Metabolism and Hepatotoxicity of Pyrazinamide, an Antituberculosis Drug

Drug Metab Dispos. 2021 Aug;49(8):679-682. doi: 10.1124/dmd.121.000389. Epub 2021 Jun 1.

Abstract

Pyrazinamide (PZA) is an important component of a standard combination therapy against tuberculosis. However, PZA is hepatotoxic, and the underlying mechanisms are poorly understood. Biotransformation of PZA in the liver was primarily suggested behind its hepatoxicity. This review summarizes the knowledge of the key enzymes involved in PZA metabolism and discusses their contributions to PZA hepatotoxicity. SIGNIFICANCE STATEMENT: This review outlines the current understanding of PZA metabolism and hepatotoxicity. This work also highlights the gaps in this field, which can be used to guide the future studies on PZA-induced liver injury.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / toxicity
  • Chemical and Drug Induced Liver Injury / etiology*
  • Humans
  • Liver* / drug effects
  • Liver* / enzymology
  • Pyrazinamide* / pharmacology
  • Pyrazinamide* / toxicity
  • Tuberculosis / drug therapy*

Substances

  • Antitubercular Agents
  • Pyrazinamide