Idiosyncratic Drug-Induced Liver Injury: Mechanistic and Clinical Challenges

Idiosyncratic drug-induced liver injury (IDILI) remains a significant problem for patients and drug development. The idiosyncratic nature of IDILI makes mechanistic studies difficult, and little is known of its pathogenesis for certain. Circumstantial evidence suggests that most, but not all, IDILI is caused by reactive metabolites of drugs that are bioactivated by cytochromes P450 and other enzymes in the liver. Additionally, there is overwhelming evidence that most IDILI is mediated by the adaptive immune system; one example being the association of IDILI caused by specific drugs with specific human leukocyte antigen (HLA) haplotypes, and this may in part explain the idiosyncratic nature of these reactions. The T cell receptor repertoire likely also contributes to the idiosyncratic nature. Although most of the liver injury is likely mediated by the adaptive immune system, specifically cytotoxic CD8+ T cells, adaptive immune activation first requires an innate immune response to activate antigen presenting cells and produce cytokines required for T cell proliferation. This innate response is likely caused by either a reactive metabolite or some form of cell stress that is clinically silent but not idiosyncratic. If this is true it would make it possible to study the early steps in the immune response that in some patients can lead to IDILI. Other hypotheses have been proposed, such as mitochondrial injury, inhibition of the bile salt export pump, unfolded protein response, and oxidative stress although, in most cases, it is likely that they are also involved in the initiation of an immune response rather than representing a completely separate mechanism. Using the clinical manifestations of liver injury from a number of examples of IDILI-associated drugs, this review aims to summarize and illustrate these mechanistic hypotheses.     

气相色谱-三重四极杆质谱法快速测定糙米中氟虫腈及其代谢物残留

目的建立气相色谱-三重四极杆质谱(gas chromatography-triple quadrupole mass spectrometry,GC-MS/MS)测定糙米中氟虫腈及其代谢产物氟甲腈、氟虫腈砜、氟虫腈硫醚残留的的分析方法。方法糙米加水涡旋混匀后乙腈提取,通过N-丙基乙二胺(primary secondary amine,PSA)、C_(18)粉末、石墨化炭黑(graphitized carbon black,GCB)粉末净化提取液,气相色谱-三重四极杆质谱多重反应离子监测模式(multiple reaction monitoring,MRM)检测,以外标法定量。结果在1～50μg/L范围下,氟虫腈及其代谢物具有良好的线性关系,相关系数(r)均大于0.99,在2、10、20μg/kg 3个添加水平下,氟虫腈及其代谢物的平均回收率为91.6%～109.9%,相对标准偏差(relative standard deviation,RSD)为4.3%～6.3%。氟虫腈及其代谢物在糙米中的定量限为0.2～0.5μg/kg,定量限添加回收率在85.0%～108.0%,RSD为5.9%～6.9%。结论该方法操作简单快速、试剂耗材消耗少、灵敏度高,适用于快速处理大批量糙米中氟虫腈及其代谢产物的残留量检测。     

Identification of In Vitro Metabolites of Synthetic Phenolic Antioxidants BHT,BHA, and TBHQ by LC-HRMS/MS

Butylated hydroxytoluene (BHT) and its analogs, butylated hydroxyanisole (BHA) and tert-butyl-hydroquinone (TBHQ), are widely used synthetic preservatives to inhibit lipid oxidation in the food, cosmetic and pharmaceutical industries. Despite their widespread use, little is known about their human exposure and related biotransformation products. The metabolism of these compounds was investigated using in vitro incubations with human and rat liver fractions. Liquid chromatography coupled to high-resolution tandem mass spectrometry was employed to detect and characterize stable and reactive species formed via oxidative metabolism, as well as phase II conjugates. Several oxidative metabolites have been detected, as well as glutathione, glucuronide, and sulfate conjugates, many of which were not previously reported. A combination of accurate mass measurements, MS/MS fragmentation behavior, and isotope-labeling studies were used to elucidate metabolite structures.     

Mycotoxin exposure and human cancer risk: A systematic review of epidemiological studies

In recent years, there has been an increasing interest in investigating the carcinogenicity of mycotoxins in humans. This systematic review aims to provide an overview of data linking exposure to different mycotoxins with human cancer risk. Publications (2019 and earlier) of case–control or longitudinal cohort studies were identified in PubMed and EMBASE. These articles were then screened by independent reviewers and their quality was assessed according to the Newcastle–Ottawa scale. Animal, cross‐sectional, and molecular studies satisfied criteria for exclusion. In total, 14 articles were included: 13 case–control studies and 1 longitudinal cohort study. Included articles focused on associations of mycotoxin exposure with primary liver, breast, and cervical cancer. Overall, a positive association between the consumption of aflatoxin‐contaminated foods and primary liver cancer risk was verified. Two case–control studies in Africa investigated the relationship between zearalenone and its metabolites and breast cancer risk, though conflicting results were reported. Two case–control studies investigated the association between hepatocellular carcinoma and fumonisin B1 exposure, but no significant associations were observed. This systematic review incorporates several clear observations of dose‐dependent associations between aflatoxins and liver cancer risk, in keeping with IARC Monograph conclusions. Only few human epidemiological studies investigated the associations between mycotoxin exposures and cancer risk. To close this gap, more in‐depth research is needed to unravel evidence for other common mycotoxins, such as deoxynivalenol and ochratoxin A. The link between mycotoxin exposures and cancer risk has mainly been established in experimental studies, and needs to be confirmed in human epidemiological studies to support the evidence‐based public health strategies.     

QuEChERS-高效液相色谱-串联质谱法快速测定鸡肉中氟虫腈及其代谢物

建立一种QuEChERS-高效液相色谱-串联质谱法,快速测定鸡肉中氟虫腈及其3种代谢产物(氟甲腈、氟虫腈砜及氟虫腈亚砜)的方法。鸡肉样品经乙腈分散,DisQuE提取管提取和DisQuE净化管净化后,采用液相色谱-串联质谱定量测定,选择性多反应监测模式检测。在0.5~20ng/mL线性范围内,氟虫腈及其代谢产物的回归方程均呈良好的线性关系,R2>0.999,在添加水平为1.0、5.0、10.0μg/kg时,平均回收率为75.2%~89.9%,相对标准偏差(RSD)为0.8%~9.2%,方法检出限为0.5μg/kg,定量限为1.0μg/kg。该方法简便快捷,灵敏度和准确度均较高,精密度较好,适用于鸡肉中氟虫腈及其代谢产物残留量的检测。     

五株海藻次级代谢产物化学筛选

海藻是海洋中未开发完全的生物新资源，富含各种有利用价值的活性代谢产物。为了确定海藻中次级代谢产物的丰富度，该实验利用化学筛选方法（薄层层析色谱（TLC）、高效液相色谱（HPLC）、气相色谱-质谱（GC-MS））对江篱、刺麒麟菜、异枝麒麟菜、石花菜及小球藻这五株海藻中的次级代谢产物进行初步筛选。结果表明，通过薄层层析色谱和高效液相色谱分析得出江蓠和石花菜显色明显，代谢产物丰富且易于提取分离。通过气相色谱-质谱分析色谱分析得出，石花菜、小球藻的石油醚相成分复杂，未知化合物较多，特别是石花菜和小球藻可以进行重点研究，为后续海藻活性代谢产物研究与应用上的研发提供有力的实验基础。     

Ion mobility mass spectrometry in the omics era: Challenges and opportunities for metabolomics and lipidomics

Researchers worldwide are taking advantage of novel, commercially available, technologies, such as ion mobility mass spectrometry (IM-MS), for metabolomics and lipidomics applications in a variety of fields including life, biomedical, and food sciences. IM-MS provides three main technical advantages over traditional LC-MS workflows. Firstly, in addition to mass, IM-MS allows collision cross-section values to be measured for metabolites and lipids, a physicochemical identifier related to the chemical shape of an analyte that increases the confidence of identification. Second, IM-MS increases peak capacity and the signal-to-noise, improving fingerprinting as well as quantification, and better defining the spatial localization of metabolites and lipids in biological and food samples. Third, IM-MS can be coupled with various fragmentation modes, adding new tools to improve structural characterization and molecular annotation. Here, we review the state-of-the-art in IM-MS technologies and approaches utilized to support metabolomics and lipidomics applications and we assess the challenges and opportunities in this growing field.