The study reveals and backs the existence of relevant metabolic biomarkers for the cholestatic and hepatocellular phenotypes of DILI. This made it possible to obtain a large amount of information which, duly processed using biocomputing mathematical models, "allowed us to identify a group of metabolites that, as a signature or analytical footprint, turned out to be characteristic and discriminating of the phenotype and severity of the disease," says Guillermo Quintás, first signee of the study. Through the metabolomic analysis of blood samples of these patients, obtained during their liver process until their full recovery (weeks/months), they assessed hundreds of metabolites in the plasma, the molecules that are part of liver cell metabolism. The article, "Metabolomic analysis to discriminate drug-induced liver injury (DILI) phenotypes," published in journal Archives of Toxicology, includes a longitudinal observational study conducted on 79 patients affected by DILI, diagnosed and recruited over three years in the La Fe hospital, as part of European project HECATOS, in which the University of Valencia played a significant role. This study is unique, as it is the first time that metabolomics have been used, or the study of the changes in metabolites that take place in a biological sample of the blood of the patients, in this case, during a liver disease. The research group of the University of Valencia Mixed Group-IIS La Fe for Experimental Hepatology and Liver Transplant, led by professor José Vicente Castell, and integrated within the CIBEREHD, has addressed this issue by combining its trajectory studying hepatotoxicity caused by drugs, with the used of advanced omics technology. Drug-induced hepatitis is not diagnosed directly by measuring certain specific parameters of the disease, but it is still done by diagnostic criteria of exclusion-after discarding other possible causes. The unpredictability of this pathology, its clinical relevance, deficient diagnosis and lack of prognostic markers represent a healthcare concern. With a predominance of hepatocellular damage and the death of lymphocytes, as a cholestasis (decreased bile flow) or under a mixed pattern. Hepatitis induced by drugs comes in three clinically differentiated forms.
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