Advancing Research into Liver Injury

Every year, more than 1 million Americans develop liver damage caused by prescription and over-the-counter drugs, and dietary and herbal supplements. The condition, known as drug-induced liver injury (DILI), can result in severe liver disease that requires transplantation. There are no tests to predict who is at risk, or to help physicians make an early diagnosis, which would prevent progressive liver damage.

Mount Sinai’s Division of Liver Diseases, however, is taking a leading role in uncovering the causes and risk factors for DILI with the goal of developing diagnostic tools. In August, Mount Sinai became the newest member of a National Institutes of Health-funded consortium charged with stimulating and facilitating translational research into DILI. Mount Sinai is one of six academic medical centers, and the first in the Northeast, to participate in the consortium, known as the Drug-Induced Liver Injury Network. The research is being funded through the National Institute of Diabetes and Digestive and Kidney Diseases.

Jawad Ahmad, MD, and Joseph Odin, MD, PhD, both Associate Professors of Medicine (Division of Liver Diseases), have been named principal investigators of the effort.

“Mount Sinai has joined a prestigious network of clinicians and researchers,” says Dr. Ahmad. “Our inclusion reflects the strength of the faculty in the Division of Liver Diseases and the Recanati/Miller Transplantation Institute, as well as our ability to utilize a multidisciplinary approach that will involve clinicians, and translational and basic scientists.” Mount Sinai also brings unique qualities to the consortium: because it serves an ethnically diverse patient base, it is able to provide a representative population of patients who suffer from DILI.

Drs. Ahmad and Odin, along with their consortium colleagues, will conduct retrospective analyses of drugs that are associated with a high incidence of DILI utilizing electronic medical records. They also plan to draw upon Mount Sinai’s unique resources in the Department of Genetics and Genomic Sciences to help complete a Genome-Wide Association Study to determine the genetic signature risk for DILI, and potentially a blood test based on that signature.

Additionally, they will work with The Charles Bronfman Institute for Personalized Medicine, which uses a new data management system known as CLIPMERGE (Clinical Implementation of Personalized Medicine through Electronic Health Records and Genomics) that analyzes DNA for genetic variations that may affect how different drugs work in a particular individual.

“Ideally, we will develop a diagnostic or predictive test that will help us better tailor treatments for our patients,” says Dr. Odin. “If a patient does have the signature predicting risk, we will note that in the patient’s electronic medical records so that clinicians know to avoid certain medications. In addition, if we can find a way to prevent liver injury, we may have an opportunity to revisit medications that had previously been discarded due to liver toxicity.”

The Mount Sinai team is recruiting patients who have or are suspected of having DILI. To learn more, email Jawad.Ahmad@mountsinai.org or Joseph.Odin@mountsinai.org, or call 212-241-8035. You may also visit www.mountsinai.org/liver.

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