Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injury

If idiosyncratic drug-induced liver injury (IDILI) is immune-mediated, it is possible that an individual’s prior exposure to antigens may affect their susceptibility to IDILI. An individual’s repertoire of memory immune cells is shaped by every past exposure to antigens. Subsequent drug-induced adve...

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Main Authors: Alastair Mak, Alexander Johnston, Jack Uetrecht
Format: Article
Language:English
Published: Taylor & Francis Group 2017-01-01
Series:Journal of Immunotoxicology
Subjects:
Online Access:http://dx.doi.org/10.1080/1547691X.2017.1290716
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author Alastair Mak
Alexander Johnston
Jack Uetrecht
author_facet Alastair Mak
Alexander Johnston
Jack Uetrecht
author_sort Alastair Mak
collection DOAJ
description If idiosyncratic drug-induced liver injury (IDILI) is immune-mediated, it is possible that an individual’s prior exposure to antigens may affect their susceptibility to IDILI. An individual’s repertoire of memory immune cells is shaped by every past exposure to antigens. Subsequent drug-induced adverse drug reactions may therefore involve an immune cell’s cross reactivity between a prior antigen and resulting drug-modified proteins. Therefore in this experiment, mice were immunized with amodiaquine (AQ)-modified hepatic proteins to mimic a previous exposure; treated with a RIBI adjuvant and anti-CD40 antibodies to stimulate an immune response; and, treated with anti-PD1 and anti-CTLA-4 antibodies prior to AQ treatment in order to overcome immune tolerance. This treatment led to greater liver injury than treatment with AQ alone. However, the mice did not develop serious liver injury. PD1−/− mice were then immunized and treated with AQ and anti-CTLA-4 antibodies so that immune tolerance would be impaired, both during immunization and also during AQ treatment. However, even this did not result in liver failure, and the liver injury was not significantly increased relative to un-immunized PD1−/− mice treated with anti-CTLA-4 and AQ. From these results we conclude that, although previous antigen exposure may affect the risk of IDILI, it appears that a very strong stimulus is required, and impairing immune tolerance remains the most effective method for producing an animal model of IDILI.
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spelling doaj.art-5e16c29ef0b3459b9dd105de0302db492022-12-22T00:43:01ZengTaylor & Francis GroupJournal of Immunotoxicology1547-691X1547-69012017-01-01141899410.1080/1547691X.2017.12907161290716Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injuryAlastair Mak0Alexander Johnston1Jack Uetrecht2University of TorontoUniversity of TorontoUniversity of TorontoIf idiosyncratic drug-induced liver injury (IDILI) is immune-mediated, it is possible that an individual’s prior exposure to antigens may affect their susceptibility to IDILI. An individual’s repertoire of memory immune cells is shaped by every past exposure to antigens. Subsequent drug-induced adverse drug reactions may therefore involve an immune cell’s cross reactivity between a prior antigen and resulting drug-modified proteins. Therefore in this experiment, mice were immunized with amodiaquine (AQ)-modified hepatic proteins to mimic a previous exposure; treated with a RIBI adjuvant and anti-CD40 antibodies to stimulate an immune response; and, treated with anti-PD1 and anti-CTLA-4 antibodies prior to AQ treatment in order to overcome immune tolerance. This treatment led to greater liver injury than treatment with AQ alone. However, the mice did not develop serious liver injury. PD1−/− mice were then immunized and treated with AQ and anti-CTLA-4 antibodies so that immune tolerance would be impaired, both during immunization and also during AQ treatment. However, even this did not result in liver failure, and the liver injury was not significantly increased relative to un-immunized PD1−/− mice treated with anti-CTLA-4 and AQ. From these results we conclude that, although previous antigen exposure may affect the risk of IDILI, it appears that a very strong stimulus is required, and impairing immune tolerance remains the most effective method for producing an animal model of IDILI.http://dx.doi.org/10.1080/1547691X.2017.1290716Idiosyncratic drug-induced liver injuryamodiaquineimmunizationimmune toleranceanimal model
spellingShingle Alastair Mak
Alexander Johnston
Jack Uetrecht
Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injury
Journal of Immunotoxicology
Idiosyncratic drug-induced liver injury
amodiaquine
immunization
immune tolerance
animal model
title Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injury
title_full Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injury
title_fullStr Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injury
title_full_unstemmed Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injury
title_short Effects of immunization and checkpoint inhibition on amodiaquine-induced liver injury
title_sort effects of immunization and checkpoint inhibition on amodiaquine induced liver injury
topic Idiosyncratic drug-induced liver injury
amodiaquine
immunization
immune tolerance
animal model
url http://dx.doi.org/10.1080/1547691X.2017.1290716
work_keys_str_mv AT alastairmak effectsofimmunizationandcheckpointinhibitiononamodiaquineinducedliverinjury
AT alexanderjohnston effectsofimmunizationandcheckpointinhibitiononamodiaquineinducedliverinjury
AT jackuetrecht effectsofimmunizationandcheckpointinhibitiononamodiaquineinducedliverinjury