DRUG INDUCED LIVER INJURY: A SYSTEMATIC REVIEW

Abstract

Drug-induced liver injury (DILI), which has a variety of pathophysiological characteristics, is an important clinical problem. This review offers a thorough analysis of DILI, covering its pathophysiological mechanisms, the interaction between the microbiota and liver disease, the potential benefit of probiotics in preventing or treating DILI, diagnostic and prognostic methods, risk factors for DILI, current prevalence rates, and available treatments. The emergence of liver damage is influenced by the complex interplay of drug metabolism, immunological responses, and hereditary variables. An extensive list of medications, nutritional supplements, herbal products, and chemotherapeutic medicines that have been linked to DILI is provided based on the various research papers. The impact of the gut microbiota on healthy liver function and liver disease has been clarified by recent studies. Drug metabolism, immunological responses, and hepatic inflammation can all be affected by changes in gut microbial makeup and function, thereby worsening DILI. Probiotics’ impact on the gut-liver axis and their potential therapeutic advantages in the prevention and treatment of DILI are investigated. For effective management of DILI, a precise diagnosis and prognosis are essential. The outcomes of patients are predicted and treatment choices are guided by prognostic variables, such as liver function tests and drug causality evaluation tools. Inherited liver illnesses, genetic differences, patient characteristics, concurrent medication use, and other risk factors all have a role in the development of DILI. Identification of those at higher risk and the facilitation of specialized preventative interventions and patient monitoring is made possible by the recognition of these risk factors. DILI prevalence rates differ between populations and geographical areas. Planning for public health and allocating resources depend on tracking the incidence and prevalence of DILI. Although supportive care and medication withdrawal are the mainstays of DILI treatment, severe cases may call for a liver transplant. As a result, DILI is a multifactorial disorder that necessitates a thorough understanding of its processes, risk factors, diagnosis, and therapy. New insights into the gut microbiota and the possible impact of probiotics present intriguing directions for further study and treatment approaches to reduce liver damage caused by DILI.