Systematic review on genetic polymorphisms associated with idiosyncratic drug-induced liver injury (iDILI): iDILInet as an interactive visualization tool

Systematic review of 139 studies identifying polymorphisms (*NAT2*, *HLA-B*, *SLCO1B1*) associated with iDILI risk, with the interactive iDILInet tool for visualizing gene-variant-drug relationships

This systematic review of 139 human genetic studies characterizes polymorphisms associated with risk of or protection against idiosyncratic drug-induced liver injury (iDILI). It identifies 83 risk genes and 25 protective genes, with NAT2, HLA-B and SLCO1B1 the most frequently reported. Functional enrichment analyses reveal pathways related to immune response, xenobiotic metabolism and bile secretion. The authors release iDILInet, an interactive web application for visualizing gene-variant-drug relationships enriched with liver expression data.

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iDILI remains a major diagnostic and medico-legal challenge, and this systematic mapping of genetic determinants is a reference resource. The predominance of HLA-B and NAT2 confirms the weight of immuno-allergic and metabolic mechanisms. The iDILInet tool, as a living systematic review, is a practical contribution for interpretation, even though most associations remain statistical and not routinely actionable.