Combined 5-hydroxymethylcytosine content of human leucocyte antigen-B and human leucocyte antigen-DQB1 as novel biomarker for anti-tuberculosis drug-induced liver injury

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.

TANC1 methylation as a novel biomarker for the diagnosis of patients with anti-tuberculosis drug-induced liver injury

We aimed to elucidate the differences in genomic methylation patterns between ADLI and non-ADLI patients to identify DNA methylation-based biomarkers. Genome-wide DNA methylation patterns were obtained using Infinium MethylationEPIC (EPIC) BeadChip array to analyze 14 peripheral blood samples (7 ADLI cases, 7 non-ADLI controls). Changes in the mRNA and DNA methylation in the target genes of another 120 peripheral blood samples (60 ADLI cases, 60 non-ADLI controls) were analyzed by real-time polymerase chain reaction and pyrosequencing, respectively. A total of 308 hypermethylated CpG sites and 498 hypomethylated CpG sites were identified. Significantly, hypermethylated CpG sites cg06961147 and cg24666046 in TANC1 associated with ADLI was identified by genome-wide DNA methylation profiling. The mRNA expression of TANC1 was lower in the cases compared to the controls. Pyrosequencing validated these two differentially methylated loci, which was consistent with the results from the EPIC BeadChip array. Receiver operating characteristic analysis indicated that the area under the curve of TANC1 (cg06961147, cg24666046, and their combinations) was 0.812, 0.842, and 0.857, respectively. These results indicate that patients with ADLI have different genomic methylation patterns than patients without ADLI. The hypermethylated differentially methylated site cg06961147 combined with cg24666046 in TANC1 provides evidence for the diagnosis of ADLI.

Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines

Idiosyncratic drug-induced liver injury mimics acute and chronic liver disease. It is under recognized and underrecognised because of the lack of pathognomonic diagnostic serological markers. Its consequences may vary from being asymptomatic to self-limiting illness to severe liver injury leading to acute liver failure. Its incidence is likely to be more common in Asia than other parts of the world, mainly because of hepatotoxicity resulting from the treatment of tuberculosis disease and the ubiquitous use of traditional and complimentary medicines in Asian countries. This APASL consensus guidelines on DILI is a concise account of the various aspects including current evidence-based information on DILI with special emphasis on DILI due to antituberculosis agents and traditional and complementary medicine use in Asia.