Drug metabolism in liver disease

Published on July 27, 2016 Reviewed on August 12, 2020   39 min

A selection of talks on Cardiovascular & Metabolic

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The talk is about drug metabolism in liver disease. I am an associate professor in pharmacology and toxicology at the American University of Beirut. Please feel free to email me if you have any question.
I'd like to acknowledge Dr. Robert Branch from the University of Pittsburgh. He's my mentor. A lot of the studies that I will mention today were conducted by his group. He has given the original talk in 2007.
Here's the outline that I will follow. I will first start with a little bit of background on drug metabolism in liver disease. Is there any evidence of change? And is this clinically relevant? This is very important for physicians who prescribe those drugs in the setting of liver disease. Then, we will talk about pathophysiology of liver disease and physiology of hepatic elimination. And with this background, then you will be able to understand better the effect of liver disease on drug metabolism. We will talk about the intact hepatocyte theory. And then move on to the progressive, sequential model in liver disease. And after that, we will see some applications of this model in liver disease over time and whether it has a role in disease prognosis. We will look at different disease entities, such as cholestatic liver disease versus non-cholestatic liver disease. And towards the end, we will try to see if gene expression or epigenetic mechanisms such as DNA methylation and miRNA expression can be used as biomarkers of drug metabolism in liver disease.
We all know that drug metabolizing enzymes are concentrated in the liver. Hence, it would make sense that most probably liver disease affects their expression and activity.