Toward predictive models for drug-induced liver injury in humans: are we there yet?

Biomark Med. 2014;8(2):201-13. doi: 10.2217/bmm.13.146.

Abstract

Drug-induced liver injury (DILI) is a frequent cause for the termination of drug development programs and a leading reason of drug withdrawal from the marketplace. Unfortunately, the current preclinical testing strategies, including the regulatory-required animal toxicity studies or simple in vitro tests, are insufficiently powered to predict DILI in patients reliably. Notably, the limited predictive power of such testing strategies is mostly attributed to the complex nature of DILI, a poor understanding of its mechanism, a scarcity of human hepatotoxicity data and inadequate bioinformatics capabilities. With the advent of high-content screening assays, toxicogenomics and bioinformatics, multiple end points can be studied simultaneously to improve prediction of clinically relevant DILIs. This review focuses on the current state of efforts in developing predictive models from diverse data sources for potential use in detecting human hepatotoxicity, and also aims to provide perspectives on how to further improve DILI prediction.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Biomarkers / metabolism
  • Chemical and Drug Induced Liver Injury / metabolism
  • Chemical and Drug Induced Liver Injury / pathology*
  • Computational Biology
  • Drug-Related Side Effects and Adverse Reactions
  • Humans
  • Models, Biological*
  • Pharmaceutical Preparations / classification
  • Pharmaceutical Preparations / metabolism
  • Quantitative Structure-Activity Relationship
  • Toxicogenetics / trends

Substances

  • Biomarkers
  • Pharmaceutical Preparations