Drug-induced Liver Injury

‚ÄčIntroduction to DILI

  • DILI is an unexpected injury to the liver that can be caused by prescribed medications, over-the-counter medications, recreational drugs and supplements.
  • Some drugs such as paracetamol are known to be harmful to the liver in high doses but other drugs, taken at a normal dose can unpredictably damage the liver of certain people.
  • DILI is a rare, unpredictable disease and it is not known why certain individuals are more likely to develop drug-induced liver injury than others. This can be life-threatening.
  • Specific genetic risk factors can contribute to individual susceptibility but they do not fully explain why people get DILI.
  • DILI is difficult to diagnose and often has similar features to auto-immune hepatitis.

Study Aims

To create a unique International Biobank resource to enable research into the causes and characteristics of drug-induced liver injury (DILI) so that new, non-invasive diagnostic tests can be developed

To predict and prevent drug-induced liver injury (DILI) so patients can be safely treated with medications they need.

This research will:

  • Improve our understanding of how medications cause DILI
  • Identify risk factors for DILI development
  • Develop and evaluate new non-invasive tests to specifically diagnose DILI.

Who can participate?

Men & women aged over 18, who appear to have had an adverse reaction to a medication or supplement which affected liver functioning (patients); or who have had no problematic response to taking specific medications or supplements (healthy volunteers).

Also adults diagnosed with autoimmune hepatitis and adults with a healthy liver who are eligible for immunotherapy for cancer can take part in this research.

Participation involves:

Patients:

Several visits/appointments with our research nurse (coinciding with your medical care where possible) to provide:

  • a blood sample,
  • a urine sample (optional)
  • a stool sample (optional)
  • Medical history

Healthy volunteers:

One visit/appointment with our research nurse to provide:

  • a blood sample,
  • a urine sample (optional)
  • a stool sample (optional)
  • Medical history

International Collaboration

We are organising a unique project with academic and industry partners to investigate drug-associated diseases across Europe and coordinate the formation of a large shared Biobank resource of biological samples with detailed information from people who have had DILI and from people who had symptoms of DILI but were subsequently found not to have DILI.

This project will collect samples from patients at the time of symptoms and over the period of recovery so that the disease process can be followed.

We also plan to collect samples from people who have taken the same medications but have not experienced any adverse effects so we can compare their characteristics and identify differences in samples collected.

To achieve this we will create a shared database of cases which holds details such as drug dose, duration, other medications, individual characteristics (such as age and weight) and other conditions, as well as clinical features and blood test results over the course of the DILI until recovery.

Study contacts:

Research/Specialist Nurse:

Jo Thomas

Tel: 0115 9249924 ext 60604

Doctor/Principal Investigator:

Prof Guru Aithal

Tel: 0115 8231149

Study Coordinators:

Dr Jane Grove | Bethany Robinson

Tel: 0115 8231149

Nottingham Digestive Diseases Clinical Research Facility:

Queens Medical Centre, Nottingham NG7 2UH. U.K.

Tel. 0115 9709966 | nddcbru@nottingham.ac.uk

Further advice on liver disease

www.nhs.uk/conditions/liver-disease

www.britishlivertrust.org.uk