Neither author is a Fellow of the American College of Clinical Pharmacology (FCP).
Drug-Induced Liver Injury: The Role of Drug Metabolism and Transport†
Article first published online: 22 FEB 2013
© The Author(s) 2013
The Journal of Clinical Pharmacology
Volume 53, Issue 5, pages 463–474, May 2013
How to Cite
Corsini, A. and Bortolini, M. (2013), Drug-Induced Liver Injury: The Role of Drug Metabolism and Transport. Journal of Clinical Pharma, 53: 463–474. doi: 10.1002/jcph.23
- Issue published online: 17 APR 2013
- Article first published online: 22 FEB 2013
- Manuscript Accepted: 17 JUL 2012
- Manuscript Received: 15 MAY 2012
- drug-induced liver injury;
- drug metabolism;
- hepatic transporter;
Many studies have pinpointed the significant contribution of liver-mediated drug metabolism and transport to the complexity of drug-induced liver injury (DILI). Phase I cytochrome P450 (CYP450) enzymes can lead to altered drug metabolism and formation of toxic metabolites, whilst Phase II enzymes are also associated with DILI. The emerging role of hepatic transporters in regulating the movement of endogenous and exogenous chemicals (e.g., bile acids and drugs) across cellular and tissue membranes is critical in determining the pathophysiology of liver disease as well as drug toxicity and efficacy. Genetic and environmental factors can have a significant impact on drug metabolism and transporter proteins, consequently increasing the risk of DILI in susceptible individuals. The assessment of these factors therefore represents an important approach for predicting and preventing DILI, by better understanding the pharmacological profile of a specific drug. This review focuses on the mechanisms of DILI associated with drug metabolism and hepatic transport, and how they can be influenced by underlying factors.