Abstract: Objective The aim of this study was to observe the combination of glutathione and tiopronin in the treatment of patients with drug-induced liver injury (DILI). Methods 72 patients with DILI were enrolled in our hospital between December 2019 and August 2022, and were randomly divided into control (n=36) and observation (n=36) group, receiving tiopronin alone or tiopronin and glutathione combination treatment for two to four weeks. Serum malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were detected by thibabituric acid, xanthine oxidation or dithiobis-nitrobenzoic acid methods, respectively. Serum human heme oxygenase-1 (HO-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), IL-1β and C-reactive protein (CRP) levels were detected by ELISA. Results At the end of treatment, serum ALT and AST levels in the observation group were (40.6±11.5)U/L and (31.0±2.6)U/L, both significantly lower than [(64.6±13.9)U/L and (63.7±15.3)U/L, respectively, P＜0.05] in the control, while there were no significant differences respect to serum bilirubin and GGT levels in the two groups [(16.8±3.9) μmol/L and (59.2±13.3)U/L vs. (20.2±4.2)μmol/L and (60.8±14.7)U/L, respectively, P>0.05]; serum SOD, GSH-Px and HO-1 levels in the observation group were (82.4±12.7)U/L, (99.8±16.6)U/L and (256.7±20.8)U/L, all significantly higher than [(75.6±10.9)U/L, (80.6±15.4)U/L and (197.5±24.9)U/L, respectively, P＜0.05], while serum MDA level was (5.1±0.8)μmol/L, much lower than [(6.2±1.3)μmol/L, P＜0.05] in the control; serum IL-6, TNF-α, IL-1β and CRP levels were (5.1±1.7)pg/mL, (4.4±1.7)pg/mL, (11.2±4.1)ng/mL and (3.9±2.0)mg/L, all significantly lower than [(9.7±1.1)pg/mL, (10.2±1.8)pg/mL, (25.3±4.8)ng/mL and (13.6±2.9)mg/L, respectively, P＜0.05] in the control group. Conclusion The combination of glutathione and tiopronin in the treatment of patients with DILI could effectively improve liver function tests back to normal, which might alleviate body inflammatory and oxidative stress reactions, and warrants further clinical investigation.

Key words: Drug-induced liver injury, Tiopronin, Glutathione, Therapy