Abstract
Morphological and metabolic aberrations in the liver caused by long-term use of anti-tubercular agent isoniazid (INH) have been an issue of great concern in tuberculosis treatment. To resolve this issue, a novel hepatoprotective prodrug strategy was developed by combining the antioxidant property of phenolic acids with INH moiety for probable synergistic effect. In this work, INH was conjugated with phenolic antioxidants using Schotten-Baumann reaction through biocleavable amide linkage. Synthesized prodrugs were characterized by spectral analysis and in vitro release studies were carried out using HPLC. They were found to be stable in acidic (pH 1.2), basic (pH 7.4) buffers, stomach homogenates of rat whereas hydrolyzed significantly (56.03–88.62%) in intestinal homogenates over a period of 6 h. Further their hepatoprotective potential was evaluated in male Wistar rats by performing liver function tests, oxidative stress markers, and histopathology studies. All the prodrugs were effective in abating oxidative stress and re-establishing normal hepatic physiology. Especially the effect of prodrugs of INH with gallic acid and syringic acid in restoring levels of enzymes superoxide dismutase and glutathione peroxidase and abrogating liver damage was noteworthy. The findings of this investigation demonstrated that reported prodrugs can add safety and efficacy to future clinical protocols of tuberculosis treatment.
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Abbreviations
- TB:
-
Tuberculosis
- CFR:
-
Case fatality ratio
- HIV:
-
Human immune deficiency virus
- GSH:
-
Glutathione
- ROS:
-
Reactive oxygen species
- GIT:
-
Gastro-intestinal tract
- ALT:
-
Alanine aminotransferase
- AST:
-
Aspartate aminotransferase
- GSHPx:
-
Glutathione peroxidase
- SOD:
-
Superoxide dismutase
- MDA:
-
Malonyl dialdehyde
- TG:
-
Triglycerides
- H:
-
Healthy control
- INH:
-
Isoniazid
- GI, SI and VI:
-
Prodrugs of INH with gallic acid, syringic acid and vanillic acid respectively
- INH + GA, INH + SA and INH + VA:
-
Physical mixtures of INH with gallic acid, syringic acid and vanillic acid respectively
References
WHO. Global Tuberculosis Report. World Health Organization Report 2016;5-7.
Wang P, Pradhan K, Zhong XB, Ma X. Isoniazid metabolism and hepatotoxicity. Acta Pharm Sin B. 2016;6:384–92.
Sridhar A, Sandeep Y, Krishnakishore C, Sriramnaveen P, Manjusha Y, Sivakumar V. Fatal poisoning by isoniazid and rifampicin. Indian J Nephrol. 2012;22:385–7.
Yamamoto K, Takasaki J, Morino E, Kobayashi N, Sugiyama H. Tenosynovitis confirmed by MRI during anti-tuberculous treatment suspected due to isoniazid—2 case reports and literature review. Kekkaku. 2014;89:659–65.
Shishido Y, Nagayama N, Masuda K, Baba M, Tamura A, Nagai H, et al. Agranulocytosis due to anti-tuberculosis drugs including isoniazid (INH) and rifampicin (RFP a report of four cases and review of the literature). Kekkaku. 2003;78:683–9.
Jena L, Harinath BC. Efficacy and safety of isoniazid preventive therapy in light of increasing multi-drug resistance in tuberculosis. Int J Mycobacteriol. 2015;4:354–5.
Shehzad A, Rehman G, Ul-Islam M, Khattak WA, Lee YS. Challenges in the development of drugs for the treatment of tuberculosis. Braz J Infect Dis. 2013;17:74–81.
Wu ZR, Zhi DJ, Zheng LF, Li JY, Li Y, Xie QJ, et al. Design and applications of bifunctional cinnamide derivatives as potential antimycobacterial agents with few hepatotoxic effects. Med Chem Res. 2015;24:161–70.
Horváti K, Mezo G, Szabó N, Hudecz F, Bosze S. Peptide conjugates of therapeutically used antitubercular isoniazid-design, synthesis and antimycobacterial effect. J Pept Sci. 2009;15:385–91.
Kakkar D, Tiwari AK, Chuttani K, Kumar R, Mishra K, Singh H, et al. Polyethylene-glycolylated isoniazid conjugate for reduced toxicity and sustained release. Ther Deliv. 2011;2:205–12.
Cassano R, Trombino S, Ferrarelli T, Cavalcanti P, Giraldi C, Lai F, et al. Synthesis, characterization and in vitro antitubercular activity of isoniazid–gelatin conjugate. J Pharm Pharmacol. 2012;64:712–8.
Singh C, Jodave L, Bhatt T, Gill MS, Suresh S. Hepatoprotective agent tethered isoniazid for the treatment of drug-induced hepatotoxicity: synthesis, biochemical andhistopathological evaluation. Toxicol Rep. 2014;1:885–93.
Hearn M, Cynamon M, Chen M, Coppins R, Davis J, Joo-On Kang H. Preparation and antitubercular activities in vitro and in vivo of novel Schiff bases of isoniazid. Eur J Med Chem. 2009;44:4169–78.
Dandawate P, Vemuri K, Swamy KV, Khan EM, Sritharan M, Padhye S. Synthesis, characterization, molecular docking and anti-tubercular activity of plumbagin–isoniazid analog and its β-cyclodextrin conjugate. Bioorg Med Chem Lett. 2014;24:5070–5.
Li S, Tan HY, Wang N, Zhang ZJ, Lao L, Wong CW, et al. The role of oxidative stress and antioxidants in liver diseases. Int J Mol Sci. 2015;16:26087–124.
Velika B, Kron I. Antioxidant properties of benzoic acid chimeras against superoxide radical. Free Radic Antioxid. 2012;2(4):62–7.
Badhani B, Sharma N, Kakkar R. Gallic acid: a versatile antioxidant with promising therapeutic and industrial applications. RSC Adv. 2015;35:27540–57.
Perazzoli MR, Perondi CK, Baratto CM, Winter E, Creczynski-Pasa TB, Locatelli C. Gallic acid and dodecyl gallate prevents carbon tetrachloride-induced acute and chronic hepatotoxicity by enhancing hepatic antioxidant status and increasing p53 expression. Biol Pharm Bull. 2017;40(4):425–34.
Itoh A, Isoda K, Kondoh M, Kawase M, Kobayashi M, Tamesada M, et al. Hepatoprotective effect of syringic acid and vanillic acid on concanavalin a-induced liver injury. Biol Pharm Bull. 2009;32:1215–9.
Itoh A, Isoda K, Kondoh M, Kawase M, Watari A, Kobayashi M, et al. Hepatoprotective effect of syringic acid and vanillic acid on CCl4-induced liver injury. Biol Pharm Bull. 2010;33(6):983–7.
Bhilare NV, Dhaneshwar SS, Sinha AJ, Kandhare AD, Bodhankar SL. Novel thioester prodrug of N-acetylcysteine for odor masking and bio availability enhancement. Curr Drug Deliv. 2015;4:611–20.
Sullivan DR, Kruijswijk Z, West CE, Kohlmeier M, Katan MB. Determination of serum triglycerides by an accurate enzymatic method not affected by free glycerol. Clin Chem. 1985;31:1227–8.
Rajesh KG, Achyut NK, Geeta W, Murthy PS, Ramesh C, Vibha T. Nutritional and hypoglycemic effect of fruit pulp of Annona squamosa in normal healthy and alloxan-induced diabetic rabbits. Ann Nutr Metab. 2005;49:407–13.
Marklund S, Marklund G. Involvement of the superoxide anion radical in the autoxidation of pyrogallol and a convenient assay for superoxide dismutase. Eur J Biochem. 1974;47:469–74.
Chanchal SK, Mahajan UB, Siddharth S, Reddy N, Goyal SN, Patil PH, et al. In vivo and in vitro protective effects of omeprazole against neuropathic pain. Sci Rep. 2016;6:30007.
Moron MS, Depierre JW, Mannervik B. Levels of glutathione, glutathione reductase and glutathione S-transferase activities in rat lung and liver. Biochim Biophys Acta. 1979;582:67–78.
Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem. 1979;95:351–8.
Ozer J, Ratner M, Shaw M, Bailey W, Schomaker S. The current state of serum biomarkers of hepatotoxicity. Toxicology. 2008;245:194–205.
Tian Z, Liu H, Su X, Fang Z, Dong Z, Yu C, et al. Role of elevated liver transaminase levels in the diagnosis of liver injury after blunt abdominal trauma. Exp Ther Med. 2012;4:255–60.
Timmins GS, Deretic V. Mechanism of action of isoniazid. Mol Microbiol. 2006;62:1220–7.
Saxena B, Sharma S. Food color induced hepatotoxicity in Swiss albino rats, Rattus norvegicus. Toxicol Int. 2015;22:152–15.
Abirami A, Nagarani G, Siddhuraju P. Hepatoprotective effect of leaf extracts from Citrus hystrix and C. maxima against paracetamol induced liver injury in rats. Food Sci Human Wellness. 2015;4:35–41.
Evan Prince S, Udhaya LB, Sunitha PS, Arumugam G. Reparation of isoniazid and rifampicin combinatorial therapy-induced hepatotoxic effects by Bacopa monnieri. Pharmacology. 2016;98:29–34.
Swamy AHMV, Kulkarni RV, Koti BC, Gadad PC, Thippeswamy AHM, Gore A. Hepatoprotective effect of Cissus quadrangularis stem extract against rifampicin-induced hepatotoxicity in rats. Indian J Pharm Sci. 2012;74:183–7.
Sankar M, Rajkumar J, Sridhar D. Hepatoprotective activity of heptoplus on isoniazid and rifampicin induced liver damage in rats. Indian J Pharm Sci. 2015;77:556–62.
Pal R, Rana SV, Vaiphei K, Singh K. Isoniazid-rifampicin induced lipid changes in rats. Clin Chim Acta. 2008;389:55–60.
Shakun NP, Tabachuk OE. The comparative action of isoniazid, rifampicin and ethambutol on liver function. Eksp Klin Farmakol. 1992;55:45–7.
Santhosh S, Sini T, Anandan R, Mathew P. Effect of chitosan supplementation on antitubercular drugs-induced hepatotoxicity in rats. Toxicology. 2006;219:53–9.
Flora SJ, Dwivedi N, Deb U, Kushwaha P, Lomash V. Effects of co-exposure to arsenic and dichlorvos on glutathione metabolism, neurological, hepatic variables and tissue histopathology in rats. Toxicol Res. 2014;3:23–31.
Tousson E, Atteya Z, El-Atrash A, Jeweely OI. Abrogation by Ginkgo byloba leaf extract on hepatic and renal toxicity induced by methotrexate in rats. Cancer Res Treat. 2014;2:44–51.
Brewer MS. Natural antioxidants: sources, compounds, mechanisms of action, and potential applications. Compr Rev Food Sci Food Saf. 2011;10:221–47.
Acknowledgements
The authors would like to gratefully acknowledge Lupin Research Park, Lupin Ltd., Aurangabad, India, for providing the gift sample of isoniazid.
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Bhilare, N.V., Dhaneshwar, S.S. & Mahadik, K.R. Phenolic acid-tethered isoniazid for abrogation of drug-induced hepatotoxicity: design, synthesis, kinetics and pharmacological evaluation. Drug Deliv. and Transl. Res. 8, 770–779 (2018). https://doi.org/10.1007/s13346-018-0500-1
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DOI: https://doi.org/10.1007/s13346-018-0500-1