Drug-induced liver injury (DILI), one of the most common causes of acute liver failure, mandating liver transplantation, is an adverse reaction, or the toxicity of the liver, resulting from overexposure to pharmaceutical drugs either during an ongoing clinical drug trial or from the misuse of medically approved over-the-counter drugs. Metabolomics is finding increased applicability in studying liver diseases such as xenobiotic hepatotoxicity, non-alcoholic fatty liver disease, steatosis, and cirrhosis, among others. A study has successfully applied the metabolome in mapping DILI.
The serum levels of a few specific transaminases, three clinical phenotypes of DILI are recognized: the hepatocellular (90% of DILI cases), the cholestatic, and the mixed-type DILI (Table 1). The enzymes considered disease biomarkers for DILI-types include alanine aminotransferase (ALT), alkaline phosphatase…
