Abstract
Drug-induced liver injury (DILI) is a challenging clinical event in medicine, particularly because of its ability to present with a variety of phenotypes including that of autoimmune hepatitis or other immune mediated liver injuries. Limited diagnostic and therapeutic tools are available, mostly because its pathogenesis has remained poorly understood for decades. The recent scientific and technological advancements in genomics and immunology are paving the way for a better understanding of the molecular aspects of DILI. This review provides an updated overview of the genetic predisposition and immunological mechanisms behind the pathogenesis of DILI and presents the state-of-the-art experimental models to study DILI at the pre-clinical level.
Highlights
Drug-induced Liver Injury (DILI) is defined by the presence of some degree of liver injury, commonly detected by the rise of liver-related enzymes in the blood, which can be causally related to a specific drug [1]
The authors of the study assessed the discriminative power of polygenic risk score (PRS) in primary hepatocytes and stem-cell derived organoids, revealing that there is a shared Drug-induced liver injury (DILI) predisposition which is independent of chemical properties of each specific drug
They identified higher rates of inactivation of genes involved in mitochondria and translation in subjects with higher PRS values and pointed out that DILI susceptibility is due to several biological pathways in hepatocytes, including oxidative stress and unfolded protein response [15]
Summary
Drug-induced Liver Injury (DILI) is defined by the presence of some degree of liver injury, commonly detected by the rise of liver-related enzymes in the blood, which can be causally related to a specific drug [1]. Estimates of incidence report around 15–20 cases per. 100,000 individuals, and DILI accounts for half of the cases of acute liver failure in Western countries [1]. Registries such as the Spanish DILI Registry represent invaluable tools to study the epidemiology and disease course of DILI [2]
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