Abstract
The liver is the most important organ involved in the metabolism of virtually all drugs and xenobiotics introduced into the body. Drug-induced liver injury (DILI) is a major health problem. The hepatotoxicity associated with some drugs can be severe and life-threatening. DILI has been identified as the most frequent single incidence leading to the withdrawal or restricted use of marketed drugs or termination of clinical trials of investigational drugs during development. The pathogenesis of DILI is very complex. In addition to genetic and environmental factors, drug-induced hepatocyte injury plays a central role in the pathogenesis of DILI. During the last several decades, extensive research has been done to identify the molecular mechanisms underlying DILI. Emerging evidence indicates that endoplasmic reticulum (ER) stress is an important contributor to the pathogenesis of DILI by disrupting hepatic metabolism, inducing inflammation and cell apoptosis. In this chapter, we summarize the current understanding of ER stress in DILI with a focus on HIV protease inhibitor-induced hepatic injury.
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