Effect of Asian and Siberian ginseng on serum digoxin measurement by five digoxin immunoassays. Significant variation in digoxin-like immunoreactivity among commercial ginsengs.
Asian and Siberian ginsengs contain glycosides with structural similarities to digoxin. We studied potential interference of ginseng in 5 digoxin immunoassays in 3 Asian (2 liquid extracts, 1 capsule) and 3 Siberian ginseng preparations (1 liquid extract, 2 capsules). With the fluorescence polarization immunoassay (FPIA), we observed apparent digoxin activity in 1 Asian liquid preparation and in the liquid extract and 1 capsule form of Siberian ginseng. In mice fed ginseng, we observed digoxin activities in the serum (Asian, 0.48-0.68 ng/mL [0.6-0.9 nmol/L]; Siberian, 0.20-0.47 ng/mL [0.3-0.6 nmol/L]), indicating that such interferences also occur in vivo. Serum pools prepared from samples from patients receiving digoxin and then supplemented with Asian or Siberian ginseng showed falsely increased digoxin values using the FPIA (e.g., for Asian ginseng, 1.54 ng/mL [2.0 nmol/L] vs control value, 1.10 ng/mL [1.4 nmol/L]) and falsely decreased values using the microparticle enzyme immunoassay (MEIA; 0.73 ng/mL [0.9 nmol/L] vs control value, 1.04 ng/mL [1.3 nmol/L]). Digoxin-like immunoreactive substances (DLISs) showed synergistic effects with ginsengs in interfering with the FPIA and MEIA for digoxin. No interference was observed with 3 other digoxin assays, even in the presence of elevated DLISs.
Dasgupta
Amitava
A
Department of Pathology and Laboratory Medicine, University of Texas-Houston Medical School, 6431 Fannin, MSB 2.292, Houston, TX 77030, USA.
Wu
Sang
S
Actor
Jeffrey
J
Olsen
Margaret
M
Wells
Alice
A
Datta
Pradip
P
D000818:Animals; D002624:Chemistry, Clinical / Q000379:methods*; D004077:Digoxin / Q000097:blood / Q000737:chemistry* / Q000493:pharmacokinetics; D004347:Drug Interactions; D016903:Drug Monitoring; D028001:Eleutherococcus / Q000737:chemistry* / Q000276:immunology / Q000378:metabolism; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D051379:Mice; D005894:Panax / Q000737:chemistry* / Q000276:immunology / Q000378:metabolism; D028321:Plant Preparations / Q000494:pharmacology; D015203:Reproducibility of Results
D028321:Plant Preparations; D004077:Digoxin