Metabolic and Immune Toxicities of Common Therapies for Diabetes, BPH, and Autoimmune Conditions: A Comparative Review of Hepatic and Systemic Adverse Effects

Metabolic and Immune Toxicities of Common Therapies for Diabetes, BPH, and Autoimmune Conditions: A Comparative Review of Hepatic and Systemic Adverse Effects

Mwende Wairimu G.

School of Natural and Applied Sciences Kampala International University Uganda

ABSTRACT

Chronic diseases such as type 2 diabetes mellitus, benign prostatic hyperplasia (BPH), and autoimmune disorders necessitate long-term pharmacotherapy, which can predispose patients to metabolic, hepatic, and immune toxicities. This review examines the comparative adverse effects of commonly used therapies across these conditions, focusing on systemic and hepatic outcomes. Antidiabetic agents-including metformin, sulfonylureas, thiazolidinediones, insulin, GLP-1 receptor agonists, and SGLT2 inhibitors-can induce mitochondrial dysfunction, oxidative stress, and rare hepatotoxic events, in addition to metabolic derangements such as weight gain, dyslipidemia, and insulin resistance. BPH treatments, particularly alpha-adrenergic blockers and 5-alpha-reductase inhibitors, rarely affect liver function but can influence systemic hemodynamics, metabolic balance, and immune pathways. Immunomodulatory therapies, including conventional and targeted DMARDs, biologics, and JAK inhibitors, carry significant risks of hepatotoxicity, immune suppression, and idiosyncratic drug reactions. Shared mechanisms such as oxidative injury, mitochondrial impairment, and cytokine modulation underpin toxicities across these diverse drug classes. The review emphasizes the need for vigilant liver function monitoring, individualized dosing strategies, pharmacogenomic assessment, and adjunctive interventions targeting oxidative stress and metabolic resilience. Understanding these overlapping toxicity patterns is critical for optimizing therapeutic efficacy while minimizing systemic and hepatic complications in patients with complex comorbidities.

Keywords: Hepatotoxicity, Metabolic toxicity, Immunomodulatory therapy, Diabetes mellitus, Benign prostatic hyperplasia

 

CITE AS: Mwende Wairimu G. (2026). Metabolic and Immune Toxicities of Common Therapies for Diabetes, BPH, and Autoimmune Conditions: A Comparative Review of Hepatic and Systemic Adverse Effects. IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 11(1):36-41.  https://doi.org/10.59298/IDOSR/JBBAF/2026/1023641