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

描述(由申请人提供)： 2002年由美国国立卫生研究院资助的药物所致肝损伤网络是减轻DILI不良后果的一项重要战略。遍布美国的这个广泛的中心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样本，这将拓宽我们对帝力的理解。最初的工作集中在对四种药物：阿莫西林/克拉维酸、丙戊酸、苯妥英钠和异烟肼的DILI的回溯性数据收集。后续工作正在进行中，涉及任何药物或补充和替代药物引起的帝力事件病例的预期应计费用。这项赠款申请的目的是通过费城的一个大型财团的参与来促进DILIN的扩展；杰斐逊和宾夕法尼亚大学卫生系统分别是该地区最大和第二大卫生保健系统。他们吸引了来自宾夕法尼亚州东部、特拉华州、新泽西州南部和中部以及马里兰州北部的成人和儿童肝病患者。来自这些医疗保健系统的肝病领导已经同意作为一个单一的临床中心合作，以获得他的资助。此外，盖辛格健康系统将作为杰斐逊的一个子网站参与；这个组成部分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。该财团将为DILIN带来大量种族和社会经济多元化的患者群体。这项建议的具体目标如下：1)在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的区域内确定真正的成人和儿童DILI病例；2)与DILIN的其他成员一起，验证疾病归属的准确性；3)通过提供临床信息和样本，支持致力于促进DILI的药物遗传学和药物流行病学研究的全国中心网络；以及4)参与开发和维护一个网站，用作DILI的教育资源。

DESCRIPTION (provided by applicant): 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 retrospective data 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 his 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 New Jersey; 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) To participate in the development and maintenance of a website for use as an educational resource on DILI.