The effect of paracetamol on human Chang liver cells infected by different dengue serotypes based on liver enzyme activity

Abstract

Background: Paracetamol (PCM) is an effective analgesic and antipyretic when used in recommended doses. The World Health Organization (WHO) has recommended PCM as a first line antipyretic in many conditions including dengue fever (DF) or dengue hemorrhagic fever (DHF). Liver is one of the major organs affected in dengue infection. As PCM is metabolized in the liver, prescription of PCM in dengue infection may result in further deterioration of liver dysfunction. The aim of this study is to investigate the effect of PCM together with different dengue serotypes in Human Chang liver cells based on the liver enzyme activity.Methods: The MTT assay was first used to determine the 50% cytotoxicity (IC50) of PCM on Human Chang liver cells before investigating the effect of PCM on the cells infected with dengue viruses. Human Chang liver cells were then incubated with the four dengue serotypes followed by adding the predetermined level of IC50 of PCM for 24 hours. Healthy cells (non-infected and non-treated) was used as a control. The level of aspartate transaminase (AST) and alpha Glutathione-S-transferase 1 (GSTA1) were determined in the incubation mixture.Results: In the order of increasing AST cytotoxicity level, DENV-4 (23.5%), DENV-1 (37%), DENV-3 (44%) and DENV-2 (50%) was documented. For the non-infected cells (PCM alone), the AST level was 12%. Findings showed no significant difference in AST levels in infected cells as compared to control except for DENV-2 (<0.05) and DENV-3 (<0.05). There has been no significant difference in AST level when compared between the four serotypes. For GSTA1, the study showed no significant difference in levels of the four serotypes with 0.66 ug/ml (DENV-1), 0.64 ug/ml (DENV-2), 0.64 ug/ml (DENV-3), 0.70 ug/ml (DENV-4) and 0.76 ug/ml (noninfected) as compared to control with 1.88ug/ml. Conclusion:There are four dengue serotypes which infect the liver cells and elevates AST, the differences in the percentage of elevation between serotypes is not significant. GSTA1 is not a suitable marker for liver cytotoxicity in dengue infection as compared to AST in our study as AST is found to be more specific.