Pregnane X receptor in drug-induced liver injury: Friend or foe?

Abstract

The pregnane X receptor (PXR) is a ligand activated nuclear receptor that is highly expressed in the liver and regulates many cellular functions including drug metabolism, endobiotic metabolism, oxidative stress response, apoptosis, inflammation, cell proliferation and regeneration. PXR activation promotes drug-induced liver injury (DILI) through its ability to increase the expression of phase Ⅰ and phase Ⅱ drug metabolizing enzymes. The PXR also increases lipid synthesis and fatty acid uptake into the liver, leading to lipid accumulation and steatosis. In recent years, PXR has been explored as an important target in DILI and liver diseases. This review will highlight the roles of PXR in modulating DILI. PXR polymorphisms that have been associated with DILI will also be discussed. Keywords: Pregnane X receptor (PXR), Drug-induced liver injury (DILI), Drug metabolism, Endobiotic metabolism, Oxidative stress response, Apoptosis, Inflammation, Cell proliferation, Cell regeneration