1. Introduction
Stroke, defined as a sudden neurological dysfunction in the brain caused by either ischemia (lack of blood supply to the brain) or a hemorrhage, has become one of the leading causes of severe neuronal impairment, loss of brain functions, and death [
1]. Around 80% of strokes result from cerebrovascular system blockage (ischemia) [
2]. Reperfusion is considered as an effective approach to improve the ischemic condition of the brain, particularly for vascular blockage, however, cerebral ischemia and reperfusion (I/R) may induce an accumulation of reactive oxygen species released from mitochondria, which possibly accelerates lipid peroxidation and the process of neuronal death [
3]. The resulting oxidative stress could worsen the extent of stroke [
4].
Many traditional Chinese medicines (TCMs) are reported to facilitate recovery from stroke [
4]. Xin-Shao formula, consisting of
Erigeron breviscapus (Vant.) Hand.-Mazz and
Paeonia veitchii Lynch, is a common TCM and has been used for the prevention and treatment of acute brain infarcts and stroke [
5,
6,
7]. Our early studies demonstrated that Xin-Shao formula remarkably inhibited the arteriovenous bypass thrombogenesis in rats [
8], protected against cerebral I/R injury in rats [
9], improved microcirculation disturbance resulting from blood deficiency in ischemic site of brain [
9], and decreased reactive oxygen species in middle cerebral artery occlusion (MCAO) rats [
9] and in cultured PC12 cells [
10].
A pharmacokinetic study of Xin-Shao formula has been performed in normal rats in our laboratory [
11]. However, the pharmacokinetic behaviors of the herbal medicine are not necessarily the same under pathophysiological conditions, specifically in cerebral I/R injury. Cerebral I/R injury is commonly recognized as a major factor which could be an obstacle to effective cure of stroke. Cerebral I/R injury was reported to alter pharmacokinetic behaviors of some herbal medicines [
2,
12,
13]. The primary objective of this study was to compare pharmacokinetic properties of Xin-Shao formula in cerebral I/R injury model rats and sham-operated rats. Scutellarin (
Figure 1A) and paeoniflorin (
Figure 1B), two major components known to protect against cerebral I/R injury [
14,
15,
16,
17,
18,
19,
20], were monitored for the pharmacokinetic study. We hoped the study would provide useful information to guide the effective use of Xin-Shao formula in the clinic.
3. Discussion
Cerebral I/R injury was reported to induce liver injury and hepatic dysfunction which results from an excessive accumulation of reactive oxygen species [
21], activation of apoptosis [
22], energy deficiency [
22], and inflammatory reaction [
23]. The resulting hepatic energy deficiency and apoptosis even necrosis may cause alternation in functions of drug-metabolizing enzymes and transporters [
23], which possibly affect drug biotransformation and disposition.
The major hepatic metabolic pathways for scutellarin include hydrolysis and glucuronic acid conjugation [
24]. The hydrolysis of scutellarin by β-glucuronidase offers scutellarein (aglycone) and glucuronic acid. The later pathway produces the corresponding glucuronide [
24], and UDP-glucuronosyltransferases (UGTs) are the enzymes responsible for the formation of glucuronides. Glucuronidation could be an important factor commanding the elimination of drugs [
25]. The conjugation process of scutellarin was mainly mediated by UGT1A9, 1A1 and 1A8 [
26]. Glucuronidation is a conjugative clearance system with a large capacity and plays a dominant role in the elimination of scutellarin [
24]. The expression of UGT1A9 and 1A1 was reported to be down-regulated in response to pathophysiological conditions such as inflammatory reaction [
27] which often takes place during cerebral I/R injury [
28]. The present study showed that the disappearance of scutellarin in plasma was slower in MCAO rats than in sham-operated rats. The higher values of t
1/2z and MRT
(0–t) found in MCAO rats than sham-operated rats possibly attributed to the reduction in the elimination of scutellarin, and such reduction might arise from the decreased expression of UGT1A9 and 1A1 reported.
Expression of cytochromes P450s 3A [
29], 2E1 [
30], and 2B [
31] were reportedly down-regulated in MCAO rats. As a result, the metabolism of those drugs mainly catalyzed by P450s 3A, 2E1, and 2B may be slowed down in MCAO rats. The present study clearly demonstrated that the disappearance of paeoniflorin in plasma was slower in MCAO rats than in sham-operated rats, which indicates that alteration induced by cerebral I/R injury of Xin-Shao formula extracts in pharmacokinetic behavior was evident. Paeoniflorin is mainly metabolized by a number of P450 enzymes, such as P450s 3A4, 2C9, and 2C8, and P450 3A4 was reported to be the primary enzyme responsible for the metabolism of paeoniflorin in liver [
32]. The observed slow disappearance of plasma paeoniflorin in MCAO rats likely resulted from slowed metabolism of paeoniflorin mediated by P450 3A2, which reduces non-renal clearance of paeoniflorin. When drugs were administered intravenously, metabolism occurring in liver is a major factor dictating the fate of drugs [
33]. Accordingly, the observed higher values of AUC
(0–t) and C
max in MCAO rats than sham-operated rats as well as decreased V
z in MCAO rats possibly resulted from decreased elimination of paeoniflorin.
4. Materials and Methods
4.1. Chemicals and Reagents
E. breviscapus herba material was collected from Honghe, Yunnan Province, China in November, 2014 and P. veitchii radix rubra was harvested from Deyang County, Sichuan Province in October, 2014. The herbal medicines were authenticated by Qingde Long of Guizhou Medical University and voucher specimens with accession numbers 20141116 and 20141028 were deposited at the Guizhou Medical University. The herbal medicines was subsequently sun-dried and ground. Scutellarin (purity 98%), paeoniflorin (purity 99%), and puerarin (purity 98%) were purchased from the National Institute for Food and Drug Control (Beijing, China). 2,3,5-Triphenyltetrazolium chloride (TTC) was from Sigma-Aldrich (Saint Louis, MO, USA). Methanol, acetonitrile, and formic acid with HPLC-grade were obtained from Merck KGaA Co. (Darmstadt, Germany). All other chemicals and reagents were of chromatographic grade from Tianjin Kemiou Chemical Reagent Corp. (Tianjin, China). Deionized water was obtained using an EPED super-purification system (EPED, Nanjing, China).
4.2. Preparation of Xin-Shao formula Extracts
E. breviscapus herba was thoroughly soaked in water for 30 min. The soaked herb was decocted in water (1:10, w/v) for 0.5 h, followed by filtration. The filtrates were collected and the remaining was re-decocted in water (1:10, w/v) for 0.5 h. The process was repeated twice. The three filtrates were pooled and condensed under reduced pressure to concentrates with a relative density of 1.09–1.11 (50 °C). The resulting concentrates were mixed with ethanol (final concentration 55%) and were allowed to stand at room temperature for 12 h to precipitate protein and polysacchrides. The precipitates were removed by pump filtration. The ethanol in the filtrates was removed under reduced pressure and the residue was subsequently concentrated until the mixture showed a relative density of 1.10–1.12 (50 °C). The resulting concentrates were acidified with hydrochloric acid to pH 2, and the solution was kept at 50 °C for 6 h. The resulting precipites were harvested, washed with water until the aqueous phase showed pH 3–4, and lyophilized to dryness and stored in a desiccator.
P. veitchii radix rubra was thoroughly soaked in water for 30 min. The soaked radix rubra was decocted in water (1:8, w/v) for 1 h, followed by filtration. The filtrates were collected and the remaining was re-decocted in water (1:8, w/v) for 1 h. The process was repeated twice. The three filtrates were pooled and condensed under reduced pressure to concentrates with a relative density of 1.06–1.08 (50 °C). The resulting concentrates were mixed with ethanol (final concentration 60%) and were allowed to stand at room temperature for 12 h to precipitate protein and polysacchrides. The precipites were removed by pump filtration. The ethanol in the filtrates was evaporated under reduced presure and the residue was subsequently concentrated until the mixture showed a relative density of 1.18–1.20 (50 °C). Then, the filtrates were leach-extracted four times with n-butanol (BuOH), and the alcoholic layers were collected and pooled, followed by washing with water three times. The organic solvent was removed under reduced pressure. The resulting residue was dissolved in 45% ethanol and loaded onto a polyamide column. The resultant column was eluted with 45% ethanol, and the eluates were collected. The ethanol was subsequently removed by evaporation, and the resulting precipitates were dried under reduced pressure. The resulting dry extracts obtained from E. breviscapus and P. veitchii were mixed at a ratio of 2:3 (w/w). The mixture was reconstituted in saline, autoclaved, filtered, and lyophilized to dryness before use.
4.3. Establishment and Evaluation of MCAO Rat Model
Male Sprague-Dawley rats, weighing 280–300 g, were purchased from the Charles River Laboratories (Beijing, China), and allowed unlimited access to food and water while maintained in an air-conditioned animal center at a temperature of 22 ± 2 °C, relative humidity of 60% ± 10%, and on a natural light-dark cycle. The animals were fasted with access only to water for 12 h prior to the experiments. The animal welfare and experimental procedures adhered to the Guide for the Care and Use of Laboratory Animals [
34]. Furthermore, the experimental animal protocol was approved by the Animal Ethics Committee of Guiyang Medical University.
4.3.1. Establishment of MCAO Model
Animals were randomly divided into two groups consisting of the MCAO and sham-operated groups. The MCAO rat model was used to mimic an ischemic stroke and this was induced, according to a published procedure [
35] with some modification. Briefly, animals were anesthetized with 10% chloral hydrate (350 mg/kg, intraperitoneal, i.p.), and then the left common carotid artery (CCA), external carotid artery (ECA), and internal carotid artery (ICA) of the rats were carefully separated from tissues and adjacent nerves by a cervical incision. At the proximal part of CCA and ECA, permanent knots were tied to prevent the backflow of blood. Then, ICA was temporarily clamped with microsurgical clips. The tip of a 60 mm long polylysine coated nylon monofilament was rounded by heating near a glowing ember (final tip diameter, 0.38 ± 0.02 mm, Beijing Sunbio Biotech Co., Ltd., Beijing, China) and was inserted into the arteriotomy hole made on the distal part of CCA. Then the monofilament was gently impelled close to 18–20 mm from CCA to block the blood supply to MCA and achieve cerebral ischemia. Sequentially, the rats were cannulated with a polyethylene catheter (0.50 and 1.00 mm for inside diameter and outside diameter, Portex Ltd., Hythe, UK) in the right jugular vein for pharmacokinetic analysis. After induction of cerebral ischemia for 1 h, a 24-h reperfusion was performed by gently pulling out the filament. The sham-operated rats experienced the same surgical operations except for no nylon monofilament inserted. Throughout the entire surgical procedure, the environmental temperature was maintained at 37 ± 1 °C.
4.3.2. Evaluation of Neurobehavioral Dysfunction
Behavioral changes were assessed immediately after the MCAO rats received a 24 h reperfusion. Neurobehavioral dysfunction was double-blindly evaluated in sham-operated and MCAO rats (
n = 12 per group), using Longa’s five-point scale [
35] as follows: 0, normal (no neurobehavioral dysfunction); 1, slight (failure to fully flex the right forepaw); 2, moderate (circling counter-clockwise); 3, severe (leaning to the left side); and 4, very serious (no autonomous activity and rat is unconscious).
4.3.3. Measurement of Cerebral Infarction Volume
After evaluation of neurobehavioral dysfunction, six animals in each group were randomly selected to measure the cerebral infarction volume. The cerebra were immediately frozen at −20 °C for 15 min and were sliced into five 2-mm sections. The tissue sections were incubated in a 1% solution of TTC at 37 °C for 20 min and then fixed in 4% paraformaldehyde overnight protected from light by following the instructions of the manufacturer. The viable tissue was stained a deep red while the infarct remains unstained [
36]. The TTC-stained slices were photographed, and the infarction volume was measured using an image analysis software (Image-Pro Plus 5.1, Media Cybernetics, Silver Spring, MD, USA). Infarcted volume (%) was calculated according to methods described by Ding et al. [
37].
4.4. Apparatus and Analytical Conditions
An Acquity UPLC™ system equipped with a binary pump, degasser, autosampler, and temperature-controlled column compartment and a TQD quantum triple-quadrupole mass spectrometer equipped with an electrospray ionization (ESI) source (Waters Corp., Manchester, UK) were used to analyze the samples. The two analytes and the internal standard (IS, puerarin) were chromatographically separated on a Waters Acquity BEH C18 column (2.1 × 50 mm, 1.7 μm, Waters, Wexford, Ireland). The analysis was completed with a gradient elution with solvent A (acetonitrile containing 0.1% formic acid) and solvent B (water containing 0.1% formic acid) within 8.5 min at a flow rate of 0.35 mL/min. The gradient elution schedule was as follows: 0–1 min (2%–5% A), 1–3 min (5%–15% A), 3–4 min (15%–20% A), 4–5 min (20%–35% A), 5–6.8 min (35%–90% A), 6.8–7.8 min (90%–35% A), and 7.8–8.5 min (35%–2% A). The column and autosampler tray temperatures were remained at 45 and 4 °C, respectively.
For MS analysis, the ESI source was used, and the acquisition parameters were as follows: nebulizing and drying gas, nitrogen (N
2); source and desolvation temperature, 120 and 400 °C; desolvation gas flow, 800 L/h. Selected ion recording (SIR) mode was chosen for the quantification of the analytes, and specific mass spectrometric parameters are listed in
Table 5. Micromass Masslynx version 4.1 (Waters Corp., Milford, MA, USA) was used to carried out the data acquisition and processing.
4.5. Preparation of Calibration Standards and Quality Control (QC) Samples
A standard stock solution containing scutellarin and paeoniflorin was prepared in methanol to obtain final concentrations of 118.8 μg/mL for scutellarin and 120.8 μg/mL for paeoniflorin The IS stock solution was diluted with methanol to a final concentration of 1.00 μg/mL.
Two series of working solutions were prepared by diluting the standard stock solution with methanol. The working solutions (100 μL) were individually transfered to Eppendoff vials and evaporate to dryness under a stream of nitrogen at 37 °C. The residue was reconstituted in blank rat plasma (100 μL) to obtain calibration standard solutions with final concentrations in a range of 0.02899–59.37 μg/mL for scutellarin and 0.02950–60.42 μg/mL for paeoniflorin. The QC samples were prepared at three concentrations of 0.1160, 0.9277, and 14.84 μg/mL for scutellarin and of 0.1180, 0.9440, and 15.11 μg/mL for paeoniflorin in the same way as that for the preparation of the standard calibration samples.
4.6. Method Validation
4.6.1. Specificity
Specificity study was performed with three test samples, including blank plasma (obtained from five rats), blank plasma spiked with the analytes and IS, and plasma samples from rats 15 min following an intravenous administration of Xin-Shao formula extracts at a dose equivalent to a crude herb dose of 1.25 g/kg.
4.6.2. Linearity, LLOQ, Precision, and Accuracy
The calibration curves for scutellarin and paeoniflorin were constructed by plotting the peak area ratios (y) of each analyte to the IS against the plasma concentrations, and the corresponding nominal concentration (x) by weighted (1/x2) least-squares linear regression. The LLOQ was determined by identifying the lowest concentration of the analytes which exhibited a signal-to-noise ratio of 10:1 in UPLC-MS/MS analysis. The precision and accuracy were evaluated by five replicate analyses of the QC samples at low, medium, and high concentrations on the same day and on three consecutive days.
4.6.3. Recovery and Matrix Effect
Mean extraction recovery of scutellarin and paeoniflorin was determined at three QC levels with five replicates and calculated by comparing the peak areas of the analytes from extracted samples with those from unextracted samples. For evaluation of matrix effect, the peak areas of scutellarin and paeoniflorin spiked into blank plasma were compared with those added in methanol at the QC levels with five replicates.
4.6.4. Stability
The stability was evaluated by analyzing the QC samples at low, medium and high concentrations (n = 5) exposed to various conditions: 6 h at 24 °C, after three freeze-thaw cycles (−20 °C to 20 °C) on consecutive days, and after storage at −20 °C for 2 weeks.
4.7. Pharmacokinetic Study
4.7.1. Drug Administration and Plasma Sample Collection
The remaining rats in each group (n = 6 per group), whose behavioral changes had been assessed, were given the extracts at a dose equivalent to 1.25 g crude herb per kg of rat body weight (5.12 mg scutellarin and 7.90 mg paeoniflorin per kg of body weight), which was five times equivalence of a daily dose for an adult. Blood samples (280 μL) were harvested in heparinized centrifuge tubes at designed time points (0, 2, 5, 10, 15, 20, 30, 45, 60, 90, 120, 240, 360, and 480 min) and centrifuged at 3300× g for 3 min. The resulting plasma was stored at −80 °C until analyzed. After each blood sample collection, 100 μL of saline containing 20 units/mL of heparin was immediately injected into the catheter to prevent coagulation.
4.7.2. Plasma Sample Preparation
The plasma samples (100 μL) were mixed with 0.08 % formic acid (50 μL) and IS solution (puerarin, 15 μL, 1.0 μg/mL) and vortexed for 30 s. The resulting mixture was extracted with 360 μL of methanol by vortexing for 3 min. After centrifugation at 13,000× g for 10 min at 4 °C, the supernatants were concentrated to dryness with a stream of nitrogen at 30 °C. The residue was reconstituted with 150 μL of 50% acetonitrile and centrifuged at 20,000× g for 10 min at 4 °C. The supernatants (3 μL) were subjected to UPLC-MS/MS for analysis.
4.8. Pharmacokinetic Studies and Statistical Analysis
Pharmacokinetic parameters, including the relational AUC(0–t), MRT(0–t), t1/2z, CLz, Vz, and Cmax, were calculated using DAS 2.0 pharmacokinetic software package (Mathematical Pharmacology Professional Committee of China, Shanghai, China). All the reported measurements were presented as the mean ± SD. The significant difference between sham-operated and MCAO groups was determined using Statistical Package for the Social Sciences (SPSS, version 22.0, Armonk, NY, USA) by performing independent Student’s t-tests with a two-tailed distribution for the comparison of two mean values. A p < 0.05 was considered statistically significant.