In order to better understand the first steps leading to drug-induced immunoallergic hepatitis, we studied the target of anti-LKM2 autoantibodies appearing in tienilic acid-induced hepatitis, and the target of tienilic acid-reactive metabolites. It was identified as cytochrome P450 2C9, (P450 2C9): indeed, anti-LKM2 specifically recognized P450 2C9, but none of the other P450s tested (including other 2C subfamily members, 2C8 and 2C18). Tienilic acid-reactive metabolite(s) specifically bound to P450 2C9, and experiments with yeast expressing active isolated P450s showed that P450 2C9 was responsible for tienilic acid-reactive metabolite(s) production. Results of qualitative and quantitative covalent binding of tienilic acid metabolite(s) to human liver microsomes were then compared to those obtained with two drugs leading to direct toxic hepatitis, namely, acetaminophen and chloroform. Kinetic constants (Km and Vmax) were measured, and the covalent binding profile of the metabolites to human liver microsomal proteins was studied. Tienilic acid had both the lowest Km and the highest covalent binding rate at pharmacological doses. For acetaminophen and chloroform, several microsomal proteins were covalently bound, while covalent binding was highly specific for tienilic acid and dihydralazine, another drug leading to immunoallergic hepatitis. Although low numbers of drugs were tested, these results led us to think that there may exist a relationship between the specificity of covalent binding and the type of hepatotoxicity.

Phenobarbital-induced rat liver homogenate and microsomes were used to study covalent binding of 14C-labelled (at the alcohol moiety) cismethrin, 14C-labelled (at the alcohol and acid moieties) cypermethrin, and 14C-labelled (at the alcohol and acid moieties) deltamethrin. Covalent binding was dependent on pyrethroid concentration. With liver homogenate, inhibition of esterases by tetraethylpyrophosphate and of mitochondrial respiration by rotenone or potassium cyanide only slightly altered the covalent binding level. With microsomes, inhibition of cytochrome P-450 and mixed function oxidases by carbon monoxide and piperonyl butoxide reduced the covalent binding so far as to be nearly absent. Eighty percent inhibition of epoxide hydrolase decreased the covalent binding by 50%. The comparison of data between alcohol and acid labelling of the same pyrethroid suggested that, in vitro, the whole molecule is bound to proteins and that hydrolysis can occur afterwards. The experiments stress the role of cytochrome P-450-dependent monoxygenases in the covalent binding process.

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To explore the possibility of liver enzyme induction by deltamethrin, subacute intoxication was carried out in rats for 28 days, by administration 7.2 mg.Kg-1.day-1 of deltamethrin i.p. delivered by an osmotic pump inserted in the peritoneal cavity. The body weight curve of the treated rats increased slightly but not significantly compared to the controls. No neurotoxic effect was observed. Blood parameters were unchanged, except for eosinophilia and an increase in the plasma Na+ level. Cytochrome P-450, cytochrome b5, NADPH-cytochrome c reductase, esterases and the activities of six mixed function oxidases were assayed. No variation was noted. Ultrastructural study of the liver, more specially in midlobular region, showed that deltamethrin increased the number of mitochondria and altered their shape which became irregular. These findings were consistent with morphometric results. Succinate cytochrome c reductase, citrate synthase and cytochrome c oxidase were essayed, only this last showed a significant enhancement in deltamethrin treated rats.