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Updated: Mar 3, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
Evaluating the Role of Multidrug Resistance Protein 3 (MDR3) Inhibition in Predicting Drug-Induced Liver Injury Using
Michael D Aleo1, Falgun Shah2, Kan He3
1Drug Safety Research and Development, Pfizer Inc. , Groton, Connecticut 06340, United States.
Drug-induced liver injury (DILI) can involve inhibition of the multidrug resistant protein 3 (MDR3), which affects phospholipid secretion. Compounds inhibiting both MDR3 and bile salt export protein (BSEP) may pose higher DILI risks.
Area of Science:
- Hepatology
- Pharmacology
- Drug Safety
Background:
- Bile salt export protein (BSEP) inhibition is a known DILI mechanism.
- Multidrug resistant protein 3 (MDR3) inhibition, crucial for phospholipid secretion, is less studied in DILI.
- MDR3 and BSEP coordinate bile acid micelle formation.
Purpose of the Study:
- To investigate MDR3 inhibition by 125 drugs across DILI concern levels.
- To identify physicochemical properties associated with MDR3 inhibition.
- To assess the combined risk of MDR3 and BSEP inhibition in DILI.
Main Methods:
- Assessed MDR3 inhibition in human hepatocytes for 125 drugs.
- Analyzed drug physicochemical properties (PSA, cPFLogD) and basicity.
- Compared MDR3 inhibition IC50 values with DILI classifications and systemic exposure safety margins.
Main Results:
- 41-47% of tested drugs showed MDR3 inhibition (IC50 <50 μM).
- Basic compounds and those with PSA <100 Ų or cPFLogD 1.5-5 were more likely MDR3 inhibitors.
- Nine high-DILI concern drugs inhibited both MDR3 and BSEP (<20 μM).
Conclusions:
- MDR3 inhibition is a relevant factor in DILI.
- Combined inhibition of MDR3 and BSEP may increase DILI severity.
- Testing for multiple efflux transporter inhibition can aid DILI risk assessment.
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