Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis

Introduction. Liver damage can be a dangerous side effect of using isoniazid. Individual susceptibility to isoniazid in humans is dependent on the presence of N-acetyltransferase 2 allelic variants in genome. It was imperative to assess the effect of genetically determined isoniazid acetylation rate...

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Main Authors: N. M. Krasnova, N. E. Evdokimova, A. A. Egorova, O. I. Filippova, E. A. Alekseeva, Z. A. Rudykh, Ya. V. Chertovskykh, A. I. Vengerovskii, A. F. Kravchenko, D. A. Sychev
Format: Article
Language:Russian
Published: LLC "Publishing House OKI" 2020-11-01
Series:Антибиотики и Химиотерапия
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Online Access:https://www.antibiotics-chemotherapy.ru/jour/article/view/751
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author N. M. Krasnova
N. E. Evdokimova
A. A. Egorova
O. I. Filippova
E. A. Alekseeva
Z. A. Rudykh
Ya. V. Chertovskykh
A. I. Vengerovskii
A. F. Kravchenko
D. A. Sychev
author_facet N. M. Krasnova
N. E. Evdokimova
A. A. Egorova
O. I. Filippova
E. A. Alekseeva
Z. A. Rudykh
Ya. V. Chertovskykh
A. I. Vengerovskii
A. F. Kravchenko
D. A. Sychev
author_sort N. M. Krasnova
collection DOAJ
description Introduction. Liver damage can be a dangerous side effect of using isoniazid. Individual susceptibility to isoniazid in humans is dependent on the presence of N-acetyltransferase 2 allelic variants in genome. It was imperative to assess the effect of genetically determined isoniazid acetylation rate in terms of risk of developing isoniazid-induced hepatotoxicity, as well as prevention of potential hepatopathy, and improvement of tuberculosis chemotherapy safety. Aim. To study the effect of acetylation type on the incidence of isoniazid hepatotoxicity in residents of the Sakha Republic (Yakutia) with newly diagnosed pulmonary tuberculosis. Methods. The study included 112 patients with newly diagnosed pulmonary tuberculosis. Genotyping was performed using real-time polymerase chain reaction. The following single nucleotide polymorphisms were studied: rs1801280, rs1799930, rs1799931, rs1799929, rs1208, rs1041983. Hepatotoxicity was determined based on the results of clinical laboratory monitoring and using the criteria developed by the European Association for the Study of the Liver (2019). Results. Hepatotoxic reactions developed more often in slow acetylators (43.2%), compared to fast acetylators (20.7%) and intermediate acetylators (10.9%); p=0.002. Serum alanine aminotransferase activity was 5 or more times above the upper limit of normal activity in 37.8% of slow acetylators, and in 8.7% of intermediate acetylators; p=0.001. Clinical manifestations of isoniazid hepatotoxicity were observed more often in slow acetylators (29.7%), than in fast acetylators (3.4%); p=0.000. Conclusion. Slow acetylation type ought to be considered an important risk factor for developing isoniazid hepatotoxicity in patients with pulmonary tuberculosis.
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spelling doaj-art-ca02c6044cb84284ba0a6f3415f262a32025-08-20T03:42:00ZrusLLC "Publishing House OKI"Антибиотики и Химиотерапия0235-29902020-11-01657-8313610.37489/0235-2990-2020-65-7-8-31-36738Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary TuberculosisN. M. Krasnova0N. E. Evdokimova1A. A. Egorova2O. I. Filippova3E. A. Alekseeva4Z. A. Rudykh5Ya. V. Chertovskykh6A. I. Vengerovskii7A. F. Kravchenko8D. A. Sychev9M. K. Ammosov North-Eastern Federal UniversityPhthisiatry Research-Practice CenterPhthisiatry Research-Practice CenterPhthisiatry Research-Practice CenterRepublican Hospital no. 3Republican Hospital no. 3Republican Hospital no. 3Siberian State Medical UniversityPhthisiatry Research-Practice CenterRussian Medical Academy of Continuous Professional EducationIntroduction. Liver damage can be a dangerous side effect of using isoniazid. Individual susceptibility to isoniazid in humans is dependent on the presence of N-acetyltransferase 2 allelic variants in genome. It was imperative to assess the effect of genetically determined isoniazid acetylation rate in terms of risk of developing isoniazid-induced hepatotoxicity, as well as prevention of potential hepatopathy, and improvement of tuberculosis chemotherapy safety. Aim. To study the effect of acetylation type on the incidence of isoniazid hepatotoxicity in residents of the Sakha Republic (Yakutia) with newly diagnosed pulmonary tuberculosis. Methods. The study included 112 patients with newly diagnosed pulmonary tuberculosis. Genotyping was performed using real-time polymerase chain reaction. The following single nucleotide polymorphisms were studied: rs1801280, rs1799930, rs1799931, rs1799929, rs1208, rs1041983. Hepatotoxicity was determined based on the results of clinical laboratory monitoring and using the criteria developed by the European Association for the Study of the Liver (2019). Results. Hepatotoxic reactions developed more often in slow acetylators (43.2%), compared to fast acetylators (20.7%) and intermediate acetylators (10.9%); p=0.002. Serum alanine aminotransferase activity was 5 or more times above the upper limit of normal activity in 37.8% of slow acetylators, and in 8.7% of intermediate acetylators; p=0.001. Clinical manifestations of isoniazid hepatotoxicity were observed more often in slow acetylators (29.7%), than in fast acetylators (3.4%); p=0.000. Conclusion. Slow acetylation type ought to be considered an important risk factor for developing isoniazid hepatotoxicity in patients with pulmonary tuberculosis.https://www.antibiotics-chemotherapy.ru/jour/article/view/751tuberculosisisoniazidn-acetyltransferase 2acetylation typeshepatotoxicity
spellingShingle N. M. Krasnova
N. E. Evdokimova
A. A. Egorova
O. I. Filippova
E. A. Alekseeva
Z. A. Rudykh
Ya. V. Chertovskykh
A. I. Vengerovskii
A. F. Kravchenko
D. A. Sychev
Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis
Антибиотики и Химиотерапия
tuberculosis
isoniazid
n-acetyltransferase 2
acetylation types
hepatotoxicity
title Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis
title_full Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis
title_fullStr Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis
title_full_unstemmed Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis
title_short Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis
title_sort influence of the acetylation type on the incidence of isoniazid induced hepatotoxicity in patients with newly diagnosed pulmonary tuberculosis
topic tuberculosis
isoniazid
n-acetyltransferase 2
acetylation types
hepatotoxicity
url https://www.antibiotics-chemotherapy.ru/jour/article/view/751
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