Girish Chandrashekaran, Sanjay Sukumaran
Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.
World J Hepatol. 2021 Nov 27;13(11):1677-1687. doi: 10.4254/wjh.v13.i11.1677.
Drug-induced liver injury (DILI) is one of the leading causes of liver failure and withdrawal of drugs from the market. A poor understanding of the precipitating event aetiology and mechanisms of disease progression has rendered the prediction and subsequent treatment intractable. Recent literature suggests that some drugs can alter the liver's repair systems resulting in injury. The pathophysiology of DILI is complex, and immune dysfunction plays an important role in determining the course and severity of the disease. Immune dysfunction is influenced by the host response to drug toxicity. A deeper understanding of these processes may be beneficial in the management of DILI and aid in drug development. This review provides a structured framework presenting DILI in three progressive stages that summarize the interplay between drugs and the host defence networks.
药物性肝损伤(DILI)是肝衰竭和药物退市的主要原因之一。对引发事件的病因及疾病进展机制了解不足,使得预测及后续治疗变得棘手。近期文献表明,某些药物可改变肝脏的修复系统,从而导致损伤。DILI的病理生理学很复杂,免疫功能障碍在决定疾病的进程和严重程度方面起着重要作用。免疫功能障碍受宿主对药物毒性反应的影响。更深入地了解这些过程可能有助于DILI的管理并促进药物研发。本综述提供了一个结构化框架,将DILI呈现为三个递进阶段,总结了药物与宿主防御网络之间的相互作用。