Drug-induced liver injury
Drug-induced liver injury
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DOI：
10.1086/381446
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发表时间：
2004-03-01
影响因子：
11.8
通讯作者：
Kaplowitz, N
中科院分区：
文献类型：
--
作者：
Kaplowitz, N
药物性肝毒性是导致肝损伤的常见原因。主要的临床表现是急性肝炎和/或胆汁淤积，尽管几乎任何急性或慢性肝病的临床病理类型都可以发生。药物性肝病的发病机制通常涉及母体药物或代谢物的参与，这些药物或代谢物要么直接影响细胞生化，要么引发免疫反应。每一种肝毒素都与损伤和潜伏期模式有关的特征特征相关联。然而，一些药物可能会表现出>；1签名。对药物引起的肝毒性的易感性也受到遗传和环境风险因素的影响。不可预测的、低频的、特殊的反应通常发生在轻度无症状肝损伤发生率较高的背景下，虽然很难预测，但可以通过监测血清丙氨酸转氨酶水平来发现。近期和未来在毒理基因组学和蛋白质组学方面的进展将有助于危险因素的识别和对特异性肝毒性的理解。
Drug-induced hepatotoxicity is a frequent cause of liver injury. The predominant clinical presentation is acute hepatitis and/or cholestasis, although almost any clinical pathological pattern of acute or chronic liver disease can occur. The pathogenesis of drug-induced liver disease usually involves the participation of the parent drug or metabolites that either directly affect the cell biochemistry or elicit an immune response. Each hepatotoxin is associated with a characteristic signature regarding the pattern of injury and latency. However, some drugs may exhibit >1 signature. Susceptibility to drug-induced hepatotoxicity is also influenced by genetic and environmental risk factors. Unpredictable, low-frequency, idiosyncratic reactions often occur on a background of a higher rate of mild asymptomatic liver injury and, although difficult to predict, they may be detected by monitoring serum alanine aminotransferase levels. Recent and future advances in toxicogenomics and proteomics should improve the identification of risk factors and the understanding of idiosyncratic hepatotoxicity.