scholarly journals Hepatocyte-Derived Exosomes Promote Liver Immune Tolerance: Possible Implications for Idiosyncratic Drug-Induced Liver Injury

2019 ◽  
Vol 170 (2) ◽  
pp. 499-508 ◽  
Author(s):  
Natalie S Holman ◽  
Rachel J Church ◽  
Manisha Nautiyal ◽  
Kelly A Rose ◽  
Sarah E Thacker ◽  
...  
Keyword(s):  
Liver Injury ◽  
Immune Tolerance ◽  
Target Genes ◽  
Normal Liver ◽  
T Cell Response ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Adaptive Immune ◽  
Immune Attack ◽  
Mock Control

Abstract Most idiosyncratic drug-induced liver injury appears to result from an adaptive immune attack on the liver. Recent evidence suggests that the T-cell response may be facilitated by the loss of immune tolerance. In this study, we explored the hypothesis that constitutively released hepatocyte-derived exosomes (HDE) are important for maintaining normal liver immune tolerance. Exosomes were isolated from the conditioned medium of primary human hepatocytes via polymer precipitation. Mock controls were prepared by processing fresh medium that was not hepatocyte exposed with precipitation reagent. THP-1 monocytes were then treated with HDE or an equivalent volume of mock control for 24 h, followed by a 6-h stimulation with LPS. HDE exposure resulted in a significant decrease in the LPS-induced media levels of interleukin-1β and interleukin-8. Gene expression profiling performed in THP-1 cells just prior to LPS-induced stimulation identified a significant decrease among genes associated with innate immune response. MicroRNA (miRNA) profiling was performed on the HDE to identify exosome contents that may drive immune suppression. Many of the predicted mRNA target genes for the most abundant microRNAs in HDE were among the differentially expressed genes in THP-1 cells. Taken together, our data suggest that HDE play a role in maintaining normal liver immune tolerance. Future experiments will explore the possibility that drugs causing idiosyncratic liver injury promote the loss of homeostatic HDE signaling.

scholarly journals Inhibition of the Adaptive Immune Response following Drug‐Induced Liver Injury

2006 ◽  
Vol 20 (5) ◽  
Author(s):  
Mary Jane Masson ◽  
Christine J. Chung ◽  
Richard Peterson ◽  
Mary L. Graf ◽  
Jeffrey L Ambroso ◽  
...  
Keyword(s):  
Immune Response ◽  
Liver Injury ◽  
Adaptive Immune Response ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Adaptive Immune

scholarly journals The Characteristics, Prevalence, and Risk Factors of Drug-Induced Liver Injury Among Brucellosis Inpatients in Xinjiang, China

2021 ◽  
Vol 12 ◽  
Author(s):  
Maermaer Tuohutaerbieke ◽  
Xinjie Li ◽  
Yue Yin ◽  
Wei Chen ◽  
Dongmei Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Injury ◽  
Serum Albumin ◽  
Rating Scale ◽  
Normal Liver ◽  
Hepatocellular Injury ◽  
Drug Induced ◽  
International Consensus ◽  
Drug Induced Liver Injury ◽  
Drug Of Choice

Background: We investigated the prevalence, demographic and clinical features, and risk factors associated with drug-induced liver injury (DILI) during the treatment of brucellosis inpatients in a retrospective study.Methods: We collected the clinical data of 782 brucellosis inpatients admitted at the Shawan County People’s Hospital, Xinjiang, from 2015–2019. All cases were re-evaluated using the international consensus of DILI criteria and RUCAM rating scale. 71 patients were confirmed as DILI cases and compared with 523 other patients with normal liver function.Results: It was indicated that DILI occurred with a prevalence of about 9.08% among brucellosis inpatients receiving drug therapy. Hepatocellular injury was the most common type of DILI (61.97%, 95% confidence interval [CI] 50.34–72.37), followed by mixed (23.94%, 95% CI 15.52–35.04) and cholestatic types (14.08%, 95% CI 7.83–24.02). In addition, 13.64% of the hepatocellular DILI cases fulfilled Hy’s law criteria and only two cases (2.82%) progressed to severe DILI. Most patients adopted the combination of rifampicin, antipyretic analgesics, anti-infective agents, and traditional Chinese medicine for the treatment of brucellosis, with all the 71 patients taking rifampicin as the drug of choice. Multivariable logistic regression analyses indicated that obesity, regular alcohol intake, and decreased serum albumin were the independent risk factors of DILI in patients with brucellosis after adjusting for gender, age, and ethnicity.Conclusion: DILI occurred in a minority of inpatients diagnosed with brucellosis receiving rifampicin-based therapeutic regimen. In addition, obesity, alcohol abuse, and decreased serum albumin were valuable predictors of the risk of DILI in patients with brucellosis.

Investigating the Mechanism of Action of Frankincense against Drug-Induced Liver Injury Using Network Pharmacology and Molecular Docking

2021 ◽  
Vol 18 ◽  
Author(s):  
Yu-cheng Liao ◽  
Jing-wen Wang ◽  
Qian Yang ◽  
Wen-jun Wanga ◽  
Chao Zhao ◽  
...  
Keyword(s):  
Molecular Docking ◽  
Liver Injury ◽  
Mechanism Of Action ◽  
Target Genes ◽  
Network Pharmacology ◽  
Active Components ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Pathway Enrichment ◽  
Core Genes

Background: Frankincense has been used as a traditional medicine in many countries. It is an important herb with multiple targets and therapeutic effects including liver protection. However, its mechanism of action in drug-induced liver injury (DILI) remains unknown. Objective: The purpose of this work was to elucidate the active components, core genes, and molecular mechanism of frankincense in DILI through network pharmacology and molecular docking approaches. Method: The active components of frankincense and its target genes were obtained from the BATMAN-TCM database, and the DILI target genes were obtained from the GeneCards and DrugBank databases. Cytoscape was used to create the compound-shared gene target network. STRING and DAVID software were used to analyze key targets and pathway enrichment. Autodock Vina software was used for molecular docking. Results: Network analysis identified 16 compounds in frankincense and 103 target genes that are highly related to DILI. The core genes in the protein-protein interaction network are INS, IL6, TP53, TNF, SRC, PTGS2, IL1B, CAT, IL10, and IGF1. Furthermore, GO and KEGG pathway enrichment analyses indicated that the effect of frankincense on DILI is related to positive regulation of transcription from RNA polymerase II promoter and inflammatory response. Core pathways such as the HIF-1, TNF, FoxO, PI3K-Akt, and the sphingolipid signaling pathway are closely related to DILI. Conclusion: This study revealed the chemical constituents and pharmacological effects of frankincense and unveiled potential DILI healing targets. This study could provide insights for further development of drugs that specifically target DILI.

scholarly journals Idiosyncratic Drug-Induced Liver Injury: Mechanistic and Clinical Challenges

2021 ◽  
Vol 22 (6) ◽  
pp. 2954
Author(s):  
Alison Jee ◽  
Samantha Christine Sernoskie ◽  
Jack Uetrecht
Keyword(s):  
Immune Response ◽  
Immune System ◽  
T Cell ◽  
Liver Injury ◽  
Clinical Manifestations ◽  
Adaptive Immune System ◽  
Human Leukocyte ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Adaptive Immune

Idiosyncratic drug-induced liver injury (IDILI) remains a significant problem for patients and drug development. The idiosyncratic nature of IDILI makes mechanistic studies difficult, and little is known of its pathogenesis for certain. Circumstantial evidence suggests that most, but not all, IDILI is caused by reactive metabolites of drugs that are bioactivated by cytochromes P450 and other enzymes in the liver. Additionally, there is overwhelming evidence that most IDILI is mediated by the adaptive immune system; one example being the association of IDILI caused by specific drugs with specific human leukocyte antigen (HLA) haplotypes, and this may in part explain the idiosyncratic nature of these reactions. The T cell receptor repertoire likely also contributes to the idiosyncratic nature. Although most of the liver injury is likely mediated by the adaptive immune system, specifically cytotoxic CD8+ T cells, adaptive immune activation first requires an innate immune response to activate antigen presenting cells and produce cytokines required for T cell proliferation. This innate response is likely caused by either a reactive metabolite or some form of cell stress that is clinically silent but not idiosyncratic. If this is true it would make it possible to study the early steps in the immune response that in some patients can lead to IDILI. Other hypotheses have been proposed, such as mitochondrial injury, inhibition of the bile salt export pump, unfolded protein response, and oxidative stress although, in most cases, it is likely that they are also involved in the initiation of an immune response rather than representing a completely separate mechanism. Using the clinical manifestations of liver injury from a number of examples of IDILI-associated drugs, this review aims to summarize and illustrate these mechanistic hypotheses.

Drug Hepatotoxicity

2018 ◽  
Author(s):  
Fernando Bessone ◽  
Raúl J Andrade
Keyword(s):  
Immune System ◽  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Causality Assessment ◽  
Adaptive Immune System ◽  
Genome Wide Association Studies ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Adaptive Immune

Idiosyncratic drug-induced liver injury (DILI) caused by xenobiotics (drugs, herbals, and dietary supplements) is an elusive liver disease presenting with a range of phenotypes and severity, including acute hepatitis that is indistinguishable from viral hepatitis, autoimmune hepatitis, steatosis, fibrosis or rare chronic vascular syndromes, asymptomatic liver test abnormalities,and acute liver failure. Case definition and characterization using liver biochemistry and histology are crucial for appropriate phenotyping. The incidence of DILI is probably higher than expected by the cases that are identified in clinical practice because of misdiagnosis and underreporting.The pathogenesis of DILI is complex, depending on the interaction of a drug’s physicochemical properties and host factors. Genome-wide association studies have identified several alleles from the major histocompatibility complex system, indicating a fundamental role of the adaptive immune system in DILI pathogenesis. As specific biomarkers for hepatotoxicity are still not available, the diagnosis of DILI remains one of exclusion of the alternative causes of liver damage. Structured causality assessment using the Roussel Uclaf Causality Assessment Method (RUCAM) or previously Council for International Organizations of Medical Sciences (CIOMS) instrument adds consistency to the diagnostic process, although there is room for improvement in the scale domains and score weighting. The therapy for idiosyncratic hepatotoxicity is supportive and relies on the prompt withdrawal of the offending agent. Corticosteroid therapy for hypersensitivity reactions or ursodeoxycholicacid for prolonged cholestasis is empirically used, although the degree of evidence is low. Existing databases have enabled a better prediction of immediate and long-term DILI prognosis. Multivariate models have identified clinical and analytical variables as predictive of acute liver failure and mortality as well as of chronic DILI. This review contains 2 figures, 5 tables, and 55 references Key Words: adaptive immune system; causality assessment; drug-induced liver injury; epidemiology; HLA alleles; pharmacogenetics; registries; risk factors

EZH2 Alleviates Antituberculosis Drug-Induced Liver Injury in Mice by Reducing H3K27 Trimethylation at the Nrf2 Promoter

2021 ◽  
Author(s):  
pei shengfei ◽  
luming yang ◽  
lin wang ◽  
xuelei gao ◽  
yu guo ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Liver Injury ◽  
Transcriptional Activation ◽  
Target Genes ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Preventative Measures ◽  
Oxidative Stress Pathway ◽  
Stress Pathway

Abstract BackgroundAnti-tuberculosis drug-induced liver injury (ADLI) limits the treatment of tuberculosis. The mechanisms underlying ADLI are unclear and there are no effective preventative measures to avoid this complication. MethodsIn this stuy, the protein contents of EZH2, Nrf2, NQO1 and HO-1 were detected by ELISA kit, while those of EZH2 and Nrf2 were determined by Western blot. The Chip experiment was used to detect the level of H3K27me3 in the Nrf2 promoter region.The liver were analyzed histopathologically in vivo using hematoxylin and eosin staining.ResultsHere we developed a murine model of ADLI that recapitulates liver injury in the human disease. Using this model, we investigated the potential involvement of the enhancer of zeste homolog 2 methyltransferase (EZH2), a histone methyltransferase which inhibits the transcriptional activation of the Nrf2-ARE oxidative stress pathway. Compared to controls, mice livers with ADLI showed decreased expression of EZH2 together with reduced H3K27me3 marks in the Nrf2 promoter. This was accompanied by increased expression of Nrf2 and its target genes NQO1 and HO-1. Liver injury in the mice with ADLI could be alleviated to an extent by in vivo delivery of siRNAs targeting EZH2, which further downregulated EZH2 expression and H3K27me3 levels in the Nrf2 promoter along with accompanying increases in Nrf2, NQO1 and HO-1 expression. ConclusionsTherefore, inhibiting EZH2 likely reduced liver damage in ADLI by enhancing this key anti-oxidative stress pathway. Our results establish a role for EZH2 in a mouse model of ADLI and furthermore provides valuable mechanistic insights into the development of ADLI pathology.

scholarly journals The chemical, genetic and immunological basis of idiosyncratic drug–induced liver injury

2015 ◽  
Vol 34 (12) ◽  
pp. 1310-1317 ◽  
Author(s):  
A Tailor ◽  
L Faulkner ◽  
DJ Naisbitt ◽  
BK Park
Keyword(s):  
Liver Injury ◽  
Adaptive Immune System ◽  
Idiosyncratic Drug Reactions ◽  
Cellular Mechanisms ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Chemical Genetic ◽  
Adaptive Immune ◽  
Drug Companies

Idiosyncratic drug reactions can be extremely severe and are not accounted for by the regular pharmacology of a drug. Thus, the mechanism of idiosyncratic drug–induced liver injury (iDILI), a phenomenon that occurs with many drugs including β-lactams, anti-tuberculosis drugs and non-steroidal anti-inflammatories, has been difficult to determine and remains a pressing issue for patients and drug companies. Evidence has shown that iDILI is multifactorial and multifaceted, which suggests that multiple cellular mechanisms may be involved. However, a common initiating event has been proposed to be the formation of reactive drug metabolites and covalently bound adducts. Although the fate of these metabolites are unclear, recent evidence has shown a possible link between iDILI and the adaptive immune system. This review highlights the role of reactive metabolites, the recent genetic innovations which have provided molecular targets for iDILI, and the current literature which suggests an immunological basis for iDILI.

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