Pyrazinamide alleviates rifampin-induced steatohepatitis in mice by regulating the activities of cholesterol-activated 7α-hydroxylase and lipoprotein lipase

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The combination of rifampin and pyrazinamide is commonly used in the clinical treatment of tuberculosis, but its safety needs to be further clarified. Mice were intragastric administration of rifampin 300 mg/kg, pyrazinamide 625 mg/kg, rifampin 300 mg/kg plus pyrazinamide 625 mg/kg. The results showed that rifampin significantly increased transaminases, TBIL and TBA levels in serum, increased TG, TC content, HMGCR and CYP7A1 protein, CYP7A1, FGFR4, PXR, FAS and FXR mRNA expression, but decreased the level of SREBP-1c mRNA and induced severe steatohepatitis and hepatocyte necrosis in liver in mice. While pyrazinamide can improve many abnormal indexes when it used with RFP, including liver histopathology, liver TG, TC level and serum biochemistry, GPHBP1, FAS and CYP7A1 mRNA, LPL protein expression and activity induced by rifampin. However, pyrazinamide alone significantly decreased liver TG levels and caused only slight inflammatory pathological changes in liver histopathology in mice. These data suggested that rifampin increases TG and TC levels in the liver may be related to activate HMGCR, CYP7A1, PXR and FXR, theses toxic actions of rifampin were alleviated by pyrazinamide may be due to inhibite the activity of CYP7A1, PXR and FAS, and increasing the LPL protein expression and activity.