Harmful effects of chlorhexidine on hepatic metabolism

Chlorhexidine (CHX) is an over-the-counter antiseptic amply used by the population. There are reports that CHX acts in mitochondria as an uncoupler and inhibitor. The purpose of this study was to investigate the short-term effects of CHX on hepatic metabolic pathways linked to energy metabolism in the perfused rat liver. The compound inhibited both glucose synthesis and the urea cycle. Oxygen consumption was raised at low concentrations (up to 10 μM) and diminished at higher ones. A pronounced diminution in the cellular ATP content was observed. Conversely, CHX stimulated glycolysis and enhanced leakage of cellular enzymes (lactate dehydrogenase and fumarase). In isolated mitochondria, this antiseptic inhibited pyruvate carboxylation, oxidases, and oxygen uptake at very low concentrations (2 μM) and promoted uncoupling. The results described herein raise great concerns about the safety of CHX, as the observed effects can induce hypoglycemia, lactic acidosis, ammonemia as well as cell membrane disruption. [Display omitted] •CHX reduced the cellular ATP content and the ATP/AMP ratio.•Hepatic anabolic pathways rate are inhibited and catabolic ones are increased.•Oxygen uptake was stimulated at slow concentrations and inhibited at higher ones in the liver.•CHX inhibited pyruvate carboxylation in isolated mitochondria.•CHX compromised mitochondrial energetic efficiency and disrupted the cell membrane.