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Candidate biomarkers for the diagnosis and prognosis of drug‐induced liver injury: An international collaborative effort

Church, Rachel J., Kullak‐Ublick, Gerd A., Aubrecht, Jiri, Bonkovsky, Herbert L., Chalasani, Naga, Fontana, Robert J., Goepfert, Jens C., Hackman, Frances, King, Nicholas M. P., Kirby, Simon, Kirby, Patrick, Marcinak, John, Ormarsdottir, Sif, Schomaker, Shelli J., Schuppe‐Koistinen, Ina, Wolenski, Francis, Arber, Nadir, Merz, Michael, Sauer, John‐Michael, Andrade, Raul J., van Bömmel, Florian, Poynard, Thierry, Watkins, Paul B.·2019·Hepatology
DOI 10.1002/hep.29802PMC PMC6054900
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Abstract

Current blood biomarkers are suboptimal in detecting drug‐induced liver injury (DILI) and predicting its outcome. We sought to characterize the natural variabilty and performance characteristics of 14 promising DILI biomarker candidates. Serum or plasma from multiple cohorts of healthy volunteers (n = 192 and n = 81), subjects who safely took potentially hepatotoxic drugs without adverse effects (n = 55 and n = 92) and DILI patients (n = 98, n = 28, and n = 143) were assayed for microRNA‐122 (miR‐122), glutamate dehydrogenase (GLDH), total cytokeratin 18 (K18), caspase cleaved K18, glutathione S‐transferase α, alpha‐fetoprotein, arginase‐1, osteopontin (OPN), sorbitol dehydrogenase, fatty acid binding protein, cadherin‐5, macrophage colony‐stimulating factor receptor (MCSFR), paraoxonase 1 (normalized to prothrombin protein), and leukocyte cell‐derived chemotaxin‐2. Most candidate biomarkers were significantly altered in DILI cases compared with healthy volunteers. GLDH correlated more closely with gold standard alanine aminotransferase than miR‐122, and there was a surprisingly wide inter‐ and intra‐individual variability of miR‐122 levels among healthy volunteers. Serum K18, OPN, and MCSFR levels were most strongly associated with liver‐related death or transplantation within 6 months of DILI onset. Prediction of prognosis among DILI patients using the Model for End‐Stage Liver Disease was improved by incorporation of K18 and MCSFR levels. Conclusion: GLDH appears to be more useful than miR‐122 in identifying DILI patients, and K18, OPN, and MCSFR are promising candidates for prediction of prognosis during an acute DILI event. Serial assessment of these biomarkers in large prospective studies will help further delineate their role in DILI diagnosis and management.

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  • Cytokeratin 18, macrophage colony-stimulating factor receptor 1, and osteopontin have been identified as DILI biomarkers that predict a poor prognosis.

    “Cytokeratin 18, macrophage colonystimulating factor receptor 1, and osteopontin have also been identified as DILI biomarkers that predict a poor prognosis [177].”

    From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [177]

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Metadata

Authors
Church, R. J., Kullak‐Ublick, G. A., Aubrecht, J., Bonkovsky, H. L., Chalasani, N., Fontana, R. J., Goepfert, J. C., Hackman, F., King, N. M. P., Kirby, S., Kirby, P., Marcinak, J., Ormarsdottir, S., Schomaker, S. J., Schuppe‐Koistinen, I., Wolenski, F., Arber, N., Merz, M., Sauer, J., Andrade, R. J., van Bömmel, F., Poynard, T., & Watkins, P. B.
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-06-27
Volume
69
Issue
2
Pages
760-773
ISSN
  • 0270-9139
  • 1527-3350
DOI
10.1002/hep.29802
PMC
PMC6054900
Cited by
231
References
0
Language
en
Licence

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