Abstract

Isoniazid (INH) and Rifampicin (RFP) are widely used in the world for the treatment of tuberculosis, but the hepatotoxicity is a major concern during clinical therapy. Previous studies showed that these drugs induced oxidative stress in liver, and several antioxidants abated this effect. Metallothionein (MT), a member of cysteine-rich protein, has been proposed as a potent antioxidant. This study attempts to determine whether endogenous expression of MT protects against INH and RFP-induced hepatic oxidative stress in mice. Wild type (MT+/+) and MT-null (MT−/−) mice were treated intragastrically with INH (150 mg/kg), RFP (300 mg/kg), or the combination (150 mg/kg INH +300 mg/kg RFP) for 21 days. The results showed that MT−/− mice were more sensitive than MT+/+ mice to INH and RFP-induced hepatic injuries as evidenced by hepatic histopathological alterations, increased serum AST levels and liver index, and hepatic oxidative stress as evidenced by the increase of MDA production and the change of liver antioxidant status. Furthermore, INH increased the protein expression of hepatic CYP2E1 and INH/RFP (alone or in combination) decreased the expression of hepatic CYP1A2. These findings clearly demonstrate that basal MT provides protection against INH and RFP-induced toxicity in hepatocytes. The CYP2E1 and CYP1A2 were involved in the pathogenesis of INH and RFP-induced hepatotoxicity.

Highlights

  • Tuberculosis (TB) is an airborne infectious disease and remains one of the major public health problems in the world today

  • Co-administration of RFP with INH dramatically increased the concentration of AST and liver index in MT2/2 mice compared to control group

  • Metushi et al found that INH itself can be oxidized to a reactive metabolite that covalently binds to mouse and human hepatic proteins, and INH-induced liver injury is immune-mediated [36]

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Summary

Introduction

Tuberculosis (TB) is an airborne infectious disease and remains one of the major public health problems in the world today. Isoniazid (INH) and Rifampicin (RFP) are first-line drugs for anti-TB therapy, but the hepatotoxicity that results from use of these drugs remains a significant problem for clinical treatment [2]. Acetylhydrazine and hydrazine might be oxidized by CYPs to form hepatotoxic intermediates [4]. Human genetic studies have shown that CYP2E1 is involved in INH-related hepatotoxicity [5]. RFP is a complex macrocyclic antibiotic that inhibits ribonucleic acid synthesis in a broad range of microbial pathogens. It has bactericidal action and a potent sterilizing effect against tubercle bacilli in both cellular and extracellular locations. Various forms of CYP, such as CYP1A1, CYP1A2 and CYP2E1, are involved in free radical generation and RFP-

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