Prospective study of ALDH1A1 gene polymorphisms associated with antituberculosis drug-induced liver injury in western Chinese Han population

Alcohol consumption as a risk factor for anti-tuberculosis drug induced liver injury: A systematic review and meta-analysis

BACKGROUND

Tuberculosis (TB) is a major infectious disease in the world, and liver injury caused by anti-tuberculosis (ATTB) drugs is an important reason for reduced patient compliance with ATTB treatment. At present, there is controversy over the role of alcohol consumption in ATTB drugs induced liver injury (ATDILI).

METHODS

All data on alcohol consumption and ATDILI were collected from PubMed, Web of Science, Scopus and Embase databases from inception to April 2023. Odds ratio (OR) and 95 % confidence interval (95 % CI) were used for statistical analysis, and Begg test and Egger test were used to evaluate publication bias.

RESULTS

A total of 1152 literatures were reviewed, and 53 literatures were included for systematic review and meta-analysis. Studies have found that alcohol consumption increases the risk of ATDILI (OR: 1.55; 95 % CI: 1.19-2.04). And an increased risk of ATDILI was found in both the alcoholic and non-alcoholic subgroups. The Begg test and Egger test showed no publication bias.

CONCLUSION

Alcohol consumption is a risk factor for ATDILI in TB patients on treatment. While on ATTB treatment, patients need to reduce alcohol consumption. More research is needed to assess the link between alcohol consumption and ATDILI.

Genetic polymorphism related to ethambutol outcomes and susceptibility to toxicity

The World Health Organization (WHO) stated that ensuring access to effective and optimal treatment is a key component to eradicate tuberculosis (TB) through the End TB Strategy. Personalized medicine that depends on the genetic profile of an individual is one way to optimize treatment. It is necessary because of diverse drug responses related to the variation in human DNA, such as single-nucleotide polymorphisms (SNPs). Ethambutol (EMB) is a drug widely used as the treatment for Mycobacterium Tuberculosis (Mtb) and/non-tuberculous mycobacteria and has become a potential supplementary agent for a treatment regimen of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB. In human genetic polymorphism studies of anti-tuberculosis, the majority focus on rifampicin or isoniazid, which discuss polymorphisms related to their toxicity. Whereas there are few studies on EMB, the incidence of EMB toxicity is lower than that of other first-line anti-TB drugs. To facilitate personalized medicine practice, this article summarizes the genetic polymorphisms associated with alterations in the pharmacokinetic profile, resistance incidence, and susceptibility to EMB toxicity. This study includes 131 total human studies from 17 articles, but only eight studies that held in the low-middle income country (LMIC), while the rest is research conducted in developed countries with high incomes. Personalized medicine practices are highly recommended to maintain and obtain the optimal therapeutic effect of EMB.

ALDH1A1 in Cancers: Bidirectional Function, Drug Resistance, and Regulatory Mechanism

Aldehyde dehydrogenases 1 family member A1(ALDH1A1) gene codes a cytoplasmic enzyme and shows vital physiological and pathophysiological functions in many areas. ALDH1A1 plays important roles in various diseases, especially in cancers. We reviewed and summarized representative correlative studies and found that ALDH1A1 could induce cancers via the maintenance of cancer stem cell properties, modification of metabolism, promotion of DNA repair. ALDH1A1 expression is regulated by several epigenetic processes. ALDH1A1 also acted as a tumor suppressor in certain cancers. The detoxification of ALDH1A1 often causes chemotherapy failure. Currently, ALDH1A1-targeted therapy is widely used in cancer treatment, but the mechanism by which ALDH1A1 regulates cancer development is not fully understood. This review will provide insight into the status of ALDH1A1 research and new viewpoint for cancer therapy.