In Vitro Assessment of Drug-Induced Liver Injury Using Cell-Based Models: A Review

Drug-induced liver injury (DILI) is the reason for 15–18% of medicinal product recalls from the market. Since interspecies differences often limit the relevance of standard non-clinical tests in vivo, a promising alternative is to develop cell-based in vitro methods.

The aim of the study was to review current advances in cell modelling for the in vitro identification of DILI.

In vitro mechanistic studies of DILI require cells that exhibit activity specific to hepatic metabolising enzymes and transporters. This article reviews the main cell cultures (primary human hepatocytes, immortal cell lines, stem cell-derived hepatocyte-like cells, co-cultures of hepatocytes and non-parenchymal liver cells) and their configurations. The optimisation of cell systems is directed towards enhancing their viability, functionality, compositional and configurational complexity, thus bringing them closer to in vivo models. Potential DILI causes include chemically reactive metabolites, oxidative stress, mitochondrial damage, intracellular accumulation of toxic bile acids resulting from transporter inhibition, and adaptive immune system activation. Accordingly, DILI studies rely on various methods, including innovative technologies for acquisition, storage, and analysis of large datasets (e.g. high-content screening, transcriptomics, proteomics, and metabolomics). Cell models are applicable to both DILI identification and mechanistic studies. Currently, the most promising technologies are omics, complex co-culture models, and organ-on-a-chip systems.

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