Liver function and enzyme activity (LFT)

Liver function and enzyme activity refers to the complex physiological processes performed by the liver, including nutrient metabolism, xenobiotic detoxification, and the synthesis of vital plasma proteins such as albumin and clotting factors [1, 2]. Clinically, these functions are assessed through Liver Function Tests (LFTs), which measure the serum concentration of specific enzymes like alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) that are released into circulation following hepatocyte damage [1, 3]. While not a specific molecular target, liver function is a primary clinical endpoint and safety parameter in drug development and clinical practice [3]. Dysregulation of liver enzyme activity is a hallmark of various pathologies, including viral hepatitis, non-alcoholic fatty liver disease (NAFLD), and cirrhosis [1, 4]. In pharmacology, monitoring liver function is essential for detecting drug-induced liver injury (DILI), which remains a leading cause of drug attrition and post-market withdrawals [4]. Understanding the impact of therapeutic agents on hepatic enzyme activity is critical for ensuring patient safety, optimizing drug dosing in patients with liver impairment, and managing potential drug-drug interactions involving the cytochrome P450 system [2, 4].

Other names

Liver function testsHepatic functionHepatic enzymesLiver biomarkersLFTs

As a phenotypic category rather than a single target, the mechanism of action varies by drug: therapeutic agents may act as FXR agonists to reduce bile acid toxicity, while hepatotoxic drugs may cause mitochondrial stress, oxidative damage, or covalent binding to hepatic proteins, leading to elevated enzyme levels [4].