Hepatocytic transcriptional signatures predict comparative drug interaction potential of rifamycin antibiotics

Sci Rep. 2020 Jul 28;10(1):12565. doi: 10.1038/s41598-020-69228-z.

Abstract

Current strategies to treat tuberculosis (TB) and co-morbidities involve multidrug combination therapies. Rifamycin antibiotics are a key component of TB therapy and a common source of drug-drug interactions (DDIs) due to induction of drug metabolizing enzymes (DMEs). Management of rifamycin DDIs are complex, particularly in patients with co-morbidities, and differences in DDI potential between rifamycin antibiotics are not well established. DME profiles induced in response to tuberculosis antibiotics (rifampin, rifabutin and rifapentine) were compared in primary human hepatocytes. We identified rifamycin induced DMEs, cytochrome P450 (CYP) 2C8/3A4/3A5, SULT2A, and UGT1A4/1A5 and predicted lower DDIs of rifapentine with 58 clinical drugs used to treat co-morbidities in TB patients. Transcriptional networks and upstream regulator analyses showed FOXA3, HNF4α, NR1I2, NR1I3, NR3C1 and RXRα as key transcriptional regulators of rifamycin induced DMEs. Our study findings are an important resource to design effective medication regimens to treat common co-conditions in TB patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / adverse effects*
  • Antitubercular Agents / pharmacology
  • Constitutive Androstane Receptor
  • Cytochrome P-450 Enzyme System / genetics
  • Cytochrome P-450 Enzyme System / metabolism
  • Drug Interactions
  • Hepatocytes / drug effects*
  • Hepatocytes / enzymology
  • Humans
  • Rifamycins / adverse effects*
  • Rifamycins / pharmacology
  • Sulfotransferases / genetics
  • Sulfotransferases / metabolism
  • Tuberculosis / drug therapy

Substances

  • Antitubercular Agents
  • Constitutive Androstane Receptor
  • NR1I3 protein, human
  • Rifamycins
  • Cytochrome P-450 Enzyme System
  • Sulfotransferases
  • alcohol sulfotransferase