Identifying Drug-Induced Liver Injury Associated With Inflammation-Drug and Drug-Drug Interactions in Pharmacologic Treatments for COVID-19 by Bioinformatics and System Biology Analyses : The Role of Pregnane X Receptor

Copyright © 2022 Huang, Zhang, Hao, Qiu, Tan, Liu, Wang, Yang and Qu..

Of the patients infected with coronavirus disease 2019 (COVID-19), approximately 14-53% developed liver injury resulting in poor outcomes. Drug-induced liver injury (DILI) is the primary cause of liver injury in COVID-19 patients. In this study, we elucidated liver injury mechanism induced by drugs of pharmacologic treatments against SARS-CoV-2 (DPTS) using bioinformatics and systems biology. Totally, 1209 genes directly related to 216 DPTS (DPTSGs) were genes encoding pharmacokinetics and therapeutic targets of DPTS and enriched in the pathways related to drug metabolism of CYP450s, pregnane X receptor (PXR), and COVID-19 adverse outcome. A network, constructed by 110 candidate targets which were the shared part of DPTSGs and 445 DILI targets, identified 49 key targets and four Molecular Complex Detection clusters. Enrichment results revealed that the 4 clusters were related to inflammatory responses, CYP450s regulated by PXR, NRF2-regualted oxidative stress, and HLA-related adaptive immunity respectively. In cluster 1, IL6, IL1B, TNF, and CCL2 of the top ten key targets were enriched in COVID-19 adverse outcomes pathway, indicating the exacerbation of COVID-19 inflammation on DILI. PXR-CYP3A4 expression of cluster 2 caused DILI through inflammation-drug interaction and drug-drug interactions among pharmaco-immunomodulatory agents, including tocilizumab, glucocorticoids (dexamethasone, methylprednisolone, and hydrocortisone), and ritonavir. NRF2 of cluster 3 and HLA targets of cluster four promoted DILI, being related to ritonavir/glucocorticoids and clavulanate/vancomycin. This study showed the pivotal role of PXR associated with inflammation-drug and drug-drug interactions on DILI and highlighted the cautious clinical decision-making for pharmacotherapy to avoid DILI in the treatment of COVID-19 patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:13

Enthalten in:

Frontiers in pharmacology - 13(2022) vom: 20., Seite 804189

Sprache:

Englisch

Beteiligte Personen:

Huang, Jingjing [VerfasserIn]
Zhang, Zhaokang [VerfasserIn]
Hao, Chenxia [VerfasserIn]
Qiu, Yuzhen [VerfasserIn]
Tan, Ruoming [VerfasserIn]
Liu, Jialin [VerfasserIn]
Wang, Xiaoli [VerfasserIn]
Yang, Wanhua [VerfasserIn]
Qu, Hongping [VerfasserIn]

Links:

Volltext

Themen:

COVID-19
Drug induced liver injury
Drug-drug interactions
Inflammation-drug interactions
Journal Article
PXR
SARS-CoV-2

Anmerkungen:

Date Revised 19.08.2022

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.3389/fphar.2022.804189

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM344978494