Mitomycin, 5-fluorouracil, leflunomide, and mycophenolic acid directly promote hepatitis B virus replication and expression in vitro

BACKGROUND: Reactivation of hepatitis B virus is a common complication that occurs in patients with hepatitis B virus (HBV) infection who have received cytotoxic chemotherapy or immunosuppressive therapy. This clinical phenomenon not only occurs in overt HBV infection patients but also occurs in patients with resolved HBV infection. Previous research has confirmed that epirubicin and dexamethasone can stimulate HBV replication and expression directly rather than indirectly through immunosuppression. Mitomycin and 5-fluorouracil are currently used as cytotoxic chemotherapy drugs for cancer patients. Leflunomide and mycophenolic acid are regarded as immunosuppressants for autoimmune diseases, and numerous clinical studies have reported that these drugs can reactivate HBV replication. In this study, we aimed to investigate whether mitomycin, 5-fluorouracil, leflunomide and mycophenolic acid induce HBV reactivation directly rather than indirectly through immunosuppression.

METHODS: To observe the effect of mitomycin, 5-fluorouracil, leflunomide and mycophenolic acid on HBV replication and expression, we employed HepG2.2.15 and HBV-NLuc-35 cells as a cell model. Next, by native agarose gel electrophoresis (NAGE), quantitative PCR (qPCR), luciferase assay and HBV e antigen (HBeAg) enzyme-linked immunosorbent assay (ELISA) we detected changes in HBV replication and expression induced by these drugs. We also investigated whether lamivudine could inhibit the observed phenotype. SPSS 18.0 software was employed for statistical analysis, One-way ANOVA was used to compare multiple groups.

RESULTS: Expression of HBV capsids and HBeAg in HepG2.2.15 cells was increased by increasing concentration of mitomycin, 5-fluorouracil, leflunomide, and mycophenolic acid. This phenomenon was also demonstrated in HBV-NLuc-35 cells, and the expression of capsids and luciferase activity increased in the same concentration-dependent manner. Replication levels of intracellular capsid DNA and extracellular HBV DNA in HepG2.2.15 cells gradually increased in a dose-dependent manner. In addition, although epirubicin, mitomycin, 5-fluorouracil, dexamethasone, leflunomide and mycophenolic acid enhanced HBV replication, lamivudine inhibited this process.

CONCLUSION: Our study confirmed that mitomycin, 5-fluorouracil, leflunomide and mycophenolic acid directly upregulated HBV replication and expression in vitro. This effect was investigated not only in HepG2.2.15 cells but also in the HBV-NLuc-35 replication system. Moreover, this effect could be prevented by nucleoside analogs, such as lamivudine (LAM). Thus, for patients with HBV infection, prophylactic antiviral therapy is necessary before receiving cytotoxic chemotherapy or immunosuppressive therapy.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:17

Enthalten in:

Virology journal - 17(2020), 1 vom: 01. Juli, Seite 89

Sprache:

Englisch

Beteiligte Personen:

Ruan, Jie [VerfasserIn]
Sun, Shuo [VerfasserIn]
Cheng, Xin [VerfasserIn]
Han, Pengyu [VerfasserIn]
Zhang, Yinge [VerfasserIn]
Sun, Dianxing [VerfasserIn]

Links:

Volltext

Themen:

5-fluorouracil
50SG953SK6
Antineoplastic Agents
Fluorouracil
G162GK9U4W
HU9DX48N0T
Hepatitis B e Antigens
Immunosuppressive Agents
Journal Article
Lamivudine
Leflunomide
Mitomycin
Mycophenolic Acid
Mycophenolic acid
Reactivation of hepatitis B virus; Mitomycin
Research Support, Non-U.S. Gov't
U3P01618RT

Anmerkungen:

Date Completed 08.04.2021

Date Revised 08.04.2021

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12985-020-01339-5

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM311892841