Characterization of amoxicillin and clavulanic-acid-responsive CD4+ And CD8+ T-cells in patients with co-amoxiclav-induced liver injury

Background Co-amoxiclav, a combination antibiotic consisting of amoxicillin and clavulanic acid, is one of the most commonly prescribed anti-microbial drugs. Unfortunately, human exposure is associated with liver injury and in rare cases, acute liver failure has been reported. The risk of liver injury appears be higher when amoxicillin/clavulanic acid is used in combination. Little is known about the mechanistic basis of co-amoxiclav-induced liver injury. However, several HLA class I and II genotypes have recently been shown to affect susceptibility, which indicates a potential role for the adaptive immune system. Thus, the objective of this study was to (1) investigate whether drug responsive T-cells are detectable in the peripheral blood of patients with co-amoxiclav-induced liver injury, (2) define antigen specificity and (3) characterize the phenotype and function of antigen-specific T-cells.