The Role of Connexin in Cutaneous Adverse Drug Reactions (CADRs) in Patients with Increasing Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT)

D. Oktarina, Gilang Baswara, H. Soebono
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Abstract

Background: The occurrence of Cutaneous Adverse Drug Reactions (CADRs) is relatively rare but can be fatal when causing organ failure, especially in the liver. The supporting examinations to determine liver injury are aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Connexin-32 (Cx32) and connexin-43 (Cx43) are gap junction proteins that can be found in the liver and allegedly have a role in the mechanism of liver injury. To date, correlations between the level of connexin and aminotransferases enzyme in humans with CADRs cases are still unclear. Purpose: To determine the correlations between Cx32/Cx43 and AST/ALT levels in CADRs cases. Methods: This was a retrospective study, data collected from inpatient and outpatient’s medical records, Department of Dermatology and Venereology of Dr. Sardjito Hospital, from 2011–2015. Result: A total of 25 patients with CADRs and 35 healthy controls were included in this study. The levels between Cx32 and AST, Cx32 and ALT, Cx43 and AST, and Cx43 and ALT were not significantly correlated in CADRs cases (p>0.05). Both Cx32 and Cx43 were not significantly different between patients with and without CADRs (p>0.05). Confounding factors such as gender were not associated with this study (p>0.05). Conclusion: There was no correlation between levels of Cx32/Cx43 and increasing AST/ALT in CADRs cases. Therefore, further study is necessary to conclude the correlation between connexin and aminotransferase enzyme in CADRs patients.
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连接蛋白在谷草转氨酶(AST)和丙氨酸转氨酶(ALT)升高患者皮肤药物不良反应(CADRs)中的作用
背景:皮肤药物不良反应(CADRs)的发生相对罕见,但当引起器官衰竭时,尤其是肝脏,可能是致命的。判断肝损伤的辅助检查是天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)。Connexin-32 (Cx32)和connexin-43 (Cx43)是在肝脏中发现的间隙连接蛋白,据称在肝损伤机制中起作用。迄今为止,CADRs患者中连接蛋白和转氨酶水平之间的相关性尚不清楚。目的:探讨CADRs患者Cx32/Cx43与AST/ALT水平的相关性。方法:回顾性研究,收集Dr. Sardjito医院皮肤性病科2011-2015年住院和门诊病历资料。结果:本研究共纳入25例cadr患者和35例健康对照。在CADRs患者中,Cx32与AST、Cx32与ALT、Cx43与AST、Cx43与ALT的表达无显著相关性(p>0.05)。Cx32和Cx43在CADRs患者和非CADRs患者中均无显著差异(p>0.05)。性别等混杂因素与本研究无关(p>0.05)。结论:CADRs患者Cx32/Cx43水平与AST/ALT升高无相关性。因此,有必要进一步研究连接蛋白与转氨酶在CADRs患者中的相关性。
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