Drug-induced liver injury (DILI) is a foremost cause of abrasion throughout the early and late phases of drug development and after a drug is promoted. DILI is generally classified as either intrinsic or idiosyncratic. Intrinsic DILI is dose dependent and expectable (e.g., acetaminophen toxicity). Though, forecasting the incidence of idiosyncratic DILI, which has a very low occurrence and is related with severe liver damage, is tough because of its multifaceted nature and the poor understanding of its mechanism. Bearing in mind, drug metabolism and pharmacokinetics, we recognised experimental animal models of DILI for 14 clinical drugs that cause idiosyncratic DILI in humans, which is characterized by the development of reactive metabolites and the participation of both innate and adaptive immunity. These findings increase the understanding of the mechanisms of DILI and can help forecast and stop idiosyncratic DILI due to certain drugs.

Source: Annual Review of Pharmacology and Toxicology 2021; 61:247-268.