Expression Profile of Markers of Oxidative Stress, Injury and Apoptosis in anti-tuberculosis drugs induced nephrotoxicity.

AIM: Isoniazid (INH), Rifampicin (RIF) and Pyrazinamide (PZA) are part of first-line anti-tuberculosis therapy used against infection caused by Mycobacterium tuberculosis. However these drugs are known to be potentially harmful as these are associated with numerous side effects and when taken together their harmful outcomes are elevated in a synergistic manner. Identification of possible mechanism underlying RIF+INH+PZA induced nephrotoxicity may be advantageous in developing strategies to prevent their toxic implications.

METHODS: In this study rats were distributed in 2 groups of 6 each: Control (tap water) and Toxicant (INH + RIF + PZA) in dosage derived through extrapolation from human dosage for 28 days once in a day. Antioxidant activity and histology of kidney were examined. In addition apoptosis was also studied using pro and anti-apoptotic markers and TUNEL staining to check nephrotoxicity.

RESULTS: Findings indicated that combined (INH, RIF and PZA) 28 day exposure in wistar rats caused increase in number of free radicals/ reactive oxygen species which further cause changes in levels of enzymatic antioxidants such as glutathione, Superoxide dismutase, Catalase, and Glutathione-s-transferase. Altered content of pro (BAD&BAX) and anti-apoptotic genes (BCL-2&BCL2L1) genes, TUNEL positive cells and DNA fragmentation emphasized involvement of apoptosis.

CONCLUSION: This study concluded that nephrotoxicity is accompanied during combinational anti-tuberculosis drug therapy.