Recent Advances in the Histopathology of Drug-Induced Liver Injury

Abstract

Drug-induced liver injury (DILI) is constantly changing as new drugs are approved and as new herbals and dietary supplements (HDS) reach the market. The pathologist plays a key role in the evaluation of DILI by classifying and interpreting the histologic findings considering patients' medical history and drug exposure. The liver biopsy findings may suggest alternative explanations of the injury and additional testing that should be performed to exclude non-DILI causes. Recent reports of iatrogenic liver injury are reviewed with attention to immunomodulatory and antineoplastic agents as well as reports of injury associated with HDS use.

Effect of levofloxacin on some body tissues in mice

“…Although the mechanism of how the levofloxacin causing liver injury is not well understood, but reseaches suggested that the hepatic injury induced by flouroquinolones is mainly due to mitochondrial damage (12). Necrotic changes, inflammatory reaction and apoptosis are the most important and common outcomes in drug induced liver injury (13). Apoptosis is programmed cell death and regular cell turnover that occurs under body control (14).…”

Clinicopathological features of He Shou Wu‐induced liver injury: This ancient anti‐aging therapy is not liver‐friendly

“…Review of the published reports in Pubmed and CNKI databases showed that by 2016, 612 cases of liver injury associated with He Shou Wu had been reported (most in Chinese), including reports of cirrhosis, liver transplantation, and death. 8,9,25 In our study, the number of women affected by He Shou Wu was larger than that of men. Middle-aged women also appeared to be more liable to He Shou Wu-induced liver injury.…”

“…However, increasing numbers of patients with He Shou Wu‐induced liver injury have been reported in recent years. Review of the published reports in Pubmed and CNKI databases showed that by 2016, 612 cases of liver injury associated with He Shou Wu had been reported (most in Chinese), including reports of cirrhosis, liver transplantation, and death …”

“…However, attributing liver injury to the umbrella term “herb” does not result in timely diagnosis, treatment, prevention, or exploration of the underlying mechanisms of HILI. As is available for modern drug(s) from hepatology textbooks, recent publications and the LiverTox website, it is time to summarise the chief clinical and histological characteristics of herbal hepatic toxicity and its natural history for specific herbs. Such data would improve hepatologists’ understanding of the characteristics of hepatotoxic effects of a given herb, which in turn would contribute to early recognition of disease, provision of optimal care, and establishment of a comprehensive database to facilitate study of the underlying mechanisms of such toxicity.…”

Protective Effect of Cassava Leaf Extract on Gentamicin-Induced Hepatotoxity In Mice

“…Nekrosis sel ditandai dengan adanya pengerutan inti sel (piknosis), pecahnya inti sel menjadi fragmenfragmen (kariokinesis), dan lisis inti sel (kariolisis), serta lisis membran sel sehingga batas antar sel tidak jelas (Prasetiawan et al, 2015;Istikhomah dan Lisdiana, 2016;Sari et al, 2018). Nekrosis sel hati yang disebabkan oleh induksi obat-obatan termasuk dalam pola nekrosis zonal yang melibatkan zona 3 dan dapat pula melibatkan zona 1 (Krishna, 2017;Kleiner, 2018).…”