Next Article in Journal
Structural Communication Between C-Peptide and Insulin Within the Proinsulin Molecule
Previous Article in Journal
Desiccation Tolerance in Moss and Liverwort: Insights into the Evolutionary Mechanisms of Terrestrialization
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
IJMS
Volume 27
Issue 1
10.3390/ijms27010482
ijms-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Human Leukocyte Antigen (HLA) Signatures and Idiosyncratic Drug-Induced Liver Injury

by
Alexia Onaciu
1,
Alina Grama
2,3,*,
Ștefan Agoșton
1,
Alexandra Mititelu
2,3,
Bianca Mariş
2,3,
Horia Ştefănescu
4,5 and
Tudor Lucian Pop
2,3
1
Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
2
2nd Pediatric Discipline, Department of Mother and Child, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
3
2nd Pediatric Clinic, Emergency Clinical Hospital for Children, 400370 Cluj-Napoca, Romania
4
“Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
5
Department of Internal Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2026, 27(1), 482; https://doi.org/10.3390/ijms27010482
Submission received: 23 November 2025 / Revised: 28 December 2025 / Accepted: 1 January 2026 / Published: 2 January 2026
(This article belongs to the Section Molecular Immunology)
Versions Notes

Abstract

Drug-induced liver injury (DILI) remains one of the most challenging adverse drug reactions in clinical practice, particularly in its idiosyncratic form, which is not dose-dependent and is largely driven by host-specific immune and genetic factors. Recent genomic studies have revealed strong associations between certain human leukocyte antigen (HLA) alleles and susceptibility to DILI, supporting an immunogenetic mechanism in which drug or metabolite–protein adducts act as neoantigens, triggering aberrant T-cell activation and hepatocellular injury. This review summarizes current evidence on the contribution of HLA polymorphisms to the pathogenesis of idiosyncratic DILI, highlighting allele-specific risk patterns, such as HLA-B*57:01 associated with flucloxacillin, HLA-DRB1*15:01–DQB1*06:02 in amoxicillin–clavulanate, and HLA-B*35:02 in minocycline-induced liver injury. Furthermore, ethnic variability and allele-haplotype interactions are discussed as potential modulators of susceptibility and clinical phenotype. By integrating genetic and immunological insights, the identification of HLA signatures offers promising tools for precision medicine, enabling earlier identification of at-risk individuals and improved prevention of severe hepatotoxic reactions.
Keywords: drug-induced liver injury; HLA polymorphisms; adaptive immune response; idiosyncratic drug reactions drug-induced liver injury; HLA polymorphisms; adaptive immune response; idiosyncratic drug reactions

Share and Cite

MDPI and ACS Style

Onaciu, A.; Grama, A.; Agoșton, Ș.; Mititelu, A.; Mariş, B.; Ştefănescu, H.; Pop, T.L. Human Leukocyte Antigen (HLA) Signatures and Idiosyncratic Drug-Induced Liver Injury. Int. J. Mol. Sci. 2026, 27, 482. https://doi.org/10.3390/ijms27010482

AMA Style

Onaciu A, Grama A, Agoșton Ș, Mititelu A, Mariş B, Ştefănescu H, Pop TL. Human Leukocyte Antigen (HLA) Signatures and Idiosyncratic Drug-Induced Liver Injury. International Journal of Molecular Sciences. 2026; 27(1):482. https://doi.org/10.3390/ijms27010482

Chicago/Turabian Style

Onaciu, Alexia, Alina Grama, Ștefan Agoșton, Alexandra Mititelu, Bianca Mariş, Horia Ştefănescu, and Tudor Lucian Pop. 2026. "Human Leukocyte Antigen (HLA) Signatures and Idiosyncratic Drug-Induced Liver Injury" International Journal of Molecular Sciences 27, no. 1: 482. https://doi.org/10.3390/ijms27010482

APA Style

Onaciu, A., Grama, A., Agoșton, Ș., Mititelu, A., Mariş, B., Ştefănescu, H., & Pop, T. L. (2026). Human Leukocyte Antigen (HLA) Signatures and Idiosyncratic Drug-Induced Liver Injury. International Journal of Molecular Sciences, 27(1), 482. https://doi.org/10.3390/ijms27010482

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Article metric data becomes available approximately 24 hours after publication online.
Back to TopTop