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Rittberg R, Abraham N, Laskin J, Ho C. Hyper-Sensitive? Targeted Therapy With a Primed Immune System. J Thorac Oncol 2022; 17:734-736. [PMID: 35623671 DOI: 10.1016/j.jtho.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Rebekah Rittberg
- Department of Medical Oncology, BC Cancer, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ninan Abraham
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janessa Laskin
- Department of Medical Oncology, BC Cancer, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cheryl Ho
- Department of Medical Oncology, BC Cancer, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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Dang NL, Matlock MK, Hughes TB, Swamidass SJ. The Metabolic Rainbow: Deep Learning Phase I Metabolism in Five Colors. J Chem Inf Model 2020; 60:1146-1164. [DOI: 10.1021/acs.jcim.9b00836] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Na Le Dang
- Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 S. Euclid Ave., St. Louis, Missouri 63110, United States
| | - Matthew K. Matlock
- Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 S. Euclid Ave., St. Louis, Missouri 63110, United States
| | - Tyler B. Hughes
- Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 S. Euclid Ave., St. Louis, Missouri 63110, United States
| | - S. Joshua Swamidass
- Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 S. Euclid Ave., St. Louis, Missouri 63110, United States
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Chun-qi W, Yu-feng L, Zhi-bing Z, Yan-sheng D, Ben-li Y, Song L, Ming-yang L, Quan-jun W. Regulation of bacterial lipopolysaccharide in liver toxicity caused by chlorpromazine and Z24 in Sprague-Dawley rats. Toxicol Res (Camb) 2015. [DOI: 10.1039/c4tx00109e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
LPS-induced inflammatory response could be used to establish screening models for ILT and provides a new way to reduce liver toxicity of Z24.
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Affiliation(s)
- Wu Chun-qi
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
| | - Li Yu-feng
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
| | - Zheng Zhi-bing
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
| | - Dong Yan-sheng
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
| | - Yuan Ben-li
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
| | - Li Song
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
| | - Liao Ming-yang
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
| | - Wang Quan-jun
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- State Key Laboratory of Toxicology and Medical Countermeasures (Academy of Military Medical Sciences)
- Beijing 100850
- China
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van Wijk F, Nierkens S. Assessment of drug-induced immunotoxicity in animal models. DRUG DISCOVERY TODAY. TECHNOLOGIES 2014; 3:103-9. [PMID: 24980108 DOI: 10.1016/j.ddtec.2006.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With the growing understanding that drugs might induce immune-mediated adverse reactions in patients, immunotoxicity testing of new pharmaceuticals has become an important topic in drug development. The nonclinical assessment of unexpected immune suppression is based on relatively well-standardized and validated assays and animal models. For the evaluation of direct immune stimulation few animal models are available, whilst the development of animal models to assess drug-induced hypersensitivity and in particular autoimmunity is in its infancy.:
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Affiliation(s)
- Femke van Wijk
- Institute for Risk Assessment Sciences, Department of Immunotoxicology, Utrecht University, Utrecht, The Netherlands
| | - Stefan Nierkens
- Nijmegen Centre for Molecular Life Sciences, Department of Tumorimmunology, Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Apisarnthanarak A, Pinitchai U, Warachan B, Warren DK, Khawcharoenporn T, Hayden MK. Effectiveness of infection prevention measures featuring advanced source control and environmental cleaning to limit transmission of extremely-drug resistant Acinetobacter baumannii in a Thai intensive care unit: An analysis before and after extensive flooding. Am J Infect Control 2014; 42:116-21. [PMID: 24485368 DOI: 10.1016/j.ajic.2013.09.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 09/23/2013] [Accepted: 09/23/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Advanced source control (once-daily bathing and 4-times daily oral care with chlorhexidine aqueous solution) and thorough environmental cleaning were implemented in response to an increased incidence of colonization and infection with extremely drug-resistant (XDR) Acinetobacter baumannii in a Thai medical intensive care unit (MICU). METHODS During the 12-month baseline period (P1), contact isolation, active surveillance for XDR A baumannii, cohorting of XDR A baumannii patients, twice-daily environmental cleaning with detergent-disinfectant, and antibiotic stewardship were implemented. In the 5.5-month intervention period (P2), additional measures were introduced. Sodium hypochlorite was substituted for detergent-disinfectant, and advanced source control was implemented. All interventions except cleaning with sodium hypochlorite were continued during the 12.5-month follow-up period (P3). Extensive flooding necessitating closure of the hospital for 2 months occurred between P2 and P3. RESULTS A total of 1,365 patients were studied. Compared with P1 (11.1 cases/1,000 patient-days), the rate of XDR A baumannii clinical isolates declined in P2 (1.74 cases/1,000 patient-days; P < .001) and further in P3 (0.69 cases/1,000 patient-days; P < .001). Compared with P1 (12.15 cases/1,000 patient-days), the rate of XDR A baumannii surveillance isolates also declined in P2 (2.11 cases/1,000 patient-days; P < .001) and P3 (0.98 cases/1,000 patient-days; P < .001). Incidence of nosocomial infections remained stable. Six patients developed chlorhexidine-induced rash (1.4/1,000 patient-days); 31 patients developed mucositis (17.1/1,000 patient-days). CONCLUSIONS These results support advanced source control and thorough environmental cleaning to limit colonization and infection with XDR A baumannii in MICUs in resource-limited settings.
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Kobayashi M, Higuchi S, Ide M, Nishikawa S, Fukami T, Nakajima M, Yokoi T. Th2 cytokine-mediated methimazole-induced acute liver injury in mice. J Appl Toxicol 2012; 32:823-33. [DOI: 10.1002/jat.2731] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 01/03/2012] [Accepted: 01/03/2012] [Indexed: 12/31/2022]
Affiliation(s)
| | - Satonori Higuchi
- Drug Metabolism and Toxicology, Faculty of Pharmaceutical Sciences; Kanazawa University; Kanazawa; 920-1192; Japan
| | - Mika Ide
- Research Division, Mitsubishi Tanabe Pharma. Co.; Kisarazu; Chiba; 292-0818; Japan
| | - Satomi Nishikawa
- Research Division, Mitsubishi Tanabe Pharma. Co.; Kisarazu; Chiba; 292-0818; Japan
| | - Tatsuki Fukami
- Drug Metabolism and Toxicology, Faculty of Pharmaceutical Sciences; Kanazawa University; Kanazawa; 920-1192; Japan
| | - Miki Nakajima
- Drug Metabolism and Toxicology, Faculty of Pharmaceutical Sciences; Kanazawa University; Kanazawa; 920-1192; Japan
| | - Tsuyoshi Yokoi
- Drug Metabolism and Toxicology, Faculty of Pharmaceutical Sciences; Kanazawa University; Kanazawa; 920-1192; Japan
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Association of HLA-B*5801 allele and allopurinol-induced Stevens Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis. BMC MEDICAL GENETICS 2011; 12:118. [PMID: 21906289 PMCID: PMC3189112 DOI: 10.1186/1471-2350-12-118] [Citation(s) in RCA: 134] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 09/09/2011] [Indexed: 01/09/2023]
Abstract
Background Despite some studies suggesting a possible association between human leukocyte antigen, HLA-B*5801 and allopurinol induced Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), the evidence of association and its magnitude remain inconclusive. This study aims to systematically review and meta-analyze the association between HLA-B*5801 allele and allopurinol-induced SJS/TEN. Methods A comprehensive search was performed in databases including MEDLINE, Pre-MEDLINE, Cochrane Library, EMBASE, International Pharmaceutical Abstracts (IPA), CINAHL, PsychInfo, the WHO International, Clinical Trial Registry, and ClinicalTrial.gov from their inceptions to June 2011. Only studies investigating association between HLA-B*5801 with allopurinol-induced SJS/TEN were included. All studies were extracted by two independent authors. The primary analysis was the carrier frequency of HLA-B*5801 comparison between allopurinol-induced SJS/TEN cases and each comparative group. The pooled odds ratios were calculated using a random effect model. Results A total of 4 studies with 55 SJS/TEN cases and 678 matched-controls (allopurinol-tolerant control) was identified, while 5 studies with 69 SJS/TEN cases and 3378 population-controls (general population) were found. SJS/TEN cases were found to be significantly associated with HLA-B*5801 allele in both groups of studies with matched-control (OR 96.60, 95%CI 24.49-381.00, p < 0.001) and population-control (OR 79.28, 95%CI 41.51-151.35, p < 0.001). Subgroup analysis for Asian and Non-Asian population yielded similar findings. Conclusion We found a strong and significant association between HLA-B*5801 and allopurinol-induced SJS/TEN. Therefore, HLA-B*5801 allele screening may be considered in patients who will be treated with allopurinol.
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Apisarnthanarak A, Mundy LM. High incidence of chlorhexidine-induced rash among Thai health care workers. Clin Infect Dis 2011; 53:848-9. [PMID: 21846832 DOI: 10.1093/cid/cir518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Genetic variations in GRIA1 on chromosome 5q33 related to asparaginase hypersensitivity. Clin Pharmacol Ther 2010; 88:191-6. [PMID: 20592726 DOI: 10.1038/clpt.2010.94] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The genetic variations that result in allergy to asparaginase are as yet undetermined. We interrogated more than 500,000 single-nucleotide polymorphisms (SNPs) in 485 children with acute lymphoblastic leukemia (ALL), 322 in a discovery cohort, and 163 in a validation cohort. In the top 100 SNPs associated with allergy in the discovery cohort, chromosome 5 was overrepresented as compared with other chromosomes (P = 0.00032), hosting 10 SNPs annotated to genes. Among these 10 SNPs, one SNP (rs4958351) [corrected], in GRIA1 on chromosome 5q33, was replicated in the validation cohort (P = 1.8 x 10(-5), 2.9 x 10(-3), and 3.5 x 10(-7) in the discovery, validation, and combined cohorts, respectively). Four additional SNPs annotated to GRIA1 were also significantly associated with allergy (P < 0.05) in both cohorts. Chromosome 5q33 has previously been associated with asthma and atopy. These data contribute to the growing body of evidence that there is an inherited component to predisposition to drug allergy.
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Kobayashi M, Higuchi S, Mizuno K, Tsuneyama K, Fukami T, Nakajima M, Yokoi T. Interleukin-17 is involved in alpha-naphthylisothiocyanate-induced liver injury in mice. Toxicology 2010; 275:50-7. [PMID: 20594950 DOI: 10.1016/j.tox.2010.05.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 05/23/2010] [Accepted: 05/31/2010] [Indexed: 11/24/2022]
Abstract
Drug-induced liver injury (DILI) is a major safety concern in drug development and clinical drug therapy. The pathogenesis of DILI usually involves the participation of the parent drug or metabolites that either directly affect the cell biochemistry or elicit an immune response. However, in most cases the mechanisms are unknown. Alpha-naphthylisothiocyanate (ANIT) is known as a hepatotoxicant that causes biliary cell and hepatocyte damage and induces intense neutrophil infiltration in the liver. To investigate whether an immune-mediated mechanism is involved in ANIT-induced liver injury, we examined the plasma AST, ALT and T-Bil levels, hepatic expression of transcriptional factors, cytokines and CXC chemokine genes, plasma IL-17 level and histopathological changes in liver after ANIT administration in mice. Hepatic mRNA expression of retinoid related orphan receptor gamma t (ROR gamma t) and macrophage inflammatory protein (MIP-2) and plasma IL-17 level was significantly increased in ANIT-administered mice as well as the plasma AST, ALT and T-Bil. Neutralization of IL-17 using anti-IL-17 antibody (100 microg/mouse, single i.p.) suppressed the hepatotoxic effect of ANIT. Co-administration of recombinant IL-17 (1 microg/mouse, single i.p.) to ANIT-administered mice resulted in a remarkable increase of the plasma AST, ALT and T-Bil levels. In conclusion, it was firstly demonstrated that IL-17 is involved in the ANIT-induced liver injury in mice.
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Affiliation(s)
- Masanori Kobayashi
- Drug Metabolism and Toxicology, Faculty of Pharmaceutical Sciences, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
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Schnackenberg LK, Chen M, Sun J, Holland RD, Dragan Y, Tong W, Welsh W, Beger RD. Evaluations of the trans-sulfuration pathway in multiple liver toxicity studies. Toxicol Appl Pharmacol 2009; 235:25-32. [DOI: 10.1016/j.taap.2008.11.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Revised: 11/13/2008] [Accepted: 11/20/2008] [Indexed: 10/21/2022]
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Puente J, Jaque M, Carrasco C, Cruz C, Valenzuela M, Wolf M, Mosnaim A. Triptan drugs, natural killer cell cytotoxicity, and neutrophils pro-matrix metalloproteinase-9 secretion. Headache 2008; 48:1482-9. [PMID: 18479418 DOI: 10.1111/j.1526-4610.2008.01136.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To study the effect of various triptan-like drugs, eg, avitriptan, naratriptan, and sumatriptan, as well as the benzopyran alnitidan, on the natural killer cell (NKC) activity of peripheral blood mononuclear cell (PBMC) samples and highly purified NKC (HPNKC) preparations. We also examined the possible role of these agents as immunomodulators by studying their effect upon the in vitro secretion of pro-matrix metalloproteinase-9 (pMMP-9) from whole blood and purified neutrophils samples. BACKGROUND The pharmacological profile of a large number of triptan-like compounds has been extensively studied. However, relatively little is known of their interactions with cellular components of the immune system. METHODS Blood was obtained from nonsmoking, drug-free healthy individuals from the Blood Bank of the University of Chile main Clinical Hospital (J.J.A.). PBMC were separated by centrifugation and HPNKC acquired by an immunomagnetic isolation procedure. NKC cytotoxicity was assayed using (51)Cr-labeled K-562 cells as target. Addition of drugs and of effector cells (30 : 1, 50 : 1, and 70 : 1 ratio for PBMCs, and 5 : 1 for HPNKCs) was followed by incubation. Paired Student's t-test (2-tailed) was used to determine the significance of the specific (51)Cr release in controls vs drug-treated samples. Aliquots of whole blood or purified neutrophils were added test drug, incubated, centrifuged, and the supernatant analyzed by gelatine zymography. Gelatinolytic activity was visualized, and a digested zone at MW 92 kD indicated presence of pMMP-9. Area of proteolysis was estimated by densitometry; prestained standards were used to assess pMMP-9 molecular weight. RESULTS Peripheral blood mononuclear cell's NKC cytotoxicity was consistently decreased after incubation with each and every one of the drugs tested. This result, observed for the 3 effector : target (E : T) cell ratios used, was relatively similar among the various compounds studied, and reached statistical significance only at E : T 70 : 1. Similar drug treatment failed, however, to produce significant changes in the cytotoxicity of HPNKC preparations, suggesting that modulation of the PBMC's NKC activity and that of HPNKC samples require different kinds of cell's derived signal. Incubation with either of the drugs tested failed to significantly alter (basal) nonstimulated pMPP-9 secretion by whole blood samples. However, basal pMMP-9 secretion by purified neutrophil preparations was significantly inhibited by alnitidan and sumatriptan, and not affected by naratriptan. CONCLUSIONS Various drugs with a triptan-like chemical structure interact with cellular components of the innate immune system, resulting in an apparent indirect inhibition of NKC activity and direct inhibition of neutrophils pMMP-9 secretion. These results suggest that they may play a positive role in decreasing the severity of inflammatory processes. Whether this effect is part of triptans antimigraine mechanism of action, or just an added beneficial effect of their use for the reversal treatment of migraine headaches remains to be explored.
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Affiliation(s)
- Javier Puente
- University of Chile - Biochemistry and Molecular Biology, Santiago, Chile
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Cullen JM, Miller RT. The role of pathology in the identification of drug-induced hepatic toxicity. Expert Opin Drug Metab Toxicol 2006; 2:241-7. [PMID: 16866610 DOI: 10.1517/17425255.2.2.241] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Pathologists play a central role in the recognition and prevention of drug-induced toxicity. Pathologists engaged in clinical practice must identify a pattern of histological lesions that are interpreted in concert with a variety of clinical data to determine the probability of drug-induced toxicity versus background disease processes and the most likely drug, often of many, to have caused the specific injury. Toxicological pathologists, working in concert with other scientists, have the responsibility of preventing drug-induced toxicity in humans by identifying potentially toxic drugs and keeping them from the marketplace. In this process of drug development, a broad array of in vivo testing using a number of animal species and in vitro assays are used. Technological advances require pathologists to integrate molecular-based mechanistic data effectively with traditional morphological evaluation to develop a more detailed grasp of the pathogenesis of drug-induced injury. All pathologists have the responsibility to effectively and accurately communicate their findings and interpretations to the appropriate audiences.
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Affiliation(s)
- John M Cullen
- North Carolina State University, College of Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA.
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López-García MP, Dansette PM, Coloma J. Kinetics of tienilic acid bioactivation and functional generation of drug–protein adducts in intact rat hepatocytes. Biochem Pharmacol 2005; 70:1870-82. [PMID: 16257391 DOI: 10.1016/j.bcp.2005.09.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Revised: 09/27/2005] [Accepted: 09/28/2005] [Indexed: 11/24/2022]
Abstract
Drug-induced autoimmune hepatitis is among the most severe hepatic idiosyncratic adverse drug reactions. Considered multifactorial, the disease combines immunological and metabolic aspects, the latter being to date much better known. As for many other model drugs, studies on tienilic acid (TA)-induced hepatitis have evidenced the existence of bioactivation during the hepatic oxidation of the drug, allowing the identification of the neoantigen of anti-LKM2 autoantibodies and the pathway responsible for its formation. However, most of these results are based on the use of microsomal fractions whose relevance to the liver in vivo still needs to be established. In the more complex intact cell environment, several endogenous processes may play a significant role on triggering the reaction and should therefore be considered. In this work we have characterised the kinetics of TA biotransformation in metabolically competent hepatocytes, the influence of TA bioactivation on physiological GSH levels, and the qualitative and quantitative profile of drug-protein conjugates generated in situ, as a function of exposure time. Results confirm that intact hepatocytes reproduce in vitro the metabolic sequence that leads to the functional generation of drug-protein adducts, in conditions that simulate clinical human exposure to TA. Metabolically competent cultured hepatocytes appear as a very promising approach to investigate the early preimmunological events of drug-induced autoimmune hepatitis, adequate to identify the conditions that may modulate the formation and specificity of drug-protein adducts in vivo, to study the hepatic disposition of the TA-protein targets, and to define the specific role of the hepatocyte in the origin of this adverse reaction.
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Affiliation(s)
- M Pilar López-García
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain.
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Dayer JM, Molnarfi N, Burger D. From cellular receptors to transduction–transcription pathways for cytokines: at which level should the inhibition be targeted in inflammation? Expert Opin Biol Ther 2005; 5 Suppl 1:S83-96. [PMID: 16187943 DOI: 10.1517/14712598.5.1.s83] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
An imbalance in cytokine homeostasis is considered to play a major part in the pathogenesis of immuno-inflammatory diseases. Since the identification and cloning of cytokines and their receptors, therapeutic approaches have been developed with the purpose of impeding the interaction between the ligand (cytokine) and its specific receptor, or interactions that involve the use of anti-inflammatory cytokines to switch off inflammation. Although some diseases have been treated successfully with cytokines or anticytokines (i.e., anti-TNF, and to a lesser extent recombinant IL-1 receptor antagonist, in rheumatoid arthritis; IFN-beta in multiple sclerosis), the fact remains that these therapies do not abrogate the concomitant use of steroids or immunosuppressive drugs, and that a significant percentage of patients do not respond to such therapies; these are important limitations. The identification of signalling pathways preferentially used in inflammatory conditions has boosted approaches that target these intracellular mechanisms. This review examines the different therapeutic approaches that may be considered for the treatment of immuno-inflammatory diseases, and discusses the advantages and disadvantages of targeting extracellular or intracellular mechanisms.
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Affiliation(s)
- Jean-Michel Dayer
- University Hospital & Faculty of Medicine, 24, Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
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