Bioenhancers are added to drugs and dietary supplements to improve the availability of the contained active ingredients at the target structures. Bioenhancers almost always have a plant origin.
What are bioenhancers?
Bioenhancers are added to drugs and dietary supplements to improve the availability of the contained active ingredients at the target structures. The concept of bioenhancers is based on Ayurvedic medicine. Ayurveda is a traditional Indian healing art that is still widely used today in India, Nepal and Sri Lanka. The term bioenhancer was coined in Jammu at the Indian Institute of Integrative Medicine. The institute has been doing research in the field of Ayurveda for a long time. Bioenhancers were described as early as 1929 by Kartick Chandra Bose. In his 1929 book Pharmacographia Indica, Bose named the enhancing effects of long pepper. He found that the antiasthmatic effect of Indian Lungwort increased when patients took Long Pepper at the same time. However, Bose could not find out why this was so. It was not until 1979 that it was discovered that the piperine found in the pepper was responsible for this effect. Thus, the piperine from the long pepper was the first bioavailibility enhancer. Today, bioavailibility enhancers are added to various drugs and dietary supplements to improve their absorption and effect in the body.
Pharmacological action
Different mechanisms of action underlie the various bioenhancers. First, the active ingredients increase the absorption of the corresponding substances in the intestine. The substances are then less degraded in both the intestine and the liver. In the liver in particular, many active ingredients are lost for further processing in the body. This phenomenon is also known as the first-pass effect. Drugs administered in combination with bioenhancers can enter the pathogens (the structures causing the disease) more easily. For example, the membrane of tumor cells or bacteria becomes more permeable to the drugs. Furthermore, bioenhancers inhibit the defense mechanisms of viruses, bacteria or fungi. Likewise, the defense mechanisms of tumor tissue are inhibited. Bioenhancers also ensure that the active ingredients can bind better to the respective pathogens. They influence DNA and proteins in such a way that the active ingredients can adhere and exert their effect. Many active ingredients cannot cross the blood–brain barrier without the help of bioenhancers. The blood–brain barrier is a physiological barrier between the bloodstream and the central nervous system in the brain. It is designed to protect the brain from neurotransmitters, toxins and pathogens from the circulating blood. Through the blood-brain barrier, many agents cannot reach their intended site.
Medical application and use
The exact applications depend on the particular bioenhancer. One important bioenhancer is piperine. This is an alkaloid that is extracted from pepper. Piperine serves as a bioenhancer for vitamins. It is especially effective for vitamins A, B1, B2, B6, C, D, E and K.
Amino acids such as lysine, isoleucine, leucine, valine, tryptophan, methionine and threonine can also be better utilized when administered together with piperine. Furthermore, the absorption of minerals (iodine, iron, zinc, calcium, selenium, copper, manganese, magnesium) and herbal agents improves. Celiprolol is a drug from the group of ß-receptor blockers and is used to treat high blood pressure. Midazolam] is a benzidazepine used in anesthesia and rescue medicine. The bioenhancer quercetin is extracted from fruits and leaves of plants. Quercetin is most effective in combination with the drug paclitaxel, which is used in medicine to treat cancer. Glycyrrhizin, a saponin from licorice root, increases the activity and absorption of antibiotics and antifungals. The bioenhancer allicin is contained in garlic. Allicin increases the effect of the drug amphotericin B on yeast fungi. In return, it acts on ergosterol transport in cells.
Risks and side effects
It is important to adjust the dose of the appropriate drug when a bioenhancer is administered concomitantly. Otherwise, an overdose may occur, which may be associated with severe side effects, depending on the drug.Researchers also see the crossing of the blood-brain barrier by bioenhancers as problematic. Thus, it could be that harmful substances also enter the brain with the bioenhancers, which could lead to inflammation or other neurological damage.
