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Research Report 1: The role of glutathione in idiosyncratic and non-idiosyncratic drug induced liver injury

Starokozhko, V. (2013) Research Report 1: The role of glutathione in idiosyncratic and non-idiosyncratic drug induced liver injury. Master's Thesis / Essay, Biology.

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Introduction: The probability of idiosyncratic drug-induced liver injury (IDILI) occurrence is defined as a rare combination of several events at the same time, such as chemical properties of the drug, toxicant exposure, environmental and genetic factors. In the present study, we addressed the interaction of drugs and an environmental factor. It is known that different environmental factors can enhance the probability of IDILI: tobacco, alcohol consumption, diet, pre-existing diseases, viral or bacterial infections, etc. Accordingly, the aim of this study was to investigate the effect of an inflammatory agent, lipopolysaccharide (LPS), on the redox cellular homeostasis and to discover the role of glutathione in IDILI manifestation. Material and Methods: Mouse and human precision-cut liver slices (PCLS) were incubated for 24 h with acetaminophen (APAP) and its isomer 3’-hydroxyacetanilide (AMAP), different IDILI-related drugs: diclofenac (DF), ketoconazole (KT), clozapine (CZ), carbamazepine (CBZ), troglitazone (TGZ); and two non-toxic comparator drugs of KT and CZ, voriconazole (VC) and olanzapine (OZ) respectively, in the absence or presence of LPS. Furthermore, drugs, that did not reveal synergistic toxicity with LPS following 24 h incubation of mouse PCLS, were tested for 48 h. Viability of PCLS was assessed by means of total and reduced (GSH) glutathione levels, GSH/GSSG ratio, ATP content and LDH leakage from PCLS to incubation media. Results: AMAP was shown to be less toxic in mouse PCLS than APAP, while in human PCLS, AMAP revealed higher toxicity in comparison with APAP. It was shown that LPS by itself noticeably but not significantly increased total glutathione and GSH levels in mouse PCLS after 24 h incubation, which was not found after 48 h. Statistically significant synergistic toxicity was observed when mouse PCLS were incubated for 24 h with KT+LPS and CZ+LPS with a decline in glutathione level, and for 48 h with TGZ+LPS without changes in glutathione level. Similar results were demonstrated with human PCLS after 24 h incubation: supra-additive toxicity with a decline in glutathione level was shown in KT+LPS-/CZ+LPS-treated groups, though it was not found to be statistically significant. Discussion: The maintenance of a glutathione level under conditions of mild liver injury after LPS exposure is possibly caused by the up-regulated production of reducing power, NADPH, and/or induction of glutathione synthesis de novo. Different molecular mechanisms seem to be responsible for IDILI development. Accordingly, glutathione was shown to play a role in KT and CZ synergistic hepatotoxicity, while TGZ-induced toxicity appears to be independent of the antioxidant status and glutathione level. The present study demonstrated once more, that inflammation can play a vital role in IDILI development. Additionally, it was shown, that glutathione content may be regarded as a potential novel biomarker for certain IDILI prediction and prevention.

Item Type: Thesis (Master's Thesis / Essay)
Degree programme: Biology
Thesis type: Master's Thesis / Essay
Language: English
Date Deposited: 15 Feb 2018 07:52
Last Modified: 15 Feb 2018 07:52

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