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Title: Establishing reference ranges for circulating biomarkers of drug‐induced liver injury in healthy human volunteers 1

Journal Article · · British Journal of Clinical Pharmacology
DOI: https://doi.org/10.1111/bcp.16371 · OSTI ID:2481391
 [1]; ORCiD logo [2];  [2];  [2];  [2];  [2];  [2];  [2]; ORCiD logo [2]
  1. Department of Health Data Science, Institute of Population Health University of Liverpool Liverpool UK
  2. Centre for Drug Safety Science, Department of Pharmacology and Therapeutics, Molecular &, Clinical Pharmacology, Institute of Systems, Molecular and Integrative Biology University of Liverpool Liverpool UK

Aims The potential of mechanistic biomarkers to improve prediction of drug‐induced liver injury (DILI) and hepatic regeneration is widely acknowledged. We sought to determine reference intervals for new biomarkers of DILI and regeneration, as well as to characterize their natural variability and impact of diurnal variation. Methods Serum samples from 227 healthy volunteers were recruited as part of a cross‐sectional study; of these, 25 subjects had weekly serial sampling over 3 weeks, while 23 had intensive blood sampling over a 24h period. Alanine aminotransferase (ALT), MicroRNA‐122 (miR‐122), High Mobility Group Box‐1 (HMGB1), total Keratin‐18 (K18), caspase‐cleaved Keratin‐18 (ccK18), Glutamate Dehydrogenase (GLDH) and Macrophage Colony‐Stimulating Factor‐1 (CSF‐1) were assayed. Results Reference intervals were established for each biomarker based on the 97.5% quantile (90% CI) following the assessment of fixed effects in univariate and multivariable models. Intra‐individual variability was found to be non‐significant, and there was no significant impact of diurnal variation. Conclusion Reference intervals for novel DILI biomarkers have been described. An upper limit of a reference range might represent the most appropriate mechanism to utilize these data. These data can now be used to interpret data from exploratory clinical DILI studies and to assist their further qualification as required by regulatory authorities.

Sponsoring Organization:
USDOE
OSTI ID:
2481391
Journal Information:
British Journal of Clinical Pharmacology, Journal Name: British Journal of Clinical Pharmacology Journal Issue: 5 Vol. 91; ISSN 0306-5251
Publisher:
Wiley-BlackwellCopyright Statement
Country of Publication:
United Kingdom
Language:
English

References (25)

Serum Biomarkers in Head and Neck Squamous Cell Cancer journal January 2014
Diurnal variation of serum and urine biomarkers in patients with radiographic knee osteoarthritis journal July 2006
Next‐Generation DILI Biomarkers: Prioritization of Biomarkers for Qualification and Best Practices for Biospecimen Collection in Drug Development journal September 2019
Refining Liver Safety Risk Assessment: Application of Mechanistic Modeling and Serum Biomarkers to Cimaglermin Alfa (GGF2) Clinical Trials journal May 2017
Acute liver failure: Summary of a workshop journal December 2007
Cytokeratin-18 Fragment Levels as Noninvasive Biomarkers for Nonalcoholic Steatohepatitis journal October 2009
Circulating microRNAs as potential markers of human drug-induced liver injury journal November 2011
Candidate biomarkers for the diagnosis and prognosis of drug‐induced liver injury: An international collaborative effort journal June 2018
The Influence of Blood Collection Tubes in Biomarkers’ Screening by Mass Spectrometry journal May 2020
Factors associated with serum high mobility group box 1 (HMGB1) levels in a general population journal December 2009
Case Definition and Phenotype Standardization in Drug-Induced Liver Injury journal May 2011
Alanine Aminotransferase: A Clinical and Regulatory Tool for Detecting Liver Injury–Past, Present, and Future journal August 2012
The Effects of Heparins on the Liver: Application of Mechanistic Serum Biomarkers in a Randomized Study in Healthy Volunteers journal June 2012
Cytokeratin 18 in plasma of patients with gastrointestinal adenocarcinoma as a biomarker of tumour response journal July 2009
Pathogenesis of Idiosyncratic Drug-Induced Liver Injury and Clinical Perspectives journal April 2014
Drug-Induced Hepatotoxicity journal July 2003
Circulating microRNAs, potential biomarkers for drug-induced liver injury journal February 2009
Prerequisites for establishing common reference intervals journal June 2004
Evaluating the Sensitivity and Specificity of Promising Circulating Biomarkers to Diagnose Liver Injury in Humans journal January 2021
Keratin‐18 and microRNA‐122 complement alanine aminotransferase as novel safety biomarkers for drug‐induced liver injury in two human cohorts journal October 2013
The transformation in biomarker detection and management of drug‐induced liver injury journal May 2017
Serum Transaminase Levels in Experimental Myocardial Infarction journal May 1955
The Significance of the Serum Glutamic Oxalacetic Transaminase Activity Following Acute Myocardial Infarction journal June 1955
Evidence for Increased Serum Glutamic Oxalacetic Transaminase (SGO-T) Activity Following Graded Myocardial Infarcts in Dogs journal August 1955
The mechanism underlying acetaminophen-induced hepatotoxicity in humans and mice involves mitochondrial damage and nuclear DNA fragmentation journal April 2012