[Gut microbiota-associated metabolites with drug-induced liver injury].

Drug-induced liver injury (DILI) is a condition that is induced by the hepatocellular toxicity of drugs or their metabolites or by hypersensitivity reactions of the liver to drugs and their metabolites. Clinical heterogeneity is high, with diverse liver injury patterns associated with drug toxicity, the body's functioning status, and individual susceptibility. The incidence rate shows an increasing trend year by year, and there is a lack of efficient and specific treatment methods. In recent years, the role of gut microbiota and its metabolites has received considerable attention in DILI. Patients with DILI exhibit imbalances in gut microbial ecology, with changes in the relative abundance of specific microbial populations and their associated metabolites (such as lipopolysaccharides, bile acids, short-chain fatty acids, amino acids, etc.), which can further participate in the DILI process through the "gut-liver axis." Therefore, gut microbiota-targeted regulation and metabolite intervention are expected to become novel targets for DILI diagnosis and treatment. This review focuses on the impact of microbiota-associated metabolites on DILI and explores their potential value in clinical prevention and treatment, aiming to provide a theoretical basis for a deeper understanding of DILI pathogenesis and the development of novel intervention strategies.