ASSESSING THE PROTECTIVE EFFECT OF SYZYGIUM CUMINI ON VILDAGLIPTIN-INDUCED PANCREATIC TOXICITY: AN IN-VIVO STUDY
Main Article Content
Keywords
DPP-4 inhibitors, vildagliptin, Syzygium cumini, antidiabetic, pancreatitis.
Abstract
Background: Many oral hypoglycemic drugs are available for the treatment of diabetes mellitus. Along with other hypoglycemics dipeptidylpeptidase-4 inhibitors i.e, vildagliptin is one of the new drug which are used for the treatment of diabetes. The DPP4 inhibitors are gliptins that are used orally. The mechanism of DPP-4 inhibitors is to increase incretin levels (GLP-1 and GIP) which inhibit glucagon release, which in turn increases insulin secretion.
Objectives: Vildagliptin may cause pancreatitis and infections so the combination of Vildagliptin and syzygium cumini can be helpful to reduce dose of Vildagliptin and can increase its safety and efficacy. Syzygium cumini belongs to family Myrtaceae. It is commonly known as Jambol fruit and locally as Jamun. The seeds of Jamun used as antidiabetic agent.
Methods: An in vivo study was conducted to evaluate the effects of vildagliptin on diabetes. Blood samples from normal and diabetic male rats were analyzed and compared to a control diabetic group.
Study Design: Experimental.
Place and Duration: Study was conducted at University of Karachi, from November 2023 to April 2024.
Results: The results showed that combination of vildagliptin and syzygium cumini showed its potential in managing diabetes and has synergistic hypoglycemic activity. Vildagliptin not only produced antidiabetic but it may produce severe pancreatitis and toxicity. Serum amylase and serum lipase level reduced with combination so it can increase protection against pancreatitis. Conclusion: The studied concluded that vildagliptin have marked good antidiabetic activity and combination of vildagliptin and syzygium cumini reduce the dose of vildagliptin which in turn its safety and efficacy and protecting the pancreas from damage and toxicity.
References
2. Herman GA; Stevens C, Van Dyck K, Bergman A, Yi B, De Smet M, Snyder K, Hilliard D, Tanen M, Tanaka W, Wang AQ, Zeng W, Musson D, Winchell G, Davies MJ, Ramael S, Gottesdiener KM, Wagner JA. "Pharmacokinetics and pharmacodynamics of vildagliptin, an inhibitor of dipeptidyl peptidase IV, in healthy subjects: results from two randomized, double-blind, placebo- controlled studies with single oral doses". Clin Pharmacol Ther, 2005; 78(6): 675–88.
3. Ulf F, Carsten S, Michael S, Carsten K, Thomas S, Jutta S, Andreas S, Reinhard P. "Inhibition of CD26/Dipeptidyl Peptidase IV Enhances CCL11/Eotaxin-Mediated Recruitment of Eosinophils In Vivo". Journal of Immunology, 2008; 181(2): 1120–7.
4. Olansky L (2010). "Do incretin-based therapies cause acute pancreatitis?". J Diabetes Sci Technol, 2010; 4(1): 228–9.
5. Elashoff M, Matveyenko AV, Gier B, Elashoff R, Butler PC. Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1-based herapies. Gastroenterology, 2011; 141(1): 150–6.
6. Dore DD, Seeger JD, Arnold Chan K. Use of a claims-based active drug safety surveillance system to assess the risk of acute pancreatitis with exenatide or vildagliptin compared to metformin or glyburide.Curr Med Res Opin, 2009; 25(4): 1019–27.
7. Lacroix JS, Kurt AM, Pochon N, Bretton C, Lundberg JM, Deshusses J. Neutral endopeptidase activity and concentration of sensory neuropeptide in the human nasal mucosa. Eur Arch Otorhinolaryngol, 1995; 252: 465–468.
8. Grouzmann E, Monod M, Landis B, Wilk S, Brakch N, Nicoucar K, Giger R, Malis D, Szalay-Quinodoz I, Cavadas C, Morel DR, Lacroix JS. Loss of dipeptidylpeptidase IV activity in chronic rhinosinusitis contributes to the neurogenic inflammation induced by substance P in the nasal mucosa. FASEB J. 2002; 16: 1132–1134.
9. Giger R, Nicoucar K, Kurt AM, Grouzman E, Lacroix JS. Study of the enzyme peptidyl peptidase IV in nasal mucosa. Schweiz Med Wochenschr Supple, 2000; 125: 99S–101S.
10. Singh S, Chang HY, Richards TM, Weiner JP, Clark JM, Segal JB. Glucagonlike peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population- based matched case-control study. JAMA Intern Med., 2013; 173(7): 534-9.
11. en Español. FDA Drug Safety Communication: FDA investigating reports of possible increased risk of pancreatitis and pre-cancerous findings of the pancreas from incretin mimetic drugs for type 2 diabetes.2013;http:www.fda.gov/drugs/drugs safety.
12. Nadkarni, K. M. ‘Indian Materia Medica.1954; Vol. 1, Popular Book Depot, Bombay 7.
13. Villasenor IM, Lamadrid MRA. Comparative antihyperglycaemic potentials of medicinal plants. J Ethnopharmacol, 2006; 104: 129–131.
14. Vikrant V, Grover JK, Tandon N, Rathi SS, Gupta N. Treatment with extracts of Momordica charantiaand Eugenia jambolana prevents hyperglycemia and hyperinsulinemia in fructose fed rats. J Ethnopharmacol, 2001; 76: 139–143.
15. Prince PSM, Kamalakkannan N, Menon VP. Syzigium cumini seed extracts reduce tissue damage in diabetic rat brain. J Ethnopharmacol, 2003; 84: 205–209.
16. Sharma SB, Nasir A, Prabhu KM, Murthy PS, Dev G. Hypoglycaemic and hypolipidemic effect of ethanolic extract of seeds of Eugenia jambolana in streptozotocin-induced diabetic rats. J Ethnopharmacol, 2003; 85: 201–206.
17. Sharma SB, Nasir A, Prabhu KM, Murthy PS. Antihyperglycaemic effect of the fruit-pulp of Eugenia jambolana in experimental diabetes mellitus. J Ethnopharmacol, 2006; 104: 367–373.
18. Maiti S, Ali KM, Jana K, Chatterjee K, De D, Ghosh D. Ameliorating effect of mother tincture of Syzygium jambolanum on carbohydrate and lipid metabolic disorders in streptozotocin-induced diabetic rat: Homeopathic remedy. J Nat SciBiol Med., 2013; 4(1): 68-73.
19. Samadder A, Das S, Das J, Paul A, Khuda-Bukhsh AR. Ameliorative effects of Syzygium jambolanum extract and its poly (lactic-co-glycolic) acid nano-encapsulated form on arsenic-induced hyperglycemic stress: a multi-parametric evaluation. J Acupunct Meridian Stud, 2012; 5(6): 310-8. Grover JK, Vats V, Rathi SS. Antihyperglycaemic effect of Eugenia jambolana and Tinospora cordifoliain experimental diabetes and their effects on key metabolic enzymes involved in carbohydrate metabolism. J Ethnopharmacol, 2000; 73: 461–470.
20. Maciel MC, Farias JC, Maluf MJ, Gomes EA, Pereira PV, Aragão-Filho WC, Frazão JB, Costa GC, Sousa SM, Silva LA, Amaral FM, Russo M, Guerra RN, Nascimento FR. Syzygium jambolanum treatment improves survival in lethal sepsis induced in mice. BMC Complement Altern Med., 2008; 13; 8: 57.
21. Chandrasekaran M, Venkatesalu V. Antibacterial and antifungal activity of Syzygium jambolanum seeds. J Ethnopharmacol, 2004; 91(1): 105-8.
22. Jianpu Wang, Rong Wan, Yiqun Mo, Qunwei Zhang, Leslie C. Sherwood, and SufanChien. Creating a Long-Term Diabetic Rat Model.Experimental Diabetes Research, 2010; 2010:289614.
23. Huralikuppi J.C. (1991). Antidiabetic effect of Nelumbo nucifera extract: Part 2. Phytother. Res., 1991; 5: 217-223.
24. Monami M, Dicembrini I, Mannucci E. Dipeptidyl Peptidase-4 Inhibitors and pancreatitis risk.Diabetes ObesMetab, 2014 Jan; 16(1): 48-56.
25. Raz I, Hanefeld M, Xu L, Caria C, Williams- Herman D, Khatami H. (Vildagliptin Study 023 Group. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor vildagliptin as monotherapy in patients with type 2 diabetes mellitus. Diabetologia, 2006; 12: 2564–2571.