New biomarkers for drug-induced liver injury: Are they really better? What do they diagnose?

摘要

It is proposed in this issue (1) by a distinguished group of academic and pharmaceutical industry investigators that serum biomarkers microRNA-122 (miR-122) and the M65 epitope of keratin-18 (K18:M65) may complement alanine aminotransferase (ALT) and even outperform it as sensitive, specific and predictive biomarkers for drug-induced liver injury (DILI). In an interesting and original study, they have retrospectively analysed the sera from two studies on acetaminophen and antitubercular/immunodeficiency treatments that caused mild DILI in recipients, using these new biomarkers. As better sensitivity, they defined slightly more rapid increase in the biomarker values after exposure to the causative agents, and as better specificity, they cite the lack of response of the two new biomarkers to skeletal muscle injury in subjects taking part in an extreme adventure race.