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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">ETM</journal-id>
<journal-title-group>
<journal-title>Experimental and Therapeutic Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">1792-0981</issn>
<issn pub-type="epub">1792-1015</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/etm.2015.2895</article-id>
<article-id pub-id-type="publisher-id">ETM-0-0-2895</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Bioavailability and safety study of resveratrol 500 mg tablets in healthy male and female volunteers</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>SERGIDES</surname><given-names>CHRISTAKIS</given-names></name>
<xref rid="af1-etm-0-0-2895" ref-type="aff">1</xref>
<xref rid="c1-etm-0-0-2895" ref-type="corresp"/></contrib>
<contrib contrib-type="author"><name><surname>CHIRIL&#x0102;</surname><given-names>MARINELA</given-names></name>
<xref rid="af2-etm-0-0-2895" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author"><name><surname>SILVESTRO</surname><given-names>LUIGI</given-names></name>
<xref rid="af3-etm-0-0-2895" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author"><name><surname>PITTA</surname><given-names>DAPHNE</given-names></name>
<xref rid="af1-etm-0-0-2895" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author"><name><surname>PITTAS</surname><given-names>ANDREAS</given-names></name>
<xref rid="af1-etm-0-0-2895" ref-type="aff">1</xref></contrib>
</contrib-group>
<aff id="af1-etm-0-0-2895"><label>1</label>Research and Development Department, Medochemie Ltd., Limassol 3011, Cyprus</aff>
<aff id="af2-etm-0-0-2895"><label>2</label>Medical Team Department, Medochemie Ltd., Bucharest 011437, Romania</aff>
<aff id="af3-etm-0-0-2895"><label>3</label>Mass Spectrometry Laboratory, S-Pharmacological Consultation and Research GmbH, Harpstedt 27243, Germany</aff>
<author-notes>
<corresp id="c1-etm-0-0-2895"><italic>Correspondence to</italic>: Dr Christakis Sergides, Research and Development Department, Medochemie Ltd, 1-10 Constantinopoleos Street, Limassol 3011, Cyprus, E-mail: <email>christakis.sergides@medochemie.com</email></corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>01</month>
<year>2016</year></pub-date>
<pub-date pub-type="epub">
<day>25</day>
<month>11</month>
<year>2015</year></pub-date>
<volume>11</volume>
<issue>1</issue>
<fpage>164</fpage>
<lpage>170</lpage>
<history>
<date date-type="received"><day>22</day><month>12</month><year>2014</year></date>
<date date-type="accepted"><day>08</day><month>10</month><year>2015</year></date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2015, Spandidos Publications</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<abstract>
<p>Over the past few decades, <italic>trans</italic>-resveratrol has received widespread attention as a preventive agent for numerous diseases. Several studies have demonstrated that it has significant biological and pharmacological properties. <italic>Trans</italic>-resveratrol has been reported to possess anti-oxidant, anti-inflammatory, anticarcinogenic, antidiabetic, anti-aging, cardioprotective and neuroprotective properties, which can be relevant in chronic diseases and longevity in humans. The aim of the present study was to investigate the rate and extend of absorption, and also the safety of resveratrol following a single 500 mg oral dose. This was an open label, single dose, one period, bioavailability study in 15 healthy volunteers under fasting conditions. Blood samples were collected at predefined time points up to 24 h after resveratrol administration, and plasma concentrations of resveratrol and its conjugated (glucuronated and sulphated) metabolites were determined using a validated high performance liquid chromatography/tandem mass spectrometry method. Pharmacokinetic parameters, including Cmax, AUC0-t, AUC<sub>0</sub>-inf, Tmax, T1/<sub>2</sub> and MRT, were determined from plasma concentration-time profiles and found to be in good agreement with previously reported data. Cmax and AUC<sub>0</sub>-inf were lower for resveratrol when compared with the values for its glucuronated and sulphated metabolites. Cmax for resveratrol, glucuronated resveratrol and sulphated resveratrol were 71.2&#x00B1;42.4 ng/ml, 4,083.9&#x00B1;1,704.4 ng/ml and 1,516.0&#x00B1;639.0 ng/ml, respectively, while the AUC0-inf values were 179.1&#x00B1;79.1 ng/ml, 39,732.4&#x00B1;16,145.6 ng/ml and 14,441.7&#x00B1;7,593.2 ng/ml, respectively. No adverse reactions associated with resveratrol were reported during the study. The plasma concentrations of resveratrol (free and conjugated) were in agreement with those mentioned in the literature, and were adequate to promote the pharmacological activities of resveratrol. In conclusion, resveratrol 500 mg tablets were well-tolerated by all participants of the study.</p>
</abstract>
<kwd-group>
<kwd>resveratrol</kwd>
<kwd>absorption</kwd>
<kwd>bioavailability</kwd>
<kwd>metabolism</kwd>
<kwd>safety</kwd>
<kwd>supplements</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Resveratrol (3,4&#x2032;,5-trihydroxy-<italic>trans</italic>-stilbene) is a polyphenolic phytoalexin that is naturally produced in plants as a response to injuries or stresses, such as a pathogenic attack or irradiation with ultraviolet light. This compound is found in grapes, peanuts, berries, groundnut, spruce, mulberries and dried roots of <italic>Polygonum cuspidatum</italic> (also known as kojo-kon in Japanese), which have long been used in traditional oriental medicine (<xref rid="b1-etm-0-0-2895" ref-type="bibr">1</xref>,<xref rid="b2-etm-0-0-2895" ref-type="bibr">2</xref>). In plants, resveratrol inhibits the development of an infection (<xref rid="b3-etm-0-0-2895" ref-type="bibr">3</xref>). In humans, it has several beneficial effects due to its antioxidant, anti-inflammatory, anticarcinogenic, antidiabetic, cardioprotective, estrogenic and anti-aging properties (<xref rid="b4-etm-0-0-2895" ref-type="bibr">4</xref>&#x2013;<xref rid="b6-etm-0-0-2895" ref-type="bibr">6</xref>). Resveratrol is widely available in the human diet, although exposure to this substance is enhanced upon ingestion of grapes, red wine and peanuts (<xref rid="b4-etm-0-0-2895" ref-type="bibr">4</xref>&#x2013;<xref rid="b13-etm-0-0-2895" ref-type="bibr">13</xref>). It has been intensively studied in clinical and nonclinical trials, and was found to act on a number of different targets using various mechanisms of action that can explain its diverse biological activities, including: Free-radical scavenging activity (<xref rid="b14-etm-0-0-2895" ref-type="bibr">14</xref>), anti-inflammatory activity (<xref rid="b5-etm-0-0-2895" ref-type="bibr">5</xref>,<xref rid="b9-etm-0-0-2895" ref-type="bibr">9</xref>,<xref rid="b11-etm-0-0-2895" ref-type="bibr">11</xref>,<xref rid="b12-etm-0-0-2895" ref-type="bibr">12</xref>,<xref rid="b14-etm-0-0-2895" ref-type="bibr">14</xref>,<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>), prevention of tumour growth and anticancer activity (<xref rid="b6-etm-0-0-2895" ref-type="bibr">6</xref>&#x2013;<xref rid="b9-etm-0-0-2895" ref-type="bibr">9</xref>,<xref rid="b16-etm-0-0-2895" ref-type="bibr">16</xref>), estrogenic activity (<xref rid="b11-etm-0-0-2895" ref-type="bibr">11</xref>), inhibition of lipid peroxidation, modulation of lipid metabolism (<xref rid="b9-etm-0-0-2895" ref-type="bibr">9</xref>), chelation of copper and inhibition of platelet aggregation (<xref rid="b9-etm-0-0-2895" ref-type="bibr">9</xref>,<xref rid="b13-etm-0-0-2895" ref-type="bibr">13</xref>).</p>
<p>Resveratrol exists as two geometric isomers: <italic>Cis</italic> and <italic>trans</italic> (<xref rid="f1-etm-0-0-2895" ref-type="fig">Fig. 1</xref>) (<xref rid="b8-etm-0-0-2895" ref-type="bibr">8</xref>,<xref rid="b9-etm-0-0-2895" ref-type="bibr">9</xref>). The <italic>trans</italic> form is able to undergo isomerization into the <italic>cis</italic> form upon exposure to ultraviolet irradiation (<xref rid="b9-etm-0-0-2895" ref-type="bibr">9</xref>). Although the two isomers often exist in combination, the <italic>trans</italic> form is more biologically active and more frequently investigated (<xref rid="b8-etm-0-0-2895" ref-type="bibr">8</xref>,<xref rid="b9-etm-0-0-2895" ref-type="bibr">9</xref>,<xref rid="b17-etm-0-0-2895" ref-type="bibr">17</xref>,<xref rid="b18-etm-0-0-2895" ref-type="bibr">18</xref>). Red wine is known to contain a high concentration of <italic>trans</italic>-resveratrol. The levels of <italic>trans</italic>- and <italic>cis</italic>-resveratrol in 26 wines were evaluated by Gu <italic>et al</italic> in 1999 (<xref rid="b17-etm-0-0-2895" ref-type="bibr">17</xref>), and <italic>trans</italic>-resveratrol levels ranged between 0.987 and 25.4 &#x00B5;mol/l, while <italic>cis</italic>-resveratrol levels were considerably lower.</p>
<p>Previous <italic>in vitro</italic> data have shown that 5 &#x00B5;mol/l resveratrol is the minimum concentration required for the chemopreventive effects of the compound to be elicited (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>). Following oral administration in humans, 75&#x0025; of resveratrol is absorbed, possibly by transepithelial diffusion. However, oral bioavailability is low (&#x003C;1&#x0025;) due to rapid and extensive metabolism in the intestine and liver (<xref rid="b18-etm-0-0-2895" ref-type="bibr">18</xref>,<xref rid="b19-etm-0-0-2895" ref-type="bibr">19</xref>). These levels are maintained even after repeated or increased dosage administration. The major metabolites identified in the plasma and urine by metabolic studies are resveratrol glucuronides and sulphates (<xref rid="b20-etm-0-0-2895" ref-type="bibr">20</xref>&#x2013;<xref rid="b22-etm-0-0-2895" ref-type="bibr">22</xref>). Other metabolites of resveratrol have been reported in the literature, including reduced dihydro-resveratrol conjugates and other unknown highly polar products (<xref rid="b21-etm-0-0-2895" ref-type="bibr">21</xref>,<xref rid="b23-etm-0-0-2895" ref-type="bibr">23</xref>). As already mentioned, the major sites of metabolism are the intestine and liver; however, colonic bacterial metabolism may be an important metabolic pathway (<xref rid="b24-etm-0-0-2895" ref-type="bibr">24</xref>). The efficacy of resveratrol at the target site may be enhanced by deconjugating enzymes, such as &#x03B2;-glucuronidase and sulphatase, as well as by specific tissue accumulation of resveratrol (<xref rid="b24-etm-0-0-2895" ref-type="bibr">24</xref>). Lu <italic>et al</italic> (<xref rid="b25-etm-0-0-2895" ref-type="bibr">25</xref>) showed that resveratrol is delivered as a stable sulphate conjugated form to the target tissues, where the parent compound is gradually regenerated and provides the beneficial <italic>in vivo</italic> effects. The activities of the metabolites have also been investigated. The metabolites were found to be pharmacologically active and thus are considered to contribute to the <italic>in vivo</italic> biological effects of the parent compound (<xref rid="b6-etm-0-0-2895" ref-type="bibr">6</xref>,<xref rid="b25-etm-0-0-2895" ref-type="bibr">25</xref>).</p>
<p>Considering all the beneficial effects of resveratrol on human health, drug supplements containing resveratrol have been developed. The aim of the present study was to assess the pharmacokinetic properties and safety of resveratrol following a 500 mg single oral dose (one Evelor 500 mg tablet; Agetis Supplements Ltd., Limassol, Cyprus) administered to fasting healthy male and female subjects. In order to evaluate the bioavailability of resveratrol, plasma concentration-time curves of the parent compound and its metabolites (glucuronides, sulphates and mixed conjugates) were used to assess the rate and extent of absorption.</p>
</sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title/>
<sec>
<title>Study design</title>
<p>The study was an open label, one period, one sequence, noncontrolled, bioavailability study of 500 mg resveratrol, which was performed on healthy male and female volunteers under fasting conditions. The study was approved by an independent Ethics Committee (County Ethics Committee for Drug Clinical Studies, Suceava, Romania) and was performed respecting the Good Clinical Practice requirements. A written informed consent was obtained from each subject prior to participation in the study.</p>
</sec>
<sec>
<title>Study population</title>
<p>A total of 15 healthy male and female subjects, with an age of 18&#x2013;55 years and body mass index (BMI) of 20&#x2013;30 kg/m<sup>2</sup>, were enrolled in the study. Demographic characteristics are presented in <xref rid="tI-etm-0-0-2895" ref-type="table">Table I</xref>. The subjects were selected based on the following eligibility criteria: Normal physical examination, vital signs and laboratory screening results within normal ranges, willingness to abstain from specific aliments and drink beverages, ability to understand the full nature and purpose of the study, and nonpregnant and nonlactating women. The exclusion criteria included the following: History of hypersensitivity to the test substance and to the inactive ingredients, hospitalization for any reason or donation of blood (&#x2265;450 ml) within 8 weeks prior to the initiation of the study, intake of any drugs within 2 weeks prior to or during the study, history or presence of any relevant medical condition, history of drug or alcohol abuse, and subjects that were vegetarian or followed a particular diet.</p>
<p>Three days prior to the study and until the end of the study period (24 h post-dose), the volunteers kept a strict diet. The subjects did not consume aliments or beverages with a high content of resveratrol, including red/black fruit, kiwi, red/black grapes, peanuts, nuts and red wine. In addition, the diet was strictly controlled during the entire confinement period. The subjects received standard light meals that avoided aliments containing high quantities of resveratrol.</p>
</sec>
<sec>
<title>Resveratrol dose</title>
<p>The test product used in the present study was Evelor 500 mg tablets (containing trans-resveratrol), which were obtained from Agetis Supplements Ltd. These tablets were manufactured under the Good Manufacturing Practice guidelines and according to a patented procedure (<xref rid="b26-etm-0-0-2895" ref-type="bibr">26</xref>).</p>
<p>Each subject received one 500-mg tablet of Evelor subsequent to overnight fasting. Evelor was administered orally with 200 ml water under the direct observation of the clinical investigator.</p>
</sec>
<sec>
<title>Sample preparation</title>
<p>During the treatment day, about 5 ml venous blood samples were drawn in labelled tubes containing lithium heparin as an anticoagulant (Monovettes&#x00AE;; Sarstedt, N&#x00FC;mbrecht, Germany), at the following time points: Prior to resveratrol administration, and at 0.083, 0.167, 0.33, 0.5, 0.75, 1.0, 2.0, 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, 10.0, 12.0, 16.0 and 24.0 h after resveratrol administration.</p>
<p>Each blood sample containing heparin was immediately centrifuged at 1,500 &#x00D7; g for 5 min at 4&#x00B0;C. The plasma was separated and placed in duplicate labelled test tubes (two aliquots per sample). Subsequently, the test tubes were securely closed, and the plasma samples were racked, frozen and stored at &#x2212;20&#x00B0;C or cooler until tested.</p>
</sec>
<sec>
<title>Bioanalytical method</title>
<p>The identification and quantification of resveratrol and its metabolites in plasma was performed by high performance liquid chromatography (HPLC) (<xref rid="b27-etm-0-0-2895" ref-type="bibr">27</xref>) with detection by tandem mass spectrometry (MS/MS), using a triple quadrupole AB-Sciex model API 4000 mass spectrometer (AB Sciex, Ontario, Canada), equipped with an atmospheric pressure electrospray ionization interface. Analyses were performed on a multiplexing HPLC system controlled by Cohesive Aria software (Thermo Fisher Scientific, San Jose, CA, USA) and composed by two binary chromatographic pumps (Agilent 1100 Series, Agilent Technologies, Santa Clara, CA, USA) and an HTS PAL autosampler (CTC Analytics, Zwingen, Switzerland). Data were acquired in negative ions mode using a multiple reaction monitoring method (<xref rid="b27-etm-0-0-2895" ref-type="bibr">27</xref>).</p>
<p>Chromatographic separations were performed on Discovery HSC18 chromatographic columns (100 &#x00D7; 2.1 mm, 5 &#x00B5;m; Supelco, Sigma-Aldrich, Bellefonte, PA, USA). For data acquisition and processing, the Analyst software (version 1.6; AB Sciex) was used.</p>
<p>The analytical standard of resveratrol used to prepare the calibration curves and quality control samples was purchased from Sigma-Aldrich. The internal standard added during extraction (resveratrol-13C6) was obtained from TLC Pharmaceutical Standards, Ltd. (Vaughan, Ontario, Canada)</p>
</sec>
<sec>
<title>Pharmacokinetic parameters</title>
<p>The parameters calculated for resveratrol and the metabolites using a noncompartmental approach were as follows: AUC<sub>0-t</sub>, which is the area under the curve that was integrated (by the trapezoidal rule) from the plasma concentrations between time 0 h and the last quantifiable sample; C<sub>max</sub>, which is the maximum plasma concentration, obtained directly from the data without interpolation; T<sub>max</sub>, which is the time to reach the C<sub>max</sub>, obtained directly from the data without interpolation; AUC<sub>0-inf</sub>, which is the area under the curve that was integrated from the blood concentrations by extrapolation of the terminal elimination period; &#x0025; extrapolated AUC, which is the ratio of (AUC<sub>0-inf</sub> - AUC<sub>0-t</sub>)/AUC<sub>0-inf</sub> &#x00D7; 100; T<sub>1</sub>/<sub>2</sub>, which is the plasma half life, calculated as 0.693/elimination rate constant; MRT, which is the mean residence time, calculated as AUMC<sub>inf</sub>/AUC<sub>0-inf</sub>, where AUMC<sub>inf</sub> is the area under the moment curve.</p>
</sec>
<sec>
<title>Safety assessment</title>
<p>Safety assessments were then performed. In particular, adverse events were monitored from the screening visit for the entire duration of the study. Screening and follow-up safety tests included physical examinations, electrocardiograms and investigation of clinical laboratory parameters, including hematology (red cells, hemoglobin, hematocrit, white cells, differential count and platelet count), clinical chemistry (uric acid, total nitrogen, glucose, creatinine, total bilirubine, aspartate transaminase, alanine transaminase, total cholesterol and triglyceride levels) and urinalysis examinations. Vital signs were also evaluated, including the sitting systolic arterial pressure, diastolic arterial pressure and heart rate. Pre-dose safety evaluation included analysis of the blood glucose levels, vital signs (in laying position), oxygen saturation and body temperature.</p>
</sec>
<sec>
<title>Statistical analysis</title>
<p>Bioavailability and statistical calculations were performed using the SAS software (version 9.1; SAS Analytical Solutions S.R.L., Bucharest, Romania). Descriptive statistics was performed for all parameters [arithmetic mean, harmonic mean, geometric mean, standard error of mean, standard deviation (SD), median and range]. Mean comparisons for the safety data were conducted using analysis of variance testing, with P&#x003C;0.05 considered to indicate a statistically significant difference.</p>
</sec>
</sec>
</sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title/>
<sec>
<title>Patient characteristics</title>
<p>All volunteers that were enrolled completed the study. The demographic characteristics of the subjects included in the present study are presented in <xref rid="tI-etm-0-0-2895" ref-type="table">Table I</xref>. The mean age of the patients was 31.40&#x00B1;10.80 years (age range, 19&#x2013;50 years), the mean weight was 69.07&#x00B1;13.22 kg (weight range, 49&#x2013;98 kg), the mean height was 172.13&#x00B1;9.80 cm (height range, 150&#x2013;185 cm), and the mean BMI value was 23.13&#x00B1;2.79 (BMI range, 20.2&#x2013;29.7). Mean values are presented as the mean &#x00B1; SD.</p>
</sec>
<sec>
<title>Pharmacokinetic parameters</title>
<p>The pharmacokinetic parameters for resveratrol and its metabolites (glucuronides, sulphates and mixed conjugates) following oral administration of a single dose of 500 mg resveratrol were determined based on the plasma levels from 15 healthy volunteers.</p>
<p>The results indicated that the pharmacokinetic parameters for free resveratrol were as follows: C<sub>max</sub>, 71.18 ng/ml; T<sub>max</sub>, 1.3 h; and AUC<sub>0-inf</sub>, 179.1 ng/ml. The mean pharmacokinetic characteristics for resveratrol are presented in the <xref rid="tII-etm-0-0-2895" ref-type="table">Table II</xref></p>
<p>In the case of sulphated resveratrol, the C<sub>max</sub> of 1,516.01 ng/ml was reached within 2.8 h (T<sub>max</sub>) and the AUC<sub>0-inf</sub> was found to be 14,441.7 ng/ml. The mean pharmacokinetic characteristics of sulphated resveratrol are listed in the <xref rid="tIII-etm-0-0-2895" ref-type="table">Table III</xref>.</p>
<p>With regards to glucuronated resveratrol, the C<sub>max</sub> was 4,083.90 ng/ml and this was reached within 3.0 h (T<sub>max</sub>), while the AUC<sub>0-inf</sub> value was 39,732.4 ng/ml. The mean pharmacokinetic characteristics of glucuronated resveratrol are presented in the <xref rid="tIV-etm-0-0-2895" ref-type="table">Table IV</xref>.</p>
<p>Furthermore, the pharmacokinetic parameters of mixed conjugates (glucuronide and sulphate metabolites) were also considered, and their values were reported as follows: C<sub>max</sub>, 5,440.4 ng/ml; T<sub>max</sub>, 3.2 h; and AUC<sub>0-inf</sub>, 63,536.6 ng/ml. The mean pharmacokinetic characteristics for mixed metabolites are presented in the <xref rid="tV-etm-0-0-2895" ref-type="table">Table V</xref>.</p>
<p>As already mentioned, low levels of resveratrol (parent compound) were identified when compared with the metabolite levels. The plasma concentration versus time curves for resveratrol and its metabolites are depicted in <xref rid="f2-etm-0-0-2895" ref-type="fig">Figs. 2</xref> and <xref rid="f3-etm-0-0-2895" ref-type="fig">3</xref>. In <xref rid="f2-etm-0-0-2895" ref-type="fig">Fig. 2</xref>, as the plasma levels of resveratrol were low, the curve for resveratrol is superposing the 0 point. <xref rid="f3-etm-0-0-2895" ref-type="fig">Fig. 3</xref> is a magnified version of <xref rid="f2-etm-0-0-2895" ref-type="fig">Fig. 2</xref> that demonstrates the resveratrol levels, while the plasma levels of metabolites are presented only as a guide to show their high levels.</p>
</sec>
<sec>
<title>Safety results</title>
<p>The resveratrol 500 mg tablet was well-tolerated by all study participants. Only one adverse event (traumatic cutaneous wound) of moderate intensity occurred in 1 subject in the present study; however, this was not associated with the medication used in the study. No statistically significant differences in any of the safety parameters considered were observed at follow-up compared with the parameters at screening, with the exception of lower values of red blood cells and hematocrit at follow-up compared with their values at screening; however, these statistical differences are devoid of clinical significance.</p>
</sec>
</sec>
</sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Previous studies have demonstrated that resveratrol is well-absorbed following oral administration, with ~75&#x0025; of the dose absorbed. Following absorption, resveratrol undergoes rapid and extensive metabolism leading to low bioavailability (<xref rid="b18-etm-0-0-2895" ref-type="bibr">18</xref>,<xref rid="b19-etm-0-0-2895" ref-type="bibr">19</xref>). Resveratrol pharmacokinetics have shown circadian variation, with higher bioavailability after morning administration (<xref rid="b18-etm-0-0-2895" ref-type="bibr">18</xref>). Resveratrol is mainly metabolized in the intestines and liver, and its major metabolites are resveratrol glucuronides and sulphates (<xref rid="b20-etm-0-0-2895" ref-type="bibr">20</xref>&#x2013;<xref rid="b22-etm-0-0-2895" ref-type="bibr">22</xref>). Colonic bacterial metabolism is also considered to be an important metabolic pathway (<xref rid="b24-etm-0-0-2895" ref-type="bibr">24</xref>). The plasma levels of the conjugated metabolites were reported to be higher compared with those of the parent compound in animal and in human studies (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>,<xref rid="b28-etm-0-0-2895" ref-type="bibr">28</xref>).</p>
<p>Numerous beneficial effects of resveratrol have been reported, although low levels of this compound are detected in the plasma. According to Biasutto <italic>et al</italic> (<xref rid="b29-etm-0-0-2895" ref-type="bibr">29</xref>), up to 76&#x0025; of resveratrol is not accounted for when only plasma is evaluated; the cellular fraction of resveratrol is missed if analysis of the whole blood is not performed and therefore its bioavailability is not accurately determined (<xref rid="b29-etm-0-0-2895" ref-type="bibr">29</xref>). According to data in the literature, the conjugate metabolites have relevant biological activities, and the efficacy of resveratrol is also mediated by its metabolites and through accumulation in specific tissues (<xref rid="b24-etm-0-0-2895" ref-type="bibr">24</xref>,<xref rid="b30-etm-0-0-2895" ref-type="bibr">30</xref>).</p>
<p>Studies in humans revealed that resveratrol was well-tolerated and the adverse events, if any, were mild in severity (<xref rid="b18-etm-0-0-2895" ref-type="bibr">18</xref>,<xref rid="b19-etm-0-0-2895" ref-type="bibr">19</xref>,<xref rid="b22-etm-0-0-2895" ref-type="bibr">22</xref>). Only high doses of resveratrol (2.5 and 5 g) were associated with mild to moderate gastrointestinal symptoms (<xref rid="b22-etm-0-0-2895" ref-type="bibr">22</xref>).</p>
<p>The purpose of the present study was to evaluate the rate and extent of absorption, and the safety of resveratrol 500 mg tablets. Plasma levels of resveratrol and its metabolites were determined in 15 healthy volunteers using a validated HPLC-MS/MS method. The plasma levels of resveratrol were lower when compared with those of its conjugated metabolites. The predominant conjugates were the glucuronated resveratrol (62.53&#x0025; of total resveratrol) and sulphated resveratrol (22.73&#x0025; of total resveratrol). Free (unconjugated) resveratrol was 0.28&#x0025; of the total resveratrol. C<sub>max</sub> values for resveratrol, glucuronated resveratrol and sulphated resveratrol were found to be 71.2&#x00B1;42.4, 4,083.9&#x00B1;1,704.4 and 1,516.0&#x00B1;639.0 ng/ml, respectively, while the AUC<sub>0-inf</sub> values were found to be 179.1&#x00B1;79.1, 39,732.4&#x00B1;16,145.6 and 14,441.7&#x00B1;7,593.2 ng/ml, respectively. In addition, T<sub>max</sub> was 1.3 h for resveratrol, 3.0 h for glucuronated resveratrol and 2.8 h for sulphated resveratrol.</p>
<p>Similar results were reported in studies by Brown <italic>et al</italic> (<xref rid="b22-etm-0-0-2895" ref-type="bibr">22</xref>) and Almeida <italic>et al</italic> (<xref rid="b18-etm-0-0-2895" ref-type="bibr">18</xref>), in which repeated administration of resveratrol (doses between 0.15 and 5 g) led to lower concentrations of the parent compound and higher levels of glucuronide and sulphate conjugates in the plasma.</p>
<p>The results of the present study were compared with the results reported by Boocock <italic>et al</italic> (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>), and the pharmacokinetics of 500 mg resveratrol treatment in these two studies are presented in <xref rid="tVI-etm-0-0-2895" ref-type="table">Table VI</xref>. In the study by Boocock <italic>et al</italic> (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>), 42 volunteers (age, 19&#x2013;61 years) received a single dose of 0.5, 1.0, 2.5 or 5.0 g resveratrol, but only the data obtained from the 500 mg dose were used for comparison with the present study. The C<sub>max</sub> and AUC<sub>0-inf</sub> values for resveratrol that were observed in the two studies were similar. In the case of the sulphate conjugate, similar results were observed for C<sub>max</sub>, while for AUC<sub>0-inf</sub>, the levels registered in the present study were 3.5 times higher than the data obtained by Boocock <italic>et al</italic> (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>). This difference can be justified by the fact that in the study of Boocock <italic>et al</italic> only a specific sulphate form was measured, while it is possible that other types of sulphates were not detected; however, these were measured in the present study after enzymatic digestion. A similar situation was observed for glucuronated resveratrol, for which the differences between the two studies were even greater, with higher levels observed following the enzymatic degradation. Resveratrol was well-tolerated and no severe adverse reactions were reported in the two studies.</p>
<p>In addition, the present study investigated the doses of resveratrol used in various <italic>in vivo</italic> and <italic>in vitro</italic> studies, as well as the concentration required to elicit noteworthy pharmacological activities (<xref rid="b8-etm-0-0-2895" ref-type="bibr">8</xref>&#x2013;<xref rid="b18-etm-0-0-2895" ref-type="bibr">18</xref>,<xref rid="b22-etm-0-0-2895" ref-type="bibr">22</xref>,<xref rid="b23-etm-0-0-2895" ref-type="bibr">23</xref>). <italic>In vitro</italic> data showed that a minimum of 5 &#x00B5;mol/l resveratrol is required for the chemopreventive effects to be elicited (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>). In humans, the plasma level of resveratrol following oral administration is very low; however, the metabolite levels are much higher. Considering that back conversion from metabolite to parent compound in the target tissues has been described in the case of resveratrol (<xref rid="b30-etm-0-0-2895" ref-type="bibr">30</xref>), and also that the metabolites are pharmaceutically active (<xref rid="b6-etm-0-0-2895" ref-type="bibr">6</xref>,<xref rid="b25-etm-0-0-2895" ref-type="bibr">25</xref>), the plasma levels of resveratrol along with the plasma levels of the metabolites have to be considered when investigating the concentrations expected to achieve <italic>in vivo</italic> biological effects. The levels of total plasma resveratrol (free resveratrol and metabolites) reported in the current study are well above the minimum 5 &#x00B5;mol/l level required to promote <italic>in vitro</italic> biological effects, as described in the literature (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>).</p>
<p>In clinical studies, numerous biological effects of resveratrol have been studied and the dose employed varied widely between 10 mg and 5 g (<xref rid="b31-etm-0-0-2895" ref-type="bibr">31</xref>). Brasny&#x00F3; <italic>et al</italic> (<xref rid="b32-etm-0-0-2895" ref-type="bibr">32</xref>) found that 10 mg oral resveratrol was sufficient to decrease insulin resistance. According to Bhatt <italic>et al</italic> (<xref rid="b33-etm-0-0-2895" ref-type="bibr">33</xref>), 250 mg resveratrol improved glycemic control and was proposed as a potential adjuvant in the treatment of diabetes. The study of Patel <italic>et al</italic> (<xref rid="b30-etm-0-0-2895" ref-type="bibr">30</xref>) showed that oral doses of 500 mg and 1 g resveratrol administered daily to patients with histologically confirmed colorectal cancer provided plasma levels of resveratrol under the limit of quantification. However, Patel <italic>et al</italic> (<xref rid="b30-etm-0-0-2895" ref-type="bibr">30</xref>) were investigating the tissue levels of resveratrol and metabolites in the gastrointestinal tract associated with anticarcinogenic effects. A recent study performed in Germany by Witte <italic>et al</italic> (<xref rid="b34-etm-0-0-2895" ref-type="bibr">34</xref>) showed that 200 mg resveratrol administered daily to elderly individuals improved memory performance in correlation with improved glucose metabolism and also increased the hippocampal functional connectivity. Therefore, the proposed 500 mg dose of resveratrol used in the present study is considered to provide adequate plasma and target tissue concentrations to promote various beneficial biological effects.</p>
<p>With regard to the safety profile, 500 mg resveratrol was well-tolerated by all the subjects, with no adverse reactions associated with resveratrol reported during the study. Similarly, good tolerability of 500 mg resveratrol was reported by Brown <italic>et al</italic> (<xref rid="b22-etm-0-0-2895" ref-type="bibr">22</xref>), who also found that only 2.5 and 5 g doses caused mild to moderate gastrointestinal symptoms.</p>
<p>In conclusion, the results of the present human pharmacokinetic study proved that resveratrol is well-absorbed following oral administration of Evelor 500 mg tablets. The plasma levels of resveratrol were comparable with those reported in the literature for other formulations of resveratrol. In addition, plasma concentrations of resveratrol and its metabolites were found to be within the range reported to promote noteworthy pharmacological activities <italic>in vitro.</italic> Finally, resveratrol was well-tolerated by all the participant subjects.</p>
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<floats-group>
<fig id="f1-etm-0-0-2895" position="float">
<label>Figure 1.</label>
<caption><p>Chemical structures of <italic>cis</italic>- (left) and <italic>trans</italic>-resveratrol (right).</p></caption>
</fig>
<fig id="f2-etm-0-0-2895" position="float">
<label>Figure 2.</label>
<caption><p>Mean plasma concentration vs. time curves for resveratrol and its metabolites. Test g, glucuronidase digested resveratrol; Test gs, glucuronidase and sulphatase digested (total) resveratrol; Test nd, nondigested resveratrol; Test s, sulphatase digested resveratrol.</p></caption>
</fig>
<fig id="f3-etm-0-0-2895" position="float">
<label>Figure 3.</label>
<caption><p>Magnified mean plasma concentration vs. time of sampling curves for resveratrol and its metabolites. Test g, glucuronidase digested resveratrol; Test gs, glucuronidase and sulphatase digested (total) resveratrol; Test nd, nondigested resveratrol; Test s, sulphatase digested resveratrol.</p></caption>
</fig>
<table-wrap id="tI-etm-0-0-2895" position="float">
<label>Table I.</label>
<caption><p>Demographic characteristics of the study population.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Subject no.</th>
<th align="center" valign="bottom">Gender</th>
<th align="center" valign="bottom">Age (years)</th>
<th align="center" valign="bottom">Weight (kg)</th>
<th align="center" valign="bottom">Height (cm)</th>
<th align="center" valign="bottom">BMI</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;1</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">31</td>
<td align="center" valign="top">98</td>
<td align="center" valign="top">185</td>
<td align="center" valign="top">28.6</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;2</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">22</td>
<td align="center" valign="top">79</td>
<td align="center" valign="top">182</td>
<td align="center" valign="top">23.8</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;3</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">46</td>
<td align="center" valign="top">73</td>
<td align="center" valign="top">178</td>
<td align="center" valign="top">23.0</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;4</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">36</td>
<td align="center" valign="top">75</td>
<td align="center" valign="top">176</td>
<td align="center" valign="top">24.2</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;5</td>
<td align="center" valign="top">F</td>
<td align="center" valign="top">35</td>
<td align="center" valign="top">52</td>
<td align="center" valign="top">160</td>
<td align="center" valign="top">20.3</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;6</td>
<td align="center" valign="top">F</td>
<td align="center" valign="top">49</td>
<td align="center" valign="top">49</td>
<td align="center" valign="top">150</td>
<td align="center" valign="top">21.8</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;7</td>
<td align="center" valign="top">F</td>
<td align="center" valign="top">33</td>
<td align="center" valign="top">65</td>
<td align="center" valign="top">170</td>
<td align="center" valign="top">22.5</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;8</td>
<td align="center" valign="top">F</td>
<td align="center" valign="top">27</td>
<td align="center" valign="top">62</td>
<td align="center" valign="top">162</td>
<td align="center" valign="top">23.6</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;9</td>
<td align="center" valign="top">F</td>
<td align="center" valign="top">50</td>
<td align="center" valign="top">90</td>
<td align="center" valign="top">174</td>
<td align="center" valign="top">29.7</td>
</tr>
<tr>
<td align="left" valign="top">10</td>
<td align="center" valign="top">F</td>
<td align="center" valign="top">29</td>
<td align="center" valign="top">55</td>
<td align="center" valign="top">165</td>
<td align="center" valign="top">20.2</td>
</tr>
<tr>
<td align="left" valign="top">11</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">36</td>
<td align="center" valign="top">68</td>
<td align="center" valign="top">170</td>
<td align="center" valign="top">23.5</td>
</tr>
<tr>
<td align="left" valign="top">12</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">19</td>
<td align="center" valign="top">72</td>
<td align="center" valign="top">185</td>
<td align="center" valign="top">21.0</td>
</tr>
<tr>
<td align="left" valign="top">13</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">20</td>
<td align="center" valign="top">69</td>
<td align="center" valign="top">173</td>
<td align="center" valign="top">23.1</td>
</tr>
<tr>
<td align="left" valign="top">14</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">19</td>
<td align="center" valign="top">67</td>
<td align="center" valign="top">180</td>
<td align="center" valign="top">20.7</td>
</tr>
<tr>
<td align="left" valign="top">15</td>
<td align="center" valign="top">M</td>
<td align="center" valign="top">19</td>
<td align="center" valign="top">62</td>
<td align="center" valign="top">172</td>
<td align="center" valign="top">21.0</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1-etm-0-0-2895"><p>M, male; F, female; BMI, body mass index.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tII-etm-0-0-2895" position="float">
<label>Table II.</label>
<caption><p>Mean pharmacokinetic characteristics of free resveratrol.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Value</th>
<th align="center" valign="bottom">C<sub>max</sub> (ng/ml)</th>
<th align="center" valign="bottom">T<sub>max</sub> (h)</th>
<th align="center" valign="bottom">AUC<sub>0-t</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC<sub>0-inf</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC extra&#x0025;</th>
<th align="center" valign="bottom">T<sub>1/2</sub> (h)</th>
<th align="center" valign="bottom">MRT (h)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Mean</td>
<td align="center" valign="top">71.181</td>
<td align="center" valign="top">&#x00A0;&#x00A0;1.339</td>
<td align="center" valign="top">154.545</td>
<td align="center" valign="top">179.074</td>
<td align="center" valign="top">13.303</td>
<td align="center" valign="top">&#x00A0;&#x00A0;5.114</td>
<td align="center" valign="top">&#x00A0;&#x00A0;7.064</td>
</tr>
<tr>
<td align="left" valign="top">SD</td>
<td align="center" valign="top">42.431</td>
<td align="center" valign="top">&#x00A0;&#x00A0;1.297</td>
<td align="center" valign="top">&#x00A0;&#x00A0;67.250</td>
<td align="center" valign="top">&#x00A0;&#x00A0;79.151</td>
<td align="center" valign="top">&#x00A0;&#x00A0;7.572</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4.185</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4.279</td>
</tr>
<tr>
<td align="left" valign="top">CV</td>
<td align="center" valign="top">59.609</td>
<td align="center" valign="top">96.867</td>
<td align="center" valign="top">&#x00A0;&#x00A0;43.515</td>
<td align="center" valign="top">&#x00A0;&#x00A0;44.200</td>
<td align="center" valign="top">56.922</td>
<td align="center" valign="top">81.827</td>
<td align="center" valign="top">60.571</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn2-etm-0-0-2895"><p>AUC<sub>0-t</sub>, area under the curve (AUC) between time 0 h and the last quantifiable sample; C<sub>max</sub>, maximum plasma concentration; T<sub>max</sub>, time to reach the C<sub>max</sub>; AUC<sub>0-inf</sub>, AUC integrated from the blood concentrations by extrapolation of the terminal elimination period; AUC extra&#x0025;, percentage of extrapolated AUC; T<sub>1/2</sub>, plasma half life; MRT, mean residence time; SD, standard deviation; CV, coefficient of variation.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tIII-etm-0-0-2895" position="float">
<label>Table III.</label>
<caption><p>Mean pharmacokinetic characteristics of sulphated resveratrol.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Value</th>
<th align="center" valign="bottom">C<sub>max</sub> (ng/ml)</th>
<th align="center" valign="bottom">T<sub>max</sub> (h)</th>
<th align="center" valign="bottom">AUC<sub>0-t</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC<sub>0-inf</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC extra&#x0025;</th>
<th align="center" valign="bottom">T<sub>1/2</sub> (h)</th>
<th align="center" valign="bottom">MRT (h)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Mean</td>
<td align="center" valign="top">1,516.014</td>
<td align="center" valign="top">&#x00A0;&#x00A0;2.783</td>
<td align="center" valign="top">12,020.275</td>
<td align="center" valign="top">14,441.755</td>
<td align="center" valign="top">12.288</td>
<td align="center" valign="top">&#x00A0;&#x00A0;8.397</td>
<td align="center" valign="top">11.971</td>
</tr>
<tr>
<td align="left" valign="top">SD</td>
<td align="center" valign="top">&#x00A0;&#x00A0;639.020</td>
<td align="center" valign="top">&#x00A0;&#x00A0;1.544</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4,835.531</td>
<td align="center" valign="top">&#x00A0;&#x00A0;7,593.180</td>
<td align="center" valign="top">11.332</td>
<td align="center" valign="top">&#x00A0;&#x00A0;5.107</td>
<td align="center" valign="top">&#x00A0;&#x00A0;5.649</td>
</tr>
<tr>
<td align="left" valign="top">CV</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;42.151</td>
<td align="center" valign="top">55.459</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;40.228</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;52.578</td>
<td align="center" valign="top">92.213</td>
<td align="center" valign="top">60.822</td>
<td align="center" valign="top">47.186</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn3-etm-0-0-2895"><p>AUC<sub>0-t</sub>, area under the curve (AUC) between time 0 h and the last quantifiable sample; C<sub>max</sub>, maximum plasma concentration; T<sub>max</sub>, time to reach the C<sub>max</sub>; AUC<sub>0-inf</sub>, AUC integrated from the blood concentrations by extrapolation of the terminal elimination period; AUC extra&#x0025;, percentage of extrapolated AUC; T<sub>1/2</sub>, plasma half life; MRT, mean residence time; SD, standard deviation; CV, coefficient of variation.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tIV-etm-0-0-2895" position="float">
<label>Table IV.</label>
<caption><p>Mean pharmacokinetic characteristic of glucuronated resveratrol.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Value</th>
<th align="center" valign="bottom">C<sub>max</sub> (ng/ml)</th>
<th align="center" valign="bottom">T<sub>max</sub> (h)</th>
<th align="center" valign="bottom">AUC<sub>0-t</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC<sub>0-inf</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC extra&#x0025;</th>
<th align="center" valign="bottom">T<sub>1/2</sub> (h)</th>
<th align="center" valign="bottom">MRT (h)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Mean</td>
<td align="center" valign="top">4,083.900</td>
<td align="center" valign="top">&#x00A0;&#x00A0;3.050</td>
<td align="center" valign="top">33,535.028</td>
<td align="center" valign="top">39,732.442</td>
<td align="center" valign="top">12.226</td>
<td align="center" valign="top">&#x00A0;&#x00A0;7.815</td>
<td align="center" valign="top">12.081</td>
</tr>
<tr>
<td align="left" valign="top">SD</td>
<td align="center" valign="top">1,704.447</td>
<td align="center" valign="top">&#x00A0;&#x00A0;2.172</td>
<td align="center" valign="top">&#x00A0;&#x00A0;9,781.198</td>
<td align="center" valign="top">16,145.561</td>
<td align="center" valign="top">10.775</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4.142</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4.895</td>
</tr>
<tr>
<td align="left" valign="top">CV</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;41.736</td>
<td align="center" valign="top">71.202</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;29.167</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;40.636</td>
<td align="center" valign="top">88.129</td>
<td align="center" valign="top">53.004</td>
<td align="center" valign="top">40.522</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn4-etm-0-0-2895"><p>AUC<sub>0-t</sub>, area under the curve (AUC) between time 0 h and the last quantifiable sample; C<sub>max</sub>, maximum plasma concentration; T<sub>max</sub>, time to reach the C<sub>max</sub>; AUC<sub>0-inf</sub>, AUC integrated from the blood concentrations by extrapolation of the terminal elimination period; AUC extra&#x0025;, percentage of extrapolated AUC; T<sub>1/2</sub>, plasma half life; MRT, mean residence time; SD, standard deviation; CV, coefficient of variation.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tV-etm-0-0-2895" position="float">
<label>Table V.</label>
<caption><p>The mean pharmacokinetic characteristic of sulphated and glucuronated resveratrol (mixed conjugates).</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Value</th>
<th align="center" valign="bottom">C<sub>max</sub> (ng/ml)</th>
<th align="center" valign="bottom">T<sub>max</sub> (h)</th>
<th align="center" valign="bottom">AUC<sub>0-t</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC<sub>0-inf</sub> (ng/ml/h)</th>
<th align="center" valign="bottom">AUC extra&#x0025;</th>
<th align="center" valign="bottom">T<sub>1/2</sub> (h)</th>
<th align="center" valign="bottom">MRT (h)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Mean</td>
<td align="center" valign="top">5,440.383</td>
<td align="center" valign="top">&#x00A0;&#x00A0;3.200</td>
<td align="center" valign="top">50,668.459</td>
<td align="center" valign="top">63,536.643</td>
<td align="center" valign="top">15.691</td>
<td align="center" valign="top">&#x00A0;&#x00A0;9.244</td>
<td align="center" valign="top">14.035</td>
</tr>
<tr>
<td align="left" valign="top">SD</td>
<td align="center" valign="top">2,101.507</td>
<td align="center" valign="top">&#x00A0;&#x00A0;2.007</td>
<td align="center" valign="top">14,130.030</td>
<td align="center" valign="top">&#x00A0;&#x00A0;27,641.662</td>
<td align="center" valign="top">13.093</td>
<td align="center" valign="top">&#x00A0;&#x00A0;5.448</td>
<td align="center" valign="top">&#x00A0;&#x00A0;6.611</td>
</tr>
<tr>
<td align="left" valign="top">CV</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;38.628</td>
<td align="center" valign="top">62.723</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;27.887</td>
<td align="center" valign="top">&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;&#x00A0;43.505</td>
<td align="center" valign="top">83.443</td>
<td align="center" valign="top">58.937</td>
<td align="center" valign="top">47.108</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn5-etm-0-0-2895"><p>AUC<sub>0-t</sub>, area under the curve (AUC) between time 0 h and the last quantifiable sample; C<sub>max</sub>, maximum plasma concentration; T<sub>max</sub>, time to reach the C<sub>max</sub>; AUC<sub>0-inf</sub>, AUC integrated from the blood concentrations by extrapolation of the terminal elimination period; AUC extra&#x0025;, percentage of extrapolated AUC; T<sub>1/2</sub>, plasma half life; MRT, mean residence time; SD, standard deviation; CV, coefficient of variation.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tVI-etm-0-0-2895" position="float">
<label>Table VI.</label>
<caption><p>Pharmacokinetics parameters reported in the current study and in the study of Boocock <italic>et al</italic> (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>).</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Parameter</th>
<th align="center" valign="bottom">Present study (Evelor 500 mg tablets)<sup><xref rid="tfn6-etm-0-0-2895" ref-type="table-fn">a</xref></sup></th>
<th align="center" valign="bottom">Study by Boocock <italic>et al</italic> (<xref rid="b15-etm-0-0-2895" ref-type="bibr">15</xref>) (500 mg resveratrol)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Free resveratrol (ng/ml)</td>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;C<sub>max</sub></td>
<td align="center" valign="top">71.2&#x00B1;42.4</td>
<td align="center" valign="top">72.6 (48.9&#x0025;)<sup><xref rid="tfn6-etm-0-0-2895" ref-type="table-fn">a</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;AUC<sub>0-inf</sub></td>
<td align="center" valign="top">179.1&#x00B1;79.1</td>
<td align="center" valign="top">223.7<sup><xref rid="tfn7-etm-0-0-2895" ref-type="table-fn">b</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">Glucuronated resveratrol<sup><xref rid="tfn8-etm-0-0-2895" ref-type="table-fn">c</xref></sup> (ng/ml)</td>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;C<sub>max</sub></td>
<td align="center" valign="top">4,083.9&#x00B1;1,704.4</td>
<td align="center" valign="top">774.1 (38&#x0025;)<sup><xref rid="tfn9-etm-0-0-2895" ref-type="table-fn">d</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;AUC<sub>0-inf</sub></td>
<td align="center" valign="top">39,730.3&#x00B1;16,145.9</td>
<td align="center" valign="top">3,206 (30&#x0025;)<sup><xref rid="tfn9-etm-0-0-2895" ref-type="table-fn">d</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">Sulfated resveratrol (ng/ml)</td>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;C<sub>max</sub></td>
<td align="center" valign="top">1,516.0&#x00B1;639.0</td>
<td align="center" valign="top">1,135 (25.7)<sup><xref rid="tfn9-etm-0-0-2895" ref-type="table-fn">d</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;AUC<sub>0-inf</sub></td>
<td align="center" valign="top">&#x00A0;&#x00A0;14,441.0&#x00B1;7,593.3</td>
<td align="center" valign="top">4,049 (26.6&#x0025;)<sup><xref rid="tfn9-etm-0-0-2895" ref-type="table-fn">d</xref></sup></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn6-etm-0-0-2895"><label>a</label><p>Data presented as the mean &#x00B1; standard deviation.</p></fn>
<fn id="tfn7-etm-0-0-2895"><label>b</label><p>Only 1 subject evaluated.</p></fn>
<fn id="tfn8-etm-0-0-2895"><label>c</label><p>Calculated as total amount of glucuronide 1 and glucuronide 2.</p></fn>
<fn id="tfn9-etm-0-0-2895"><label>d</label><p>Coefficient of variation. C<sub>max</sub>, maximum plasma concentration; AUC<sub>0-inf</sub>, area under the curve, integrated from the blood concentrations by extrapolation of the terminal elimination period.</p></fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</article>
