Figure 1 Schematic overview of common mechanisms of DILI

This is followed by mitochondrial dysfunction-characterized by ATP depletion, opening of the PTP and/or MOMP, Cyt c release, and activation of the caspase cascade-ultimately leading to cell death. In addition, some drugs inhibit transporters such as the BSEP, causing intracellular bile acid accumulation and cholestatic toxicity.

Meanwhile, drug-protein adducts and DAMP activate inflammatory and immune responses, promoting immune cell recruitment and exacerbating hepatocellular injury.