Role of the Adaptive Immune System in Idiosyncratic Drug-Induced Liver Injury

摘要: There is increasing evidence that almost all idiosyncratic drug-induced liver injury (IDILI) mediated by the adaptive immune system. The incidence of mild resolves despite continued treatment much higher than failure. This response referred to as adaptation, but if immune-mediated, then adaptation presumably represents tolerance, which dominant in liver. One mechanism for tolerance appears involve direct activation CD8+ T cells hepatocytes, leading their death. regulatory and M2 macrophages also contribute tolerance. Different patients can have different reactions same drug, probably caused differences HLA cell receptor repertoire. A better understanding mechanisms IDILI would likely make it easier predict drug candidates are cause such develop ways treating them.