Review
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World J Immunol. Nov 27, 2014; 4(3): 149-157
Published online Nov 27, 2014. doi: 10.5411/wji.v4.i3.149
Immunological aspects of drug-induced liver injury
Kazuto Tajiri, Yukihiro Shimizu
Kazuto Tajiri, The Third Department of Internal Medicine, Toyama University Hospital, Toyama 930-0194, Japan
Yukihiro Shimizu, Gastroenterology Unit, Nanto Municipal Hospital, Nanto, Toyama, 932-0211, Japan
Author contributions: Both Tajiri K and Shimizu Y wrote the manuscript.
Correspondence to: Yukihiro Shimizu, MD, PhD, Gastroenterology Unit, Nanto Municipal Hospital, Nanto, Toyama 932-0211, Japan. rsf14240@nifty.com
Telephone: +81-763-821475 Fax: +81-763-821853
Received: March 5, 2014
Revised: May 17, 2014
Accepted: July 17, 2014
Published online: November 27, 2014
Processing time: 258 Days and 20.1 Hours
Abstract

Drug induced liver injury (DILI) is a common condition of increasing incidence. Many environmental and genetic factors are involved in its pathogenesis, and immunological mechanisms are also thought to contribute to the development and severity of DILI. This review summarizes current understanding of the immunological pathogenesis of DILI and discusses the perspective for clinical applications.

Keywords: Immune cells; Cytokine; Human leukocyte antigen; Innate immunity; Drug-induced liver injury

Core tip: Drug-induced liver injury (DILI) is a common liver disease that occurs frequently after drug ingestion. DILI can be classified as predictable or idiosyncratic. The former is dose dependent, has a short latency period, and results from direct toxicity of the drug or its metabolite(s). Idiosyncratic DILI may be more problematic because it is usually unpredictable and is found more frequently in the clinical setting. This type of DILI is due to an allergic reaction or the toxicity of metabolites generated via individual drug metabolism reactions. Various factors, such as environmental, genetic and immunological reactions, may be associated with adduct formation and the onset of DILI. This review summarizes current knowledge on the immunological aspects of DILI, including its pathogenesis, diagnosis and treatment.