The
clinical use of some drugs, such as carbamazepine, phenytoin,
and allopurinol, is often associated with adverse cutaneous reactions.
The bioactivation of drugs into immunologically reactive metabolites
by the liver is postulated to be the first step in initiating a downstream
cascade of pathological immune responses. Current mechanistic understanding
and the ability to predict such adverse drug cutaneous responses have
been partly limited by the lack of appropriate cutaneous drug bioactivation
experimental models. Although in vitro human liver models have been
extensively investigated for predicting hepatotoxicity and drug–drug
interactions, their ability to model the generation of antigenic reactive
drug metabolites that are capable of eliciting immunological reactions
is not well understood. Here, we employed a human progenitor cell
(HepaRG)-derived hepatocyte model and established highly sensitive
liquid chromatography-mass spectrometry analytical assays to generate
and quantify different reactive metabolite species of three paradigm
skin sensitizers, namely, carbamazepine, phenytoin, and allopurinol.
We found that the generation of reactive drug metabolites by the HepaRG-hepatocytes
was sensitive to the medium composition. In addition, a functional
assay based on the activation of U937 myeloid cells into the antigen-presenting
cell (APC) phenotype was established to evaluate the immunogenicity
potential of the reactive drug metabolites produced by HepaRG-derived
hepatocytes. We showed that the reactive drug metabolites of known
skin sensitizers could significantly upregulate
IL
8,
IL
1β, and
CD
86 expressions
in U937 cells compared to the metabolites from a nonskin sensitizer
(i.e., acetaminophen). Thus, the extent of APC activation by HepaRG-hepatocytes
conditioned medium containing reactive drug metabolites can potentially
be used to predict their skin sensitization potential.