Biomedical Engineering and Bioengineering Commons^™

Idiosyncratic Drug-Induced Liver Injury (Idili): Potential Mechanisms And Predictive Assays, Alexander D. Roth, Moo-Yeal Lee

Chemical & Biomedical Engineering Faculty Publications

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 …