Drug-Induced Liver Disease (Third Edition): Chapter 10 - Role of Inflammation in Drug-Induced Liver Injury

Elsevier, Drug-Induced Liver Disease (Third Edition), 2013, Pages 157-173
Robert A. Roth and Patricia E. Ganey

The innate immune response plays important roles in drug-induced liver injury (DILI) in both the pathogenesis of the injury and its resolution. Drug-induced liver inflammation contributes to the progression of injury from agents that cause intrinsic hepatotoxicity, such as acetaminophen, and this contribution can involve numerous inflammatory cells and soluble mediators. Activation of the innate immune system occurring independently of drug administration, such as from exposure to bacterial lipopolysaccharide, can interact with numerous drugs to enhance hepatotoxicity. This interaction has provided the basis for animal models of idiosyncratic DILI. This chapter provides a discussion of the various inflammatory factors that can contribute to DILI by emphasizing animal models and using several drugs as examples.