RRC ID 82567
Author Moriyama A, Ueda H, Narumi K, Asano S, Furugen A, Saito Y, Kobayashi M.
Title Contribution of aldehyde oxidase to methotrexate-induced hepatotoxicity: in vitro and pharmacoepidemiological approaches.
Journal Expert Opin Drug Metab Toxicol
Abstract BACKGROUND:Methotrexate (MTX) is partially metabolized by aldehyde oxidase (AOX) in the liver and its clinical impact remains unclear. In this study, we aimed to demonstrate how AOX contributes to MTX-induced hepatotoxicity in vitro and clarify the relationship between concomitant AOX inhibitor use and MTX-associated liver injury development using the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).
METHODS:We assessed intracellular MTX accumulation and cytotoxicity using HepG2 cells. We used the FAERS database to detect reporting odds ratio (ROR)-based MTX-related hepatotoxicity event signals.
RESULTS:AOX inhibition by AOX inhibitor raloxifene and siRNA increased the MTX accumulation in HepG2 cells and enhanced the MTX-induced cell viability reduction. In the FAERS analysis, the ROR for MTX-related hepatotoxicity increased with non-overlap of 95% confidence interval when co-administered with drugs with higher Imax, u (maximum unbound plasma concentration)/IC50 (half-maximal inhibitory concentration for inhibition of AOX) calculated based on reported pharmacokinetic data.
CONCLUSION:AOX inhibition contributed to MTX accumulation in the liver, resulting in increased hepatotoxicity. Our study raises concerns regarding MTX-related hepatotoxicity when co-administered with drugs that possibly inhibit AOX activity at clinical concentrations.
Volume 20(5)
Pages 399-406
Published 2024-5-1
DOI 10.1080/17425255.2024.2352453
PMID 38706380
MeSH Adverse Drug Reaction Reporting Systems* Aldehyde Oxidase* / metabolism Antimetabolites, Antineoplastic / administration & dosage Antimetabolites, Antineoplastic / adverse effects Cell Survival / drug effects Chemical and Drug Induced Liver Injury* / etiology Hep G2 Cells Humans Inhibitory Concentration 50 Methotrexate* / administration & dosage Methotrexate* / adverse effects RNA, Small Interfering / administration & dosage RNA, Small Interfering / pharmacology United States United States Food and Drug Administration
IF 3.47
Resource
Human and Animal Cells Hep G2