Bio: Guruprasad P. Aithal is Professor of Hepatology and the Deputy Director of Translational Medical Sciences, School of Medicine, University of Nottingham. He is also the Deputy Director and Gastrointestinal & Liver Theme lead of the NIHR Nottingham Biomedical Research Centre (BRC). He was the President of the British Association for the Study of the Liver between 2020 and 2021. He co-chaired International Drug-induced Liver Injury Consortium (iDILIC) (2010-13) that delivered crucial breakthrough in the field.

Abstract: Drug-induced liver injury (DILI) is a critical concern in drug development and clinical practice, often leading to severe liver damage and drug withdrawal. This report explores the journey from molecular biology to clinical application in understanding and managing DILI. At the molecular level, DILI mechanisms involve drug metabolism, oxidative stress, mitochondrial dysfunction, and immune-mediated toxicity. Recent advancements in molecular biology, including genomics, transcriptomics, and proteomics, have unveiled key biomarkers and genetic predispositions, such as HLA alleles and microRNAs, which enhance early detection and risk prediction. Clinically, DILI presents a diagnostic challenge due to its heterogeneous manifestations and lack of specific biomarkers. Current diagnostic approaches rely on clinical evaluation, causality assessment tools, and exclusion of other liver diseases. Emerging technologies, such as machine learning and multi-omics integration, are revolutionizing DILI risk assessment and patient stratification. Therapeutic strategies are also evolving, with targeted interventions focusing on antioxidant therapy, anti-inflammatory agents, and liver regeneration. The integration of pharmacogenomics into clinical practice enables personalized medicine, reducing DILI incidence in high-risk populations. This report would underscore the importance of translating molecular insights into clinical applications, advocating for multidisciplinary collaboration to improve DILI prediction, diagnosis, and treatment.