Powell, who is an assistant research professor of medicinein the school’s Division of Clinical Pharmacology, said he and his team were building on existing evidence that people with NAFLD may be at risk for altered response to some commonly used medications.
“We wanted to see if this could be due to changes in how the liver expresses genes important to handling the metabolism and transport of these medicines in the body,” he said.
Subsequently, the team found that the gene responsible for making an enzyme called CYP2C19 was significantly decreased in liver biopsies of people with worsening NAFLD.
“Further studies will be needed, but our results suggest that people with NAFLD will have slower clearance of certain medications from their body–like some antidepressants–and that medicines which use CYP2C19 to become activated may not work as well, such as the antiplatelet medicine clopidogrel,” he said.
Naga Chalasani, MD, the study’s senior author, said these findings could have aglobal impact.
“Our findings have immediate potential implications for patients with NAFLD and nonalcoholic steatohepatitis (NASH), which are both highly prevalent here in the United States and around the world,” he said.
That impact is largely due to the potential for new approaches to development and prescribing ofmedications that are sensitive to metabolism by the CYP2C19 enzyme, according to the paper.
“Our findings are exciting from a precision medicine standpoint because we can now work on making medicines safer and more effective for people with NAFLD,” said Powell.
This study was a collaboration between investigators in the Division of Gastroenterology and Hepatology and the Division of Clinical Pharmacology at IU School of Medicine, and investigators from Eli Lilly and Company.
“We are very thankful to our collaborators from Lilly who made this translational study possible,” said Chalasani.
About IU School of Medicine
IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.