title: Idiosyncratic Drug-Induced Liver Injury (IDILI): Potential Mechanisms and Predictive Assays.
abstract: Idiosyncratic drug-induced liver injury (IDILI) is a significant source of drug recall and acute liver failure (ALF) in the United States. While current drug development processes emphasize general toxicity and drug metabolizing enzyme- (DME-) mediated toxicity, it has been challenging to develop comprehensive models for assessing complete idiosyncratic potential. In this review, we describe the enzymes and proteins that contain polymorphisms believed to contribute to IDILI, including ones that affect phase I and phase II metabolism, antioxidant enzymes, drug transporters, inflammation, and human leukocyte antigen (HLA). We then describe the various assays that have been developed to detect individual reactions focusing on each of the mechanisms described in the background. Finally, we examine current trends in developing comprehensive models for examining these mechanisms. There is an urgent need to develop a panel of multiparametric assays for diagnosing individual toxicity potential.
authors.affiliation: Department of Chemical & Biomedical Engineering, Cleveland State University, 1960 East 24th Street, Cleveland, OH 44115-2214, USA.
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Roth
authors.affiliation: Department of Chemical & Biomedical Engineering, Cleveland State University, 1960 East 24th Street, Cleveland, OH 44115-2214, USA.
authors.forename: Moo-Yeal
authors.identifier: 0000-0001-6922-609X
authors.initials: MY
authors.lastname: Lee
mesh_terms: D001681:Biological Assay / Q000379:methods*; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000235:genetics; D018920:Coculture Techniques; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000473:pathology; D050217:Metabolic Detoxication, Phase II; D015398:Signal Transduction