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Author Spotlight: Developing a Simple and Robust Hepatic Model for Pharmacological and Toxicological Applications
Published on: October 20, 2023
Mechanistic Modeling Reveals the Critical Knowledge Gaps in Bile Acid-Mediated DILI
J L Woodhead1, K Yang2, K L R Brouwer2
1The Hamner-UNC Institute for Drug Safety Sciences, The Hamner Institutes for Health Sciences, Research Triangle Park, North Carolina, USA.
Bile salt export pump (BSEP) inhibition can cause drug-induced liver injury (DILI). Modeling reveals that inhibiting BSEP in humans increases specific bile acids in the liver, highlighting key research areas for understanding liver injury.
Area of Science:
- Pharmacology
- Toxicology
- Computational Biology
Background:
- Bile salt export pump (BSEP) inhibition is a key mechanism implicated in drug-induced liver injury (DILI).
- Understanding bile acid (BA) homeostasis is crucial for predicting and mitigating DILI.
- Mechanistic modeling can identify knowledge gaps and guide experimental research.
Purpose of the Study:
- To construct and validate a mechanistic model of BA homeostasis within the DILIsym framework.
- To simulate the effects of BSEP inhibition on BA profiles in rats and humans.
- To identify critical factors influencing BA homeostasis and DILI.
Main Methods:
- Developed a submodel of BA homeostasis in rats and humans integrated into the DILIsym platform.
- Conducted in vivo experiments in rats using glibenclamide to validate the model.
- Performed simulations of theoretical BSEP inhibition to analyze impacts on liver BA concentrations.
Main Results:
- Model validation using glibenclamide-treated rats confirmed predictive capabilities.
- Simulated BSEP inhibition in humans predicted increased liver concentrations of conjugated chenodeoxycholic acid (CDCA) and sulfate-conjugated lithocholic acid (LCA).
- Concentrations of other liver BAs were predicted to remain constant or decrease under BSEP inhibition.
Conclusions:
- BSEP inhibition significantly alters liver BA profiles, with specific conjugated BAs accumulating.
- Sensitivity analysis identified BSEP expression levels, intestinal LCA synthesis, and FXR-mediated regulation as critical unknowns.
- The DILIsym model provides a valuable tool for prioritizing research in BA homeostasis and DILI.
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