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IB Perova, KI Eller, EV Tumol`Skaya Health Risk Analysis. 2019. No. 3

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IB Perova, KI Eller, EV Tumol`Skaya Health Risk Analysis. 2019. No. 3 I.B. Perova, K.I. Eller, E.V. Tumol`skaya UDC 614.31.613.292.614.35.615.31.543.51.543.54.544.1.547.7.547.8 Read DOI: 10.21668/health.risk/2019.3.06.eng online SCREENING RESULTS FOR NON-DECLARED SYNTHETIC PHOSPHODIESTERASE-5 INHIBITORS BEING ADDED TO DIETARY SUPPLEMENTS OF PLANT ORIGIN I.B. Perova, K.I. Eller, E.V. Tumol`skaya Federal research centre of nutrition and biotechnology, 2/14 Ustinskiy Proezd, Moscow, 109240, Russian Federation Non-declared addition of synthetic phosphodiesterase-5 inhibitors (PDE-5 inhibitors) to dietary supplements (DS) of plant origin in order to stimulate potency is a serios problem. Such counterfeiting strengthens therapeutic effects pro- duced by a product; similar effects can’t occur only due to components of DS of plant origin. Synthetic PDE-5 inhibitors are both substances of official medications and their structural analogues. When synthetic PDE-5 inhibitors are con- sumed as components in DS in order to increase potency, it can be hazardous for consumers’ health due to unpredictable or even lethal side effects. Our research goal was to reveal concentrations of non-declared synthetic PDE-5 inhibitors in DS consumed by males. Our research objects were 175 DS selected by Rospotrebnadzor in different Russian regions. Synthetic PDE-5 inhibitors were detected in samples by HPLC with diode array spectrophotometric detection and MS-detection as per guidelines developed by us and approved on by Rospotrebnadzor (MG 4.1.3331-16). Our research revealed that 36% of DS that were consumed to increase potency contained non-declared synthetic PDE-5 inhibitors with Tadalafil and Sildenafil being the most widely spread ones 42.9% and 28.6% of all counterfeit cases). Their combination or analogues of PDE-5 inhibitors were detected significantly less frequently; complicated mix- tures containing three or more components were also rather rare. Contents of Tadalafil, Sildenafil, or Vardenafil in DS varied from trace quantities to concentrations that corresponded to recommended daily doses for these medications or even higher than such doses. We identified derivatives of Sildenafil and Tadalafil among PDE-5 inhibitors; their quanti- ties varied from 1.2 mg/capsule to 24.3 mg/capsule. The developed procedure allowed detecting counterfeited DS with not only Tadalafil, Sildenafil, or Vardenafil being added to them, but also analogues of synthetic PDE-5 inhibitors. Key words: DS, safety, health risk, Synthetic phosphdiesterase-5 inhibitors, Tadalafil, Vardenafil, Sildenafil, HPLC-DAD-MS. Vegetable biologically active additives erective dysfunction (ED) which occurs due (BAAs) to food that are used to stimulate to diseases in the urogenital system. BAAs potency are widely spread all over the world to food aimed at stimulating potency usually and considered to be safe. But it is such ad- contain certain aphrodisiacs (extracts of bar- ditives that are the most frequently falsified renwort, ginseng, magnolia-vine, eleuthero- as they contain non-declared drug substances coccus, yohimbe, damiana, etc.), prostate that are added to raise their stated efficiency. protectors (extracts of cinquefoil, pumpkin These additives are applied to stimulate po- seeds, palmetto, yam, licorice, ground bur- tency in case there is overall weakening of a nuts, etc.), antioxidants (coenzyme Q10, ex- body but they are non-efficient in case of tracts of maidenhair tree, tomatoes, Acai __________________________ Perova I.B., Eller K.I., Tumol`skaya E.V., 2019 Irina B. Perova – Candidate of Pharmaceutical Sciences, Researcher at the Laboratory for Metabolomic and Proteome Analysis (e-mail: [email protected]; tel.: +7 (495) 698-53-92; ORCID: https://orcid.org/0000-0001- 5975-1376). Konstantin I. Eller – Doctor of Chemical Sciences, Head of the Laboratory for Metabolomic and Proteome Analysis (e-mail: [email protected]; tel.: +7 (495) 698-54-07;ORCID: https://orcid.org/0000-0003-1046-4442). Elena V. Tumol`skaya – Junior researcher at the Laboratory for Metabolomic and Proteome Analysis (e-mail: [email protected]; tel.: +7 (495) 698-53-92; ORCID: https://orcid.org/0000-0002-3913-0799). 50 Health Risk Analysis. 2019. no. 3 Screening results for non-declared synthetic phosphodiesterase-5 inhibitors being added to vegetable food products palm, etc.), vitamins (especially A, E, and (Zidena®, Dong-A Pharmaceutical Co. Ltd)1. PP), and microelements (selenium, zinc and The latter is also registered in South Korea some others). At the same time accom- and Malaysia [1]. In the USA and EU there plished research revealed that potency- is another allowed drug in this group in addi- stimulating BAAs to food contained not only tion to Tadalafil, Vardenafil, and Udenafil, declared vegetable components but also syn- namely Avanafil (Stendra®, Vivus; Spedra®, thetic phosphodiesterase-5 inhibitors (PDA-5 Mitsubishi Tanabe Pharma) [2]. There is an- inhibitors). other PDE-5 inhibitor allowed in South Ko- These drugs are selective inhibitors of c- rea; it is called Mirodenafil (Mvix®, SK GMP-specific phosphodiesterase-5 (PDE-5) ChemicalsLifeScience) [1]. Lodenafil car- that metabolizes c-GMP into 5'-GMP in bonate is applied in Brazil to treat ED smooth muscles cells of blood vessels that (Helleva®, Cristália Produtos Quími‐cose supply blood to cavernous bodies of the pe- Farmacêuticos) [3]. Chemical structures of nis (and artery walls in the lungs). PDE-5 all the drugs from PDE-5 inhibitors group blocking is accompanied with c-GMP accu- are shown in Figure 1. mulation and stronger and longer erection In some cases falsified BAAs to food when sexual arousal occurs. So, PDE-5 in- contained structural analogs of PDE-5 in- hibitors are applied to treat ED and pulmo- hibitors that were not registered as pharma- nary hypertension. At present there are four ceutical substances but produced the same drugs belonging to PDE-5 inhibitors group pharmacological effects. Since 2003 a lot of that are registered in the RF: Sildenafil (Via- research work has been accomplished with gra®, Pfizer), Tadalafil (Sialis®, ElliLilly), its focus on discovering and identifying Vardenafil (Levitra®, Bayer), and Udenafil various analogs of Sildenafil, Tadalafil, and Tadalafil Vardenafil Sildenafil Udenafil Avanafil Mirodenafil Lodenafil carbonate Figure 1. Chemical structures of PDE-5 inhibitors __________________________ 1 The State Register of Medications. Available at: https://grls.rosminzdrav.ru/Default.aspx (date of visit March 23, 2019). ISSN (Print) 2308-1155 ISSN (Online) 2308-1163 ISSN (Eng-online) 2542-2308 51 I.B. Perova, K.I. Eller, E.V. Tumol`skaya Vardenafil via high-performance liquid Our research goal was to detect con- chromatography (HPLC) with diode-array tents of non-declared synthetic PDE-5 inhibi- detector (DAD) and mass-spectrometric de- tors in potency-stimulating BAAs to food. tectors with high and low resolution as well In order to protect population health as infra-red spectroscopy and nuclear- and provide safety and quality of BAAs to magnetic resonance spectroscopy [4–32]. So, food consumed by men, in 2015 Rospotreb- by 2018 approximately 80 synthetic PDE-5 nadzor started examining possible BAAs inhibitors have been discovered in potency- falsifications with synthetic PDE-5 inhibi- stimulating BAAs to food, Sildenafil analogs tors. Analytical tasks that are to be solved prevailing among them [33]. by test laboratories in order to perform con- Synthetic substances that are illegally trol over potency-stimulating BAAs to food included into BAAs to food create substan- are rather complicated due to a great num- tial hazards for consumers’ health. While ber of synthetic PDE-5 inhibitors (there are there is available information on toxicity, approximately 100 known substances and counter-indications, side effects, and maxi- 80 of them have been detected in BAAs to mum single or daily dose for PDE-5 inhibi- food), standard substances being available, tors allowed to be used in medical practices, unfair manufacturers being too creative there is practically no such information for (they add exotic analogues and their mix- most their analogs. Hypersensitivity to PDE- tures into BAAs or include PDE-5 inhibitors 5 inhibitors and simultaneous intake of ni- into a cover of a capsule), and a great variety trates or other nitrogen oxide donators are of BAAs matrixes. Given that, it has become counter-indications to intake of these drugs. necessary to develop a new methodology Safety precautions and limitations imposed that would allow detecting synthetic PDE-5 on taking these drugs mostly concern men inhibitors in a multi-component matrix of with cardiovascular diseases, diabetes, those a BAA to food; it was the main task of our who are older than 71, men suffering from research. hereditary degenerative diseases of the eye Data and methods. We accomplished retina, and those prone to priapism. Besides, our research on Agilent 1100 liquid chroma- quality, efficiency, and safety of PDE-5 tographer with degasser, binary pump, col- inhibitors that are allowed to be used in umn thermostat, constant-temperature auto- medical practices are controlled by public sampler, diode-array spectrophotometric de- healthcare authorities while there are no such tector (DAD), and time-of-flight Agilent procedures for illegally manufactured sub- 6210 LC/MS-TOF mass-spectrometric detec- stances. Therefore, taking non-declared sub- tor (Agilent Technologies, the USA); we stances contained in BAAs to food can result also applied Ultimate 3000 system for liquid in grave side effects, especially when
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