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  • Saran, ChitraUniv N Carolina, UNC Sch Med, Dept Pharmacol, Chapel Hill, NC 27599 USA.;Univ N Carolina, UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, CB 7569,Kerr Hall, Chapel Hill, NC 27599 USA. (author)

Novel Bile Acid-Dependent Mechanisms of Hepatotoxicity Associated with Tyrosine Kinase Inhibitors

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2021-11-18
  • American Society for Pharmacology & Experimental Therapeutics (ASPET),2022
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-470569
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-470569URI
  • https://doi.org/10.1124/jpet.121.000828DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Drug-induced liver injury (DILI) is the leading cause of acute liver failure and a major concern in drug development. Altered bile acid homeostasis via inhibition of the bile salt export pump (BSEP) is one mechanism of DILI. Dasatinib, pazopanib, and sorafenib are tyrosine kinase inhibitors (TKIs) that competitively inhibit BSEP and increase serum biomarkers for hepatotoxicity in similar to 25-50% of patients. However, the mechanism(s) of hepatotoxicity beyond competitive inhibition of BSEP are poorly understood. This study examined mechanisms of TKI-mediated hepatotoxicity associated with altered bile acid homeostasis. Dasatinib, pazopanib, and sorafenib showed bile acid-dependent toxicity at clinically relevant concentrations, based on the C-DILI assay using sandwich-cultured human hepatocytes (SCHH). Among several bile acid-relevant genes, cytochrome P450 (CYP) 7A1 mRNA was specifically upregulated by 6.2- to 7.8-fold (dasatinib) and 5.7-to 9.3-fold (pazopanib), compared with control, within 8 hours. This was consistent with increased total bile acid concentrations in culture medium up to 2.3-fold, and in SCHH up to 1.4-fold, compared with control, within 24 hours. Additionally, protein abundance of sodium tauro cholate co-transporting polypeptide (NTCP) was increased up to 2.0-fold by these three TKIs. The increase in NTCP protein abundance correlated with increased function; dasatinib and pazopanib increased hepatocyte uptake clearance (CLuptake) of taurocholic acid, a probe bile acid substrate, up to 1.4-fold. In conclusion, upregulation of CYP7A1 and NTCP in SCHH constitute novel mechanisms of TKI-associated hepatotoxicity. SIGNIFICANCE STATEMENT Understanding the mechanisms of hepatotoxicity associated with tyrosine kinase inhibitors (TKIs) is fundamental to development of effective and safe intervention therapies for various cancers. Data generated in sandwich-cultured human hepatocytes, an in vitro model of drug-induced hepatotoxicity, revealed that TKIs upregulate bile acid synthesis and alter bile acid uptake and excretion. These findings provide novel insights into additional mechanisms of bile acid-mediated drug-induced liver injury, an adverse effect that limits the use and effectiveness of TKI treatment in some cancer patients.

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  • Sundqvist, LouiseUppsala universitet,Institutionen för farmaci,Univ N Carolina, UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, CB 7569,Kerr Hall, Chapel Hill, NC 27599 USA. (author)
  • Ho, HenryUniv N Carolina, UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, CB 7569,Kerr Hall, Chapel Hill, NC 27599 USA. (author)
  • Niskanen, JonnaUniv Eastern Finland, Sch Pharm, Kuopio, Finland. (author)
  • Honkakoski, PaavoUniv N Carolina, UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, CB 7569,Kerr Hall, Chapel Hill, NC 27599 USA.;Univ Eastern Finland, Sch Pharm, Kuopio, Finland. (author)
  • Brouwer, Kim L. R.Univ N Carolina, UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, CB 7569,Kerr Hall, Chapel Hill, NC 27599 USA. (author)
  • Univ N Carolina, UNC Sch Med, Dept Pharmacol, Chapel Hill, NC 27599 USA.;Univ N Carolina, UNC Eshelman Sch Pharm, Div Pharmacotherapy & Expt Therapeut, CB 7569,Kerr Hall, Chapel Hill, NC 27599 USA.Institutionen för farmaci (creator_code:org_t)

Related titles

  • In:Journal of Pharmacology and Experimental Therapeutics: American Society for Pharmacology & Experimental Therapeutics (ASPET)380:2, s. 114-1250022-35651521-0103

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