Keratin-18 and micro RNA-122 complement alanine aminotransferase as novel safety biomarkers for drug-induced liver injury in two human cohorts.

Background & Aims There is a demand for more sensitive, specific and predictive biomarkers for drug-induced liver injury ( DILI) than the gold standard used today, alanine aminotransferase ( ALT). The aim of this study was to qualify novel DILI biomarkers (keratin-18 markers M65/M30, micro RNA-122, glutamate dehydrogenase and alpha-foetoprotein) in human DILI. Methods Levels of the novel biomarkers were measured by enzyme-linked immunosorbent assay or real-time quantitative reverse-transcription PCR ( qRT-PCR) in two human DILI cohorts: a human volunteer study with acetaminophen and a human immunodeficiency virus (HIV)/tuberculosis (TB) study. Results In the acetaminophen study, serum M65 and micro RNA-122 levels were significantly increased at an earlier time point than ALT. Furthermore, the maximal elevation of M65 and micro RNA-122 exceeded the increase in ALT. In the HIV/ TB study, all the analysed novel biomarkers increased after 1 week of treatment. In contrast to ALT, the novel biomarkers remained stable in a human cohort with exercise-induced muscular injury. Conclusions M65 and micro RNA-122 are potential biomarkers of DILI superior to ALT with respect to sensitivity and specificity. [ABSTRACT FROM AUTHOR]