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In vitro studies have been performed to investigate the potential of CAM to activate nuclear receptors and to induce metabolizing enzymes. An overview of these studies is given in Table 3. Raucy [61] used CYP3A4 mRNA analysis in primary cultures of human hepatocytes of 17 individuals to test the inductive properties of several flavonoids, including quercetin, resveratrol, and curcumin. Of these, only quercetin produced accumulation of CYP3A4 mRNA. However, when a reporter gene assay with hPXR was used, quercetin did not show a significant increase in luciferase activity, suggesting that CYP3A4 was induced by mechanisms not involving PXR. Herbs like grapeseed extract, ginseng, garlic, and kava-kava also increased CYP3A4 mRNA levels in hepatocytes, but of these botanicals, only kava-kava produced enhanced luciferase activity [61]. The results of that study clearly showed that some CAMs have the potential to induce CYP3A4, although not always mediated via PXR. Individual forms of vitamin E also activate gene expression via PXR. Zhou et al. [62] found that -, -, -, and tocotrienols, forms of vitamin E, but not -, -, -, and tocopherols specifically bind to and activate PXR. In that study, it was shown, however, that the induction of target genes was tissue specific: upregulation of CYP3A4, but not UGT1A1 or MDR-1, in primary hepatocytes in contrast to increased UGT1A1 and MDR-1, but not CYP3A4, expression in intestinal LS180 cells [62]. Another study, also using a cell-based reporter system, showed that although - and tocotrienol showed the strongest inductive efficacy, -, -, and -tocopherol could also activate PXR [63]. In that study, exposure of HepG2 cells to -tocotrienol gave an upregulation of endogenous CYP3A4 and CYP3A5 mRNA. Other studies using gene reporter assays or mRNA levels of CYP3A4 in human hepatocytes showed the potential of several CAMs to induce CYP3A4 by activation of PXR: Gugulipid, or its chemical constituents guggulsterones, derived from the Mukul myrrh tree [6467], hops [64], two traditional Chinese medicines TCMs ; , Wu Wei Zi Schisandra chinensis Baill ; and Gan Cao Glycyrrhiza uralensis Fisch ; , and their selective constituents [68], carotenoids, especially -carotene, and retinol [69]. Flavonoids, like chrysin, induce UGT1A1 expression via another receptor, the aryl hydrocarbon receptor AhR ; , which is beyond the scope of this review. However, PXR and CAR were also shown to contribute to the overall UGT1A1 response to flavonoids [70], for instance, citalopram half life.
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OBJECTIVE: Since 1999, the Ministry of Public Health MOPH ; , Thailand, has developed website to inform reference drug price to public health service institutions. The objectives of this study were to analyze the available reference drug price data and compare the price based on Weighted Average Price WAP ; and Drug Price Discrepancy Index DPDI ; . METHODS: Drug price data in 2001 were used for the analyses. The 62 drugs from a provincial collective drug purchasing database were selected based on the their high expenditure and the same 62 drugs were also selected from an individual purchasing database for studying their purchasing prices. The WAP and DPDI of individual drugs were calculated. The WAP was calculated from every unit price and volume purchased divided by total amount of drug purchased. Drug Price Discrepancy Index DPDI ; was the ratio of the individual unit price of each collective purchasing group and the WAP. To determine high unit price of purchased drug for individual collective purchasing group, the acceptable DPDI was set up to be greater than 1.2. The WAP and DPDI of each drug were compared within the collective or individual purchasing group. RESULTS: Of the drug purchased by collective purchasing at provincial level, 15 24% ; drugs had a high purchasing price and of the drug purchased by individual purchasing, 20 32% ; drugs had high a purchasing price. The WAP and DPDI parameter provided the group of target drugs to be monitored to prevent highly purchased drug prices. CONCLUSIONS: The WAP might be used to assist hospital in drug procurement to improve the efficient use of the pharmacy budget. Other affiliating factors including quality of drug should also be considered in actual purchasing. It is anticipated that the DPDI will enable the collective purchasing network and MOPH to be aware of high unit prices of drugs purchased around the country.
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Confirmed heavy mercury content in six commonly available skin-lightening products. City officials issued alerts and press releases to health care practitioners and ordered 163 stores to stop selling the products and provide it with names of distributors. With the funding of the new National Environmental Public Health Tracking Program, the databases of NCEH and ATSDR have become more accessible. Efforts are underway to collect these data in the same format, which will expedite the CDC's ability to investigate reports of poisonings. Environmental public health threats associated with hazardous waste sites are addressed by ATSDR. It conducts public health assessments, consultations and health studies at and near hazardous waste sites, working closely with the Environmental Protection Agency and state and local public health organizations. It also provides grant funding, expertise and consultation to 29 state public health agencies to train local health professionals on responses to hazardous waste site exposures and contamination. For more information about NCEH and ATSDR, refer to the Summer 2005 edition of Ecos or visit cdc.gov nceh and atsdr c.gov. For more information about environmental public health tracking, visit cdc.gov nceh tracking . What Legislators Can Do The harmful effects of both mercury and carbon monoxide poisoning can be lessened through education and legislation. State legislators can take an active role to protect their constituents by providing funding opportunities to educate new arrivals on the use of substances like mercury. Supporting education programs for agencies and consumers that offer a clear understanding of Hispanic cultural practices and introducing behavioral changes when Hispanics move to the U.S. also may improve outcomes. Without such understanding, opportunities are missed to educate new arrivals and embark on a prevention opportunity. It's.
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