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

由美国国立卫生研究院于2002年资助的药物肝损伤网络(DILIN)， 是减轻帝力不良后果的一项重要战略。已经，这个广泛的网络 已经培养了一批令人印象深刻的基于病例的临床信息和 这些样本将扩大我们对帝力的了解。最初的工作以回顾数据为中心 四种药物：阿莫西林/克拉维酸、丙戊酸、苯妥英钠和异烟肼。 后续工作正在进行中，涉及任何毒品导致的帝力事件案件的预期应计费用 或补充和替代药物治疗。这项拨款申请的目的是为 通过费城的一个大型财团的参与扩大DILIN；杰斐逊和 宾夕法尼亚大学医疗系统是美国最大和第二大医疗保健系统 分别为该地区。他们吸引了来自该地区的成人和儿童肝病患者。 由宾夕法尼亚州东部、特拉华州、新泽西州南部和中部以及马里兰州北部组成。 来自这些医疗保健系统的肝病专家已经同意作为一个单一的临床中心进行合作 这笔赠款。此外，盖辛格健康系统将作为杰斐逊的一个子网站参与；该组件 将扩大该财团的覆盖范围，包括宾夕法尼亚州中部的大部分地区。该财团将带来 DILIN是一大批种族和社会经济多元化的患者。这样做的具体目的是 建议如下：1)查明区域内真正的成人和儿童帝力病例 包括宾夕法尼亚州东部和中部、马里兰州、特拉华州和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 致力于推进药物遗传学和生物医学研究的国家中心网络 通过提供临床信息和样本进行帝力的药物流行病学研究；以及4) 参与开发和维护一个网站，作为关于帝力的教育资源。 相关性(参见说明)：‘ 这个庞大的临床中心网络对识别和记录药物性肝损伤病例很感兴趣 将提供关于药物流行病学的独特观察。临床表现，以及 这类债务的后果。它将帮助创建一个独特的数据库和样品储存库 随后的药物基因组分析。

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.