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Cytochrome P450-derived versus mitochondrial oxidant stress in acetaminophen hepatotoxicity.

ABSTRACT: In evaluating the mechanisms of acetaminophen hepatotoxicity in experimental systems, it is critical to keep in mind the relevance of the model system for humans. Important aspects of the human toxicity include formation of a reactive metabolite by the cytochrome P450 system and protein adduct formation, which is thought to trigger mitochondrial dysfunction and oxidant stress ultimately causing necrotic cell death. If models that miss critical parts of this well-established mechanism are used, the relevance of the new information for the human toxicity has to be questioned. Therefore, we feel it is necessary to express our concern regarding the recent publication by Jiang et al. (2015).

SUBMITTER: Jaeschke H

PROVIDER: S-EPMC4536554 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Cytochrome P450-derived versus mitochondrial oxidant stress in acetaminophen hepatotoxicity.

Jaeschke Hartmut H McGill Mitchell R MR

Toxicology letters 20150406 3

In evaluating the mechanisms of acetaminophen hepatotoxicity in experimental systems, it is critical to keep in mind the relevance of the model system for humans. Important aspects of the human toxicity include formation of a reactive metabolite by the cytochrome P450 system and protein adduct formation, which is thought to trigger mitochondrial dysfunction and oxidant stress ultimately causing necrotic cell death. If models that miss critical parts of this well-established mechanism are used, t ...[more]

PMID: 25858113

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Project description:Acetaminophen (APAP) is one of the most popular and safe pain medications worldwide. However, due to its wide availability, it is frequently implicated in intentional or unintentional overdoses where it can cause severe liver injury and even acute liver failure (ALF). In fact, APAP toxicity is responsible for 46% of all ALF cases in the United States. Early mechanistic studies in mice demonstrated the formation of a reactive metabolite, which is responsible for hepatic glutathione depletion and initiation of the toxicity. This insight led to the rapid introduction of N-acetylcysteine as a clinical antidote. However, more recently, substantial progress was made in further elucidating the detailed mechanisms of APAP-induced cell death. Mitochondrial protein adducts trigger a mitochondrial oxidant stress, which requires amplification through a MAPK cascade that ultimately results in activation of c-jun N-terminal kinase (JNK) in the cytosol and translocation of phospho-JNK to the mitochondria. The enhanced oxidant stress is responsible for the membrane permeability transition pore opening and the membrane potential breakdown. The ensuing matrix swelling causes the release of intermembrane proteins such as endonuclease G, which translocate to the nucleus and induce DNA fragmentation. These pathophysiological signaling mechanisms can be additionally modulated by removing damaged mitochondria by autophagy and replacing them by mitochondrial biogenesis. Importantly, most of the mechanisms have been confirmed in human hepatocytes and indirectly through biomarkers in plasma of APAP overdose patients. The extensive necrosis caused by APAP overdose leads to a sterile inflammatory response. Although recruitment of inflammatory cells is necessary for removal of cell debris in preparation for regeneration, these cells have the potential to aggravate the injury. This review touches on the newest insight into the intracellular mechanisms of APAP-induced cells death and the resulting inflammatory response. Furthermore, it discusses the translation of these findings to humans and the emergence of new therapeutic interventions.

Dataset Information

Cytochrome P450-derived versus mitochondrial oxidant stress in acetaminophen hepatotoxicity.

Publications

Cytochrome P450-derived versus mitochondrial oxidant stress in acetaminophen hepatotoxicity.

Similar Datasets

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