Keywords
drug-related hepatotoxicity
liver disease
How to Cite
Abstract
The study of immune-mediated drug-related hepatotoxicity (IADR) is important for medical and pharmaceutical practice. IADR is unrelated to drug action, does not occur in all patients, and is not dose dependent. The mechanism of this phenomenon is not fully understood, but theories suggest a role for Kupffer cells as antigen presenting cells (APCs) in the IADR process. As APCs, Kupffer cells may influence T-cell tolerance in response to the drug-protein combination. There is evidence that insufficient synthesis of costimulatory molecules by Kupffer cells can lead to induction of Tcell tolerance and avoidance of IADR responses. However, overexpression of costimulatory molecules or disruption of the mechanism of danger signals that activate Kupffer cells can lead to full activation of T cells and induction of IADR. Another theory suggests that IADR may result from the interaction of the drug with endotoxin, leading to activation of Kupffer cells and secretion of the inflammatory factor TNF-α. This can lead to hypoxia and necrosis of liver cells. The role of Kupffer cells in IADR is an important area of research, and activation or dysfunction of these cells may have a significant impact on the occurrence of immune-mediated adverse drug reactions.References
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