Wang Qiaoling, Huang Ang, Wang Jia-Bo, Zou Zhengsheng
Peking University 302 Clinical Medical School, Beijing, China.
Department of Liver Disease of Chinese PLA General Hospital, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
Front Pharmacol. 2021 Mar 8;12:627133. doi: 10.3389/fphar.2021.627133. eCollection 2021.
Chronic drug-induced liver injury (DILI), defined as DILI with persistent liver injury more than one year after the first onset by the latest European guidelines, is a notable challenge globally with big issues of defining causality and establishing effective treatment. About 20% of patients with DILI develop into chronic DILI. Chronic DILI manifests as persistent or repeated inflammatory or diminishing bile ducts, even progresses to cirrhosis and needs liver transplantation eventually. However, research on chronic DILI over the last decades is still lacking, and the incidence, phenotypes, mechanisms, risk factors, and treatment have not been fully understood. In this paper, we reviewed the definition of chronic DILI, updated clinical studies in terms of incidence, special manifestations, and promising risk factors of chronic DILI, along with the recent progress and challenges in glucocorticoid therapy.
慢性药物性肝损伤（DILI），根据最新欧洲指南定义为首次发病后持续肝损伤超过一年的DILI，是全球范围内一项显著挑战，存在因果关系判定和确立有效治疗等重大问题。约20%的DILI患者会发展为慢性DILI。慢性DILI表现为持续性或反复性炎症或胆管萎缩，甚至进展为肝硬化并最终需要肝移植。然而，过去几十年对慢性DILI的研究仍然不足，其发病率、表型、机制、危险因素及治疗方法尚未完全明确。本文回顾了慢性DILI的定义，更新了关于慢性DILI发病率、特殊表现及潜在危险因素的临床研究，以及糖皮质激素治疗方面的最新进展和挑战。
