Immunization with amodiaquine-modified hepatic proteins prevents amodiaquine-induced liver injury
Bibliographic record
Abstract
Amodiaquine (AQ) has been reported to cause severe idiosyncratic drug-induced liver injury (IDILI) in humans. There is evidence that AQ-induced idiosyncratic drug reactions are immune mediated, but their exact mechanism is not fully understood. AQ is oxidized to a reactive quinoneimine metabolite, and it has been suggested that covalent binding of this metabolite leads to an immune response and liver injury. A valid animal model would greatly facilitate mechanistic studies. This laboratory had previously reported that chronic treatment of C57BL/6 mice with AQ induced a delayed-onset mild liver injury that appeared to resolve with immune tolerance. The current study attempted to prevent immune tolerance by first immunizing mice with AQ-modified hepatic proteins. This study used a soluble adjuvant known as 'covax' that has been reported to produce a better immune response than Freund's adjuvant. After immunization, the mice were treated with 0.2% AQ in food for 5 weeks, as previously done. Paradoxically, the immunization protected animals from AQ-induced liver injury instead of exacerbating it. Consistent with this protection, immunization also appeared to lead to a tolerogenic response with an increase in myeloid derived suppressor cells, M2 macrophages, and FoxP3(+) T-cells. This attempt to develop an animal model of IDILI was unsuccessful and illustrated the complexity of the immune response and the difficulty of inducing a sustained immune response in the liver. It also reinforces the hypothesis that the key determinant of IDILI is immune tolerance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".