Andrew Dellinger publishes article on liver injury caused by a common antibiotic

A new publication in the journal Hepatology, with many analyses performed by Assistant Professor of Mathematics Andrew Dellinger, found that alleles 14:01 and 35:01 of the HLA-B gene were found to be associated with liver damage due to the antibiotic Bactrim.

Assistant Professor of Mathematics Andrew Dellinger has published a new article in the journal Hepatology.

Andrew Dellinger, assistant professor of mathematics

Working with the Drug Induced Liver Injury Network (DILIN), an international research group funded by the National Institute of Health (NIH), Dellinger and others searched for the cause of liver injury due to a common antibiotic. This antibiotic goes by names such as Bactrim, Septra, Sulfatrim, SMZ-TMP, and sulfamethoxazole with trimethoprim.

A set of 61 patients were studied whose medical records were evaluated and expertly determined that the cause of their liver injury was Bactrim. Genetic data was obtained using microarrays and DNA sequencing. A previous study of over 2,000 cases and over 12,000 controls indicated that the HLA region of chromosome 6 significantly influenced liver damage regardless of the particular medication, herbal ingredient, or supplement causing the damage. Therefore, the HLA region was the focus of the analysis.

Allele 14:01 of the HLA-B gene (B*14:01) was found to be significantly associated with liver injury due to Bactrim in European American patients. People in this population with this allele are at greater risk for liver injury when taking Bactrim. Haplotype analysis found that alleles B*14:01 and C*08:02 together were more strongly associated with liver injury in this population than B*14:01 alone.  From amino acid analysis, it is believed that the Sulfamethoxazole medication in Bactrim binds to an amino acid called cysteine in position 67 of the B*14:01 protein.

Allele 35:01 of the HLA-B gene was found to be significantly associated with liver injury due to Bactrim in African American patients. People in this population with this allele are at greater risk for liver injury when taking Bactrim. In this population, it is believed that the Sulfamethoxazole medication in Bactrim binds to an amino acid called phenylalanine in position 67 of the B*35:01 protein.

The research was e-published in the journal Hepatology (https://www.ncbi.nlm.nih.gov/pubmed/32270503) on April 9 ahead of the printed paper.