Abstract

Assessing the potential of a new drug to cause drug-induced liver injury (DILI) is a challenge for the pharmaceutical industry. We therefore determined whether cell models currently used in safety assessment (HepG2, HepaRG, Upcyte and primary human hepatocytes in conjunction with basic but commonly used endpoints) are actually able to distinguish between novel chemical entities (NCEs) with respect to their potential to cause DILI. A panel of thirteen compounds (nine DILI implicated and four non-DILI implicated in man) were selected for our study, which was conducted, for the first time, across multiple laboratories. None of the cell models could distinguish faithfully between DILI and non-DILI compounds. Only when nominal in vitro concentrations were adjusted for in vivo exposure levels were primary human hepatocytes (PHH) found to be the most accurate cell model, closely followed by HepG2. From a practical perspective, this study revealed significant inter-laboratory variation in the response of PHH, HepG2 and Upcyte cells, but not HepaRG cells. This variation was also observed to be compound dependent. Interestingly, differences between donors (hepatocytes), clones (HepG2) and the effect of cryopreservation (HepaRG and hepatocytes) were less important than differences between the cell models per se. In summary, these results demonstrate that basic cell health endpoints will not predict hepatotoxic risk in simple hepatic cells in the absence of pharmacokinetic data and that a multicenter assessment of more sophisticated signals of molecular initiating events is required to determine whether these cells can be incorporated in early safety assessment.

Highlights

  • Drug-induced liver injury (DILI) poses a serious issue for patients and healthcare professionals, and for the pharmaceutical industry and regulatory authorities

  • Nine compounds that are associated with human DILI and four that are not (Table 4) were investigated using four simple cell types: primary human hepatocytes (PHH), HepG2, HepaRG and Upcyte cells

  • We conducted a comprehensive and unbiased acute cytotoxicity assessment of four cell models (PHH, HepG2, HepaRG and Upcyte cells, in conjunction with basic measures of cell health, namely ATP and resorufin) that are currently used in industry as part of a testing strategy to determine DILI risk

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Summary

Introduction

Drug-induced liver injury (DILI) poses a serious issue for patients and healthcare professionals, and for the pharmaceutical industry and regulatory authorities This is mainly due to the occurrence of human-specific and idiosyncratic adverse reactions at the clinical and post-marketing stages, leading to the termination of drug development, black box warnings or even withdrawal of drugs from the market (Bell and Chalasani 2009; Marino et al 2001). In vitro models, such as the human hepatocarcinoma cell line HepG2, are widely used across the pharmaceutical and chemical industries, as an initial screen to determine the likely risk of new chemical entities (NCEs) eliciting DILI in man. PHH cultured in vitro are still considered to be useful in the testing paradigm, as the nearest representation of the key metabolically active cell of the liver

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