Continuation and Expansion of the Drug Induced Liver Injury Network(PHILLY-DILIN)

药物性肝损伤网络（DILIN），由美国国立卫生研究院于2002年资助， 代表减轻DILI不良后果的关键策略。这个庞大的网络 美国各地的中心已经培养了令人印象深刻的基于病例的临床信息库， 这将扩大我们对DILI的理解。最初的工作围绕回顾性数据展开 收集可归因于4种药物的DILI;阿莫西林/克拉维汀、丙戊酸、苯妥英和异烟肼。 后续工作正在进行中，包括任何药物引起的DILI事件病例的前瞻性累积 或补充和替代药物。本基金申请的目的是为 通过一个大型费城财团的参与，扩大了DILIN;杰斐逊和 宾夕法尼亚大学卫生系统代表了美国最大和第二大的医疗保健系统， 地区，分别。他们从该地区吸引成人和儿童肝病患者 包括宾夕法尼亚州东部、特拉华州、新泽西南部和中部以及北方马里兰州。 来自这些医疗保健系统的肝病学领导者已同意作为一个单一的临床中心进行合作， 这个grant。此外，Geisinger卫生系统将作为Jefferson的子站点参与;该组件 将扩大财团的覆盖范围，包括宾夕法尼亚州中部的大部分地区。该财团将带来 DILIN是一个庞大的种族和社会经济多样化的患者群体。具体目标是 建议如下：1）确定本地区真正的成人和儿童DILI病例 包括宾夕法尼亚州东部和中部、马里兰州、特拉华州以及新泽西州南部和中部; 2)与DILIN的其他成员一起验证疾病归因的准确性; 3）支持 一个致力于药物遗传学发展的国家中心网络， 通过提供临床信息和样本进行药物性肝损伤的药物流行病学研究;以及4）4.到 参与开发和维护一个网站，作为DILI的教育资源。 相关性（见说明）： 这个大型临床中心网络致力于识别和记录药物性肝损伤病例 将提供独特的观察药物流行病学，临床表现， 这种伤害的后果。它将帮助创建一个独特的数据库和样本库， 随后进行药物基因组学分析。

The Drug Induced Liver Injury Network (DILIN), funded by the National Institutes of Health in 2002, represents a critical strategy to mitigate the adverse consequences of DILI. Already, this extensive network of centers around the U.S. has cultivated an impressive repertoire of case-based clinical information and samples which will broaden our understanding of DILI. Initial work centered around retrospectivedata collection on DILI attributable to four drugs; amoxicillin/clavulanate, valproic acid, phenytoin, and isoniazid. Subsequent work, which is ongoing, involves the prospective accrual of incident cases of DILI from any drug or complementary and alternative medication. The purpose of this grant application is to contribute to the expansion of the DILIN through the participation of a large Philadelphia-based consortium; the Jefferson and University of Pennsylvania Health Systems represent the largest and second largest health care systems in the region, respectively. They draw adult and pediatric patients with hepatic disease from the region comprising Eastern Pennsylvania, Delaware, Southern and Central New Jersey, and Northern Maryland. Hepatology leaders from these health care systems have agreed to collaborate as a single clinical center for this grant. In addition, the Geisinger Health System will participate as a subsite of Jefferson; this component will extend the consortium's reach to include a large part of central Pennsylvania. The consortium will bring to DILIN a large ethnically and socioeconomically diverse population of patients. The specific aims of this proposal are as follows: 1) To identify bona fide adult and pediatric cases of DILI within the region comprising Eastern and Central Pennsylvania, Maryland, Delaware,and Southern and Central NewJersey; 2) To validate the accuracy of disease attribution, in conjunction with other members of DILIN; 3) To support a national network of centers devoted to the advancement of pharmacogenetic and pharmacoepidemiological study of DILI, by providing clinical information and samples; and 4) 4. To participate in the development and maintenance of a website for use as an educational resource on DILI. RELEVANCE (Seeinstructions): ' This large network of clinical centers interested in identifying and recording cases of drug induced liver injury will provide unique observations on pharmacoepidemiology.the clinical manifestations,and the consequences of such inury. It will help create a unique data base and repository of samplesfor any subsequent pharmacogenomic analysis.