Serum zinc protoporphyrin and protoporphyrin IX levels as potential biomarkers for anti-tuberculosis drug-induced hepatotoxicity.

Authors

Min Zhu, Fei Wang, Lizhi Lv, Yu Wu, Ruina Chen, Jingru Cheng, Meiling Zhang, Xiaoyan Xu, Shaowen Tang

Published in

Pakistan journal of pharmaceutical sciences. Volume 39. Issue 10. Pages 3089-3097.

Abstract

Anti-tuberculosis drug-induced hepatotoxicity (ATDH) remains a significant clinical challenge, highlighting the critical demand for predictive biomarkers.
This study aimed to investigate serum zinc protoporphyrin (ZnPP) and protoporphyrin IX (PPIX) as potential ATDH predictors.
Blood samples were collected at baseline and two subsequent liver function tests in 58 cases and 191 controls from four hospitals.
The ZnPP levels of controls at baseline and two subsequent time points (147.9, 152.0 and 147.5 pg/ml, respectively) were significantly higher than cases (113.1, 134.3 and 119.0 pg/ml), while the PPIX levels were significantly higher in ATDH cases (8.6, 9.4 and 9.1 ng/ml, respectively) than controls (7.0, 7.6 and 7.1 ng/ml) (P<0.05). Multivariate analysis identified liver disease history, baseline serum ZnPP and PPIX as independent ATDH risk factors. A predictive model combining the three variables achieved an area under curve (AUC) of 0.714 (95% CI, 0.639~0.790), with improved AUC in moderate-severe cases (AUC, 0.782; 95% CI, 0.688~0.877).
The present study provides the first clinical evidence linking baseline serum ZnPP/PPIX levels with ATDH risk, suggesting their potential as predictive biomarkers, especially for moderate-severe cases.

PMID:
42474164
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.

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