Effects of St. John's wort on irinotecan metabolism
Why this work is in the frame
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Bibliographic record
Abstract
St. John's wort (SJW), a widely used herbal product, has been implicated\n in drug interactions resulting from the induced expression of the\n cytochrome P450 CYP3A4 isoform. In this study, we determined the effect of\n SJW on the metabolism of irinotecan, a pro-drug of SN-38 and a known\n substrate for CYP3A4. Five cancer patients were treated with irinotecan\n (350 mg/m(2), intravenously) in the presence and absence of SJW (900 mg\n daily, orally for 18 days) in an unblinded, randomized crossover study\n design. The plasma levels of the active metabolite SN-38 decreased by 42%\n (95% confidence interval [CI] = 14% to 70%) following SJW cotreatment with\n 1.0 micro M x h (95% CI = 0.34 micro M x h to 1.7 micro M x h) versus 1.7\n micro M x h (95% CI = 0.83 micro M x h to 2.6 micro M x h) (P =.033,\n two-sided paired Student's t test). Consequently, the degree of\n myelosuppression was substantially worse in the absence of SJW. These\n findings indicate that patients on irinotecan treatment should refrain\n from taking SJW because plasma levels of SN-38 were dramatically reduced,\n which may have a deleterious impact on treatment outcome.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it