summarize the mechanisms of interaction between food and drugs, and further prompted some attentions to the daily diet during the clinical drug treatment. Through reviewing the literatures in recent years, we summarized the effect of a specific component in food on process of absorption, distribution, metabolism and excretion of drug in vivo. Effect of drug transporters and metabolic enzymes mediated by food in absorption of drug is mainly regulated via intestinal epithelial uptake and efflux transporters in vivo; the distribution of drug is mainly influenced by regulating the barrier transporters in the body; the metabolism of drug is mainly influenced by regulating the excretion function of drug transporters metabolic enzymes; the excretion of drug is mainly influenced by regulating the renal and hepatic bile excretion by drug transporters, further affect the clearance rate of drug. Conclusion： the interaction between food and drugs mediated by drug transporters and metabolic enzymes could directly affect the therapeutic effect of some drugs in clinical practice.