Revealing potential drug targets in liver dysfunction through proteome-wide Mendelian randomization.

Liver damage, ranging from mild hepatic impairment to severe liver failure, presents a significant global health burden with limited therapeutic options. Understanding the molecular underpinnings of liver damage and identifying actionable protein targets are crucial for advancing treatment strategies. We employed summary-data-based Mendelian randomization and colocalization analyses to identify plasma proteins associated with 6 liver biomarkers (aspartate transaminase, alanine transaminase, alkaline phosphatase, gamma-glutamyltransferase, total bilirubin, and direct bilirubin) by leveraging proteomic data from the deCODE cohort. Functional enrichment analyses were conducted to elucidate biological roles, and protein-protein interaction networks were constructed to explore their relationship with current drug targets for liver damage drug prediction and molecular docking studies were performed to evaluate therapeutic potential and drug-target interactions. In the summary-data-based Mendelian randomization analysis, while 21 to 106 proteins were found to be significant, only 30 were validated as potential drug targets through colocalization analysis (PP.H4 > 0.8). Enrichment analysis shows involvement in purine metabolism, nucleotide metabolism, and other pathways. Protein-protein interaction networks identified interactions with known liver damage pathways. Drug prediction highlighted potential compounds, including 7,8-benzoflavone, quercetin and tetradioxin, with strong binding affinities validated by molecular docking. This integrative study identified 30 proteins with strong evidence as potential therapeutic targets for liver damage. We provide novel insights into the molecular mechanisms of liver damage and actionable leads for drug development. Further functional and clinical validation is warranted to translate these findings into personalized therapeutic strategies.