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Unlike many forms of DILI which are idiosyncratic, the underlying mechanism for APAP toxicity is unlikely to involve T cell response but, as discussed above, there is a role for the innate immune system.64 There has been good progress to date on identifying genetic risk factors for idiosyncratic DILI and, in particular, various human leukocyte antigen (HLA) alleles have been demonstrated to be strong risk factors.65 However, for the concentration-dependent intrinsic DILI seen in APAP overdose, progress on identifying genetic risk factors is more limited

Dietary patterns (e.g., Mediterranean diet, increased plant protein) and specific prebiotics can modulate microbial composition, enhance SCFA production, and reduce uremic toxins