NSAID-Induced Enteropathy Affects Regulation of Hepatic Glucose Production by Decreasing GLP-1 Secretion

Ibuprofen induces hepatic Cyp7a1 expression in mice via the intestinal FXR-FGF15 signaling

Non-steroidal anti-inflammatory drugs (NSAIDs) may cause drug-induced liver injury (DILI). However, the molecular mechanisms underlying NSAIDs hepatotoxicity remain elusive. Dysregulations of bile acids (BAs) have been implicated in various DILI. In this study, we systematically investigated the effects of ibuprofen, the most commonly used NSAID, on BA metabolism and signaling in adult male C57/BL6 mice after oral administration of ibuprofen (IBU) at clinically relevant doses (30, 100, and 200 mg/kg) for one week. Notably, IBU significantly decreased BA concentrations in the liver in a dose-dependent manner, with a concomitant increase in both mRNA and protein expression of cholesterol 7alpha-hydoxylase (CYP7A1), the rate-limiting enzyme for BA synthesis. Mechanically, IBU altered the composition of gut microbiota and increased cecal BAs, leading to reduced intestinal absorption of BAs and thus deactivated ileal farnesoid X receptor-fibroblast growth factor 15 (FXR-FGF15) signaling. Additionally, diclofenac and indomethacin also induced hepatic Cyp7a1 expression in mice via their effects on gut microbiota and intestinal BA signaling. To conclude, the current findings suggest that NSAIDs-induced liver injury could be at least partially attributable to the dysregulation of BA metabolism and signaling.

SIRT1 regulates endoplasmic reticulum stress-related organ damage

Endoplasmic reticulum (ER) stress plays a key role in the pathogenesis of several organ damages. Studies show that excessive ER stress (ERS) can destroy cellular homeostasis, causing cell damage and physiological dysfunction in various organs. In recent years, Sirtuin1 (SIRT1) has become a research hotspot on ERS. Increasing evidence suggests that SIRT1 plays a positive role in various ERS-induced organ damage via multiple mechanisms, including inhibiting cellular apoptosis and promoting autophagy. SIRT1 can also alleviate liver, heart, lung, kidney, and intestinal damage by inhibiting ERS. We discuss the possible mechanism of SIRT1, explore potential therapeutic targets of diseases, and provide a theoretical basis for treating ERS-related diseases.

Regular use of ibuprofen or paracetamol and incident type 2 diabetes: A prospective cohort study in the UK Biobank

BACKGROUND

The relation of regular ibuprofen or paracetamol use with the risk of type 2 diabetes (T2DM) remained undetermined. We aimed to evaluate the prospective association between regular ibuprofen or paracetamol use and incidence of T2DM.

METHODS

This cohort included 372,843 participants with available data of ibuprofen, paracetamol use and without diabetes at baseline from the UK Biobank. The primary outcome was incident T2DM. Cox proportional hazards models were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of T2DM.

RESULTS

During a median of 12.1 years' follow-up, 11,527 (3.1%) participants developed T2DM. Overall, participants with regular use of paracetamol showed a significantly higher risk of incident T2DM (adjusted HR, 1.25; 95%CI: 1.19,1.31), compared with non-users. Moreover, a stronger positive association of paracetamol use with incident T2DM was found among those aged <60 years (vs. ≥60 years, P-interaction =0.008), free of cardiovascular diseases (CVD) (vs. CVD patients, P-interaction =0.01), and without the use of anti-hypertensive drugs (vs. users, P-interaction =0.016) at baseline. However, there was no significant association between regular use of ibuprofen (users vs. non-users; adjusted HR, 1.05; 95%CI: 0.99,1.12) and incident T2DM. More importantly, genetic risks of T2DM did not significantly modify the relations of ibuprofen, or paracetamol use with incident T2DM (Both P-interactions >0.05).

CONCLUSIONS

Regular use of paracetamol, but not ibuprofen, was associated with a significantly higher risk of incident T2DM among middle aged UK adults. Our current findings highlight the need for greater consideration in the clinical selection of paracetamol or ibuprofen.