Open questions on how metabolic dysfunction-associated steatotic liver disease shapes the course of drug-induced liver injury.

In this article, we discuss the article recently published by Zhao et al. This study focused on the intersection of metabolic dysfunction-associated steatotic liver disease (MASLD) and drug-induced liver injury (DILI), two major contributors to the global burden of liver disease. By analyzing clinical characteristics, metabolic parameters, immune profiles, and liver pathology, Zhao et al comprehensively explored how MASLD influences the presentation, severity, and prognosis of DILI. Additionally, this study underscores the importance of structured diagnostic tools, such as the Roussel Uclaf Causality Assessment Method, to accurately assess the causality of DILI within the MASLD population. Although this study provides valuable insights, limitations such as its retrospective design and cohort heterogeneity underscore the need for future prospective research to refine diagnostic approaches and therapeutic strategies.