In vivo investigation on the chronic hepatotoxicity induced by sertraline

Environ Toxicol Pharmacol. 2018 Jul:61:107-115. doi: 10.1016/j.etap.2018.05.021. Epub 2018 May 30.

Abstract

Although sertraline is widely prescribed as relatively safe antidepressant drug, hepatic toxicity was reported in some patients with sertraline treatment. The present study was conducted to investigate the morphometric, hepatotoxicity, and change in gene expression of drug metabolizing enzymes. Male healthy adult rabbits (Oryctolagus cuniculus) ranging from 1050 to 1100 g were exposed to oral daily doses of sertraline (0, 1, 2, 4, 8 mg/kg) for 9 weeks. The animals were subjected to morphometric, hepatohistological, histochemical and quantitative real-time polymerase chain reaction analyses. Sertraline chronic exposure induced morphometric changes and provoked histological and histochemical alterations including: hepatocytes hydropic degeneration, necrosis, nuclear alteration, sinusoidal dilation, bile duct hyperplasia, inflammatory cells infiltration, portal vessel congestion, Kupffer cells hyperplasia, portal fibrosis and glycogen depletion. In addition, the gene expression of drug and arachidonic acid metabolizing enzymes were reduced significantly (p value <0.05). The most affected genes were cyp4a12, ephx2, cyp2d9 and cyp1a2, demonstrating 5 folds or more down-regulation. These findings suggest that chronic sertraline treatment induced toxic histological alterations in the hepatic tissues and reduced the gene expression of drug metabolizing enzymes. Patients on chronic sertraline treatment may be on risk of hepatotoxicity with reduced capacity to metabolize drugs and fatty acids.

Keywords: Gene expression; Glycogen depletion; Hepatotoxicity; Histological alterations; Metabolizing enzymes; Sertraline.

MeSH terms

  • Animals
  • Antidepressive Agents / toxicity*
  • Chemical and Drug Induced Liver Injury / genetics
  • Chemical and Drug Induced Liver Injury / metabolism
  • Chemical and Drug Induced Liver Injury / pathology
  • Chronic Disease
  • Cytochrome P-450 Enzyme System / genetics
  • Gene Expression Regulation / drug effects
  • Glucose Transporter Type 1 / genetics
  • Glucuronosyltransferase / genetics
  • Glycogen / metabolism
  • Liver / drug effects*
  • Liver / metabolism
  • Liver / pathology
  • Male
  • Rabbits
  • Selective Serotonin Reuptake Inhibitors / toxicity*
  • Sertraline / toxicity*
  • Urinary Bladder / drug effects
  • Urinary Bladder / pathology

Substances

  • Antidepressive Agents
  • Glucose Transporter Type 1
  • Serotonin Uptake Inhibitors
  • Glycogen
  • Cytochrome P-450 Enzyme System
  • Glucuronosyltransferase
  • Sertraline