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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 5
May  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(5): 1097-1100

A preliminary study on the peripheral seroimmunological characteristics of drug-induced liver injury

DOI: 10.3969/j.issn.1001-5256.2022.05.023
  • 1.

    Department of Gastroenterology, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China

  • 2a.

    Second Department of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

  • 2b.

    Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

  • 3.

    Shanghai Innovation Center of TCM Health Service, Shanghai 201203, China

Research funding:

Scientific Research Project of Shanghai Municipal Health Commission (20214Y0236);

Three-year Action Plan for the Development of Traditional Chinese Medicine in Shanghai (ZY〔2018-2020〕-CCCX-5001);

Science and Technology Planning Project of Shanghai Science and Technology Commission (20Z21900100)

More Information
  • Corresponding author: LI Shuang, 15800647366@163.com(ORCID: 0000-0001-6220-6408); LIU Chenghai, chenghailiu@hotmail.com(ORCID: 0000-0002-1696-6008)
  • Received Date: 2021-09-22
  • Accepted Date: 2021-10-25
  • Published Date: 2022-05-20
    Abstract
  •   Objective  To investigate the characteristic manifestation of the peripheral seroimmunological indicators such as cellular immunity and cytokines in drug-induced liver injury (DILI).  Methods  The medical records of 219 patients with DILI collected in Shuguang Hospital and Baoshan Branch from January 2019 to August 2021 were retrospectively analyzed, grouped according to the type of drug injury and the degree of injury, and their clinical characteristics, biochemical and peripheral serum immunological characteristics were analyzed. analyze.Twenty-nine cases were selected from the healthy subjects as the normal liver function group, and 42 cases of DILI cases who had undergone cytokine and cellular immune evaluation within 1 week before the acute onset treatment were confirmed as the DILI control group. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Fisher test was used to compare the count data between groups.  Results  Among the 219 DILI patients, 122 (56%) were female and 97 (44 %) were male. 89 cases (40%) of injuries were caused by traditional Chinese medicines, proprietary Chinese medicines or health products, and 130 cases (60%) were caused by western medicines such as anti-tuberculosis and anti-tumor. Among them, 82 cases (37%) were classified as hepatocyte injury type, 17 cases (8%) of cholestatic type, and 120 cases (55%) of mixed injury type. The longest incubation period was 180 days, the shortest was 1 day, and the median was 15 days. Fatigue accounted for 49% of the main symptoms. There were statistically significant differences in cytotoxic T lymphocytes (%) and CD4/CD8 ratio between the traditional Chinese medicine, Chinese patent medicine or health product group and the western medicine group (Z=2.55 and 3.08, P=0.011 and 0.002, ). From 219 DILI patients, it was confirmed that 42 patients who had detected peripheral immune indicators were compared with 29 patients with normal liver function physical examination. The statistical analysis showed that IL-6 and IL-10 were statistically significant in the peripheral immune serum distribution of DILI. Significance (Z=3.828 and 2.695, P < 0.001 and 0.007).  Conclusion  Cytotoxic T lymphocytes may play different roles in the pathogenic mechanisms of Chinese herbal medicines, Chinese patent medicine preparations or health products and western medicines; drugs or drug-protein complexes may affect inflammatory and immune pathways and release related cytokines For example, IL-6 and IL-10 are involved in the pathogenesis of DILI.

     

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    • References(14)
  • [1]
    CHEN QQ, LU HH, SUN FF, et al. Progress on chronic drug-induced liver injury[J/CD]. Chin J Liver Dis(Electronic Edition), 2020, 12(4): 38-42. DOI: 10.3969/j.issn.1674-7380.2020.04.007.

    陈琦琪, 陆慧慧, 孙芳芳, 等. 药物性肝损伤慢性化研究进展[J/CD]. 中国肝脏病杂志(电子版), 2020, 12(4): 38-42. DOI: 10.3969/j.issn.1674-7380.2020.04.007.
    [2]
    Drug-induced Liver Disease Study Group, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the management of drug-induced liver injury[J]. J Clin Hepatol, 2015, 31(11): 1752-1769. DOI: 10.3969/j.issn.1001-5256.2015.11.002.

    中华医学会肝病学分会药物性肝病学组. 药物性肝损伤诊治指南[J]. 临床肝胆病杂志, 2015, 31(11): 1752-1769. DOI: 10.3969/j.issn.1001-5256.2015.11.002.
    [3]
    VILLANUEVA-PAZ M, MORÁN L, LÓPEZ-ALCÁNTARA N, et al. Oxidative stress in drug-induced liver injury (DILI): From mechanisms to biomarkers for use in clinical practice[J]. Antioxidants (Basel), 2021, 10(3): 390. DOI: 10.3390/antiox10030390.
    [4]
    DEVARBHAVI H, AITHAL G, TREEPRASERTSUK S, et al. Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines[J]. Hepatol Int, 2021, 15(2): 258-282. DOI: 10.1007/s12072-021-10144-3.
    [5]
    AMACHER DE. Female gender as a susceptibility factor for drug-induced liver injury[J]. Hum Exp Toxicol, 2014, 33(9): 928-939. DOI: 10.1177/0960327113512860.
    [6]
    SHEN T, LIU Y, SHANG J, et al. Incidence and etiology of drug-induced liver injury in mainland China[J]. Gastroenterology, 2019, 156(8): 2230-2241. e11. DOI: 10.1053/j.gastro.2019.02.002.
    [7]
    IORGA A, DARA L. Cell death in drug-induced liver injury[J]. Adv Pharmacol, 2019, 85: 31-74. DOI: 10.1016/bs.apha.2019.01.006.
    [8]
    OZAWA S, MIURA T, TERASHIMA J, et al. Recent progress in prediction systems for drug-induced liver injury using in vitro cell culture[J]. Drug Metab Lett, 2021, 14(1): 25-40. DOI: 10.2174/1872312814666201202112610.
    [9]
    ZEN Y, YEH MM. Checkpoint inhibitor-induced liver injury: A novel form of liver disease emerging in the era of cancer immunotherapy[J]. Semin Diagn Pathol, 2019, 36(6): 434-440. DOI: 10.1053/j.semdp.2019.07.009.
    [10]
    GANEY PE, LUYENDYK JP, MADDOX JF, et al. Adverse hepatic drug reactions: Inflammatory episodes as consequence and contributor[J]. Chem Biol Interact, 2004, 150(1): 35-51. DOI: 10.1016/j.cbi.2004.09.002.
    [11]
    WANG X, ZHANG L, JIANG Z. T-helper cell-mediated factors in drug-induced liver injury[J]. J Appl Toxicol, 2015, 35(7): 695-700. DOI: 10.1002/jat.3115.
    [12]
    THOMSON PJ, KAFU L, MENG X, et al. Drug-specific T-cell responses in patients with liver injury following treatment with the BACE inhibitor atabecestat[J]. Allergy, 2021, 76(6): 1825-1835. DOI: 10.1111/all.14652.
    [13]
    JIANG ML, XU F, HU JL, et al. Clinical value of IL-6, CRP, PCT and endotoxin in predicting the risk of liver failure with bacterial infection[J]. Chin J Nosocomiol, 2020, 30(20): 3062-3065. DOI: 10.11816/cn.ni.2020-193056.

    姜曼蕾, 许飞, 胡江玲, 等. IL-6、CRP、PCT和内毒素预判肝衰竭合并细菌感染风险中的临床价值[J]. 中华医院感染学杂志, 2020, 30(20): 3062-3065. DOI: 10.11816/cn.ni.2020-193056.
    [14]
    ROTH RA, MAIURI AR, GANEY PE. Idiosyncratic drug-induced liver injury: Is drug-cytokine interaction the linchpin?[J]. J Pharmacol Exp Ther, 2017, 360(2): 461-470. DOI: 10.1124/jpet.116.237578.
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