RT Journal Article
SR Electronic
T1 The 2-Hydroxyiminostilbene Metabolite of Carbamazepine or the Supernatant from Incubation of Hepatocytes with Carbamazepine Activates Inflammasomes; Implications for Carbamazepine-induced Hypersensitivity Reactions
JF Drug Metabolism and Disposition
JO Drug Metab Dispos
FD American Society for Pharmacology and Experimental Therapeutics
SP dmd.119.087981
DO 10.1124/dmd.119.087981
A1 Ryuji Kato
A1 Yoshio Ijiri
A1 Tetsuya Hayashi
A1 Jack Uetrecht
YR 2019
UL http://dmd.aspetjournals.org/content/early/2019/07/18/dmd.119.087981.abstract
AB Although the pathophysiology of carbamazepine-induced idiosyncratic or hypersensitivity reactions is unclear, they are presumed to be immune mediated involving a complex interaction between drug metabolism and activation of the immune system. Cell stress can be caused by reactive metabolites and this has the potential to release damage-associated molecular patterns (DAMPs), which are responsible for activation of the immune system. The reason that idiosyncratic drug reactions occur mainly in the liver is because of its role in drug metabolism and reactive metabolite formation. DAMPs can activate inflammasomes, which may be a common mechanism by which DAMPs lead to an immune response. In the present study, we investigated whether carbamazepine induces the release of DAMPs by using human hepatocarcinoma functional liver cell-4 (FLC-4) cells for bioactivation of carbamazepine. The human macrophage cell line, THP-1 cells were used for detecting inflammasome activation. We found that increased caspase-1 activity and production of IL-1β by THP-1 cells were caused by the supernatant from the incubation of carbamazepine with FLC-4 cells. In the supernatant, heat shock protein 60 was significantly increased. In addition, 2-hydroxyiminostilbene, which is a metabolite of carbamazepine, activated inflammasomes. These results suggest that the reactive iminoquinone metabolite can directly activate inflammasomes or stressed hepatocytes cause the release of DAMPs, which are responsible for inflammasome activation. The activation of inflammasomes may be an important step in the immune system activation by carbamazepine, which can lead to hypersensitivity reactions in some patients.SIGNIFICANCE STATEMENT A metabolite of carbamazepine, 2-hydroxyiminostilbene itself, and the damage-associated molecular patterns released from hepatocytes incubated with carbamazepine activated inflammasomes. The activation of inflammasomes may be an important step in the immune system activation by carbamazepine, which can lead to hypersensitivity reactions in some patients.