Abstract
Chloroquine (CQ) and hydroxychloroquine (HCQ) have been used in treating COVID-19 patients recently. However, both drugs have some contradictions and rare but severe side effects, such as hypoglycemia, retina and cardiac toxicity. To further uncover the toxicity profile of CQ and HCQ in different tissues, we evaluated the cytotoxicity of them in 8 cell lines, and further adopted the physiologically-based pharmacokinetic models (PBPK) to predict the tissue risk respectively. Retina, myocardium, lung, liver, kidney, vascular endothelium and intestinal epithelium originated cells were included in the toxicity evaluation of CQ and HCQ respectively. The proliferation pattern was monitored in 0-72 hours by IncuCyte S3, which could perform long-term continuous image and video of cells upon CQ or HCQ treatment. CC50 and the ratio of tissue trough concentrations to CC50 (RTTCC) were brought into predicted toxicity profiles. The CC50 at 24 h, 48 h, 72 h of CQ and HCQ decreased in the time-dependent manner, which indicates the accumulative cytotoxic effect. HCQ was found to be less toxic in 7 cell types except cardiomyocytes H9C2 cells (CC50-48 h=29.55 μM; CC50-72 h=15.26 μM). In addition, RTTCC is significant higher in CQ treatment group compared to HCQ group, which indicates that relative safety of HCQ. Both CQ and HCQ have certain cytotoxicity in time dependent manner which indicates the necessity of short period administration clinically. HCQ has the less impact in 7 cell lines proliferation and less toxicity compared to CQ in heart, liver, kidney and lung.
Footnotes
Funding sources, This work was supported by the MOST (Ministry of Science and Technology of the People’s Republic of China) foundation for SARS-nCov-02 Research (grant No. 2020YFC0844500) and Bill & Melinda Gates Foundation [INV-015694]; and “13th Five-Year” National Major New Drug Projects (No. 2017ZX09101001-002-001).
Abbreviations
- SARS-CoV-2
- Severe Acute Respiratory Syndrome Coronavirus 2
- ARDS
- Acute respiratory distress syndrome
- CQ
- Chloroquine
- HCQ
- Hydroxychloroquine
- COVID-19
- Coronavirus disease 2019
- SLE
- Systemic lupus erythematosus
- EC50
- Concentration for 50% of maximal effect
- CC50
- The median cytotoxic concentration
- PBPK
- Physiologically-based pharmacokinetic models
- RTTCC
- Ratio of tissue trough concentration vs CC50)