RT Journal Article T1 Intestinal permeability and immune-inflammatory markers in patients with idiosyncratic drug-induced liver injury, drug induced steatosis and metabolic dysfunction–associated steatotic liver disease (MASLD) A1 Di Zeo-Sánchez, Daniel Enrique A1 Díaz-Alberola, irene A1 Pinazo-Bandera, José M. A1 García-Cortés, Miren A1 Sanabria-Cabrera, Judith Adriana A1 Robles-Díaz, María Mercedes A1 Álvarez-Álvarez, Ismael A1 Lucena, M. Isabel A1 Andrade, Raúl J. A1 Villanueva-Paz, Marina A1 Stephens, Camilla K1 Farmacología K1 Toxicología K1 Inmunología AB Background and PurposeAdverse immuno-inflammatory responses possibly influenced by bacterial compounds reaching the liver as a consequence of altered intestinal permeability appear to be crucial in the pathogenesis of drug-induced liver injury and steatotic liver diseases. This study aimed to assess intestinal permeability and immuno-inflammatory status in patients by measuring indirect biomarkers.Experimental ApproachCirculating marker levels were measured in serum and plasma samples of 36 healthy controls, 32 patients with drug-induced liver injury, 14 with autoimmune hepatitis, 13 with viral hepatitis, 40 with metabolic dysfunction–associated steatotic liver disease (MASLD) and 16 with drug-induced steatosis. All patients with acute liver injury were identified (visit 1) and followed for >30 days (visit 2). Correlation analyses were performed to determine potential associations.Key ResultsDrug-induced liver injury, autoimmune hepatitis and viral hepatitis patients had higher levels of LBP, CD14, CD163, MCSF-1R (CSFR) and ICAM-1 and significantly lower levels of MAdCAM-1 and zonulin at detection of liver injury compared with healthy controls or the second visit. Drug-induced steatosis and MASLD patients had increased levels of S100A9, S100A12 and zonulin. MASLD patients with significant fibrosis (F2–F4) also had higher levels of CD163 and MCSF-1R. No difference was found between drug-induced steatosis and MASLD with no or low fibrosis.Conclusion and ImplicationsOur results highlight similarities in macrophage activation, intestinal barrier dysfunction and translocation of bacterial products in liver injury of various aetiologies. A better understanding of the pathophysiological mechanisms may aid the development of targeted therapies for liver inflammation and fibrosis. PB Wiley YR 2025 FD 2025 LK https://hdl.handle.net/10630/39193 UL https://hdl.handle.net/10630/39193 LA eng NO Di Zeo-Sánchez, D. E., Díaz-Alberola, I., Pinazo-Bandera, J. M., García-Cortés, M., Sanabria-Cabrera, J., Robles-Díaz, M., A´ lvarez-A´ lvarez, I., Lucena, M. I., Andrade, R. J., Villanueva-Paz, M., & Stephens, C. (2025). Intestinal permeability and immune-inflammatory markers in patients with idiosyncratic drug-induced liver injury, drug-induced steatosis and metabolic dysfunction–associated steatotic liver disease (MASLD). British Journal of Pharmacology, 1–14. https://doi.org/10.1111/bph.70123 NO Funding for open access charge: Universidad de Málaga / CBUA DS RIUMA. Repositorio Institucional de la Universidad de Málaga RD 27 feb 2026