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This study aimed to assess intestinal permeability and immuno\u2010inflammatory status in patients by measuring indirect biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Experimental Approach<\/jats:title><jats:p>Circulating marker levels were measured in serum and plasma samples of 36 healthy controls, 32 patients with drug\u2010induced liver injury, 14 with autoimmune hepatitis, 13 with viral hepatitis, 40 with metabolic dysfunction\u2013associated steatotic liver disease (MASLD) and 16 with drug\u2010induced steatosis. All patients with acute liver injury were identified (visit 1) and followed for &gt;30\u2009days (visit 2). Correlation analyses were performed to determine potential associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Drug\u2010induced liver injury, autoimmune hepatitis and viral hepatitis patients had higher levels of LBP, CD14, CD163, MCSF\u20101R (CSFR) and ICAM\u20101 and significantly lower levels of MAdCAM\u20101 and zonulin at detection of liver injury compared with healthy controls or the second visit. Drug\u2010induced steatosis and MASLD patients had increased levels of S100A9, S100A12 and zonulin. MASLD patients with significant fibrosis (F2\u2013F4) also had higher levels of CD163 and MCSF\u20101R. No difference was found between drug\u2010induced steatosis and MASLD with no or low fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and Implications<\/jats:title><jats:p>Our 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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bph.70123","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T20:03:56Z","timestamp":1750881836000},"page":"5303-5316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intestinal permeability and immune\u2010inflammatory markers in patients with idiosyncratic drug\u2010induced liver injury, drug\u2010induced steatosis and metabolic dysfunction\u2013associated steatotic liver disease (MASLD)"],"prefix":"10.1111","volume":"182","author":[{"given":"Daniel E.","family":"Di Zeo\u2010S\u00e1nchez","sequence":"first","affiliation":[{"name":"UGC Aparato Digestivo, Servicio de Farmacolog\u00eda Cl\u00ednica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA, Hospital Universitario Virgen de la Victoria Universidad de M\u00e1laga  M\u00e1laga Spain"},{"name":"Centro de investigaci\u00f3n en red en el \u00e1rea tem\u00e1tica de enfermedades hep\u00e1ticas y digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"D\u00edaz\u2010Alberola","sequence":"additional","affiliation":[{"name":"UGC Aparato Digestivo, Servicio de Farmacolog\u00eda Cl\u00ednica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA, Hospital Universitario Virgen de la Victoria Universidad de M\u00e1laga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Pinazo\u2010Bandera","sequence":"additional","affiliation":[{"name":"UGC Aparato Digestivo, Servicio de Farmacolog\u00eda Cl\u00ednica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA, Hospital Universitario Virgen de la Victoria Universidad de M\u00e1laga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miren","family":"Garc\u00eda\u2010Cort\u00e9s","sequence":"additional","affiliation":[{"name":"UGC Aparato Digestivo, Servicio de Farmacolog\u00eda Cl\u00ednica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA, Hospital Universitario Virgen de la Victoria Universidad de M\u00e1laga  M\u00e1laga Spain"},{"name":"Centro de investigaci\u00f3n en red en el \u00e1rea tem\u00e1tica de enfermedades hep\u00e1ticas y digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Sanabria\u2010Cabrera","sequence":"additional","affiliation":[{"name":"UGC Aparato Digestivo, Servicio de Farmacolog\u00eda Cl\u00ednica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA, Hospital Universitario Virgen de la Victoria Universidad de M\u00e1laga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Robles\u2010D\u00edaz","sequence":"additional","affiliation":[{"name":"UGC Aparato Digestivo, Servicio de Farmacolog\u00eda Cl\u00ednica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA, Hospital Universitario Virgen de la Victoria Universidad de M\u00e1laga  M\u00e1laga Spain"},{"name":"Centro de investigaci\u00f3n en red en el \u00e1rea tem\u00e1tica de enfermedades hep\u00e1ticas y digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismael","family":"\u00c1lvarez\u2010\u00c1lvarez","sequence":"additional","affiliation":[{"name":"UGC Aparato Digestivo, Servicio de Farmacolog\u00eda Cl\u00ednica, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2010IBIMA, Hospital Universitario Virgen de la Victoria Universidad de M\u00e1laga  M\u00e1laga Spain"},{"name":"Centro de investigaci\u00f3n en red en el \u00e1rea tem\u00e1tica de enfermedades hep\u00e1ticas y digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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