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Blood toxicogenomics reveals potential biomarkers for management of idiosyncratic drug-induced liver injury

Title: Blood toxicogenomics reveals potential biomarkers for management of idiosyncratic drug-induced liver injury
Authors: Rachel J. Church; Benedict Anchang; Brian D. Bennett; Pierre R. Bushel; Paul B. Watkins
Source: Frontiers in Genetics, Vol 16 (2025)
Publisher Information: Frontiers Media S.A.
Publication Year: 2025
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: drug-induced liver injury; hepatotoxicity; RNA-seq; immune-regulated pathways; peripheral blood transcriptomics; differentially expressed genes (DEGs); Genetics; QH426-470
Description: Introduction: Accurate diagnosis, assessment, and prognosis of idiosyncratic drug-induced liver injury (IDILI) is problematic, in part due to the shortcomings of traditional blood biomarkers. Studies in rodents and healthy volunteers have supported that RNA transcript changes in whole blood may address some of these shortcomings.Methods: In this study, we conducted RNA-Seq analysis on peripheral blood samples collected from 55 patients with acute IDILI and 17 patients with liver injuries not attributed to IDILI.Results and discussion: Three differentially expressed genes (DEGs; CFD, SQLE, and INKA1) were identified as significantly associated with IDILI vs. other liver injuries. No DEGs were identified comparing IDILI patients to the 5 patients with autoimmune hepatitis, suggesting possible common underlying mechanisms. Two genes (VMO1 and EFNA1) were significantly associated with hepatocellular injury compared to mixed/cholestatic injury. When patients with severe vs. milder IDILI were compared, we identified over 500 DEGs. The top pathways identified from these DEGs had in common down regulation of multiple T-cell specific genes. Further analyses confirmed that these changes could largely be accounted for by a fall in the concentration of circulating T-cells during severe DILI, perhaps due to exhaustion or sequestration of these cells in the liver. Exploration of DEGs specific for the individual causal agents was largely unsuccessful, but isoniazid-induced IDILI demonstrated 25 DEGs compared to other non-isoniazid IDILI cases. Finally, among the 14 IDILI patients that had hepatocellular jaundice (i.e., Hy’s Law cases), we identified 39 DEGs between the 4 patients with fatal or liver transplantation outcomes compared to those that recovered. These findings suggest the potential for blood-based transcriptomic biomarkers to aid in the diagnosis and prognostic stratification of IDILI.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.frontiersin.org/articles/10.3389/fgene.2025.1524433/full; https://doaj.org/toc/1664-8021; https://doaj.org/article/681188c6cf974bfba85030b6a3533cdd
DOI: 10.3389/fgene.2025.1524433
Availability: https://doi.org/10.3389/fgene.2025.1524433; https://doaj.org/article/681188c6cf974bfba85030b6a3533cdd
Accession Number: edsbas.D5DBAF89
Database: BASE