Background: Drug-induced liver injury (DILI), an increasing etiology of liver dysfunction in hepatology, its incidence has been variably reported worldwide. To better understand the disease burden hence make appropriate preventive and treatment strategies, we conducted this meta-analysis from global perspective.Methods: PubMed, EMBASE, Web of Science and Cochrane Library were searched for studies on the incidence of DILI published from inception to Aug 1, 2021. According to the predefined criteria, only population-based studies were included. Incidence was calculated as cases per 100,000 person-years with its confidence interval (CI) using random effects model. Results: A total of 31 studies were included. The overall incidence of DILI was 4.94 (95%CI: 4.05-5.83) per 100,000 person-years. Time-based cumulative meta-analysis suggested that the incidence of DILI had increased over time since 2010. It varied by regions: Asia had the highest incidence, at 17.82 (95%CI: 6.26-29.38) per 100,000 person-years, while America had the lowest, at 1.72 (95%CI: 0.48-2.95) per 100,000 person-years. All studies had a consistent result of higher incidence of DILI in elders; but comparable incidence between male and female (3.42 vs 4.64 per 100,000 person-years). As for the specific implicated drug(s), the incidence of statins induced liver injury was 11.30 (95%CI: 6.48-19.69) per 100,000 person-years, while the incidence among patients using antifungal drugs, antidepressants, paracetamol, antidiabetic, anti-tuberculosis, nonsteroidal anti-inflammatory drugs, anti-thyroid drugs and iron chelator ranged from 0.16 to 180.97 per 100,000 person-years. Conclusions: The incidence of DILI has been increasing since 2010 worldwide, with the highest incidence in Asia. Understanding the epidemiological characteristics of DILI aids in making specific strategies to deal with the emerging health problems.
Cholestatic is an important factor causing liver fibrosis with a clinical incidence rate of about 10.26%. Although the progress of cholestatic hepatic fibrosis can be delayed by clearing the etiology and improving bile toxicity, how to treat antifibrotic is still an important and difficult problem in clinical treatment. In this study, we utilized Illumina sequencing technology to deeply mine the changes of mRNA expression during BDL-induced hepatic fibrosis. A total of 239,727,428 clean reads and 3224 Differentially expressed genes (DEGs) were obtained with 2852 genes were upregulated and 372 genes were downregulated. GO enrichment revealed that DEGs were mostly associated with biological processes, among which cellular process is the most enriched with 2253 genes up-regulated and 270 genes down-regulated. KEGG annotated 340 pathways in all, of which pathways in cancer and PI3K-Akt signaling pathway were most enriched. Six significantly DEGs were verified by RT-qPCR, and the results were consistent with the transcriptome sequencing outcome. These DEGs and pathways may play a crucial role in the occurrence and development of liver fibrosis, and may be potential therapeutic targets of liver fibrosis. Further investigations are needed to clarify its specific mechanism.
Background The clinicopathological features and long-term outcomes of vanishing bile duct syndrome (VBDS) remains to be revealed. The aim of this study was to elucidate the clinicopathological features and identify potential factors for poor prognosis in patients with VBDS.Methods This retrospective study recruited patients with liver biopsy-proven VBDS who were followed up at five hospitals in northern China from January 2003 to April 2022. Clinical and pathological data at time of biopsy were reviewed. Clinical outcomes including development of cirrhosis, decompensation events, liver transplantation (LT) or liver-related death were recorded. Cox regression analysis was used to identify risk factors in the prediction of dismal outcomes.Results A total of 183 patients were finally included. The median age at the diagnosis was 47 (38, 55) years, with 77.6% being women. During a median follow-up time of 4.8 years, 48.1% of the patients developed compensated or decompensated cirrhosis, with 27 die and 15 received liver transplantation. Multivariate Cox regression analysis showed that hepatocellular cholestasis (HR 2.953, 95%CI 1.437-6.069), foam cells (HR 2.349, 95%CI 1.092-5.053), and advanced fibrosis (HR 2.524, 95%CI 1.313-4.851) were independent predictors for LT or liver-related deaths. A nomogram formulated with the above factors showed good consistency with concordance index of 0.746 (95% CI 0.706-0.785). Conclusions Nearly half of the patients with VBDS progressed to end-stage liver disease and 23% of them had LT or liver-related death within two years after diagnosis. Histological factors including hepatocellular cholestasis, foam cells and advanced fibrosis were independently associated with poor prognosis in patients with VBDS.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.