Literature DB >> 23701583

Role of chemical structures and the 1331T>C bile salt export pump polymorphism in idiosyncratic drug-induced liver injury.

Eugenia Ulzurrun1, Camilla Stephens, Esperanza Crespo, Francisco Ruiz-Cabello, Julia Ruiz-Nuñez, Pablo Saenz-López, Inmaculada Moreno-Herrera, Mercedes Robles-Díaz, Hacibe Hallal, José M Moreno-Planas, Maria R Cabello, M Isabel Lucena, Raúl J Andrade.   

Abstract

BACKGROUND & AIMS: Several pharmaceutical compounds have been shown to exert inhibitory effects on the bile salt export pump (BSEP) encoded by the ABCB11 gene. We analysed the combined effect on drug-induced liver injury (DILI) development of the ABCB11 1331T>C polymorphism and the presence of specific chemical moieties, with known BSEP inhibiting properties, in the causative drug.
METHODS: Genotyping using a TaqMan 5' allelic discrimination assay was performed in 188 Spanish DILI patients, 219 healthy controls and 91 sex-, age- and drug-matched controls. A chemical structure analysis was performed for each individual causative drug.
RESULTS: The CC genotype was significantly associated with hepatocellular damage [odds ratio (OR) = 2.1, P = 0.001], particularly in NSAID DILI cases (OR = 3.4, P = 0.007). In addition, the CC genotype was found to be significantly linked to DILI development from drugs causing <50% BSEP inhibition (OR = 1.8, Pc = 0.011). Of the BSEP inhibitory chemical moieties, 59% of the causative drugs contained a carbocyclic system with at least one aromatic ring, corresponding to 61% of the total cases. The C allele was significantly more frequent in DILI cases containing this chemical moiety, which appear to be conditioned on the ABCB11 1331T>C polymorphism in the absence of other BSEP inhibitory structures.
CONCLUSION: Patients carrying the C allele in the ABCB11 1331T>C polymorphism are at increased risk of developing hepatocellular type of DILI, when taking drugs containing a carbocyclic system with aromatic rings.
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Entities:  

Keywords:  ABCB11; aromatic ring structure; canalicular transporter; hepatotoxicity; pharmacogenetics

Mesh:

Substances:

Year:  2013        PMID: 23701583     DOI: 10.1111/liv.12193

Source DB:  PubMed          Journal:  Liver Int        ISSN: 1478-3223            Impact factor:   5.828


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