Biochemical mechanisms in drug-induced liver injury: Certainties and doubts

Figure 1 Schematic representation of subtoxic damage of hepatocyte in response to moderate dose of drug. Drug molecule activates Kupffer cells is metabolically processed by hepatocytes. These events may result in hepatocyte stress which is worsened by the intervention of reactive oxygen species (ROS) and nitrogen species from activated endothelial cells. Final result is apoptotic death and Ito cells activation with promotion of fibrosis. EC-GF: Endothelial cell growth factor; IL1: Interleukin 1; IL1β: Interleukin 1β; RNI: Reactive nitrogen intermediates; ROS: Reactive oxygen species; TGF-β: Transforming growth factor β; TNF: Tumor necrosis factor α.