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Pharmacotherapy of Liver Fibrosis and Hepatitis: Recent Advances.

Pharmaceuticals (Basel)

December 2024

Hepato-Pancreato-Biliary Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.

Liver fibrosis is a progressive scarring process primarily caused by chronic inflammation and injury, often closely associated with viral hepatitis, alcoholic liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD), drug-induced liver injury, and autoimmune liver disease (AILD). Currently, there are very few clinical antifibrotic drugs available, and effective targeted therapy is lacking. Recently, emerging antifibrotic drugs and immunomodulators have shown promising results in animal studies, and some have entered clinical research phases.

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Recent research has concentrated on the development of suitable in vitro cell models for the early identification of hepatotoxicity during drug development in order to reduce the number of animal models and to obtain a better predictability for hepatotoxic reactions in humans. The aim of the presented study was to identify translational biomarkers for acute liver injury in human patients that can serve as biomarkers for hepatocellular injury in vivo and in vitro in simple cell models. Therefore, 188 different metabolites from patients with acute-on-chronic liver failure before and after liver transplantation were analyzed with mass spectrometry.

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As a serine hydrolase synthesized by the liver, butyrylcholinesterase (BChE) is an important biomarker in the clinical diagnosis of liver diseases. To track BChE activity in drug-induced liver injury, we designed a deep-red BChE-activatable fluorescent probe (CYL-BChE) with hemi-cyanine structure by using a cyclopropyl carbonyl group as a specific recognition moiety. Its near-infrared absorption wavelength (665 nm) and emission wavelength (762 nm) provide excellent tissue penetration capabilities, making it suitable for biological imaging.

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Background: Overdose of acetaminophen (APAP), a commonly used antipyretic analgesic, can lead to severe liver injury and failure. Current treatments are only effective in the early stages of APAP-induced acute liver injury (ALI). Therefore, a detailed examination of the mechanisms involved in liver repair following APAP-induced ALI could provide valuable insights for clinical interventions.

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Background: Statin-associated autoimmune hepatitis (AIH) is a rare but potentially life-threatening adverse event. Currently, no studies have investigated the associationbetween AIH and different statins.

Research Design And Methods: This retrospective analysis of statin-associated AIH utilized the FDA Adverse Event Reporting System (FAERS) database (Q1 2004 to Q1 2024) and a systematic literature review.

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