Risk factors related to significant hepatic inflammation in patients with acute drug-induced liver injury
Open accessAbstract
Currently, research on biopsy-proven acute drug-induced liver injury (DILI) remains limited. This study aimed to identify clinical characteristics and risk factors for significant hepatic inflammation in patients with acute DILI. An ambispective cohort study was conducted on biopsy-proven acute DILI patients admitted to our hospital from 2012 to 2018. Using the Scheuer scoring system, patients were categorized into G0-2 or G3-4 groups and followed up for 12 months after first admission. Clinical characteristics and outcomes were retrieved from medical records. The median age of the 157 enrolled patients (65.6% female) was 40.4 (interquartile range (IQR), 31.9–49.1) years. The median latency and length of hospitalization were 30.0 (IQR, 5.0–60.0) and 18.0 (IQR, 12.0–26.0) days. The proportions of patients in the G0-2 and G3-4 groups were 54.8% and 45.2%, respectively. Logistic regression analysis revealed that females (odds ratio (OR): 2.623, 95% confidence interval (CI): 1.169–5.887, p = 0.019), higher body mass index (OR: 1.168, 95% CI: 1.029–1.325, p = 0.016), higher total bilirubin (OR: 1.004, 95% CI: 1.000–1.007, p = 0.047), and lower prothrombin activity (OR: 0.976, 95% CI: 0,957–0.995, p = 0.013) were associated with significant hepatic inflammation. The predominance of the hepatocellular injury pattern (60.5%) at admission transformed into a predominance of the cholestatic pattern (60.5%) at discharge. During follow-up, 23 patients (14.6%) developed chronic DILI, with nine patients (5.7%) progressing to cirrhosis. Moreover, 15 female patients (9.6%) developed autoimmunity (3cases in the G0-2 group vs 12 cases in the G3-4 group, p < 0.05). Acute DILI patients with high-risk factors were more likely to develop significant hepatic inflammation, and females with significant inflammation were at a higher risk of developing autoimmunity during follow-up.
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With our perfusion system, we achieved extended drug perfusion at varying concentrations, faithfully replicating clinical drug administration frequency and dosages.
“By contrast, with our perfusion system, we achieved extended drug perfusion at varying concentrations, faithfully replicating clinical drug administration frequency and dosages [53].”
From Decellularized liver scaffolds for constructing drug-metabolically functional ex vivo human liver models (2025) · cites this paper as [53]
The Study design section describes a hospital-based cohort, and the Results report the duration of patients’ suspected drug use. Our copy does not address a perfusion system, varying perfusion concentrations, or clinical administration frequencies and dosages that such a system replicated (searched: perfusion system, dosing frequency, dosage). (LLM, conf=0.76)
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“By contrast, with our perfusion system, we achieved extended drug perfusion at varying concentrations, faithfully replicating clinical drug administration frequency and dosages [53].”
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- Authors
- Xiong, Y.-T., Wang, J.-F., Li, L., Bai, Z.-F., Liu, Y., Huang, A., Wang, K.-X., Fu, Y., Yang, W., Guo, C., He, M., Wang, W.-C., Wang, C.-Y., & Ji, D.
- Affiliations
- Chinese PLA General Hospital (CN)
- Peking University (CN)
- Anhui Medical University (CN)
- Corresponding author
- Ji, Dong
- Venue
- iLIVER
- Publisher
- Elsevier BV
- Published
- 2024-06
- Volume
- 3
- Issue
- 2
- Pages
- 100095
- ISSN
- 2772-9478 (ISSN-L)
- PMC
- PMC12212666
- OpenAlex
- W4396660980
- Cited by
- 6
- References
- 41
- Citations by year
- 2026: 3 · 2024: 3
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- iLiver (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Chinese PLA General Hospital
- Beijing Natural Science Foundation
- Capital Health Research and Development of Special Fund
- Beijing Municipal Science and Technology Commission
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- liver inflammation, risk factors, liver biopsy, hepatocyte injury, cholestatic liver injury, liver cirrhosis, autoimmune liver disease, prothrombin activity, total bilirubin, body mass index, sex differences, disease progression, prognosis, liver regeneration
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