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      Mechanism of drug-induced liver injury and hepatoprotective effects of natural drugs

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          Abstract

          Drug-induced liver injury (DILI) is a common adverse drug reaction (ADR) and a serious threat to health that affects disease treatments. At present, no targeted clinical drugs are available for DILI. Traditional natural medicines have been widely used as health products. Some natural medicines exert specific hepatoprotective effects, with few side effects and significant clinical efficacy. Thus, natural medicines may be a promising direction for DILI treatment. In this review, we summarize the current knowledge, common drugs and mechanisms of DILI, as well as the clinical trials of natural drugs and their bioactive components in anticipation of the future development of potential hepatoprotective drugs.

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          Incidence and Etiology of Drug-Induced Liver Injury in Mainland China

          Tao Shen, Yingxia Liu, Jia Shang … (2019)
          Article 0 comments Cited 161 times – based on 0 reviews     Review now
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            Features and Outcomes of 899 Patients With Drug-Induced Liver Injury: The DILIN Prospective Study.

            Naga Chalasani, Herbert L. Bonkovsky, Robert Fontana … (2015)
            The Drug-Induced Liver Injury Network is conducting a prospective study of patients with DILI in the United States. We present characteristics and subgroup analyses from the first 1257 patients enrolled in the study.
            Article 0 comments Cited 157 times – based on 0 reviews     Review now
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              Incidence, presentation, and outcomes in patients with drug-induced liver injury in the general population of Iceland.

              Einar S Bjornsson, Ottar M Bergmann, Helgi Björnsson … (2013)
              Little is known about the incidence of drug-induced liver injury (DILI) in the general population. We investigated the incidence and the quantitative risk of DILI in a population-based cohort. We performed a prospective study and collected data from 96 individuals diagnosed with DILI in Iceland from 2010 through 2011 (54 women; median age, 55 y). Liver injury was defined based on levels of alanine aminotransferase that were more than 3-fold the upper limit of normal and/or alkaline phosphatase levels more than 2-fold the upper limit of normal. Patients with acetaminophen toxicity were excluded. Drug history and clinical outcome were analyzed. Causality was assessed using the Roussel Uclaf Causality Assessment Method. The patients were registered in prescription databases for outpatients and inpatients. The crude annual incidence rate of DILI was 19.1 (95% confidence interval [CI], 15.4-23.3) cases per 100,000 inhabitants. DILI was caused by a single prescription medication in 75% of cases, by dietary supplements in 16% of cases, and by multiple agents in 9% of cases. The most commonly implicated drugs were amoxicillin-clavulanate (21 of 96; 22%), diclofenac (6%), azathioprine (4%), infliximab (4%), and nitrofurantoin (4%). The median duration of therapy was 20 days (range, 8-77 days); 26 patients had jaundice (27%) and 22 patients were hospitalized (23%) for a median of 5 days (range, 2-8 days). Overall 35,252 patients received amoxicillin-clavulanate as outpatients, and DILI occurred in 1 of 2350 (43 of 100,000; 95% CI, 24-70). DILI also occurred in 1 of 9480 patients taking diclofenac (11 of 100,000; 95% CI, 4-24), 1 of 133 patients taking azathioprine (752 of 100,000; 95% CI, 205-1914), 1 of 148 patients taking infliximab (675 of 100,000; 95% CI, 184-718), and 1 of 1369 patients taking nitrofurantoin (73 of 100,000; 95% CI, 20-187). In a population-based study in Iceland, the incidence of DILI was the highest reported to date. Amoxicillin-clavulanate was the most commonly implicated agent. The highest risk of hepatotoxicity was associated with azathioprine and infliximab, but the actual number of cases attributed to these agents was small. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
              Article 0 comments Cited 136 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Yongfeng Zhou: 852064509@qq.com
                Ping Zhang: zhp1231@126.com
                Xiaohe Xiao: pharmacy302xxh@126.com
                Jin Pei: peixjin@163.com
                Journal
                Journal ID (nlm-ta): Chin Med
                Journal ID (iso-abbrev): Chin Med
                Title: Chinese Medicine
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1749-8546
                Publication date (Electronic): 11 December 2021
                Publication date PMC-release: 11 December 2021
                Publication date Collection: 2021
                Volume: 16
                Electronic Location Identifier: 135
                Affiliations
                [1 ]GRID grid.411304.3, ISNI 0000 0001 0376 205X, College of Pharmacy, , Chengdu University of Traditional Chinese Medicine, ; 1166 Liutai Avenue, Wenjiang District, Chengdu, 611137 Sichuan China
                [2 ]GRID grid.24695.3c, ISNI 0000 0001 1431 9176, School of Chinese Pharmacy, , Beijing University of Chinese Medicine, ; Beijing, 102488 China
                [3 ]GRID grid.414252.4, ISNI 0000 0004 1761 8894, Department of Pharmacy, , Medical Supplies Center of PLA General Hospital, ; 100#, West 4th Ring Middle Rd., Fengtai, Beijing, 10039 China
                [4 ]GRID grid.414252.4, ISNI 0000 0004 1761 8894, Department of Liver Disease, , Fifth Medical Center of PLA General Hospital, ; 100#, West 4th Ring Middle Rd., Fengtai, Beijing, 10039 China
                Article
                Publisher ID: 543
                DOI: 10.1186/s13020-021-00543-x
                PMC ID: 8665608
                PubMed ID: 34895294
                SO-VID: 9addc1c0-3679-4b11-93d9-3446600ae586
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 3 September 2021
                Date accepted : 21 November 2021
                Funding
                Funded by: National Key R&D Program of China
                Award ID: 2018YFC1706502
                Award Recipient :
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                ScienceOpen disciplines: Complementary & Alternative medicine
                Keywords: natural medicines,drug-induced liver injury,bioactive components,mechanism
                Data availability:
                ScienceOpen disciplines: Complementary & Alternative medicine
                Keywords: natural medicines, drug-induced liver injury, bioactive components, mechanism

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