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Hepatic injury biomarkers and enzymes are a group of biochemical markers used to evaluate liver health and detect damage to hepatocytes or the biliary system (Gowda et al., 2009). This panel primarily includes enzymes such as Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST), which leak into the bloodstream during liver cell injury, and Alkaline phosphatase (ALP) and Gamma-glutamyl transferase (GGT), which are elevated in cholestatic conditions (Hall & Cashel, 2023). Other components include Bilirubin, a marker of heme metabolism and excretion, and Albumin, which reflects the liver's synthetic capacity (Mayo Clinic, 2023). These markers are essential in clinical trials to monitor for Drug-Induced Liver Injury (DILI), a leading cause of drug attrition and regulatory warnings (LiverTox, 2023). While they are not therapeutic targets themselves, their levels guide the management of diseases like Hepatitis, Cirrhosis, and Non-alcoholic fatty liver disease (NAFLD) (NIH, 2023). Clinicians use the pattern of enzyme elevations to distinguish between hepatocellular injury and cholestasis, which is vital for determining the underlying cause of liver dysfunction (StatPearls, 2023). Monitoring these enzymes is also critical for patients on long-term medications that carry a risk of hepatotoxicity, such as certain antibiotics or anti-seizure drugs (FDA, 2009).
These molecules are primarily used as diagnostic indicators of cellular damage or physiological dysfunction rather than being direct therapeutic targets. Therapeutic agents like Ursodeoxycholic acid may lower these markers by improving bile acid transport and reducing hepatocyte apoptosis (StatPearls, 2023).
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