Pharmacokinetics of Chinese medicines: strategies and perspectives
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Chinese Medicine Open Access
REVIEW
Pharmacokinetics of Chinese medicines: strategies and perspectives Ru Yan1,2*, Ying Yang1 and Yijia Chen1
Abstract The modernization and internationalization of Chinese medicines (CMs) are hampered by increasing concerns on the safety and the efficacy. Pharmacokinetic (PK) study is indispensable to establish concentration-activity/toxicity relationship and facilitate target identification and new drug discovery from CMs. To cope with tremendous challenges rooted from chemical complexity of CMs, the classic PK strategies have evolved rapidly from PK study focusing on marker/main drug components to PK-PD correlation study adopting metabolomics approaches to characterize associations between disposition of global drug-related components and host metabolic network shifts. However, the majority of PK studies of CMs have adopted the approaches tailored for western medicines and focused on the systemic exposures of drug-related components, most of which were found to be too low to account for the holistic benefits of CMs. With an area under concentration-time curve- or activity-weighted approach, integral PK attempts to understand the PK–PD relevance with the integrated PK profile of multiple co-existing structural analogs (prototyes/metabolites). Cellular PK–PD complements traditional PK–PD when drug targets localize inside the cells, instead of at the surface of cell membrane or extracellular space. Considering the validated clinical benefits of CMs, reverse pharmacology-based reverse PK strategy was proposed to facilitate target identification and new drug discovery. Recently, gut microbiota have demonstrated multifaceted roles in drug efficacy/toxicity. In traditional oral intake, the presystemic interactions of CMs with gut microbiota seem inevitable, which can contribute to the holistic benefits of CMs through biotransforming CMs components, acting as the peripheral target, and regulating host drug disposition. Hence, we propose a global PK–PD approach which includes the presystemic interaction of CMs with gut microbiota and combines omics with physiologically based pharmacokinetic modeling to offer a comprehensive understanding of the PK–PD relationship of CMs. Moreover, validated clinical benefits of CMs and poor translational potential of animal PK data urge more research efforts in human PK study. Keywords: Chinese medicines, Pharmacokinetic strategy, Pharmacokinetics–pharmacodynamics relevance, Gut microbiota, Global pharmacokinetics–pharmacodynamics Background Pharmacokinetics (PK) characterizes drug disposition in the body by studying the time-course of drug concentrations in biofluids and cell/tissue/organ samples and factors governing its absorption, distribution, metabolism and excretion (ADME) processes. PK study is a prerequisite to establish relevance of the activities/clinical benefits to the chemical contents. The information obtained *Correspondence: rl‑[email protected] 1 State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Scie
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