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   Original Article              EFFECT OF ETHANOLIC EXTRACT OF PIPER CUBEBA LINN. FRUITS
                                               ON ACTIVITY OF PIOGLITAZONE
                                                    *1Gayasuddin   Mouid Md, 2Shakil Sait S, 3Kavimani S
                                   *1Smt.Sarojini Ramulamma College of Pharmacy, Mahbubnagar - 509 001, A.P, India.
                                       2AR&D,Dr.Reddy’s Laboratories Ltd., Bachupally, Hyderabad - 500 049, A.P, India.
                                           3Mother Theresa Post Graduate and Research Institute of Health Sciences,

        Print    2231 – 3648                                    Puducherry - 605 006, India.
ISSN
        Online   2231 – 3656




       Abstract
       Herb-drug interaction about Oral antidiabetic drugs is a challenging concept, since the consumption of food
       and other herbal drugs is not documented in diabetic patients profile. Present work was designed with an
       objective to investigate any possible effect of herbal drug Piper cubeba Linn. fruits on Pioglitazone-Oral
       antidiabetic drug. Albino male wistar Rats were made diabetic using Alloxan monohydrate 180 mg/ kg and
       divided into 4 groups of 6 animals each.Group II, Group-III and Group-IV were administered with Ethanolic
       extract of Piper cubeba Linn. fruits, EtPCLF (400 mg/kg), Pioglitazone and EtPCLF +Pioglitazone 10mg/kg
       respectively. All the 4 groups were tested with intraperitoneal glucose tolerance test (IPGTT) by administering
       glucose (2.5%) intraperitoneally and decrease in blood glucose concentration was determined in each group
       using glucometer. EtPCLF enhanced the activity of Pioglitazone and significantly lowered Blood glucose
       concentration in EtPCLF + Pioglitazone treated group when compared to Pioglitazone alone treated group.
       Hence EtPCLF enhances the activity of Pioglitazone.

       Key words: Herb-Drug Interaction, Piper cubeba, Pioglitazone, IPGTT, Glucometer.


Introduction                                                          Herb-drug interaction about antidiabetic drugs is a
Diabetes mellitus is a common metabolic disorder                      challenging concept, since the consumption of food and
characterized       by     hyperglycaemia,    glycosuria,             other herbal drug is not documented on patients
polyurea and polydipsia induced by insulin deficiency                 profile. Thus the main objective of the present study is
and insulin resistance. Recent estimates indicate that                to find out any possible Herb-drug interaction occurs
there were 171 million people in world with Diabetes                  between the Ethanolic extract of Piper cubeba
in year 2000 and this may be projected to increase to                 Linn.fruits (EtPCLF) and Pioglitazone – a thiazoli-
366 millions by 2030. Diabetes mellitus is treated by                 -dinedione derivative.
using Oral hypoglycemic agents such as Sulphonyl
Ureas. Biguanides, Meglitinides and Alpha glucosidase                 Materials and Methods
inhibitors[1]. Traditional medicines like herbal drugs in             Apparatus
primary form or their extracts have been used by many                 Soxhlet Apparatus, Glucometer.
diabetic patients as they are assumed to be non –toxic                Drugs
in nature[2] but pharmacologically active constituents                Alloxan monohydrate obtained from Research Lab Fine
such as alkaloids, flavanoids , anthraquinones etc found              Chemical Industries. Mumbai. Pioglitazone Hcl obtained
in the herbs or their extract can take part in herb-drug              from Dr.Reddy’s Laboratories Pvt.Ltd
interactions[3] .
Author for Correspondence:                                            Plant material
Gayasuddin Mouid Md,                                                  Piper cubeba Linn. fruits was purchased from local
Smt.Sarojini Ramulamma College of Pharmacy,                           market. Plant material was identified and authenticated
Mahbubnagar - 509 001, A.P, India.                                    by Botanist, Department of Botany, MVS Degree College,
Email: ghayas0783@gmail.com                                           Mahbubnagar.


            Int. J. Pharm & Ind. Res                 Vol - 01                   Issue - 04                  Oct – Dec 2011
313

Preparation of extract
The shade dried coarsely powdered fruits of Piper               -neally to induce diabetes in Rats ,after 48 hours blood
cubeba Linn (400 gms) was extracted with ethanol as             was withdrawn from the cut tail tip of Rats and Blood
solvent by Continuous hot extraction process using              glucose level was measured using Glucometer. Animals
Soxhlet apparatus. Extraction was continued till the            showing more than 200 mg/dl were called Diabetic
completion of extraction and the extract was                    and were selected for the study. Group -I was
concentrated under reduced pressure. Ethanolic extract          administered with Glucose 2.5 % i.p, Group - II was
was stored in an airtight container in a refrigerator           administered with EtPCLF 400mg/kg given for 7 days,
below 10 º c.                                                   Group-III was administered with Pioglitazone 10
                                                                mg/kg, Group-IV was administered with EtPCLF 400
Animals used                                                    mg/kg for seven days followed by Pioglitazone on the
Healthy Albino male wistar Rats weighing between                day of test .An intraperitoneal glucose tolerance test
180-220 gms were used for the present study. Animals            (IPGTT) was carried out in overnight fasted diabetic
were kept in cages and fed with standard commercial             animals to determine glucose tolerance [4].
diet and water ad libitum. The experiment protocol was
approved by Institutional ethics committee of                   Blood was withdrawn at the start of experiment, half
Smt. Sarojini Ramulamma College of Pharmacy,                    an hour after drug administration, Glucose (2.5%) was
Mahbubnagar.                                                    administered to animals by intraperitoneal route and
                                                                the Blood Glucose Level was estimated at 0 min,
Experimental design                                             2 hours, and 4 hours after glucose administration.The
Albino male wistar Rats were randomly divided into 4            data obtained was expressed as Mean ± S.D .Results
groups with 6 animals in each group and 180 mg/kg               were analysed statistically by one way ANOVA
Alloxan monohydrate was administered intraperito-               followed by Tukey-Kramer Multiple Comparisons Test.

                    Table 01: Effect of EtPCLF and Pioglitazone on Blood Glucose Concentration in
                                       Alloxan induced Diabetic Rats after IPGTT
                                                             Blood Glucose Concentration (mg/dl)
                                         Before glucose
     Group             Treatment
                                         administration                    After glucose administration
                                                                O hrs                 2 hrs                 4 hrs
        I      Glucose (2.5%)           310.94±9.09       471.66±10.37       454.49±10.57            461.34±7.57
               Extract treated
       II                               310.37±12.56      467.13±6.89        465.39±7.1             464.49±14.89
               (400 mg/kg)
               Pioglitazone
       III                              376.17±15.21      442.5±18.66        526.25±7.97            413.66±4.11
               (10 mg/kg) treated
               Extract + Pioglitazone
       IV                               345.55±16.51      425.50±13.63       505.36±11.97*          454.22±10.45**
               (10mg/kg)treated
          Values are Mean ± S.D, n=6,
          Statistical analysis by One-way ANOVA followed by Tuckey Kramer Multiple comparision test.
          *P values < 0.01 when compared to Pioglitazone alone treated group.
          ** P values < 0.001 when compared to Glucose alone treated group.


Results
 In a group treated with EtPCLF + Pioglitazone, a               (P<0.001) of blood glucose concentration when
significant lowering (P<0.01) of blood glucose                  compared to glucose alone treated group. Thus the
concentration was seen when compared to Pioglitazone            EtPCLF and Pioglitazone treated group has shown a
alone treated groups at 2 hours as shown in the Table           decrease in blood glucose levels at 0, 2 and 4 hours
01. At 4 hours, the group treated with EtPCLF +                 but more precisely the glucose tolerance was shown at
Pioglitazone has shown a significant lowering                   2 hours as shown in the Table 01.


     Int. J. Pharm & Ind. Res             Vol - 01                       Issue - 04                   Oct – Dec 2011
314

Discussion                                                           References
Pioglitazone is an insulin sensitizer acting primarily on            1. S.K.Bhattacharya. Control of Blood Glucose.
Peroxisome proliferator activated receptor subtype                       Pharmacology, 2nd edition: Elsevier Publishers,
gamma type (PPAR-γ) [5,6] against insulin resistance.                    2003: 351-362.
Pioglitazone enhances tissue sensitivity to insulin rather           2. Zhou’s, et al,. Herbal Bioactivation. The good, the
than stimulating insulin secretion. Alloxan decreases the                bad and the ugly. Life Sci.2004; 74: 935-968.
insulin sensitivity and decreases the glucose uptake of              3. Markowitz et al,. Effect of St.John’s wort on CYP-
cells. Blood glucose level of EtPCLF alone treated                       450 2D6 and 3A4 activity in healthy volunteers
group when compared to Glucose alone (Control)                           .Life Sci.2000; 66: PL133-PL139.
treated group showed no significant change which                     4. Kaneto H et al,. Beneficial effects of antioxidants
clearly indicates that EtPCLF as such doesn’t have any                   in diabetes, possible protection of β-cells against
antihyperglycemic activity.                                              Glucose toxicity. Diabetes 1999; 48:2398-2406.
                                                                     5. Doyle M. Pharmacological agents that directly
The blood glucose concentration of EtPCLF                                modulate insulin secretion. Pharmacol.Rev.2003;
+Pioglitazone treated group when compared to                             55:1005-113
Pioglitazone alone treated group has shown significant               6. Supeecha et al, .The Pharmacokinetics of
reduction in blood glucose level which clearly indicates                 Pioglitazone in Thai healthy subjects. J.Med Assoc
that the decrease in blood glucose level was due to                      Thai 2006; 89(12): 2116-2122.
synergistic effect of EtPCLF on Pioglitazone. As earlier             7. S.L Bodhankar et al,. Combinative therapeutic
reported the combinative therapy with 4-                                 approach for better blood sugar level control in
Hydroxyisoleucine and Pioglitazone proved beneficial                     Alloxan diabetic Mice. Int.J.Diabetes & Metabolism
than Pioglitazone alone treated group[7] and the risk of                 2006; 14:104-105.
administration of Carica papaya extract with oral                    8. Fakey TO et al,. Effect of Co-administration of
hypoglycemics which led to Hypoglycemic condition [8]                    extract of Carica papaya Linn. (Family:
but the present studies has not shown any                                Caricaceae) on activity of two oral hypoglycemic
hypoglycemic condition but shown antihyperglycemic                       agents. Tropical Journal of Pharmaceutical
action . Enhanced antihyperglycemic action of EtPCLF                     Research2007; 6(1):671-678.
treated Pioglitazone group over Pioglitazone alone                   9. Hanfeld M.Pharmacokinetics and clinical efficacy
treated group may be due to metabolic inhibition of                      of Pioglitazone, Int.J clin pract 2011(Suppl):19-25.
Pioglitazone in intestine by the EtPCLF as Pioglitazone              10. Jaakola T et al, Pioglitazone is metabolized by
is metabolized by CYP3A4 and CYP2C8 [9, 10] and                          CYP 2C 8 and CYP3A4 invitro: Potential for
EtPCLF inhibits CYP3A4 enzymes [11] , thus leading to                    interaction with CYP2C8 inhibitors. Basic Clin
Herb-Drug interaction .                                                  Pharmacol Toxicol. 2006; 99(1); 44-51.
                                                                     11. Y.Tezuka et al, CYP3A4 and CYP2D6 inhibitory
Conclusion                                                               activities of Indonesian Medicinal Plants. Phyto-
Administration of Ethanolic extract of Piper cubeba                      -medicine 2006; 13; 67-73.
Linn. fruits with Pioglitazone led to herb drug
interaction and augmented the antihyperglycemic
activity of Pioglitazone significantly. Thus it is necessary
to adjust the dose of Pioglitazone when it is
administered with Piper cubeba fruits to minimize the
adverse effects of Pioglitazone.

Acknowledgement
We are very thankful to Smt.Sarojini Ramulamma
College of Pharmacy, Mahbubnagar for providing
facilities in bringing out this work successful.


      Int. J. Pharm & Ind. Res               Vol - 01                       Issue - 04                  Oct – Dec 2011

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Effect of ethanolic extract of piper cubeba linn fruits on activity of pioglitazone

  • 1. 312 Original Article EFFECT OF ETHANOLIC EXTRACT OF PIPER CUBEBA LINN. FRUITS ON ACTIVITY OF PIOGLITAZONE *1Gayasuddin Mouid Md, 2Shakil Sait S, 3Kavimani S *1Smt.Sarojini Ramulamma College of Pharmacy, Mahbubnagar - 509 001, A.P, India. 2AR&D,Dr.Reddy’s Laboratories Ltd., Bachupally, Hyderabad - 500 049, A.P, India. 3Mother Theresa Post Graduate and Research Institute of Health Sciences, Print 2231 – 3648 Puducherry - 605 006, India. ISSN Online 2231 – 3656 Abstract Herb-drug interaction about Oral antidiabetic drugs is a challenging concept, since the consumption of food and other herbal drugs is not documented in diabetic patients profile. Present work was designed with an objective to investigate any possible effect of herbal drug Piper cubeba Linn. fruits on Pioglitazone-Oral antidiabetic drug. Albino male wistar Rats were made diabetic using Alloxan monohydrate 180 mg/ kg and divided into 4 groups of 6 animals each.Group II, Group-III and Group-IV were administered with Ethanolic extract of Piper cubeba Linn. fruits, EtPCLF (400 mg/kg), Pioglitazone and EtPCLF +Pioglitazone 10mg/kg respectively. All the 4 groups were tested with intraperitoneal glucose tolerance test (IPGTT) by administering glucose (2.5%) intraperitoneally and decrease in blood glucose concentration was determined in each group using glucometer. EtPCLF enhanced the activity of Pioglitazone and significantly lowered Blood glucose concentration in EtPCLF + Pioglitazone treated group when compared to Pioglitazone alone treated group. Hence EtPCLF enhances the activity of Pioglitazone. Key words: Herb-Drug Interaction, Piper cubeba, Pioglitazone, IPGTT, Glucometer. Introduction Herb-drug interaction about antidiabetic drugs is a Diabetes mellitus is a common metabolic disorder challenging concept, since the consumption of food and characterized by hyperglycaemia, glycosuria, other herbal drug is not documented on patients polyurea and polydipsia induced by insulin deficiency profile. Thus the main objective of the present study is and insulin resistance. Recent estimates indicate that to find out any possible Herb-drug interaction occurs there were 171 million people in world with Diabetes between the Ethanolic extract of Piper cubeba in year 2000 and this may be projected to increase to Linn.fruits (EtPCLF) and Pioglitazone – a thiazoli- 366 millions by 2030. Diabetes mellitus is treated by -dinedione derivative. using Oral hypoglycemic agents such as Sulphonyl Ureas. Biguanides, Meglitinides and Alpha glucosidase Materials and Methods inhibitors[1]. Traditional medicines like herbal drugs in Apparatus primary form or their extracts have been used by many Soxhlet Apparatus, Glucometer. diabetic patients as they are assumed to be non –toxic Drugs in nature[2] but pharmacologically active constituents Alloxan monohydrate obtained from Research Lab Fine such as alkaloids, flavanoids , anthraquinones etc found Chemical Industries. Mumbai. Pioglitazone Hcl obtained in the herbs or their extract can take part in herb-drug from Dr.Reddy’s Laboratories Pvt.Ltd interactions[3] . Author for Correspondence: Plant material Gayasuddin Mouid Md, Piper cubeba Linn. fruits was purchased from local Smt.Sarojini Ramulamma College of Pharmacy, market. Plant material was identified and authenticated Mahbubnagar - 509 001, A.P, India. by Botanist, Department of Botany, MVS Degree College, Email: ghayas0783@gmail.com Mahbubnagar. Int. J. Pharm & Ind. Res Vol - 01 Issue - 04 Oct – Dec 2011
  • 2. 313 Preparation of extract The shade dried coarsely powdered fruits of Piper -neally to induce diabetes in Rats ,after 48 hours blood cubeba Linn (400 gms) was extracted with ethanol as was withdrawn from the cut tail tip of Rats and Blood solvent by Continuous hot extraction process using glucose level was measured using Glucometer. Animals Soxhlet apparatus. Extraction was continued till the showing more than 200 mg/dl were called Diabetic completion of extraction and the extract was and were selected for the study. Group -I was concentrated under reduced pressure. Ethanolic extract administered with Glucose 2.5 % i.p, Group - II was was stored in an airtight container in a refrigerator administered with EtPCLF 400mg/kg given for 7 days, below 10 º c. Group-III was administered with Pioglitazone 10 mg/kg, Group-IV was administered with EtPCLF 400 Animals used mg/kg for seven days followed by Pioglitazone on the Healthy Albino male wistar Rats weighing between day of test .An intraperitoneal glucose tolerance test 180-220 gms were used for the present study. Animals (IPGTT) was carried out in overnight fasted diabetic were kept in cages and fed with standard commercial animals to determine glucose tolerance [4]. diet and water ad libitum. The experiment protocol was approved by Institutional ethics committee of Blood was withdrawn at the start of experiment, half Smt. Sarojini Ramulamma College of Pharmacy, an hour after drug administration, Glucose (2.5%) was Mahbubnagar. administered to animals by intraperitoneal route and the Blood Glucose Level was estimated at 0 min, Experimental design 2 hours, and 4 hours after glucose administration.The Albino male wistar Rats were randomly divided into 4 data obtained was expressed as Mean ± S.D .Results groups with 6 animals in each group and 180 mg/kg were analysed statistically by one way ANOVA Alloxan monohydrate was administered intraperito- followed by Tukey-Kramer Multiple Comparisons Test. Table 01: Effect of EtPCLF and Pioglitazone on Blood Glucose Concentration in Alloxan induced Diabetic Rats after IPGTT Blood Glucose Concentration (mg/dl) Before glucose Group Treatment administration After glucose administration O hrs 2 hrs 4 hrs I Glucose (2.5%) 310.94±9.09 471.66±10.37 454.49±10.57 461.34±7.57 Extract treated II 310.37±12.56 467.13±6.89 465.39±7.1 464.49±14.89 (400 mg/kg) Pioglitazone III 376.17±15.21 442.5±18.66 526.25±7.97 413.66±4.11 (10 mg/kg) treated Extract + Pioglitazone IV 345.55±16.51 425.50±13.63 505.36±11.97* 454.22±10.45** (10mg/kg)treated Values are Mean ± S.D, n=6, Statistical analysis by One-way ANOVA followed by Tuckey Kramer Multiple comparision test. *P values < 0.01 when compared to Pioglitazone alone treated group. ** P values < 0.001 when compared to Glucose alone treated group. Results In a group treated with EtPCLF + Pioglitazone, a (P<0.001) of blood glucose concentration when significant lowering (P<0.01) of blood glucose compared to glucose alone treated group. Thus the concentration was seen when compared to Pioglitazone EtPCLF and Pioglitazone treated group has shown a alone treated groups at 2 hours as shown in the Table decrease in blood glucose levels at 0, 2 and 4 hours 01. At 4 hours, the group treated with EtPCLF + but more precisely the glucose tolerance was shown at Pioglitazone has shown a significant lowering 2 hours as shown in the Table 01. Int. J. Pharm & Ind. Res Vol - 01 Issue - 04 Oct – Dec 2011
  • 3. 314 Discussion References Pioglitazone is an insulin sensitizer acting primarily on 1. S.K.Bhattacharya. Control of Blood Glucose. Peroxisome proliferator activated receptor subtype Pharmacology, 2nd edition: Elsevier Publishers, gamma type (PPAR-γ) [5,6] against insulin resistance. 2003: 351-362. Pioglitazone enhances tissue sensitivity to insulin rather 2. Zhou’s, et al,. Herbal Bioactivation. The good, the than stimulating insulin secretion. Alloxan decreases the bad and the ugly. Life Sci.2004; 74: 935-968. insulin sensitivity and decreases the glucose uptake of 3. Markowitz et al,. Effect of St.John’s wort on CYP- cells. Blood glucose level of EtPCLF alone treated 450 2D6 and 3A4 activity in healthy volunteers group when compared to Glucose alone (Control) .Life Sci.2000; 66: PL133-PL139. treated group showed no significant change which 4. Kaneto H et al,. Beneficial effects of antioxidants clearly indicates that EtPCLF as such doesn’t have any in diabetes, possible protection of β-cells against antihyperglycemic activity. Glucose toxicity. Diabetes 1999; 48:2398-2406. 5. Doyle M. Pharmacological agents that directly The blood glucose concentration of EtPCLF modulate insulin secretion. Pharmacol.Rev.2003; +Pioglitazone treated group when compared to 55:1005-113 Pioglitazone alone treated group has shown significant 6. Supeecha et al, .The Pharmacokinetics of reduction in blood glucose level which clearly indicates Pioglitazone in Thai healthy subjects. J.Med Assoc that the decrease in blood glucose level was due to Thai 2006; 89(12): 2116-2122. synergistic effect of EtPCLF on Pioglitazone. As earlier 7. S.L Bodhankar et al,. Combinative therapeutic reported the combinative therapy with 4- approach for better blood sugar level control in Hydroxyisoleucine and Pioglitazone proved beneficial Alloxan diabetic Mice. Int.J.Diabetes & Metabolism than Pioglitazone alone treated group[7] and the risk of 2006; 14:104-105. administration of Carica papaya extract with oral 8. Fakey TO et al,. Effect of Co-administration of hypoglycemics which led to Hypoglycemic condition [8] extract of Carica papaya Linn. (Family: but the present studies has not shown any Caricaceae) on activity of two oral hypoglycemic hypoglycemic condition but shown antihyperglycemic agents. Tropical Journal of Pharmaceutical action . Enhanced antihyperglycemic action of EtPCLF Research2007; 6(1):671-678. treated Pioglitazone group over Pioglitazone alone 9. Hanfeld M.Pharmacokinetics and clinical efficacy treated group may be due to metabolic inhibition of of Pioglitazone, Int.J clin pract 2011(Suppl):19-25. Pioglitazone in intestine by the EtPCLF as Pioglitazone 10. Jaakola T et al, Pioglitazone is metabolized by is metabolized by CYP3A4 and CYP2C8 [9, 10] and CYP 2C 8 and CYP3A4 invitro: Potential for EtPCLF inhibits CYP3A4 enzymes [11] , thus leading to interaction with CYP2C8 inhibitors. Basic Clin Herb-Drug interaction . Pharmacol Toxicol. 2006; 99(1); 44-51. 11. Y.Tezuka et al, CYP3A4 and CYP2D6 inhibitory Conclusion activities of Indonesian Medicinal Plants. Phyto- Administration of Ethanolic extract of Piper cubeba -medicine 2006; 13; 67-73. Linn. fruits with Pioglitazone led to herb drug interaction and augmented the antihyperglycemic activity of Pioglitazone significantly. Thus it is necessary to adjust the dose of Pioglitazone when it is administered with Piper cubeba fruits to minimize the adverse effects of Pioglitazone. Acknowledgement We are very thankful to Smt.Sarojini Ramulamma College of Pharmacy, Mahbubnagar for providing facilities in bringing out this work successful. Int. J. Pharm & Ind. Res Vol - 01 Issue - 04 Oct – Dec 2011