Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ege University, İzmir, Turkey.
Toxicol Lett. 2024 Oct;400:71-80. doi: 10.1016/j.toxlet.2024.08.007. Epub 2024 Aug 10.
New generation BCR-ABL1 TKIs raised attention regarding their adverse effects, including hepatotoxicity. Indeed, bosutinib and nilotinib were associated with severe hepatotoxicity compared with imatinib. Moreover, ponatinib has a boxed warning due to its potential to cause inflammatory liver damage, even death. However, the underlying mechanisms remain unclear. This study aimed to investigate the role of NLRP3 inflammasome activation in the underlying mechanism of ponatinib and bosutinib-induced hepatotoxicity. Furthermore, we determined the initiating event of this adverse outcome pathway by measuring the levels of reactive oxygen species as well as mitochondrial membrane potential in AML12 cells. The results demonstrated that ponatinib or bosutinib markedly inhibited cell viability and caused cytosolic membrane damage in cells. Moreover, drugs (IC) dramatically induced oxidative stress and mitochondrial membrane potential disruption, which led to upregulation in the expression levels of NLRP3 inflammasome-related genes and proteins, activation of NLRP3 inflammasomes, cleavage of gasdermin-D and caspase-1, secretion of IL-1β, and cytosolic membrane damage. Furthermore, MCC950, a well-known specific inhibitor of NLRP3 inflammasome, and antioxidant N-acetyl-l-cysteine reversed the effects of drugs on the NLRP3 signaling pathway and cytosolic membranes. In summary, NLRP3 inflammasome activation is involved in new-generation BCR-ABL1 TKIs-triggered hepatotoxicity. Mitochondrial damage and reactive oxygen species accumulation were significant upstream signaling events in this signaling pathway.
新一代 BCR-ABL1 TKI 因其不良反应引起了关注,包括肝毒性。事实上,与伊马替尼相比,博舒替尼和尼罗替尼与严重肝毒性相关。此外,由于其导致炎症性肝损伤甚至死亡的潜在风险,ponatinib 被列为黑框警告药物。然而,其潜在机制尚不清楚。本研究旨在探讨 NLRP3 炎性小体激活在 ponatinib 和 bosutinib 诱导肝毒性的潜在机制中的作用。此外,我们通过测量 AML12 细胞中活性氧和线粒体膜电位的水平来确定该不良反应途径的起始事件。结果表明,ponatinib 或 bosutinib 显著抑制细胞活力,并导致细胞胞质膜损伤。此外,药物(IC)显著诱导氧化应激和线粒体膜电位破坏,导致 NLRP3 炎性小体相关基因和蛋白表达水平上调,NLRP3 炎性小体激活,gasdermin-D 和 caspase-1 裂解,IL-1β 分泌和胞质膜损伤。此外,NLRP3 炎性小体的特异性抑制剂 MCC950 和抗氧化剂 N-乙酰-l-半胱氨酸逆转了药物对 NLRP3 信号通路和胞质膜的影响。总之,NLRP3 炎性小体激活参与了新一代 BCR-ABL1 TKI 触发的肝毒性。线粒体损伤和活性氧积累是该信号通路中的重要上游信号事件。