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Protective Effects of Kaempferol on Isoniazid- and Rifampicin-Induced Hepatotoxicity

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Abstract

Isoniazid (INH) and rifampicin (RIF) are the first-line drugs for antituberculosis (anti-TB) chemotherapy. The levels of serum transaminases [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] are abnormal in 27% of patients undergoing INH and RIF treatments and in 19% of patients undergoing treatment with INH alone. Cytochrome P450 2E1 (CYP2E1) metabolizes many toxic substrates, including ethanol, carbon tetrachloride, and INH, which ultimately results in liver injury. The objective of this study was to screen for CYP2E1 inhibitors in vitro and investigate whether the selected compound could prevent INH/RIF-induced hepatotoxicity in vivo. We screened 83 known compounds from food and herbal medicines as inhibitors of CYP2E1. The hepatotoxic dose of INH/RIF was 50/100 mg kg−1 day−1. Hepatotoxicity was assessed using galactose single-point (GSP) method (a quantitative measurement of liver function), histopathological examination of the liver, malondialdehyde (MDA) assay, and measurement of AST and ALT activities. Kaempferol inhibited CYP2E1 activity in mice by 0.31- to 0.48-fold (p < 0.005). Mice with INH/RIF-induced hepatotoxicity showed significantly abnormal serum levels of AST and ALT, and GSP value, and these values could be decreased by the administration of kaempferol (p < 0.005). Kaempferol significantly reduced the depletion of hepatic glutathione and prevented the increase in MDA formation in mice. Furthermore, kaempferol did not affect the anti-TB effects of INH/RIF. To our knowledge, this is the first report of kaempferol’s utility as an adjuvant for preventing CYP2E1-mediated hepatotoxicity induced by drugs such as INH and RIF.

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Acknowledgments

We are grateful to Drs. HS Lee and CB Hsieh from the Tri-Service General Hospital. The National Defense Medical Center supported this study.

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Statement of Interest

No conflicts of interest are declared by all of the authors.

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Authors and Affiliations

  1. Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan

    Tung-Yuan Shih

  2. Division of Gastroenterology, Department of Internal Medicine, Cardinal Tien Hospital, Taipei, Taiwan

    Ton-Ho Young

  3. Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Herng-Sheng Lee

  4. Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Chung-Bao Hsieh

  5. Graduate Institute of Life Sciences, School of Pharmacy, National Defense Medical Center, P.O. Box 90048-512, Taipei, Taiwan

    Oliver Yoa-Pu Hu

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  1. Tung-Yuan Shih
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Correspondence to Oliver Yoa-Pu Hu.

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Shih, TY., Young, TH., Lee, HS. et al. Protective Effects of Kaempferol on Isoniazid- and Rifampicin-Induced Hepatotoxicity. AAPS J 15, 753–762 (2013). https://doi.org/10.1208/s12248-013-9490-6

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  • DOI: https://doi.org/10.1208/s12248-013-9490-6

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