28. Mechanisms of Drug-Induced Liver Injury

  1. Eugene R. Schiff MD, MACP, FRCP2,
  2. Willis C. Maddrey MD, MACP, FRCP3 and
  3. Michael F. Sorrell MD, FACP4
  1. Paul B. Watkins MD

Published Online: 31 OCT 2011

DOI: 10.1002/9781119950509.ch28

Schiff's Diseases of the Liver, Eleventh Edition

Schiff's Diseases of the Liver, Eleventh Edition

How to Cite

Watkins, P. B. (2011) Mechanisms of Drug-Induced Liver Injury, in Schiff's Diseases of the Liver, Eleventh Edition (eds E. R. Schiff, W. C. Maddrey and M. F. Sorrell), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119950509.ch28

Editor Information

  1. 2

    Center for Liver Diseases and Schiff Liver Institute, University of Miami Miller School of Medicine, Miami, FL, USA

  2. 3

    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

  3. 4

    University of Nebraska College of Medicine, Omaha, NE, USA

Author Information

  1. Verne S. Caviness Distinguished Professor of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Publication History

  1. Published Online: 31 OCT 2011
  2. Published Print: 9 DEC 2011

ISBN Information

Print ISBN: 9780470654682

Online ISBN: 9781119950509



  • DILI mechanisms;
  • predictable toxicity, mechanisms;
  • drug metabolism safe pathways;
  • reactive metabolite;
  • hepatotoxicity;
  • oxidative stress;
  • mitochondria, target for DILI;
  • chronic ethanol consumption;
  • CYP2E1 activity increase;
  • idiosyncratic toxicity


This chapter contains sections titled:

  • Mechanisms of predictable hepatotoxicity

  • How reactive metabolites cause hepatotoxicity

  • Progression versus recovery

  • Variation in susceptibility to predictable hepatotoxicity

  • Idiosyncratic hepatotoxicity

  • Hepatotoxicity not related to reactive metabolites

  • Pharmaceutical industry and preclinical drug testing

  • Conclusions and future directions

  • Annoted references

  • References