Tenofovir and Renal Toxicity at Cellular Level

Authors

  • Wisith Tun-Yhong
  • Perayot Pamonsinlapatham
  • Chatchai Chinpaisan

Abstract

Tenofovir disoproxil fumarate (TDF) is a high potency of anti-HIV and anti-hepatitis B virus drug. Currently, the limited use of this drug in the clinical setting is nephrotoxicity. The incidence of tenofovir-induced nephropathy is 10 - 22 percent and 5 - 18 percent in Europe and Thai population in respectively. The inhibition properties of mtDNA polymerase g encoded by POLG gene has been proposed to play a central role in tenofovir-induced mitochondrial toxicity which contributed to nephropathy. Although tenofovir has not been studied, admittedly theory is supported that this drug was induced proximal tubular apoptosis by leading to caspase-9 activation as similar as another drug in the classification of nucleotide-analog reverse transcriptase inhibitors such as adefovir and cidofovir. This theory is supported by the observation that Fanconi’s syndrome is the most common renal manifestation of mitochondria cytopathies, there are presented in the most reported cases of tenofovir-associated nephropathy. Moreover, the histopathology that observed under electron microscopy was attest the supported theories because it showed the identical data of mitochondrial enlargement, depletion and dysmorphic changes. However, there is no study was performed to demonstrate the exactly mechanism of tenofovir-induced nephrotoxicity at cellular level, in our reviewed during 2006 - 2016, then the further study to demonstrate this effects should be employed. In summary, the most encouraged mechanism of tenofovir-induced nephropathy at cellular level is associated to the inhibition of mtDNA polymerase g enzyme which conduce towards to induced proximal tubular cell apoptosis by leading to caspase - 9 activation. Keyword:  tenofovir, mitochondria, glycoprotein, nephrotoxicity, MRP

Author Biographies

Wisith Tun-Yhong

Department of Pharmacology and Toxicology, Faculty of Pharmaceutical sciences, Burapha University

Perayot Pamonsinlapatham

Department of Health-related informatics, Faculty of Pharmacy, Silpakorn University

Chatchai Chinpaisan

Department of Pharmcology and toxicology, Faculty of Pharmacy, Silpakorn University

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Published

2017-07-04