1
|
Chen X, Hao Z, Pan H, Liu W, Lu L, Zhang M, He X, Yi H, Tang S. Relationship between common telomere length-related genetic variations, telomere length, and risk of antituberculosis drug-induced hepatotoxicity in Chinese Han population: As assessed for causality using the updated Roussel Uclaf Causality Assessment Method. Fundam Clin Pharmacol 2023. [PMID: 36855016 DOI: 10.1111/fcp.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/05/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023]
Abstract
Antituberculosis drug-induced hepatotoxicity (ATDH) is a significant threat to tuberculosis control, and two recent studies indicated that leukocyte telomere length (LTL) might be a potential biomarker for ATDH. This study aimed to investigate the relationship between common telomere length-related genetic variations, LTL, and risk of ATDH in Eastern Chinese antituberculosis treatment patients. A 1:4 matched case-control study was conducted among 79 ATDH cases assessed for causality using the updated RUCAM and 316 controls. LTL was determined by quantitative real-time PCR, and nine SNPs involved in telomere biology reported by previous GWAS were assessed. Conditional logistic regression model was used to estimate the association between genotypes and risk of ATDH with odds ratios (ORs) and 95% confidence intervals (CIs). The average RUCAM score of cases was 7.1. The average LTL in cases was significantly shorter than that in controls (median = 1.239 vs. 1.481, P = 0.032). Differences in the distribution of LTL were statistically significant among three genotypes of SNP rs2736098 (CC vs. CT vs. TT, median = 1.544 vs. 1.356 vs. 1.337, P = 0.026) and rs2853677 (AA vs. AG vs. GG, median = 1.511 vs. 1.544 vs. 1.159, P = 0.005) in TERT. SNP rs7675998 in NAF1 was statistically associated with the risk of ATDH under the dominant model (adjusted OR = 1.725, 95% CI: 1.021-2.913, P = 0.042). This is the first study to investigate the relationship of LTL, common telomere length-related variations, and risk of ATDH. SNP rs2736098 and rs2853677 in TERT were significantly associated with LTL, and SNP rs7675998 in NAF1 may be associated with ATDH in Chinese population.
Collapse
Affiliation(s)
- Xinyu Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhuolu Hao
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hongqiu Pan
- Department of Tuberculosis, The Third People's Hospital of Zhenjiang Affiliated to Jiangsu University, Zhenjiang, China
| | - Wenpei Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lihuan Lu
- Department of Tuberculosis, The Second People's Hospital of Changshu, Changshu, China
| | - Meiling Zhang
- Department of Infectious Disease, The Jurong Hospital Affiliated to Jiangsu University, Jurong, China
| | - Xiaomin He
- Department of Infectious Disease, The People's Hospital of Taixing, Taixing, China
| | - Honggang Yi
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shaowen Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| |
Collapse
|
2
|
Kiyimba K, Ayikobua ET, Mwandah DC, Obakiro SB. Assessing the protective effect of Crassocephalum vitellinum against Rifampicin-induced hepatotoxicity in Wistar rats. Afr Health Sci 2022; 22:352-360. [PMID: 36032444 PMCID: PMC9382464 DOI: 10.4314/ahs.v22i1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Crassocephalum vitellinum is widely used by traditional medical practitioners and local people in East Africa to manage a large number of ailments including hepatitis 1. However, its hepatoprotective effects had not been evaluated prior to this study. The aim of this study was to assess the effect of an ethanolic leaf extract of Crassocephalum vitellinum against rifampicin-induced liver toxicity in Wistar rats. Methods Increasing doses of an ethanolic leaf extract of C. vitellinum were administered to Wistar rats daily for 35 days, together with rifampicin given orally as suspension. After the treatment period, Assessment of hepatoprotective activity was done by analysis of serum levels of biochemical and histopathological effects on the liver. Results The results showed that administration of C. vitellinum extract significantly prevented drug- induced increase in serum levels of liver biomarker enzymes and also decreased the hepatocellular necrosis and inflammatory cells infiltration. Conclusion The plant extract loweres the liver biomarker enzymes (ALT, ALP, AST) and preserves the histomorphology of the hepatocytes which is suggestive that the plant possess hepatoprotective properties.
Collapse
Affiliation(s)
- Kenedy Kiyimba
- Department of Pharmacology and Therapeutics, Faculty of health sciences, Busitema University
- Department of Pharmacology and Toxicology, School of Pharmacy, Kampala International Univrsity, Western Campus
| | | | - Daniel Chans Mwandah
- Department of Pharmacology and Toxicology, School of Pharmacy, Kampala International Univrsity, Western Campus
| | - Samuel Baker Obakiro
- Department of Pharmacology and Therapeutics, Faculty of health sciences, Busitema University
| |
Collapse
|
3
|
Gu R, Liang A, Liao G, To I, Shehu A, Ma X. Roles of co-factors in drug-induced liver injury: drug metabolism and beyond. Drug Metab Dispos 2022; 50:646-654. [PMID: 35221288 PMCID: PMC9132098 DOI: 10.1124/dmd.121.000457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Abstract
Drug-induced liver injury (DILI) remains one of the major concerns for healthcare providers and patients. Unfortunately, it is difficult to predict and prevent DILI in the clinic because detailed mechanisms of DILI are largely unknown. Many risk factors have been identified for both "intrinsic" and "idiosyncratic" DILI, suggesting that cofactors are an important aspect in understanding DILI. This review outlines the cofactors that potentiate DILI and categorizes them into two types: (1) the specific cofactors that target metabolic enzymes, transporters, antioxidation defense, immune response, and liver regeneration; and (2) the general cofactors that include inflammation, age, gender, comorbidity, gut microbiota, and lifestyle. The underlying mechanisms by which cofactors potentiate DILI are also discussed. SIGNIFICANCE STATEMENT: This review summarizes the risk factors for DILI, which can be used to predict and prevent DILI in the clinic. This work also highlights the gaps in the DILI field and provides future perspectives on the roles of cofactors in DILI.
Collapse
Affiliation(s)
- Ruizhi Gu
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences (R.G., A.S., X.M.) and School of Pharmacy (A.L., G.L., I.T.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alina Liang
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences (R.G., A.S., X.M.) and School of Pharmacy (A.L., G.L., I.T.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Grace Liao
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences (R.G., A.S., X.M.) and School of Pharmacy (A.L., G.L., I.T.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Isabelle To
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences (R.G., A.S., X.M.) and School of Pharmacy (A.L., G.L., I.T.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amina Shehu
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences (R.G., A.S., X.M.) and School of Pharmacy (A.L., G.L., I.T.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Xiaochao Ma
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences (R.G., A.S., X.M.) and School of Pharmacy (A.L., G.L., I.T.), University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
4
|
Mach J, Wang X, Hilmer SN. Quantification of serum levels in mice of seven drugs (and six metabolites) commonly taken by older people with polypharmacy. Fundam Clin Pharmacol 2020; 35:410-422. [DOI: 10.1111/fcp.12602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/31/2020] [Accepted: 08/18/2020] [Indexed: 01/09/2023]
Affiliation(s)
- John Mach
- Kolling Institute of Medical Research Royal North Shore Hospital 10 Westbourne St Sydney NSW 2065 Australia
- Departments of Clinical Pharmacology and Aged Care Royal North Shore Hospital Reserve Rd St Leonards NSW 2065 Australia
- Northern Clinical School Faculty of Medicine and Health University of Sydney 10 Westbourne St Sydney NSW 2065 Australia
| | - XiaoSuo Wang
- Bosch Mass Spectrometry Facility University of Sydney 92 Parramatta Rd Sydney NSW 2050 Australia
| | - Sarah N. Hilmer
- Kolling Institute of Medical Research Royal North Shore Hospital 10 Westbourne St Sydney NSW 2065 Australia
- Departments of Clinical Pharmacology and Aged Care Royal North Shore Hospital Reserve Rd St Leonards NSW 2065 Australia
- Northern Clinical School Faculty of Medicine and Health University of Sydney 10 Westbourne St Sydney NSW 2065 Australia
| |
Collapse
|
5
|
Bernier M, Harney D, Koay YC, Diaz A, Singh A, Wahl D, Pulpitel T, Ali A, Guiterrez V, Mitchell SJ, Kim EY, Mach J, Price NL, Aon MA, LeCouteur DG, Cogger VC, Fernandez-Hernando C, O’Sullivan J, Larance M, Cuervo AM, de Cabo R. Elucidating the mechanisms by which disulfiram protects against obesity and metabolic syndrome. NPJ Aging Mech Dis 2020; 6:8. [PMID: 32714562 PMCID: PMC7374720 DOI: 10.1038/s41514-020-0046-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022] Open
Abstract
There is an unmet need and urgency to find safe and effective anti-obesity interventions. Our recent study in mice fed on obesogenic diet found that treatment with the alcohol aversive drug disulfiram reduced feeding efficiency and led to a decrease in body weight and an increase in energy expenditure. The intervention with disulfiram improved glucose tolerance and insulin sensitivity, and mitigated metabolic dysfunctions in various organs through poorly defined mechanisms. Here, integrated analysis of transcriptomic and proteomic data from mouse and rat livers unveiled comparable signatures in response to disulfiram, revealing pathways associated with lipid and energy metabolism, redox, and detoxification. In cell culture, disulfiram was found to be a potent activator of autophagy, the malfunctioning of which has negative consequences on metabolic regulation. Thus, repurposing disulfiram may represent a potent strategy to combat obesity.
Collapse
Affiliation(s)
- Michel Bernier
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
| | - Dylan Harney
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
| | - Yen Chin Koay
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
- Heart Research Institute, The University of Sydney, Sydney, NSW 2042 Australia
| | - Antonio Diaz
- Department of Developmental and Molecular Biology, Institute for Aging Studies, Albert Einstein College of Medicine, New York, NY 10461 USA
| | - Abhishek Singh
- Vascular Biology and Therapeutics Program, Integrative Cell Signaling and Neurobiology of Metabolism Program, Department of Comparative Medicine, Department of Pathology, Yale University School of Medicine, New Haven, CT 06510 USA
| | - Devin Wahl
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
- Ageing and Alzheimer’s Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, NSW 2139 Australia
| | - Tamara Pulpitel
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
- Ageing and Alzheimer’s Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, NSW 2139 Australia
| | - Ahmed Ali
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
| | - Vince Guiterrez
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
| | - Sarah J. Mitchell
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
| | - Eun-Young Kim
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
- Functional Genomics Research Center, KRIBB, Daejeon, 305-806 Republic of Korea
| | - John Mach
- Kolling Institute of Medical Research and Sydney Medical School, University of Sydney, Sydney, NSW 2064 Australia
| | - Nathan L. Price
- Vascular Biology and Therapeutics Program, Integrative Cell Signaling and Neurobiology of Metabolism Program, Department of Comparative Medicine, Department of Pathology, Yale University School of Medicine, New Haven, CT 06510 USA
| | - Miguel A. Aon
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
| | - David G. LeCouteur
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
- Ageing and Alzheimer’s Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, NSW 2139 Australia
| | - Victoria C. Cogger
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
- Ageing and Alzheimer’s Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, NSW 2139 Australia
| | - Carlos Fernandez-Hernando
- Vascular Biology and Therapeutics Program, Integrative Cell Signaling and Neurobiology of Metabolism Program, Department of Comparative Medicine, Department of Pathology, Yale University School of Medicine, New Haven, CT 06510 USA
| | - John O’Sullivan
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
- Heart Research Institute, The University of Sydney, Sydney, NSW 2042 Australia
| | - Mark Larance
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006 Australia
| | - Ana Maria Cuervo
- Department of Developmental and Molecular Biology, Institute for Aging Studies, Albert Einstein College of Medicine, New York, NY 10461 USA
| | - Rafael de Cabo
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224 USA
| |
Collapse
|
6
|
Imam F, Sharma M, Khayyam KU, Khan MR, Ali MD, Qamar W. Determination of isoniazid acetylation patterns in tuberculosis patients receiving DOT therapy under the Revised National tuberculosis Control Program (RNTCP) in India. Saudi Pharm J 2020; 28:641-647. [PMID: 32550793 PMCID: PMC7292862 DOI: 10.1016/j.jsps.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/07/2020] [Indexed: 11/25/2022] Open
Abstract
Monitoring of liver function tests is very important in patient receiving DOT therapy. There was no significance difference reported in the differential leucocytes count. We define mechanisms underlying the adverse drug reactions observed following DOTS. The plasma INH concentration was reported to be high in slow acetylation. Plasma INH concentration greater than the antimode are slow acetylator.
Isoniazid is the most commonly used drug for treatment of tuberculosis, and is administered individually or in combination with other drugs as standard first line therapy. Offsetting its efficacy, severe adverse effects, especially peripheral neuropathy and hepatotoxicity, are associated with isoniazid therapy, limiting its use in tuberculosis. Isoniazid is acetylated in vivo producing hydrazine and acetyl hydrazine, which are responsible for hepatotoxicity. Marked pharmacogenetic differences in acetylation have been reported among different population across the globe. This study evaluates isoniazid acetylation patterns in tuberculosis patients receiving DOT therapy under the Revised National Tuberculosis Control Program (RNTCP) in a specialized tuberculosis hospital in north India. Of 351 patients from whom samples were taken for biochemical analysis of adverse events, 36 were assessed for acetylation patterns. Blood samples were taken 1 h after administration of a 600 mg dose of isoniazid, and plasma concentrations of isoniazid were determined using a validated HPLC method. Of these 36 patients, 20 (55.56%) were slow acetylators and 16 (44.44%) were fast acetylators. Our results are consistent with those of an earlier study conducted in a different region of India. Most biochemical changes produced during long-term isoniazid therapy resolve after therapy is terminated.
Collapse
Affiliation(s)
- Faisal Imam
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box: 2457, Riyadh 11451, Saudi Arabia
| | - Manju Sharma
- Department of Pharmacology, School of Pharmaceutical Education and Research, Hamdard University, New Delhi 110062, India
| | - Khalid Umer Khayyam
- Department of Epidemiology & Public Health, National Institute of Tuberculosis & Respiratory Diseases, New Delhi 110030, India
| | - Mohammad Rashid Khan
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box: 2457, Riyadh 11451, Saudi Arabia
| | - Mohammad Daud Ali
- Mohammed Al-Mana College for Medical Sciences, Abdulrazaq Bin Hammam Street, As Safa, Dammam 34222, Saudi Arabia
| | - Wajhul Qamar
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Central Laboratory Research Center, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| |
Collapse
|
7
|
DNA methylation and histone acetylation changes to cytochrome P450 2E1 regulation in normal aging and impact on rates of drug metabolism in the liver. GeroScience 2020; 42:819-832. [PMID: 32221779 DOI: 10.1007/s11357-020-00181-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/09/2020] [Indexed: 12/21/2022] Open
Abstract
Aging is associated with reduced liver function that may increase the risk for adverse drug reactions in older adults. We hypothesized that age-related changes to epigenetic regulation of genes involved in drug metabolism may contribute to this effect. We reviewed published epigenome-wide studies of human blood and identified the cytochrome P450 2E1 (CYP2E1) gene as a top locus exhibiting epigenetic changes with age. To investigate potential functional changes with age in the liver, the primary organ of drug metabolism, we obtained liver tissue from mice aged 4-32 months from the National Institute on Aging. We assayed global DNA methylation (5-methylcytosine, 5mC), hydroxymethylation (5-hydroxymethylcytosine, 5hmC), and locus-specific 5mC and histone acetylation changes around mouse Cyp2e1. The mouse livers exhibit significant global decreases in 5mC and 5hmC with age. Furthermore, 5mC significantly increased with age at two regulatory regions of Cyp2e1 in tandem with decreases in its gene and protein expressions. H3K9ac levels also changed with age at both regulatory regions of Cyp2e1 investigated, while H3K27ac did not. To test if these epigenetic changes are associated with varying rates of drug metabolism, we assayed clearance of the CYP2E1-specific probe drug chlorzoxazone in microsome extracts from the same livers. CYP2E1 intrinsic clearance is associated with DNA methylation and H3K9ac levels at the Cyp2e1 locus but not with chronological age. This suggests that age-related epigenetic changes may influence rates of hepatic drug metabolism. In the future, epigenetic biomarkers could prove useful to guide dosing regimens in older adults.
Collapse
|
8
|
Weaning Mice and Adult Mice Exhibit Differential Carbon Tetrachloride-Induced Acute Hepatotoxicity. Antioxidants (Basel) 2020; 9:antiox9030201. [PMID: 32121508 PMCID: PMC7139353 DOI: 10.3390/antiox9030201] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 02/06/2023] Open
Abstract
Age is a risk factor for drug-induced liver injury (DILI). However, there is a limited understanding of pediatric DILI. Here, 2-week-old weaning and 8-week-old adult male ICR mice were intraperitoneally injected with CCl4 (0.1 mmol/kg equal to 15.4 mg/kg) to comparatively evaluate the time-dependent liver damage and cellular events. CCl4 significantly enhanced the serum alanine aminotransferase/aspartate aminotransferase levels and hepatic centrilobular necrosis in the weaning mice, whereas it induced mild liver injury in the adult mice. CCl4-treated weaning mice exhibited higher hepatic levels of pro-apoptotic proteins (Bax, cleaved caspase-3, -7, and -9), activated MAPKs (p-JNK and p-Erk), and endoplasmic reticulum stress indicators (ATF6 and CHOP) and lower hepatic anti-apoptotic Bcl-2 levels than the adult mice. The weaning mice exhibited enhanced basal hepatic glutathione (GSH) levels due to high glutamate cysteine ligase (GCL) and low anti-cysteine dioxygenase (CDO) enzyme levels. However, CCl4 markedly reduced the hepatic GSH levels only in the weaning mice. Furthermore, higher hepatic levels of oxidative stress-induced malondialdehyde, 4-hydroxynonenal, nitrotyrosine-protein adducts, and oxidized proteins were observed in CCl4-treated weaning mice than in CCl4-treated adult mice. The enhanced levels of hepatic cytochrome P450 (CYP) 2E1 and CYP3A, and decreased hepatic GSH S-transferase (GST)-π and GSH reductase (GR) levels in the weaning mice may contribute to their enhanced susceptibility to liver damage.
Collapse
|
9
|
Abdel-Ghaf O, Hegab AM, Rayan EI. Evaluation of Antioxidative Effect of Green Tea Catechins Against Isoniazid-induced Biochemical Alterations in Rats. INT J PHARMACOL 2019. [DOI: 10.3923/ijp.2019.777.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
10
|
Ali MH, Alrasheedy AA, Kibuule D, Hassali MA, Godman B, Abdelwahab MF, Abbadi RY. Isoniazid acetylation phenotypes in the Sudanese population; findings and implications. J Clin Tuberc Other Mycobact Dis 2019; 17:100120. [PMID: 31788562 PMCID: PMC6879993 DOI: 10.1016/j.jctube.2019.100120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Isoniazid (INH) is the mainstay antimicrobial in the treatment of tuberculosis (TB). It is acetlylated in the liver to acetyl-INH. However, there is variation in rate of acetylation of INH among TB patients (i.e. fast, intermediate or slow acetylators) which impacts on the treatment outcomes. Aim The isoniazid acetylation phenotypes in the expatriate Sudanese population were determined to provide future guidance since TB is prevalent in Sudan. Methods A community-based trial among Sudanese expatriates in Saudi Arabia was undertaken to identify INH-acetylation phenotypes. After overnight fasting, a single dose of 200 mg of INH was given to the volunteers. Three hours later, 5 ml of blood were drawn from each volunteer and prepared for High-Performance Liquid Chromatography (HPLC) analysis. The main outcomes were INH and Acetyl-INH concentrations in plasma and the subsequent Acetyl-INH/INH metabolic ratio (MR). Results The findings suggest that slow acetylation is highly prevalent among the study participants (n = 43; 84.31%). Moreover, there was no statistically significant correlation between age and the MR (r = −0.18, P = 0.20). Further, there was no significant association between gender and the MR (P = 0.124). Similarly, no significant association was found between smoking habits and MR (P = 0.24). Conclusion Isoniazid phenotyping suggests predominantly slow acetylation among the Sudanese in this sample. The study found no statistically significant associations between the MR and age or gender or smoking.
Collapse
Affiliation(s)
- Monadil H Ali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia.,Faculty of Pharmacy, Northern Border University, Saudi Arabia
| | | | - Dan Kibuule
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Brian Godman
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia.,Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | | | - Raef Y Abbadi
- Faculty of Pharmacy, Northern Border University, Saudi Arabia
| |
Collapse
|
11
|
Xu SF, Hu AL, Xie L, Liu JJ, Wu Q, Liu J. Age-associated changes of cytochrome P450 and related phase-2 gene/proteins in livers of rats. PeerJ 2019; 7:e7429. [PMID: 31396457 PMCID: PMC6681801 DOI: 10.7717/peerj.7429] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/07/2019] [Indexed: 12/16/2022] Open
Abstract
Cytochrome P450s (CYPs) are phase-I metabolic enzymes playing important roles in drug metabolism, dietary chemicals and endogenous molecules. Age is a key factor influencing P450s expression. Thus, age-related changes of CYP 1–4 families and bile acid homeostasis-related CYPs, the corresponding nuclear receptors and a few phase-II genes were examined. Livers from male Sprague-Dawley rats at fetus (−2 d), neonates (1, 7, and 14 d), weanling (21 d), puberty (28 and 35 d), adulthood (60 and 180 d), and aging (540 and 800 d) were collected and subjected to qPCR analysis. Liver proteins from 14, 28, 60, 180, 540 and 800 days of age were also extracted for selected protein analysis by western blot. In general, there were three patterns of their expression: Some of the drug-metabolizing enzymes and related nuclear receptors were low in fetal and neonatal stage, increased with liver maturation and decreased quickly at aging (AhR, Cyp1a1, Cyp2b1, Cyp2b2, Cyp3a1, Cyp3a2, Ugt1a2); the majority of P450s (Cyp1a2, Cyp2c6, Cyp2c11, Cyp2d2, Cyp2e1, CAR, PXR, FXR, Cyp7a1, Cyp7b1. Cyp8b1, Cyp27a1, Ugt1a1, Sult1a1, Sult1a2) maintained relatively high levels throughout the adulthood, and decreased at 800 days of age; and some had an early peak between 7 and 14 days (CAR, PXR, PPARα, Cyp4a1, Ugt1a2). The protein expression of CYP1A2, CYP2B1, CYP2E1, CYP3A1, CYP4A1, and CYP7A1 corresponded the trend of mRNA changes. In summary, this study characterized three expression patterns of 16 CYPs, five nuclear receptors, and four phase-II genes during development and aging in rat liver, adding to our understanding of age-related CYP expression changes and age-related disorders.
Collapse
Affiliation(s)
- Shang-Fu Xu
- Key Lab for Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi, China
| | - An-Ling Hu
- Key Lab for Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi, China
| | - Lu Xie
- Key Lab for Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi, China
| | - Jia-Jia Liu
- Key Lab for Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi, China
| | - Qin Wu
- Key Lab for Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi, China
| | - Jie Liu
- Key Lab for Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi, China
| |
Collapse
|
12
|
Wang P, Shehu AI, Lu J, Joshi RH, Venkataramanan R, Sugamori KS, Grant DM, Zhong XB, Ma X. Deficiency of N-acetyltransferase increases the interactions of isoniazid with endobiotics in mouse liver. Biochem Pharmacol 2017; 145:218-225. [PMID: 28888949 DOI: 10.1016/j.bcp.2017.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/05/2017] [Indexed: 12/29/2022]
Abstract
Acetylation is the major metabolic pathway of isoniazid (INH) mediated by N-acetyltransferases (NATs). Previous reports suggest that slow acetylators have higher risks of INH hepatotoxicity than rapid acetylators, but the detailed mechanisms remain elusive. The current study used Nat1/2(-/-) mice to mimic NAT slow metabolizers and to investigate INH metabolism in the liver. We found that INH acetylation is abolished in the liver of Nat1/2(-/-) mice, suggesting that INH acetylation is fully dependent on NAT1/2. In addition to the acetylation pathway, INH can be hydrolyzed to form hydrazine (Hz) and isonicotinic acid (INA). We found that INA level was not altered in the liver of Nat1/2(-/-) mice, indicating that deficiency of NAT1/2 has no effect on INH hydrolysis. Because INH acetylation was abolished and INH hydrolysis was not altered in Nat1/2(-/-) mice, we expected an extremely high level of INH in the liver. However, we only observed a modest accumulation of INH in the liver of Nat1/2(-/-) mice, suggesting that there are alternative pathways in INH metabolism in NAT1/2 deficient condition. Our further studies revealed that the conjugated metabolites of INH with endobiotics, including fatty acids and vitamin B6, were significantly increased in the liver of Nat1/2(-/-) mice. In summary, this study illustrated that deficiency of NAT1/2 decreases INH acetylation, but increases the interactions of INH with endobiotics in the liver. These findings can be used to guide future studies on the mechanisms of INH hepatotoxicity in NAT slow metabolizers.
Collapse
Affiliation(s)
- Pengcheng Wang
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Amina I Shehu
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Jie Lu
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Rujuta H Joshi
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Raman Venkataramanan
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Kim S Sugamori
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Denis M Grant
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Xiao-Bo Zhong
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, CT 06269, USA
| | - Xiaochao Ma
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| |
Collapse
|
13
|
Tannenbaum C, Day D. Age and sex in drug development and testing for adults. Pharmacol Res 2017; 121:83-93. [PMID: 28455265 DOI: 10.1016/j.phrs.2017.04.027] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 03/24/2017] [Accepted: 04/24/2017] [Indexed: 01/11/2023]
Abstract
Individualization of drug therapy requires that the right drug be administered at the correct dose to patients who are likely to achieve the highest benefit and lowest risk. Female sex and age comprise two important risk factors for altered drug exposure and response. This review summarizes the current state of science for considering age and sex-related factors along the drug development pipeline, from cell culture and animal research through all phases of clinical trials in humans. A set of recommendations is provided to improve standards for integrating age and sex into the study design, analysis, and reporting of pre-clinical and clinical assessment of new molecular entities and biologics in adults.
Collapse
Affiliation(s)
- Cara Tannenbaum
- Institute of Gender and Health, Canadian Institutes of Health Research, Canada; Medicine and Pharmacy, Université de Montreal, Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), 4565 Chemin Queen-Mary, Montréal, Québec H3W 1W5, Canada.
| | - Danielle Day
- Fractyl Laboratories, 17 Hartwell Ave, Lexington, MA 02421, USA
| | | |
Collapse
|
14
|
Isoniazid metabolism and hepatotoxicity. Acta Pharm Sin B 2016; 6:384-392. [PMID: 27709007 PMCID: PMC5045547 DOI: 10.1016/j.apsb.2016.07.014] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/09/2016] [Accepted: 06/27/2016] [Indexed: 12/17/2022] Open
Abstract
Isoniazid (INH) is highly effective for the management of tuberculosis. However, it can cause liver injury and even liver failure. INH metabolism has been thought to be associated with INH-induced liver injury. This review summarized the metabolic pathways of INH and discussed their associations with INH-induced liver injury.
Collapse
Key Words
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AcHz, acetylhydrazine
- AcINH, acetylisoniazid
- Amidase
- Anti-tuberculosis
- DiAcHz, diacetylhydrazine
- GSH, glutathione
- GST, glutathione S-transferase
- Hepatotoxicity
- Hz, hydrazine
- INA, isonicotinic acid
- INH, isoniazid
- Isoniazid
- MPO, myeloperoxidase
- Metabolism
- N-Acetyltransferase 2
- NAD+, nicotinamide adenine dinucleotide
- NAT, N-acetyltransferase
- P450, cytochrome P450
- R.M., reactive metabolite
- TB, tuberculosis
Collapse
|
15
|
Metushi I, Uetrecht J, Phillips E. Mechanism of isoniazid-induced hepatotoxicity: then and now. Br J Clin Pharmacol 2016; 81:1030-6. [PMID: 26773235 DOI: 10.1111/bcp.12885] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/03/2015] [Accepted: 01/13/2016] [Indexed: 12/27/2022] Open
Abstract
Isoniazid (INH) remains a mainstay for the treatment of tuberculosis despite the fact that it can cause liver failure. Previous mechanistic hypotheses have classified this type of drug-induced liver injury (DILI) as 'metabolic idiosyncrasy' which was thought not to involve an immune response and was mainly due to the bioactivation of the acetylhydrazine metabolite. However, more recent studies support an alternative hypothesis, specifically, that INH itself is directly bioactivated to a reactive metabolite, which in some patients leads to an immune response and liver injury. Furthermore, there appear to be two phenotypes of INH-induced liver injury. Most cases involve mild liver injury, which resolves with immune tolerance, while other cases appear to have a more severe phenotype that is associated with the production of anti-drug/anti-CYP P450 antibodies and can progress to liver failure.
Collapse
Affiliation(s)
- Imir Metushi
- Center for Advanced Laboratory Medicine, Department of Pathology, University of California San Diego, San Diego, CA, 92116, USA
| | - Jack Uetrecht
- Leslie Dan Faculty of Pharmacy, Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON, M5S 3M2, Canada
| | - Elizabeth Phillips
- Department of Medicine, Vanderbilt School of Medicine, Nashville, TN, 37232, USA
| |
Collapse
|
16
|
Kane AE, Huizer-Pajkos A, Mach J, McKenzie C, Mitchell SJ, de Cabo R, Jones B, Cogger V, Le Couteur DG, Hilmer SN. N-Acetyl cysteine does not prevent liver toxicity from chronic low-dose plus subacute high-dose paracetamol exposure in young or old mice. Fundam Clin Pharmacol 2016; 30:263-75. [PMID: 26821200 DOI: 10.1111/fcp.12184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/07/2016] [Accepted: 01/25/2016] [Indexed: 12/27/2022]
Abstract
Paracetamol is an analgesic commonly used by people of all ages, which is well documented to cause severe hepatotoxicity with acute overexposures. The risk of hepatotoxicity from nonacute paracetamol exposures is less extensively studied, and this is the exposure most common in older adults. Evidence on the effectiveness of N-acetyl cysteine (NAC) for nonacute paracetamol exposures, in any age group, is lacking. This study aimed to examine the effect of long-term exposure to therapeutic doses of paracetamol and subacute paracetamol overexposure, in young and old mice, and to investigate whether NAC was effective at preventing paracetamol hepatotoxicity induced by these exposures. Young and old male C57BL/6 mice were fed a paracetamol-containing (1.33 g/kg food) or control diet for 6 weeks. Mice were then dosed orally eight times over 3 days with additional paracetamol (250 mg/kg) or saline, followed by either one or two doses of oral NAC (1200 mg/kg) or saline. Chronic low-dose paracetamol exposure did not cause hepatotoxicity in young or old mice, measured by serum alanine aminotransferase (ALT) elevation, and confirmed by histology and a DNA fragmentation assay. Subacute paracetamol exposure caused significant hepatotoxicity in young and old mice, measured by biochemistry (ALT) and histology. Neither a single nor double dose of NAC protected against this toxicity from subacute paracetamol in young or old mice. This finding has important clinical implications for treating toxicity due to different paracetamol exposure types in patients of all ages, and implies a need to develop new treatments for subacute paracetamol toxicity.
Collapse
Affiliation(s)
- Alice Elizabeth Kane
- Kolling Institute of Medical Research, Reserve Rd, St Leonards, NSW, Australia.,Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Aniko Huizer-Pajkos
- Kolling Institute of Medical Research, Reserve Rd, St Leonards, NSW, Australia.,Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, Australia
| | - John Mach
- Kolling Institute of Medical Research, Reserve Rd, St Leonards, NSW, Australia.,Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Catriona McKenzie
- Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia
| | - Sarah Jayne Mitchell
- National Institute on Aging, National Institutes of Health, Nathan Shock Dr, Baltimore, MD, USA
| | - Rafael de Cabo
- National Institute on Aging, National Institutes of Health, Nathan Shock Dr, Baltimore, MD, USA
| | - Brett Jones
- Kolling Institute of Medical Research, Reserve Rd, St Leonards, NSW, Australia.,Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Victoria Cogger
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,Centre for Education and Research on Ageing and ANZAC Research Institute, Hospital Rd, Concord, NSW, Australia
| | - David G Le Couteur
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,Centre for Education and Research on Ageing and ANZAC Research Institute, Hospital Rd, Concord, NSW, Australia
| | - Sarah Nicole Hilmer
- Kolling Institute of Medical Research, Reserve Rd, St Leonards, NSW, Australia.,Royal North Shore Hospital, Reserve Rd, St Leonards, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|