Usefulness of the american college of rheumatology recommendations for liver biopsy in methotrexate‐treated rheumatoid arthritis patients

Erickson, Alan R.; Reddy, Vishnu; Vogelgesang, Scott A.; West, Sterling G.

doi:10.1002/art.1780380814

Cited by 75 publications

(34 citation statements)

References 15 publications

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“…renal organic anion transporter; drug elimination; nephrotoxicity AMONG THE VARIOUS DRUGS in use for the treatment of malignancies, the group of antimetabolites is of significant practical relevance. The antifolate methotrexate (Mtx) is also successfully used in various nononcological indications like rheumatoid arthritis and psoriasis (6,8,19,23,33). However, chemotherapy with Mtx is confronted with adverse effects such as bone marrow suppression, hepatotoxicity, as well as acute and long-term nephrotoxicity.…”

mentioning

confidence: 99%

Sodium-dependent methotrexate carrier-1 is expressed in rat kidney: cloning and functional characterization

Kneuer

Honscha

2004

American Journal of Physiology-Renal Physiology

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Previous Northern blot studies suggested strong expression of a homolog to the sodium-dependent hepatocellular methotrexate transporter in the kidneys. Here, we report on the cloning of the cDNA for the renal methotrexate carrier isoform-1 (RK-MTX-1) and its functional characterization. Sequencing revealed 97% homology to the rat liver methotrexate carrier with an identical open reading frame. Differences were located in the 5Ј-untranslated region and resulted in the absence of putative regulatory elements (Barbie box, Ah/ARNT receptor) identified in the cDNA for the hepatocellular carrier. For functional characterization, MTX-1 cDNA was stably expressed in Madin-Darby canine kidney (MDCK) cells. A sodium-dependent transport of methotrexate with a Km of 41 M and a V max of 337 pmol⅐mg protein Ϫ1 ⅐min Ϫ1 was observed. This uptake was blocked by the reduced folates dihydro-and tetrahydrofolate as well as by methotrexate itself. Folate was inhibiting only weakly, whereas 5-methyltetrahydrofolate was a strong inhibitor. Further inhibitors of the methotrexate transport included the bile acids cholate and taurocholate and xenobiotics like bumetanide and BSP. PAH, ouabain, bumetanide, cholate, taurocholate, and acetyl salicylic acid were tested as potential substrates. However, none of these substances was transported by MTX-1. Furthermore, expression of RK-MTX-1 in MDCK cells enhanced methotrexate toxicity in these cells fivefold. Analysis of a fusion protein of RK-MTX-1 and the influenza virus hemagglutinin epitope by immunoblotting revealed a major band at 72 kDa within the cell membrane but not in the soluble fraction of transfected MDCK. Indirect immunofluorescence staining revealed an exclusive localization of the carrier in the plasma membrane, and by confocal laser-scanning microscopy we were able to demonstrate that the protein is expressed in the serosal region of MDCK tubules grown in a morphogenic collagen gel model.

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confidence: 99%

Sodium-dependent methotrexate carrier-1 is expressed in rat kidney: cloning and functional characterization

Kneuer

Honscha

2004

American Journal of Physiology-Renal Physiology

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“…Although one study showed transaminase elevations higher than twice the upper limit of normal in 13% of patients [111] , another report assessing 6000 patients receiving MTX, transaminase elevation was described in only 0.6% of patients [112] . Despite this wide difference, most studies concluded that prolonged use of low-dose MTX monotherapy (10 mg/wk for 2-15 years) has favorable longterm safety, and that the development of significant liver fibrosis and cirrhosis is very low [113] ; rather, steatosis was the main finding when biopsies were carried out for surveillance dictated by cumulative MTX dose ( Figure 2) [114] .…”

Section: Association Of Sle With Drug-induced Hepatotoxicitymentioning

confidence: 95%

Challenge of liver disease in systemic lupus erythematosus: Clues for diagnosis and hints for pathogenesis

Bessone

Poles

Roma

2014

WJH

106

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Systemic lupus erythematosus (SLE) encompass a broad spectrum of liver diseases. We propose here to classify them as follows: (1) immunological comorbilities (overlap syndromes); (2) non-immunological comorbilities associated to SLE; and (3) a putative liver damage induced by SLE itself, referred to as "lupus hepatitis". In the first group, liver injury can be ascribed to overlapping hepatopathies triggered by autoimmune mechanisms other than SLE occurring with higher incidence in the context of lupus (e.g. , autoimmune hepatitis, primary biliary cirrhosis). The second group includes non-autoimmune liver diseases, such as esteatosis, hepatitis C, hypercoagulation state-related liver lesions, hyperplasic parenchymal and vascular lesions, porphyria cutanea tarda, and drug-induced hepatotoxicity. Finally, the data in the literature to support the existence of a hepatic disease produced by SLE itself, or the occurrence of a SLE-associated prone condition that increases susceptibility to acquire other liver diseases, is critically discussed. The pathological mechanisms underlying each of these liver disorders are also reviewed. Despite the high heterogeneity in the literature regarding the prevalence of SLE-associated liver diseases and, in most cases, lack of histopathological evidence or clinical studies large enough to support their existence, it is becoming increasingly apparent that liver is an important target of SLE. Consequently, biochemical liver tests should be routinely carried out in SLE patients to discard liver disorders, particularly in those patients chronically exposed to potentially hepatotoxic drugs. Diagnosing liver disease in SLE patients is always challenging, and the systematization of the current information carried out in this review is expected to be of help both to attain a better understanding of pathogenesis and to build an appropriate work-up for diagnosis.

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“…462 However, adherence to only blood tests can still miss an occasional patient with advance liver disease. 464 In sarcoidosis, 100 liver biopsies were performed in 57 patients after each 1 to 1.5 g of accumulated doses. Fourteen patients had changes consistent with methotrexate toxicity (47 had changes due to sarcoidosis).…”

Section: Methotrexatementioning

confidence: 99%

Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

Baughman

Meyer

Nathanson

et al. 2012

Chest

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Objectives: Immunosuppressive pharmacologic agents prescribed to patients with diffuse interstitial and infl ammatory lung disease and lung transplant recipients are associated with potential risks for adverse reactions. Strategies for minimizing such risks include administering these drugs according to established, safe protocols; monitoring to detect manifestations of toxicity; and patient education. Hence, an evidence-based guideline for physicians can improve safety and optimize the likelihood of a successful outcome. To maximize the likelihood that these agents will be used safely, the American College of Chest Physicians established a committee to examine the clinical evidence for the administration and monitoring of immunosuppressive drugs (with the exception of corticosteroids) to identify associated toxicities associated with each drug and appropriate protocols for monitoring these agents. Methods: Committee members developed and refi ned a series of questions about toxicities of immunosuppressives and current approaches to administration and monitoring. A systematic review was carried out by the American College of Chest Physicians. Committee members were supplied with this information and created this evidence-based guideline. Conclusions: It is hoped that these guidelines will improve patient safety when immunosuppressive drugs are given to lung transplant recipients and to patients with diffuse interstitial lung disease. CHEST 2012; 142(5):e1S-e111SAbbreviations: ACCP 5 American College of Chest Physicians; ALT 5 alanine aminotransferase; ATG 5 antithymocyte globulin; CHF 5 congestive heart failure; CMV 5 cytomegalovirus; CNI 5 calcineurin inhibitor; COI 5 confl ict of interest; CsA 5 cyclosporin A; FDA 5 US Food and Drug Administration; HBV 5 hepatitis B virus; HMG-CoA 5 b -hydroxy-bmethylglutaryl-coenzyme A; HSP 5 Health and Science Policy Committee; IL2RA 5 IL-2 receptor a ; ILD 5 interstitial lung disease; IPF 5 idiopathic pulmonary fi brosis; ITP 5 idiopathic thrombocytopenia purpura; LAM 5 lymphangioleiomyomatosis; MESNA 5 sodium 2-sulfonylethanesufonate; MPA 5 mycophenolic acid; mTOR 5 mammalian target of rapamycin; PTLD 5 posttransplant lymphoproliferative disease; RCT 5 randomized controlled trial; SIRS 5 systemic infl ammatory response syndrome; TNF 5 tumor necrosis factor; TPMT 5 thiopurine methyltransferase

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Usefulness of the american college of rheumatology recommendations for liver biopsy in methotrexate‐treated rheumatoid arthritis patients

Cited by 75 publications

References 15 publications

Sodium-dependent methotrexate carrier-1 is expressed in rat kidney: cloning and functional characterization

Sodium-dependent methotrexate carrier-1 is expressed in rat kidney: cloning and functional characterization

Challenge of liver disease in systemic lupus erythematosus: Clues for diagnosis and hints for pathogenesis

Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

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