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

描述（由申请人提供）： 由美国国立卫生研究院于2002年资助的药物性肝损伤网络（DILIN）代表了减轻DILI不良后果的关键策略。这个遍布美国的广泛的中心网络已经培养了一个令人印象深刻的基于病例的临床信息和样本库，这将扩大我们对DILI的理解。最初的工作集中在可归因于四种药物的DILI的回顾性数据收集上;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，涉及任何药物或补充和替代药物引起的DILI事件病例的前瞻性累积。这项赠款申请的目的是通过一个大型费城财团的参与，为扩大DILIN做出贡献;杰斐逊和宾夕法尼亚大学卫生系统分别代表该地区最大和第二大卫生保健系统。他们从宾夕法尼亚州东部、特拉华州、新泽西南部和中部以及北方马里兰州等地区吸引成人和儿童肝病患者。来自这些医疗保健系统的肝病学领导人已经同意合作，作为一个单一的临床中心，他的赠款。此外，盖辛格卫生系统将作为杰斐逊的一个子网站参与;这一组成部分将扩大财团的范围，包括宾夕法尼亚州中部的大部分地区。该联盟将为DILIN带来大量种族和社会经济多样化的患者群体。本提案的具体目的如下：1）在包括宾夕法尼亚州东部和中部、马里兰州、特拉华州以及新泽西南部和中部的区域内，识别真正的DILI成人和儿童病例; 2）与DILIN的其他成员一起，验证疾病归因的准确性; 3）通过提供临床信息和样本，支持致力于推进DILI药物遗传学和药物流行病学研究的国家中心网络; 4）参与开发和维护一个网站，作为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.