Idiosyncratic drug-induced liver injury (DILI) is the uncommon, yet leading cause for drug withdrawal from the market. It can cause serious clinical outcomes including acute liver failure and the need for liver transplantation. The priority of patient care involves around elimination of the iatrogenic “harm” caused by a therapeutic agent. Nevertheless, recognizing culprit drugs and individuals at risk for DILI pose a significant challenge. 

Various risk factors play an important role in increasing the susceptibility of DILI. Among which, genetic factors predisposing individuals at risk, the role of the drugs’ physicochemical and toxicological properties and their interactions with host and environmental factors are crucial. There are multiple impact of these factors on mechanisms involved in DILI. 

Furthermore, sexual dimorphism (XX vs. XY) may play a vital role in gender-specific susceptibility of neurons and splenocytes to different cytotoxic agents. However, further investigations are warranted, as current knowledge is still scarce and inadequate for accurate risk prediction of DILI.

Source: J Hepatol. 2015 Aug;63(2):503-14.