Exploring the mechanism of drug induced liver injury and the regulatory role of traditional Chinese medicine in related signaling pathways

Objectives: Drug-induced liver injury (DILI) is a significant clinical challenge. This review explores the molecular mechanisms involved in DILI and examines the role of TCM in regulating key signaling pathways such as JNK, Nrf2, NF-κB, PPAR, SIRT1, Bcl-2/Bax, and AMPK. The aim is to determine how TCM modulates these pathways to slow the progression of DILI and enhance liver recovery. Methods: A comprehensive literature review was conducted covering studies published between 2017 and 2024. Relevant articles were identified through PubMed and other databases using keywords related to DILI, signaling pathways, and Traditional Chinese Medicine. Results: This review summarizes current evidence indicating that multiple signaling pathways, including oxidative stress, inflammatory, and apoptotic pathways, are critically involved in DILI and are modulated by various TCM components. Conclusion: By integrating mechanistic insights across multiple signaling pathways, this review highlights the potential regulatory roles of traditional Chinese medicine in DILI and discusses future directions for mechanistic and translational research.