microcystin and Chemical-and-Drug-Induced-Liver-Injury

Mass developments of cyanobacteria ("blue-green algae") in lakes and brackish waters have repeatedly led to serious concerns due to their frequent association with toxins. Among these are the widespread hepatotoxins microcystin (MC) and nodularin (NOD). Here, we give an overview about the ecostrategies of the diverse toxin-producing species and about the genes and enzymes that are involved in the biosynthesis of the cyclic peptides. We further summarize current knowledge about toxicological mechanisms of MC and NOD, including protein phosphatase inhibition, oxidative stress and their tumor-promoting capabilities. One biotransformation pathway for MC is described. Mechanisms of cyanobacterial neurotoxins (anatoxin-a, homanatoxin-a, and anatoxin-a(s)) are briefly explained. We highlight selected cases of human fatalities related to the toxins. A special focus is given to evident cases of contamination of food supplements with cyanobacterial toxins, and to the necessary precautions.

Topics: Animals; Bacterial Toxins; Carcinogens; Chemical and Drug Induced Liver Injury; Cyanobacteria; Cyanobacteria Toxins; Dietary Supplements; Ecosystem; Food Contamination; Humans; Marine Toxins; Microcystins; Oxidative Stress; Peptides, Cyclic; Phosphoprotein Phosphatases; Tropanes

At public health, there is increasingly interest on evaluating the possibility of human intoxication by biotoxins from blue-green algae, mainly the hepatotoxins from the microcystin group. Microcystin, a monocyclic heptapeptide, is mainly produced by a cyanobacteria called Microcistis aeruginosa. It is characterized by a few variable amino acids, from which two of them have an unusual structure and play an important role in the hepatotoxicity of the microcystin. Although human illnesses include gastroenteritis, allergic or irritative reactions, and neurotoxicity, the main target of this toxin is the liver. Inside the hepatocytes, microcystins are carried by the transportation system of the bile acid, inhibiting the activity of the protein phosphatase in the cytoplasm. This inhibition causes a morphologic change in the plasmatic membrane because of the hyperphosphorylation of cytokeratins, and also the tumoral promotion by the hyperphosphorylated proteins. The techniques used in the detection and quantification of the microcystins in the environment include liquid chromatography, bioanalysis of mice, and immunoenzymatic tests using mono and polyclonal antibodies against those toxins. The latter has been remarked because of its practicality and its high sensibility.

Topics: Acute Disease; Animals; Chemical and Drug Induced Liver Injury; Chronic Disease; Humans; Mice; Microcystins; Microcystis; Peptides, Cyclic; Rats

Microcystins are a family of more than 50 structurally similar hepatotoxins produced by species of freshwater cyanobacteria, primarily Microcystis aeruginosa. They are monocyclic heptapeptides, characterised by some invariant amino acids, including one of unusual structure which is essential for expression of toxicity. Microcystins are chemically stable, but suffer biodegradation in reservoir waters. The most common member of the family, microcystin-LR (L and R identifying the 2 variable amino acids, in this case leucine and arginine respectively) has an LD50 in mice and rats of 36-122 microg/kg by various routes, including aerosol inhalation. Although human illnesses attributed to microcystins include gastroenteritis and allergic/irritation reactions, the primary target of the toxin is the liver, where disruption of the cytoskeleton, consequent on inhibition of protein phosphatases 1 and 2A, causes massive hepatic haemorrhage. Microcystins are tight-binding inhibitors of these protein phosphatases, with inhibition constants in the nanomolar range or lower. Uptake of microcystins into the liver occurs via a carrier-mediated transport system, and several inhibitors of uptake can antagonise the toxic effects of microcystins. The most effective of these is the antibiotic rifampin (a drug approved for clinical use), which protects mice and rats against microcystin-induced lethality when given prophylactically and, in some cases, therapeutically.

Topics: Animals; Bacterial Toxins; Chemical and Drug Induced Liver Injury; Cyanobacteria; Enzyme Inhibitors; Marine Toxins; Microcystins; Peptides, Cyclic; Phosphoprotein Phosphatases

Microcystin-leucine arginine (MC-LR) is a potent liver toxin produced by freshwater cyanobacteria, also known as blue-green algae. While harmful algal blooms are increasing in frequency and severity worldwide, there is still no established method for the diagnosis and assessment of MC-LR induced liver damage. The guidelines for MC-LR safe exposure limits have been previously established based on healthy animal studies, however we have previously demonstrated that pre-existing non-alcoholic fatty liver disease (NAFLD) increases susceptiblity to the hepatotoxic effects of MC-LR. In this study, we sought to investigate the suitability of clinically used biomarkers of liver injury, specifically alanine aminotransferase (ALT) and alkaline phosphatase (ALP), as potential diagnostic tools for liver damage induced by chronic low dose administration of MC-LR in the setting of pre-existing NAFLD. In our Leprdb/J mouse model of NAFLD, we found that while MC-LR induced significant histopathologic damage in the setting of NAFLD, gene expression of ALT and ALP failed to increase with MC-LR exposure. Serum ALT and ALP also failed to increase with MC-LR exposure, except for a moderate increase in ALP with the highest dose of MC-LR used (100 μg/kg). In HepG2 human liver epithelial cells, we observed that increasing MC-LR exposure levels do not lead to an increase in ALT or ALP gene expression, intracellular enzyme activity, or extracellular activity, despite a significant increase in MC-LR induced cytotoxicity. These findings demonstrate that ALT and ALP may be unsuitable as diagnostic biomarkers for MC-LR induced liver damage.

Topics: Alanine Transaminase; Animals; Chemical and Drug Induced Liver Injury; Cyanobacteria; Gene Expression; Harmful Algal Bloom; Humans; Liver; Marine Toxins; Mice; Microcystins; Non-alcoholic Fatty Liver Disease

Microcystis aeruginosa is one of the main species of cyanobacteria that causes water blooms. M. aeruginosa can release into the water several types of microcystins (MCs), which are harmful to aquatic organisms and even humans. However, few studies have investigated the hepatotoxicity of M. aeruginosa itself in zebrafish in environments that simulate natural aquatic systems. The objective of this study was to evaluate the hepatotoxicity of M. aeruginosa in adult zebrafish (Danio rerio) after short-term (96 h) exposure and to elucidate the potential underlying mechanisms. Distinct histological changes in the liver, such as enlargement of the peripheral nuclei and sinusoids and the appearance of fibroblasts, were observed in zebrafish grown in M. aeruginosa culture. In addition, antioxidant enzyme activity was activated and protein phosphatase (PP) activity was significantly decreased with increasing microalgal density. A proteomic analysis revealed alterations in a number of protein pathways, including ribosome translation, immune response, energy metabolism and oxidative phosphorylation pathways. Western blot and real-time PCR analyses confirmed the results of the proteomic analysis. All results indicated that M. aeruginosa could disrupt hepatic functions in adult zebrafish, thus highlighting the necessity of ecotoxicity assessments for M. aeruginosa at environmentally relevant densities.

Topics: Animals; Antioxidants; Chemical and Drug Induced Liver Injury; Cyanobacteria; Humans; Microcystins; Microcystis; Proteome; Proteomics; Water Pollutants; Zebrafish; Zebrafish Proteins

A 67-year-old Caucasian male with lung cancer was presented to the Emergency Department with asthenia, anorexia, jaundice and choluria. The patient's lung cancer was being treated medically by a combination of paclitaxel/carboplatin with bi-monthly frequency. The patient was also self-medicating with several natural products, including Chlorella (520 mg/day), Silybum marianum (total of 13.5 mg silymarin/day), zinc sulphate (5.5 mg), selenium (50 μg) and 15 g/day of Curcuma longa. In first chemotherapy cycle no toxicity was observed even he was taking other medications as budesonide and sitagliptin. The toxic events started only after the introduction of the dietary products. Chlorella had contamination with cyanobacteria (Oscillatoriales) and 1.08 μg of cyanotoxin Microcystin-LR (MC-LR) per gram of biomass was found. Patient was consuming ca 0.01 μg MC-LR/kg/day. This case report describes the first known case of paclitaxel toxicity probably related to pharmacokinetic interaction with Turmeric and a contaminated Chlorella supplement resulting in an acute toxic hepatitis and the impact on oncologic patient health.

Topics: Aged; Chemical and Drug Induced Liver Injury; Chlorella; Curcuma; Cyanobacteria; Dietary Supplements; Drug Contamination; Herb-Drug Interactions; Humans; Liver; Male; Microcystins; Paclitaxel

Cyanobacterial blooms threaten human health as well as the population of other living organisms in the aquatic environment, particularly due to the production of natural toxic components, the cyanotoxin. So far, the most studied cyanotoxins are microcystins (MCs). In this study, the hepatic alterations at histological, proteome and transcriptome levels were evaluated in female and male medaka fish chronically exposed to 1 and 5 μg L

Topics: Animals; Bacterial Toxins; Cell Extracts; Chemical and Drug Induced Liver Injury; Circadian Rhythm; Down-Regulation; Female; Fish Diseases; Glycogen; Lipid Metabolism; Liver; Male; Microcystins; Microcystis; Oryzias; Oviparity; Protein Biosynthesis; Proteome; Reproduction; Transcriptome

Oxidative stress and glutathione (GSH) depletion are implicated in mycocystin hepatotoxicity. To investigate the role of nuclear factor erythroid 2-related factor 2 (Nrf2) in microcystin-induced liver injury, Nrf2-null, wild-type, and Keap1-hepatocyte knockout (Keap1-HKO) mice were treated with microcystin (50 μg/kg, i.p.). Blood and liver samples were collected 8 h thereafter. Microcystin increased serum alanine aminotransferase and aspartate aminotransferase activities, and caused extensive inflammation and necrosis in Nrf2-null and wild-type mice, but not in Keap1-HKO mice. Oxidative stress and inflammation are implicated in microcystin-induced hepatotoxicity, as evidenced by increased lipid peroxidation and increased expression of pro-inflammatory genes, such as neutrophil-specific chemokines mKC and MIP-2, and pro-inflammatory cytokines IL-1β and IL-6. The increased expression of these pro-inflammatory genes was attenuated in Keap1-HKO mice. Nrf2 and Nqo1 mRNA and protein were higher in Keap1-HKO mice at constitutive levels and after microcystin. To further investigate the mechanism of the protection, hepatic GSH and the mRNA of GSH-related enzymes were determined. Microcystin markedly depleted liver GSH by 60-70% in Nrf2 and WT mice but only 35% in Keap1-HKO mice. The mRNAs of GSH conjugation and peroxide reduction enzymes, such as Gstα1, Gstα4, Gstμ, and Gpx2 were higher in livers of Keap1-HKO mice, together with higher expression of the rate-limiting enzyme for GSH synthesis (Gclc). Organic anion transport polypeptides were increased by microcystin with the most increase in Keap1-HKO mice. In conclusion, this study demonstrates that higher basal levels of Nrf2 and GSH-related genes in Keap1-HKO mice prevented microcystin-induced oxidative stress and liver injury.

Topics: Animals; Biological Transport; Chemical and Drug Induced Liver Injury; Chemokines; Glutathione; Lipid Peroxidation; Liver; Mice; Microcystins; NF-E2-Related Factor 2; Oxidative Stress; Thiobarbituric Acid Reactive Substances

Acute cyanobacterial hepatotoxicosis in a wild roe deer (Capreolus capreolus) from Norway is reported. The diagnosis was based upon the demonstration of typical liver lesions and high liver concentrations of microcystins. The liver was markedly enlarged and histopathological examination revealed diffuse hepatocellular dissociation, degeneration and necrosis and perisinusoidal haemorrhage. Liquid chromatography-mass spectrometry demonstrated the presence of 1361 ng microcystin-YR, -LR and -RR per gram liver (wet weight). This is believed to be the first report of cyanobacterial intoxication in wild mammalian species as confirmed by demonstration of high toxin levels in the animal's tissues.

Topics: Animals; Bacterial Toxins; Chemical and Drug Induced Liver Injury; Chromatography, High Pressure Liquid; Deer; Enzyme Inhibitors; Female; Hepatomegaly; Liver; Mass Spectrometry; Microcystins

To evaluate the antagonism effects of green tea (GT) against microcystin LR (MC-LR) induced hepatotoxicity and nephrotoxicity in mice.. All 40 male mice were randomly divided into four groups. Mice in group III and IV were pretreated with green tea for free drink at doses of 2 g/L and 12 g/L prior to MC-LR intoxication, for consecutively 18 days. The toxin treatment mice were administered continually intraperitoneal injections of MC-LR at a dose of 10 microg x kg(-1) x d(-1) bw from day 6th till sacrifice, continually 13 days. Mice were sacrificed and immediately subjected to necropsy, and the body weight, relative organ weight, serum biochemical parameters, antioxidant enzyme levels (SOD and GSH), lipid peroxidation products (MDA) and histopathology were systematically evaluated.. MC-LR exposure led to increase the oxidative stress and organ injury was significantly observed through biochemical parameters and microscopic evaluation. However, high dose of GT pretreatment caused a significant elevation in serum GSH and SOD levels, and a decrease of serum MDA level as compared with MC-LR control. The mean values of GSH and SOD activities were separately 467.29 mg/L and 139.22 U/ml in group IV. Subsequently, GT pretreatment obviously diminished the serum ALT, AST and Cr activities. Those pathological damages in liver and kidney, were to a certain extent, lessened in GT pretreatment mice in correlation with the biochemical parameters.. GT might elevate antioxidant defense system, clean up free radicals, lessen oxidative damages and protect liver and kidney against MC-LR induced toxicity.

Topics: Animals; Antioxidants; Chemical and Drug Induced Liver Injury; Free Radicals; Kidney Diseases; Liver Diseases; Male; Mice; Mice, Inbred Strains; Microcystins; Oxidative Stress; Tea

In February 1996, an outbreak of illness occurred at a hemodialysis clinic in Caruaru, Pernambuco State-Brazil. At this clinic 116 (89%) of 131 patients experienced visual disturbances, nausea, vomiting, and muscle weakness, following routine haemodialysis treatment. Subsequently, 100 patients developed acute liver failure. As of December 1996, 52 of the deaths could be attributed to a common syndrome now called 'Caruaru Syndrome'. Examination of previous years' phytoplankton counts showed that cyanobacteria were dominant in the water supply reservoir since 1990. Analyses of carbon and other resins from the clinic's water treatment system plus serum and liver tissue of patients led to the identification of two groups of hepatotoxic cyanotoxins: microcystins (cyclic heptapeptides) in all of these samples and cylindrospermopsin (alkaloid hepatotoxic) in the carbon and resins. Comparison of victims symptoms and pathology with animal studies on these two cyanotoxins, leads us to conclude that the major contributing factor to death of the dialysis patients was intravenous exposure to microcystins, specifically microcystin-YR, -LR and -AR. In 2000, a review of the Brazilian regulation for drinking water quality, promoted by Brazilian Health Ministry with collaboration of PAHO, incorporated cyanobacteria and cyanotoxins into this new regulation as parameters that must to be monitored for water quality control.

Topics: Animals; Brazil; Carcinogens; Chemical and Drug Induced Liver Injury; Eutrophication; Humans; Liver; Microcystins; Peptides, Cyclic; Phytoplankton; Rats; Renal Dialysis; Water Microbiology; Water Supply

The subchronic effects of cyanobacterial lyophilizate (CL) containing microcystins on liver were investigated in female New Zealand rabbits. Sterilised CL containing microcystins was injected i.p. Liver toxicity was assessed by histological examination of liver samples. Non-invasive magnetic resonance imaging (MRI) of liver was also performed in order to assess changes in the homogeneity of liver tissue. Subchronical intoxication with microcystins caused morphological changes of liver tissue that were also detected by use of MRI. Histological analysis showed that changes seen on MRI represent liver injury characterised with fatty infiltration and periportal fibrosis. This demonstrates that subchronic exposure to microcystins can lead to liver degeneration, which can easily be detected in vivo by use of MRI.

Topics: Animals; Chemical and Drug Induced Liver Injury; Chronic Disease; Cyanobacteria; Female; Fibrosis; Liver; Liver Diseases; Magnetic Resonance Imaging; Microcystins; Peptides, Cyclic; Rabbits; Reference Values

Electrospray ionization mass spectrometry was used to develop a rapid, sensitive, and accurate method for determination and identification of hepatotoxic microcystins, cyanobacterial cyclic heptapeptides. To optimize the electrospray ionization conditions, factors affecting charge state distribution, such as amino acid components of sample, proton affinity of the additives, and additive concentration, were investigated in detail and a method for controlling charge states was developed to provide molecular-related ions for assignment of molecular weight and reasonably abundant precursor ions for MS/MS analysis. A procedure for identification of microcystins consisting of known amino acids was proposed: for microcystins giving abundant [M + 2H]2+ ions, the addition of nitrogen-containing bases to the aqueous sample solution is effective to obtain an increased intensity of [M + H]+ ions, whereas the addition of Lewis acids containing nitrogen can produce increased abundances of [M + 2H]2+ ions for microcystins giving weak [M + 2H]2+ ions. Microcystins possessing no arginine residue always give sodium adduct ions [M + Na]+ as the base peak, and these are difficult to fragment via low energy collision-induced dissociation to yield structurally informative products; the addition of oxalic acid increases [M + H]+ ion abundances, and these fragment readily.

Topics: Acetates; Amino Acids; Arginine; Chemical and Drug Induced Liver Injury; Chemical Phenomena; Chemistry, Physical; Hydrogen-Ion Concentration; Indicators and Reagents; Mass Spectrometry; Microcystins; Nitrogen; Oxalic Acid; Peptides, Cyclic

A novel amperometric HPLC detection method for the cyanobacterial (blue-green algal) peptide toxins microcystin-LR, -YR and -RR was developed. Purified microcystins and cyanobacterial extracts were chromatographed using an internal surface reversed-phase column with acetate- and phosphate-based mobile phase systems. Electrochemical oxidation reactions at 1.20 V vs. Ag/AgCl (glassy carbon working electrode) were show to originate in arginine and tyrosine residues of microcystins.

Topics: Bacterial Toxins; Chemical and Drug Induced Liver Injury; Chromatography, High Pressure Liquid; Cyanobacteria; Electrochemistry; Indicators and Reagents; Microcystins; Peptides, Cyclic; Spectrophotometry, Ultraviolet

After a drought in February, 1996, all 126 patients in a haemodialysis unit in Caruaru, north-east Brazil, developed signs and symptoms of acute neurotoxicity and subacute hepatotoxicity following the use of water from a lake with massive growth of cyanobacteria (blue-green algae). 60 patients died.. Besides recording clinical details and outcome at follow-up, we arranged laboratory, radiological, and histological investigations on the patients and toxicological studies of serum and haemodialysis water filters.. The acute presentation was with malaise, myalgia and weakness, nausea and vomiting, and tender hepatomegaly, with a range of neurological symptoms from tinnitus, vertigo, headaches, and deafness to blindness and convulsions. Liver injury ranged from abnormal liver-function test results to rapidly progressive and fatal hepatic failure. Biochemical investigations revealed gross hyperbilirubinaemia, abnormal liver enzyme activities, and hypertriglyceridaemia, but there was no evidence of haemolysis or microangiopathy. Histology revealed a novel acute toxic hepatitis with diffuse panlobular hepatocyte necrosis, neutrophil infiltration, canalicular cholestasis, and regenerative multinucleate hepatocytes. Samples of serum, dialysis filters, and water-treatment columns contained microcystins, the highly toxic low-molecular-weight hepatotoxins produced by cyanobacteria.. Cyanobacteria present water-borne hazards to health via drinking water and recreational water. Haemodialysis presents an additional high-risk exposure route: when they enter directly into the circulation, microcystins can lead to fatal clinical syndromes ranging from acute neurotoxic illness to subacute liver failure.

Topics: Bacterial Toxins; Brazil; Chemical and Drug Induced Liver Injury; Cyanobacteria; Female; Hemodialysis Units, Hospital; Humans; Male; Microcystins; Middle Aged; Nervous System Diseases; Peptides, Cyclic; Poisoning; Water Microbiology

Mustard (Sinapis alba L.) seeds were cultivated for seven days on a solid nutrient medium supplemented with 040 microg microcystin-RR per ml. Microcystin-RR affected seedling growth (IC50 0.8 microg/ml) and microcystin concentrations > or =5.0 microg/ml produced malformed plants. The inhibition of protein phosphatase 1 and 2A activity correlated with the growth inhibition. The seedlings were also shown to take up 3H-dihydromicrocystin-LR derived radioactivity up to a level corresponding to ca. 80 ng toxin per mg plant protein.

Topics: Bacterial Toxins; Chemical and Drug Induced Liver Injury; Cyanobacteria; Dose-Response Relationship, Drug; Enzyme Inhibitors; Microcystins; Mustard Plant; Peptides, Cyclic; Phosphoprotein Phosphatases; Plants, Medicinal; Protein Phosphatase 1

Simple epithelia express keratins 8 (K8) and 18 (K18) as their major intermediate filament (IF) proteins. One important physiologic function of K8/18 is to protect hepatocytes from drug-induced liver injury. Although the mechanism of this protection is unknown, marked K8/18 hyperphosphorylation occurs in association with a variety of cell stresses and during mitosis. This increase in keratin phosphorylation involves multiple sites including human K18 serine-(ser)52, which is a major K18 phosphorylation site. We studied the significance of keratin hyperphosphorylation and focused on K18 ser52 by generating transgenic mice that overexpress a human genomic K18 ser52--> ala mutant (S52A) and compared them with mice that overexpress, at similar levels, wild-type (WT) human K18. Abrogation of K18 ser52 phosphorylation did not affect filament organization after partial hepatectomy nor the ability of mouse livers to regenerate. However, exposure of S52A-expressing mice to the hepatotoxins, griseofulvin or microcystin, which are associated with K18 ser52 and other keratin phosphorylation changes, resulted in more dramatic hepatotoxicity as compared with WT K18-expressing mice. Our results demonstrate that K18 ser52 phosphorylation plays a physiologic role in protecting hepatocytes from stress-induced liver injury. Since hepatotoxins are associated with increased keratin phosphorylation at multiple sites, it is likely that unique sites aside from K18 ser52, and phosphorylation sites on other IF proteins, also participate in protection from cell stress.

Topics: 3T3 Cells; Actin Cytoskeleton; Amino Acid Substitution; Animals; Chemical and Drug Induced Liver Injury; Genetic Predisposition to Disease; Griseofulvin; Hepatectomy; Humans; Intermediate Filaments; Keratins; Liver Regeneration; Mice; Mice, Transgenic; Microcystins; Okadaic Acid; Peptides, Cyclic; Phosphorylation; Point Mutation; Protein Processing, Post-Translational

Six microcystins were identified in a laboratory culture of the cyanobacterium (blue-green alga) Microcystis aeruginosa PCC 7813 using high-performance liquid chromatography coupled with diode array detection (HPLC-DAD) and mass spectrometry (LC-MS). The toxins were purified and further characterized by amino acid analysis and tandem mass spectrometry (MS-MS). The presence of the previously reported microcystin-LR and microcystin-LY was confirmed. Two further microcystins were characterized as microcystin-LW and microcystin-LF. Another two toxins were partially characterized and are believed to be an analog of microcystin-LR (molecular weight 1008) and microcystin-LM (molecular weight 969). Natural bloom material of M. aeruginosa collected from 2 reservoirs was found to have similar microcystin profiles using HPLC-DAD and LC-MS, indicating the widespread occurrence of these microcystin variants. In addition, the presence of 5 of the microcystins was confirmed in the rumen contents of a lamb by LC-MS and LC-MS-MS, providing the first report of microcystins identified in an animal suspected of being poisoned by cyanobacterial hepatotoxins.

Topics: Amino Acid Sequence; Amino Acids; Animals; Chemical and Drug Induced Liver Injury; Chromatography, High Pressure Liquid; Dogs; Hydrolysis; Liver Diseases; Mass Spectrometry; Microcystins; Microcystis; Molecular Sequence Data; Peptides, Cyclic; Phosphoprotein Phosphatases; Rumen; Sheep; Sheep Diseases; Water Pollutants