Drug-induced liver injury: Is it somehow foreseeable? |
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作者姓名: | Giovanni Tarantino Matteo Nicola Dario Di Minno Domenico Capone |
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作者单位: | Giovanni Tarantino,Matteo Nicola Dario Di Minno(Department of Clinical and Experimental Medicine, Section of Hepatology in Internal Medicine, Federico II University, Medical School of Naples, 5 80131 Napoli, Italy);Domenico Capone(Department of Neurosciences, Unit of Clinical Pharmacology, Federico II University, Medical School of Naples, 5 80131 Napoli, Italy)
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摘 要: | The classic view on the pathogenesis of drug-induced liver injury is that the so-called parent compounds are made hepatotoxic by metabolism (formation of neosubstances that react abnormally), mainly by cytochromes P-450 (CYP), with further pathways, such as mitochondrial dysfunction and apoptosis, also playing a role. Risk factors for drug-induced liver injury include concomitant hepatic diseases, age and genetic polymorphisms of CYP. However, some susceptibility can today be predicted before drug administration, working on the common substrate, by phenotyping and genotyping studies and by taking in consideration patients' health status. Physicians should always think of this adverse effect in the absence of other clear hepatic disease. Ethical and legal problems towards operators in the health care system are always matters to consider.
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关 键 词: | 肝损害 药物性 细胞色素 肝脏疾病 遗传多态性 发病机制 细胞凋亡 功能障碍 |
收稿时间: | 2009 Apr 22 |
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