Green Tea

3.2.2. Green Tea

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3.2.2. Green Tea Oriental tea infusion has become popular across the globe in the recent decades. Green tea has been shown to inhibit CYPs as well as P-glycoprotein, whose role is to remove various foreign substances from cells in the body. This reducing effect, in turn, should result in an increase in plasma drug level [50,51,52]. However, the aforementioned inhibitory effect is not shared by all the components of botanical supplements and may differ between particular substances [53,54]. In one case report [18], researchers observed an increase in tacrolimus levels following green tea ingestion, and its normalization after the tea was discontinued. Further investigation showed that the patient represented a “poor metabolizer”. This case proved the importance of careful monitoring of this group of recipients, particularly considering the narrow therapeutic index of TAC. In contrast, murine models show a reduction in the Cmax and AUC of tacrolimus following the co-administration of specific catechins extracted from green tea [16]. However, polymerase chain reaction and Western blot showed a reducing effects of catechins on the expression of drug-metabolizing enzymes, drug transporters and the upregulation of nuclear receptors. This inconsistency needs to be further explored in the subsequent studies [55,56,57]. Despite the pharmacokinetic alteration following green tea intake, the protective properties of this herb constitute its main advantage. Commonly known antioxidative properties of green tea can reduce the nephrotoxic effects of tacrolimus, as well as play a role in preventing the development of cardiovascular diseases. Moreover, tea extracts prevent apoptotic cell death via modulation of mitochondrial cytochrome c release and modulation of caspase activation and also decrease ROS, NO and other detrimental substances in a dose- and time-dependent manner [58,59,60,61,62]. Theaflavins and catechins are active ingredients of the plant, and they do not demonstrate as high activity as the complete green tea extracts when tested separately [61]. All the reviews investigated only green tea, not black tea created by the fermentation of natural products; thus, the interaction with tacrolimus may be different. However, there is a need to explore various herbal–drug interactions in the future. Much of the currently available data are derived only from case reports conflicting with the established mechanisms of action, indicating other possible mechanisms. In 2011, a case of a 1.5–2-fold increase of tacrolimus concentration was observed after the ingestion of green tea [18]. Nevertheless, authors did not provide precise data concerning the type of green tea and the amount consumed.

Befund HOS-368842 · tacrolimus · HOS-085202 · Originalquelle ↗

Controversial Interactions of Tacrolimus with Dietary Supplements, Herbs and Food ↗

© 2022 by the authors. Miłosz Miedziaszczyk; Aleksander Bajon; Ewelina Jakielska; Marta Primke; Jędrzej Sikora; Dagmara Skowrońska; Ilona Idasiak-Piechocka. Controversial Interactions of Tacrolimus with Dietary Supplements, Herbs and Food. DOI: 10.3390/pharmaceutics14102154 · CC BY 4.0

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