A’zo va to‘qimalarda immunodepressantlar ta’sirida kuzatiladigan morfofunksional va immunogistokimyoviy o‘zgarishlar

Morphofunctional and immunohistochemical changes in organs and tissues under the influence of immunosuppressants

Main Article Content

Oripov F.S.
Jurayeva B.G.

Abstract

This review article provides a comprehensive analysis of current data on morphofunctional and immunohistochemical changes in organs and tissues (liver, kidneys, spleen, lymph nodes, bone marrow) following the use of antineoplastic immunosuppressants of various pharmacological groups, including cyclophosphamide, methotrexate, and azathioprine. The main mechanisms of toxicity are discussed: xenobiotic metabolism disturbances, activation of oxidative stress, induction of apoptosis, mitochondrial dysfunction, cytokine-mediated inflammatory responses, and fibrogenesis processes. Special attention is given to the role of immunohistochemical markers (Caspase-3, Ki-67, CD4, CD8, CD68, TNF-α, IL-6, TGF-β, 8-OHdG, 4-HNE, MDA) in detailing structural-functional changes and early diagnosis of drug-induced injuries.

Article Details

Section

Articles

How to Cite

Oripov F.S., & Jurayeva B.G. (2026). Morphofunctional and immunohistochemical changes in organs and tissues under the influence of immunosuppressants. Partner Conferences of the International Scientific Journal Research Focus, 1(5), 26-34. https://doi.org/10.66073/ReFocus-Conf/260904

References

Abraham P., Sugumar E. Cyclophosphamide induced hepatotoxicity in experimental animals // Toxicology Mechanisms and Methods. – 2015. – Vol. 25, No. 5. – P. 373-380.

Barbarino J. M. et al. PharmGKB summary: cyclosporine and tacrolimus pathways // Pharmacogenetics and genomics. – 2013. – Vol. 23, No. 10. – P. 563-585. DOI: https://doi.org/10.1097/FPC.0b013e328364db84

Allameh A. et al. Oxidative stress in liver pathophysiology and disease // Antioxidants. – 2023. – Vol. 12, No. 9. – P. 1653. DOI: https://doi.org/10.3390/antiox12091653

Chakraborty J. B., Oakley F., Walsh M. J. Mechanisms and biomarkers of apoptosis in liver disease and fibrosis // International journal of hepatology. – 2012. – Vol. 2012, No. 1. – P. 648915. DOI: https://doi.org/10.1155/2012/648915

Choi Y. Y. et al. Co-administration of everolimus and N-acetylcysteine attenuates hepatic stellate cell activation and hepatic fibrosis // American journal of translational research. – 2020. – Vol. 12, No. 6. – P. 2627.

Czaja A. J. Drug-induced autoimmune-like hepatitis // Digestive diseases and sciences. – 2011. – Vol. 56, No. 4. – P. 958-976. DOI: https://doi.org/10.1007/s10620-011-1611-4

de Lédinghen V. et al. Sinusoidal obstruction syndrome // Clinics and research in hepatology and gastroenterology. – 2020. – Vol. 44, No. 4. – P. 480-485. DOI: https://doi.org/10.1016/j.clinre.2020.03.019

Devarbhavi H. An update on drug-induced liver injury // Journal of clinical and experimental hepatology. – 2012. – Vol. 2, No. 3. – P. 247-259. DOI: https://doi.org/10.1016/j.jceh.2012.05.002

Ezhilarasan D. Hepatotoxic potentials of methotrexate: Understanding the possible toxicological molecular mechanisms // Toxicology. – 2021. – Vol. 458. – P. 152840. DOI: https://doi.org/10.1016/j.tox.2021.152840

Fan C. Q., Crawford J. M. Sinusoidal obstruction syndrome (hepatic veno-occlusive disease) // Journal of clinical and experimental hepatology. – 2014. – Vol. 4, No. 4. – P. 332-346. DOI: https://doi.org/10.1016/j.jceh.2014.10.002

Feuth T. et al. CD4/CD8 ratio is a promising candidate for non-invasive measurement of liver fibrosis in chronic HCV-monoinfected patients // European journal of clinical microbiology & infectious diseases. – 2014. – Vol. 33, No. 7. – P. 1113-1117. DOI: https://doi.org/10.1007/s10096-014-2053-7

Gerussi A. et al. Immune-mediated drug-induced liver injury: immunogenetics and experimental models // International Journal of Molecular Sciences. – 2021. – Vol. 22, No. 9. – P. 4557. DOI: https://doi.org/10.3390/ijms22094557

Guengerich F. P. Cytochrome P-450 3A4: regulation and role in drug metabolism // Annual review of pharmacology and toxicology. – 1999. – Vol. 39, No. 1. – P. 1-17. DOI: https://doi.org/10.1146/annurev.pharmtox.39.1.1

Hernandez N., Bessone F. Hepatotoxicity induced by biological agents: clinical features and current controversies // Journal of Clinical and Translational Hepatology. – 2022. – Vol. 10, No. 3. – P. 486. DOI: https://doi.org/10.14218/JCTH.2021.00243

Kleiner D. E. Liver histology in the diagnosis and prognosis of drug‐induced liver injury // Clinical Liver Disease. – 2014. – Vol. 4, No. 1. – P. 12-16. DOI: https://doi.org/10.1002/cld.371

Lim E. J. et al. Effect of immunosuppressive agents on hepatocyte apoptosis post-liver transplantation // Plos one. – 2015. – Vol. 10, No. 9. – P. e0138522. DOI: https://doi.org/10.1371/journal.pone.0138522

Lim E. J. et al. Hepatitis C‐induced hepatocyte apoptosis following liver transplantation is enhanced by immunosuppressive agents // Journal of viral hepatitis. – 2016. – Vol. 23, No. 9. – P. 730-743. DOI: https://doi.org/10.1111/jvh.12541

Lushnikova E. L. et al. Ultrastructurural picture of cyclophosphamide-induced damage to the liver // Bulletin of Experimental Biology and Medicine. – 2011. – Vol. 151, No. 6. – P. 751-756. DOI: https://doi.org/10.1007/s10517-011-1432-7

Merenkova E. A. (Меренкова Е. А.) Препараты иммуносупрессивной терапии больных интерстициальными заболеваниями легких // Український пульмонологічний журнал. – 2018. – № 1. – С. 33-38.

National Institute of Diabetes and Digestive and Kidney Diseases (US). LiverTox: clinical and research information on drug-induced liver injury. – National Institute of Diabetes and Digestive and Kidney Diseases, 2012.

Podszun M. C. et al. 4-HNE immunohistochemistry and image analysis for detection of lipid peroxidation in human liver samples using vitamin E treatment in NAFLD as a proof of concept // Journal of Histochemistry & Cytochemistry. – 2020. – Vol. 68, No. 9. – P. 635-643. DOI: https://doi.org/10.1369/0022155420946402

Ramachandran R., Kakar S. Histological patterns in drug-induced liver disease // Journal of clinical pathology. – 2009. – Vol. 62, No. 6. – P. 481-492. DOI: https://doi.org/10.1136/jcp.2008.058248

Ramos-Casals M. et al. Autoimmune diseases induced by biological agents: a double-edged sword? // Autoimmunity reviews. – 2010. – Vol. 9, No. 3. – P. 188-193. DOI: https://doi.org/10.1016/j.autrev.2009.10.003

Schmidt S. et al. Methotrexate-induced liver injury is associated with oxidative stress, impaired mitochondrial respiration, and endoplasmic reticulum stress in vitro // International journal of molecular sciences. – 2022. – Vol. 23, No. 23. – P. 15116. DOI: https://doi.org/10.3390/ijms232315116

Staatz C. E., Tett S. E. Clinical pharmacokinetics and pharmacodynamics of tacrolimus in solid organ transplantation // Clinical pharmacokinetics. – 2004. – Vol. 43, No. 10. – P. 623-653. DOI: https://doi.org/10.2165/00003088-200443100-00001

Stine J. G., Northup P. G. Autoimmune-like drug-induced liver injury: a review and update for the clinician // Expert Opinion on Drug Metabolism & Toxicology. – 2016. – Vol. 12, No. 11. – P. 1291-1301. DOI: https://doi.org/10.1080/17425255.2016.1211110

Suzuki A. et al. The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug‐induced liver injury // Hepatology. – 2011. – Vol. 54, No. 3. – P. 931-939. DOI: https://doi.org/10.1002/hep.24481

Turbayne A. K., Sparrow M. P. Low-dose azathioprine in combination with allopurinol: the past, present and future of this useful duo // Digestive diseases and sciences. – 2022. – Vol. 67, No. 12. – P. 5382-5391. DOI: https://doi.org/10.1007/s10620-022-07719-x

Wilkinson G. R. Drug metabolism and variability among patients in drug response // New England Journal of Medicine. – 2005. – Vol. 352. – P. 2211-2221. DOI: https://doi.org/10.1056/NEJMra032424

Zanger U. M., Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation and clinical relevance // Pharmacology & Therapeutics. – 2013. – Vol. 138, No. 1. – P. 103-141. DOI: https://doi.org/10.1016/j.pharmthera.2012.12.007

Zhu L. et al. Caspase-3/Treg and PI3K/AKT/mTOR pathway is involved in liver ischemia reperfusion injury (IRI) protection by everolimus // Transplant Immunology. – 2022. – Vol. 71. – P. 101541. DOI: https://doi.org/10.1016/j.trim.2022.101541

Есмембетов К. И., Калиаскарова К. С., Спатаев Ж. С. Иммуносупрессивная терапия после трансплантации печени: основные принципы и современное применение // Journal of clinical medicine of Kazakhstan. – 2018. – № 3 (49). – С. 6-14.

Коренская Е. Г., Парамонова О. В. Лекарственные поражения печени – одна из важных проблем у коморбидного пациента // Consilium Medicum. – 2019. – Т. 21. – № 8. – С. 78-83. DOI: https://doi.org/10.26442/20751753.2019.8.190355

Лазебник Л. Б. и др. Клинические рекомендации: лекарственные поражения печени у взрослых // Терапия. – 2020. – Т. 6. – № 4. – С. 52-76.

Мойсюк Я. Г. и др. Длительная иммуносупрессия после трансплантации печени в реальной клинической практике // Трансплантология. – 2025. – Т. 17. – № 4. – С. 368-384.

Эргашев Н. Х. Возможность прогнозирования выраженной нефро- и гепатотоксичности у онкобольных при химиотерапии // South Aral Region Medical Journal. – 2025. – Т. 1. – № 3. – С. 224-229.