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Liver Injury/Regeneration

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Mitochondrial superoxide dismutase and glutathione peroxidase in idiosyncratic drug-induced liver injury†‡

  1. M. Isabel Lucena1,11,§,
  2. Elena García-Martín2,12,
  3. Raúl J. Andrade3,11,¶,*,
  4. Carmen Martínez4,12,
  5. Camilla Stephens1,11,
  6. Jhon D. Ruiz4,12,
  7. Eugenia Ulzurrun1,11,
  8. M. Carmen Fernandez5,
  9. Manuel Romero-Gomez6,11,
  10. Augustin Castiella7,
  11. Ramon Planas8,11,
  12. José Antonio Durán9,
  13. Ana Melcón De Dios9,
  14. Carlos Guarner10,11,
  15. German Soriano10,11,
  16. Yolanda Borraz1,11,
  17. José A. G. Agundez4,12,§

Article first published online: 15 MAR 2010

DOI: 10.1002/hep.23668

Issue

Hepatology

Hepatology

Volume 52, Issue 1, pages 303–312, July 2010

Additional Information

How to Cite

Lucena, M. I., García-Martín, E., Andrade, R. J., Martínez, C., Stephens, C., Ruiz, J. D., Ulzurrun, E., Fernandez, M. C., Romero-Gomez, M., Castiella, A., Planas, R., Durán, J. A., De Dios, A. M., Guarner, C., Soriano, G., Borraz, Y. and Agundez, J. A. G. (2010), Mitochondrial superoxide dismutase and glutathione peroxidase in idiosyncratic drug-induced liver injury. Hepatology, 52: 303–312. doi: 10.1002/hep.23668

Author Information

  1. 1

    Servicio de Farmacología Clínica y Grupo de Estudio para las Hepatopatias Asociadas a Medicamentos, Coordinating Centre, Facultad de Medicina, Hospital Universitario Virgen de la Victoria, Campus Universitario s/n, Málaga, Spain

  2. 2

    Departamento de Bioquímica y Biología Molecular y Genética, Facultad de Ciencias, Universidad de Extremadura, Badajoz, Spain

  3. 3

    Unidad de Hepatología, Grupo de Estudio para las Hepatopatías Asociadas a Medicamentos, Coordinating Centre, Facultad de Medicina, Hospital Universitario Virgen de la Victoria, Campus Universitario de Teatinos s/n, Málaga, Spain

  4. 4

    Departamento de Farmacología, Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain

  5. 5

    Unidad de Farmacología Clínica y Servicio de Aparato Digestivo, Hospital Torrecárdenas, Almeria, Spain

  6. 6

    Unidad de Hepatología, Hospital Universitario de Valme, Sevilla, Spain

  7. 7

    Servicio de Aparato Digestivo, Hospital Mendaro, Guipuzcoa, Spain

  8. 8

    Unidad de Hepatología, Hospital Germans Trias i Puyol, Barcelona, Spain

  9. 9

    Servicio de Farmacología Clínica. Hospital Virgen de la Macarena, Sevilla, Spain

  10. 10

    Servicio de Aparato Digestivo, Hospital San Pau, Barcelona, Spain

  11. 11

    Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)

  12. 12

    Red de Investigación de Reacciones Adversas a Alergenos y Fármacos (RIRAAF)

  1. §

    These authors contributed equally to this work.

  2. fax: (34)-952-131511

*Unidad de Hepatología, Departamento de Medicina, Facultad de Medicina, Boulevard Louis Pasteur, 32, Campus de Teatinos s/n, 29071 Málaga, Spain

  1. †

    Potential conflict of interest: Nothing to report.

  2. ‡

    Participating centers of the Spanish group for the Study of Drug-Induced Liver Disease are listed in Acknowledgment.

  3. §

    These authors contributed equally to this work.

  4. fax: (34)-952-131511

Publication History

  1. Issue published online: 23 JUN 2010
  2. Article first published online: 15 MAR 2010
  3. Manuscript Accepted: 8 MAR 2010
  4. Manuscript Received: 23 DEC 2009

Funded by

  • Spanish Medicine Agency. Grant Numbers: SAS Pl-00082/07, EC 07/90910, FIS 05/1056, 06/1252
  • FUNDESALUD. CIBERehd and RIRAAF. Grant Number: RD07/0064/0016
  • Instituto de Salud Carlos III

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Abstract

Drug-induced liver injury (DILI) susceptibility has a potential genetic basis. We have evaluated possible associations between the risk of developing DILI and common genetic variants of the manganese superoxide dismutase (SOD2 Val16Ala) and glutathione peroxidase (GPX1 Pro200Leu) genes, which are involved in mitochondrial oxidative stress management. Genomic DNA from 185 DILI patients assessed by the Council for International Organizations of Medical Science scale and 270 sex- and age-matched controls were analyzed. The SOD2 and GPX1 genotyping was performed using polymerase chain reaction restriction fragment length polymorphism and TaqMan probed quantitative polymerase chain reaction, respectively. The statistical power to detect the effect of variant alleles with the observed odds ratio (OR) was 98.2% and 99.7% for bilateral association of SOD2 and GPX1, respectively. The SOD2 Ala/Ala genotype was associated with cholestatic/mixed damage (OR = 2.3; 95% confidence interval [CI] = 1.4-3.8; corrected P [Pc] = 0.0058), whereas the GPX1 Leu/Leu genotype was associated with cholestatic injury (OR = 5.1; 95%CI = 1.6-16.0; Pc = 0.0112). The presence of two or more combined risk alleles (SOD2 Ala and GPX1 Leu) was more frequent in DILI patients (OR = 2.1; 95%CI = 1.4-3.0; Pc = 0.0006). Patients with cholestatic/mixed injury induced by mitochondria hazardous drugs were more prone to have the SOD2 Ala/Ala genotype (OR = 3.6; 95%CI = 1.4-9.3; Pc = 0.02). This genotype was also more frequent in cholestatic/mixed DILI induced by pharmaceuticals producing quinone-like or epoxide metabolites (OR = 3.0; 95%CI = 1.7-5.5; Pc = 0.0008) and S-oxides, diazines, nitroanion radicals, or iminium ions (OR = 16.0; 95%CI = 1.8-146.1; Pc = 0.009). Conclusion: Patients homozygous for the SOD2 Ala allele and the GPX1 Leu allele are at higher risk of developing cholestatic DILI. SOD2 Ala homozygotes may be more prone to suffer DILI from drugs that are mitochondria hazardous or produce reactive intermediates. (HEPATOLOGY 2010)

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