Drug induced liver injury - a 2023 update.

Area of Science:

• Hepatology
• Toxicology
• Immunology

Background:

• Drug-Induced Liver Injury (DILI) is hepatic damage from drug exposure, classified as hepatocellular, cholestatic, or mixed, and can involve immune responses.
• DILI can be intrinsic (dose-dependent) or idiosyncratic (spontaneous); this review focuses on idiosyncratic DILI.
• Established molecular mechanisms include mitochondrial dysfunction, oxidative stress, apoptosis/necrosis, and immune-mediated bile duct injury, though underlying causes remain unclear.

Purpose of the Study:

• To review current knowledge on DILI mechanisms.
• To identify potential risk factors for DILI.
• To examine the impact of the COVID-19 pandemic on DILI presentation and research.

Main Methods:

• Retrospective cohort studies from global sources were analyzed.
• Literature review on established and potential DILI mechanisms.
• Examination of epidemiological patterns and risk factors.

Main Results:

• The review synthesizes current understanding of DILI mechanisms, including mitochondrial dysfunction and oxidative stress.
• Potential risk factors and the influence of the COVID-19 pandemic on DILI are discussed.
• The critical need for DILI prevention strategies due to limited treatment options is emphasized.

Conclusions:

• Further research into DILI mechanisms, biomarkers, and causality assessment is essential.
• Understanding epidemiological patterns and risk factors is crucial for prevention.
• The COVID-19 pandemic presents new challenges and research avenues for DILI.