Oluwamodupe Cecilia Ejelonu
E-Editor: Xing YX Oluwamodupe Cecilia Ejelonu,Department of Chemical Sciences,Biochemistry Programme,Ondo State University of Science and Technology,Okitipupa,Ondo State 23111,Nigeria
Abstract
Key words: Insulin; Diabetes; Hunteria umbellate; Metformin; Metabolic syndrome
A systematic review published by Hermanet al[1]revealed that eight out of ten of the world population diagnosed with type-2 diabetes are within developing and developed countries; this indicates the role of socioeconomic factors played in the demography and dynamics of type-2 diabetes.According to the International Diabetes Federation projection,one in every 10 adults will be diagnosed with diabetes by 2030[2].A year following this press release,type-2 diabetes was described as a global epidemic requiring attention and urgent action[3].These data clearly support that expedited actions should be directed towards these countries.Pathophysiologically,failed insulin secretion and insulin resistance drive type-2 diabetes[4];thus,type-2 diabetes is amenable to insulinotropic drugs[5].Due to socioeconomic constraints,low- and medium-income countries have no access to insulinotropic drugs; therefore cheaper,more accessible therapeutic options must be considered to offset current statistics and future projections.
Hunteria umbellata(K.Schum.) Hallier f.belong to the Apocynaceae family,a West African glaborous tree known as Abeere in Yoruba,Southwest Nigeria[6].It has been widely used by different folk,which include the management of infections,diseases,treatment of pain and metabolic disorders such as diabetes mellitus and obesity[7].Many genera in the Apocynaceae family have been well-studied,especially their chemical composition and economic importance.Studies have revealed that the aqueous seed extract ofHunteria umbellatahas been tested on different experimental models of diabetes[8]for its anti-hyperglycemic effect coupled with anti-obesity and anti-hyperlipidemic potentials[9],which are well-documented.Likewise,oral toxicity studies have been conducted that authenticate its safety prior to oral administration in experimental animals[10].Biometric analysis of theHunteria umbellataseed conducted by Ajibola and co-researchers revealed that aqueous extract of theHunteria umbellataseed performed well in reducing fasting blood glucose in type-2 diabetic patients in a few short weeks compared with metformin,coupled with lesser side effects.The patients placed on metformin exhibited symptoms such as abdominal pains,belching,chest pain,diarrhea,headache,nausea and vomiting,runny nose and weakness; but the only complaint recorded from patients treated with theHunteria umbellataseed was extreme bitterness,which caused one of the patients to have an allergic reaction to the extract,causing seldom vomiting[11].
Furthermore,hypoglycemic activity of its seed extract has been documented in normal,high glucose and nicotine-induced hyperglycemic rats,mediatedviaintestinal uptake of glucose coupled with adrenergic inhibition,respectively[6].Similarly,other animal models were also used and reported to ascertain the efficacy ofHunteria umbellataseed extract as an anti-diabetes and anti-obesity plant[9].It has been documented by Booneet al[12]that theHunteria umbellataseed possesses eburnamine,eburnamonine,hunteriamine,hunterine,vincamine and corymine as part of its phytoconstituent,with eburnamonine and eburnamine coupled with hunterine that have been indicated to possess strong and lasting hypotensive action.Cerebrovascular activity of theHunteria umbellataseed has been traced to eburnamonine,which is reported to be more abundant[12].This has a positive effect on general blood circulation,while anti-hypertensive and sedative properties have been attributed to vincamine[12].Likewise,Adeneye and fellow researchers[13]suggested that antihyperglycemic potential posed by theHunteria umbellataseed was attributed to an isolated,newly extracted bisindole alkaloid called erinidine,with thein vitroandin vivoanti-hyperglycemic studies conducted using erinidine confirming that theHunteria umbellataseed can mediate its anti-hyperglycemic actionviaintestinal glucose uptake inhibition.Findings have revealed that none of these studies have delved into the mechanisms by which this plant extract performs its antihyperglycemic actions in experimental diabetes models,which would provide strong progress towards drug design usingHunteria umbellataseeds.
A study revealed that aqueous extract ofHunteria umbellataseeds were capable of ameliorating metabolic syndrome associated with high fructose-induced rats,(Figure 1) thereby acting as a scavenging agent for reactive oxygen species and increased enzymes activities that detoxify reactive oxygen species,which invariably revealedHunteria umbellataseeds as a source of nutraceuticals for treating metabolic syndrome[14].
Meanwhile,metformin is known as a potent anti-hyperglycemic agent specific for type-2 diabetes,but exerts its pharmacologic actions on type-2 diabetes in routes different from any other class of drugs[15].
The apparent volume of distribution (V/F) of metformin following single oral doses of 850 mg immediate release metformin hydrochloride averaged 654 ± 358 L.Metformin is negligibly bound to plasma proteins.Metformin partitions into erythrocytes,most likely as a function of time.At usual clinical doses and dosing schedules of metformin,steady state plasma concentrations of metformin are reached within 24-48 h and are generally < 1 μg/mL during controlled clinical trials,which serve as the basis of approval for metformin.Notably,maximum metformin plasma levels did not exceed 5 μg/mL,even at maximum doses.
Intravenous single-dose studies in normal subjects demonstrate that metformin is excreted unchanged in the urine,and does not undergo hepatic metabolism or biliary excretion.Renal clearance is approximately 3.5 times greater than creatinine clearance,which indicates that tubular secretion is the major route of metformin elimination[15].
The liver is the main site of action for metformin,where it has been shown to reduce hepatic glucose output by 75%[15],and reduce hepatic glucose production mainly by inhibiting liver gluconeogenesis[16],which is the formation of glucose by the liver from non-carbohydrate sources,such as amino acids.In addition,the uptake of gluconeogenic substrates (alanine and lactate) is reduced by metformin[15].Insulin sensitivity is increased in skeletal muscles because of an increase in the tyrosine kinase activity of the insulin receptor along with increased GLUT1 (glucose transporter) transport activity by increasing translocation to the plasma membrane[15].Metformin altered endocrine function in the pancreas by stimulating the expression of the glucagon-like peptide 1 (GLP-1) receptor and GLP-1 protein in the pancreas.GLP-1 is responsible for increasing the secretion of insulin and lowering the secretion levels of glucagon (a hormone that raises blood glucose levels)[15].Metformin slightly delays the absorption of glucose through the gastrointestinal (GI) tract[15].
This short communication is put together for researchers working on type-2 diabetic drug design to explore the potential ofHunteria umbellataseed extractviathis pathway(Figure 2).
Figure1 Systemic actions of aqueous extract from the Hunteria umbellata seed in diabetics.Adopted from[14].
Figure2 Mechanistic action of metformin in hepatocytes of the liver in diabetic patients.Adopted from[8].