Jackie L. Martin, M.D., Associate Professor

It has been estimated that adverse drug reactions are the fourth leading cause of death in the U.S., surpassed only by cardiovascular disease, cancers and stroke. These adverse drug reactions occur follow the proper administration of appropriate drugs in appropriate doses to patients. We are attempting to better understand and elucidate the molecular basis for drug-induced toxic reactions. At present, one of the syndromes that we are studying is anesthetic-induced toxic reactions associated with the volatile inhaled anesthetic agents, halothane, enflurane, isoflurane, desflurane and sevoflurane. Patients suffering post-operative hepatic injury have serum antibodies directed against metabolites of the inhaled anesthetic agents. These markers are diagnostic of this disease and indicate an immune mediated toxic response in sensitized individuals. We have identified the hepatic proteins modified by the inhaled anesthetics, characterized the patients? antibody response and are actively investigating the roles of T-cells and cytokines in the evolution of this injury. In addition, we are developing an assay, which will detect patients sensitized to the inhaled anesthetics and identify patients suffering injury as a result of exposure to these agents. To this end we are a the major referral center for patients with unexplained post-operative hepatic injury following anesthesia.