Using Quantitative Systems Toxicology to Investigate Observed Species Differences in CKA-Mediated Hepatotoxicity

Toxicol Sci. 2018 Nov 1;166(1):123-130. doi: 10.1093/toxsci/kfy191.

Abstract

CKA, a chemokine receptor antagonist intended for treating inflammatory conditions, produced dose-dependent hepatotoxicity in rats but advanced into the clinic where single doses of CKA up to 600 mg appeared safe in humans. Because existing toxicological platforms used during drug development are not perfectly predictive, a quantitative systems toxicology model investigated the hepatotoxic potential of CKA in humans and rats through in vitro assessments of CKA on mitochondrial respiration, oxidative stress, and bile acid transporters. DILIsym predicted that single doses of CKA caused serum ALT >3xULN in a subset of the simulated rat population, while single doses in a simulated human population did not produce serum ALT elevations. Species differences were largely attributed to differences in liver exposure, but increased sensitivity to inhibition of mitochondrial respiration in the rat also contributed. We conclude that mechanistic modeling can elucidate species differences in the hepatotoxic potential of drug candidates.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Animals
  • Carboxylic Acids / administration & dosage
  • Carboxylic Acids / pharmacokinetics
  • Carboxylic Acids / toxicity*
  • Carrier Proteins / antagonists & inhibitors*
  • Chemical and Drug Induced Liver Injury / etiology*
  • Chemical and Drug Induced Liver Injury / metabolism
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Hep G2 Cells
  • Humans
  • Indoles / administration & dosage
  • Indoles / pharmacokinetics
  • Indoles / toxicity*
  • Liver Function Tests
  • Male
  • Membrane Glycoproteins / antagonists & inhibitors*
  • Middle Aged
  • Models, Biological*
  • Oxidative Stress / drug effects*
  • Rats, Wistar
  • Receptors, Chemokine / antagonists & inhibitors*
  • Species Specificity
  • Tissue Distribution

Substances

  • 1-(4-chloro-3-trifluoromethyl-benzyl)-5-hydroxy-1-H-indole-2-carboxylic acid
  • Carboxylic Acids
  • Carrier Proteins
  • Indoles
  • Membrane Glycoproteins
  • Receptors, Chemokine
  • bile acid binding proteins