Abstract

Tiaowei Chengqi Tang (TWCQT) is composed of rhubarb, processed liquorice, and Natrii Sulfas, which is used as a purgative in traditional Chinese medicine (TCM). This study focused on the intestinal absorption of rhein in disassembly of the TWCQT extracts through the Caco-2 cell monolayer model to explicate the possible detoxification mechanism of herb-herb compatibility in TWCQT. The results showed that the intestinal absorption of rhein occurred through active diffusion, and rhein might be composed of breast cancer resistance protein (BCRP) substrates. The extract of processed liquorice increased the exclusion rate and reduced intracellular uptake of rhein. The consistent results observed in TWCQT further implied that processed liquorice in TWCQT could suppress the absorption of rhein across the Caco-2 cell monolayer. It has therefore been concluded that the active ingredients of processed liquorice may play a critical role in reducing the intestinal absorption of rhein to alleviate the toxicity of rhubarb in TWCQT. Because of BCRP's involvement in rhein transport, we conjectured that some components in processed liquorice could inhibit the transport of rhein, possibly by mediating BCRP. These results would provide new insight into this ancient drug combination in toxicity reduction and clinical use.

Highlights

  • Tiaowei Chengqi Tang (TWCQT), recorded in Shang Han Lun and consisted of three herbs, rhubarb (Radix et Rhizoma Rhei, Polygonaceae), processed liquorice (Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle), and Natrii Sulfas, with a ratio of 4 : 2 : 3, has been traditionally used as a purgative to relieve constipation and to clear internal heat in the stomach and intestine [1]

  • We found that processed liquorice could increase the dissolution of rhein in rhubarb with processed liquorice extract (RPE) and TWCQT decoctions

  • These results provided evidence that only breast cancer resistance protein (BCRP) was involved in rhein transport, which were consistent with Ye et al [22]

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Summary

Introduction

Tiaowei Chengqi Tang (TWCQT), recorded in Shang Han Lun and consisted of three herbs, rhubarb (Radix et Rhizoma Rhei, Polygonaceae), processed liquorice (Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle), and Natrii Sulfas, with a ratio of 4 : 2 : 3, has been traditionally used as a purgative to relieve constipation and to clear internal heat in the stomach and intestine [1]. Multiherb prescription is recognized as a unique pattern of traditional Chinese medicine (TCM) clinical application, in which herbs work together to exert therapeutic actions or modulate the pharmacological and toxicological effects [1]. Rhein was the most absorbable anthraquinone derivative into blood circulation after oral administration of rhubarb extract in rats [8]; rhein was identified as one of the toxic anthraquinones [9, 10]. These evidences suggested that rhein had the good strong protein binding affinity and bioavailability to cause toxic manifestations in rhubarb

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