Drug-induced acute liver failure.
Drug-induced acute liver failure.
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DOI：
10.1016/j.cld.2013.07.001
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发表时间：
2013-11
影响因子：
5.1
通讯作者：
Lee WM
中科院分区：
文献类型：
--
作者：
Lee WM
急性肝功能衰竭（ALF）是指肝细胞功能丧失持续数天或数周而无肝硬化迹象，传统上定义为精神状态改变伴凝血障碍（国际标准化比值[INR]延长）。在这种情况下，由于包括病毒、毒素和药物在内的各种因素，观察到几乎整个肝细胞质量的损失。恢复取决于损伤是持续的还是自限性的，以及肝细胞是否能够再生。据估计，美国每年约有2000人经历ALF，其中近60%是由对乙酰氨基酚或特异质药物反应引起的，最大意义上是药物诱导的肝损伤（DILI）。总体而言，在达到ALF阈值的病例中，对乙酰氨基酚损伤远远超过特异质DILI，比例为4：1。对处方药或补充和替代药物（CAMS）的特异质反应被称为DILI，而对乙酰氨基酚肝毒性通常以缩写APAP单独提及。在过去的16年中，导致ALF的APAP相关毒性占急性肝衰竭研究组（ALFSG）招募的受试者的46%，该研究组目前包括美国的16个移植中心。1相比之下，在11%的相同受试者中观察到DILI相关的ALF。DILI仍然是APAP之后最大的单一组（图1）。
BACKGROUNDAcute liver failure (ALF), where loss of hepatocyte function occurs over days or weeks without evidence of cirrhosis, has traditionally been defined by altered mentation accompanied by coagulopathy (prolonged international normalized ratio [INR]). Loss of nearly the entire hepatocyte mass is observed in this setting because of a variety of agents including viruses, toxins, and drugs. Recovery depends on whether the injury is ongoing or self-limited and whether or not hepatocytes are capable of regenerating. It is estimated that approximately 2000 people experience ALF annually in the United States and nearly 60% of these are caused by acetaminophen or idiosyncratic drug reactions, drug-induced liver injury (DILI) in its largest sense. Overall, acetaminophen injury far exceeds idiosyncratic DILI by 4: 1 among cases reaching the threshold of ALF. Idiosyncratic reactions to prescription drugs or complementary and alternative medications (CAMS) are referred to as DILI, whereas acetaminophen hepatotoxicity is often referred to separately under the acronym APAP. Over the past 16 years, APAP-related toxicity leading to ALF has comprised 46% of subjects enrolled in the Acute Liver Failure Study Group (ALFSG), a network that currently includes 16 transplant centers across the United States. 1 By contrast, DILI-related ALF was observed in 11% of these same subjects. Still, DILI is the largest single group after APAP (Fig. 1).
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影响因子：
3.1
作者：
Singh, Sundeep;Hynan, Linda S.;Lee, William M.
通讯作者：
Lee, William M.
影响因子：
4.6
作者：
Ichai, Philippe;Duclos-Vallee, Jean-Charles;Samuel, Didier
通讯作者：
Samuel, Didier
影响因子：
4.6
作者：
Russo, MW;Galanko, JA;Watkins, P
通讯作者：
Watkins, P
DOI：
10.1124/jpet.112.202010
发表时间：
2013-05-01
影响因子：
3.5
作者：
Court, Michael H.;Freytsis, Marina;Lee, William M.
通讯作者：
Lee, William M.
影响因子：
29.4
作者：
Lee, William M.;Hynan, Linda S.;Robuck, Patricia R.
通讯作者：
Robuck, Patricia R.