Department of Zoology, Panjab University, Chandigarh, 160014, India.
Department of Zoology, Panjab University, Chandigarh, 160014, India.
J Ethnopharmacol. 2021 Apr 24;270:113771. doi: 10.1016/j.jep.2020.113771. Epub 2020 Dec 31.
Adhatoda vasica Nees is widely used herb of indigenous system to treat various ailments especially upper respiratory tract infections. Not only, anti-tubercular efficacy of crude extract and phytoconstituents of A. vasica has been documented but its hepatoprotective role against various drugs mediated hepatic alterations in different animal models has also been observed.
Isoniazid, rifampicin and pyrazinamide (H-R-Z) are anti-tubercular drugs normally prescribed by health professionals for the treatment of tuberculosis, however along with their medical effectiveness these drugs also exhibit hepatotoxicity among TB patients. Unexpectedly, substantial toxicological data on the metabolism of anti-TB drugs are available but the mystery behind these xenobiotics is too complex and partly implicit. In this study, we further explored the hepatotoxic effects of these xeno-metabolic products and their amelioration by Adhatoda vasica Nees by elucidating its mechanistic action.
We generated a hepatotoxic rodent model by oral administration of H, R and Z (30.85, 61.7 and 132.65 mg/kg body weight) drugs for 25 days in Wistar rats. Additionally, to achieve hepatoprotection two different doses of Adhatoda vasica Nees ethanolic leaf extract (200 and 300 mg/kg body weight) were used along with H-R-Z dosage, orally and once daily for 25 days and tried to ascertain their mechanistic action. For this, initially phytoconstituents of the extract were evaluated followed by extract standardization using RP-HPLC and FTIR methods. Furthermore, antioxidant activity of the extract was analyzed by DPPH assay. Finally, different treated groups were analyzed for hepatic oxidative stress markers, antioxidant markers, histopathological changes and gene expression study including CYP2E1, CYP7A1, NAT, NR1I2 and UGT1A1 genes involved in phase I and phase II xeno-metabolism.
Estimated content of vasicine in RP-HPLC method and free-radical scavenging activity in DPPH assay was found to be 134.519 ± 0.00269μg/10mg of leaf extract and 47.81 μg/mL respectively. In H-R-Z treated group, a significant increase in the levels of thiobarbituric acid, significant reduction in the levels of GSH, and enzymatic markers and marked changes in hepatic histological architecture were observed. In addition, there was significance up-regulation of CYP7A and NAT genes, down-regulation of CYP2E1 gene and insignificant expression levels of NR1I2 and UGT1A1 genes were observed in H-R-Z group. Conversely, high dose of A. vasica extract effectively diminished these alterations by declining oxidative stress and boosting of antioxidant levels. In addition, it acted as bi-functional inducer of both phase I (CYP2E1) and phase II (NAT and UGT1A1) enzyme systems.
Hence, we concluded that anti-TB drugs exposure has potential to generate reactive metabolites that eventually cause hepatotoxicity by altering oxidant-antioxidant levels and their own metabolism. This study not only emphasized on xeno-metabolism mediated hepatic alterations but also explore the benefit of A. vasica on these toxic insults.
Adhatoda vasica Nees 是一种广泛应用于本土系统的草药,用于治疗各种疾病,特别是上呼吸道感染。不仅如此,Adhatoda vasica 的粗提取物和植物成分已被证明具有抗结核功效,而且在不同动物模型中,其对各种药物介导的肝改变也具有保肝作用。
异烟肼、利福平、吡嗪酰胺(H-R-Z)是抗结核药物,通常由卫生专业人员用于治疗肺结核,然而,这些药物除了具有医疗效果外,还会在结核病患者中引起肝毒性。令人惊讶的是,关于抗结核药物代谢的大量毒理学数据是可用的,但这些外源性物质的背后的机制太复杂,部分是隐含的。在这项研究中,我们通过阐明其机制作用,进一步探讨了这些外源性代谢产物的肝毒性及其 Adhatoda vasica Nees 的改善作用。
我们通过给 Wistar 大鼠口服 H、R 和 Z(30.85、61.7 和 132.65mg/kg 体重)药物 25 天,生成了一种肝毒性啮齿动物模型。此外,为了实现保肝作用,我们使用了两种不同剂量的 Adhatoda vasica Nees 叶乙醇提取物(200 和 300mg/kg 体重),与 H-R-Z 剂量一起口服,每天一次,共 25 天,并试图确定其机制作用。为此,我们首先评估了提取物中的植物成分,然后使用 RP-HPLC 和 FTIR 方法对提取物进行标准化。此外,我们还通过 DPPH 测定法分析了提取物的抗氧化活性。最后,对不同处理组的肝氧化应激标志物、抗氧化标志物、组织病理学变化和 CYP2E1、CYP7A1、NAT、NR1I2 和 UGT1A1 基因的表达研究进行了分析,这些基因参与了 I 相和 II 相的外源性代谢。
在 RP-HPLC 方法中估计的 vasicine 含量和 DPPH 测定中的自由基清除活性分别为 134.519±0.00269μg/10mg 叶提取物和 47.81μg/mL。在 H-R-Z 处理组中,观察到丙二醛含量显著增加,GSH 水平显著降低,以及酶标记物和肝组织学结构的明显变化。此外,在 H-R-Z 组中观察到 CYP7A 和 NAT 基因的显著上调,CYP2E1 基因的下调,以及 NR1I2 和 UGT1A1 基因的无意义表达水平。相反,高剂量的 A. vasica 提取物通过降低氧化应激和提高抗氧化水平有效减轻了这些变化。此外,它作为 I 相(CYP2E1)和 II 相(NAT 和 UGT1A1)酶系统的双功能诱导剂发挥作用。
因此,我们得出结论,抗结核药物暴露有可能产生活性代谢物,通过改变氧化应激和自身代谢水平,最终导致肝毒性。本研究不仅强调了外源性代谢物介导的肝改变,还探讨了 A. vasica 对这些毒性损伤的益处。