Abstract
Acetaminophen (APAP) is the most common antipyretic analgesic worldwide. However, APAP overdose causes severe liver injury, especially centrilobular necrosis, in humans and experimental animals. At therapeutic dosage, APAP is mainly metabolized by sulfation and glucuronidation, and partly by cytochrome P450–mediated oxidation. However, APAP overdose results in production of excess reactive metabolite, N-acetyl-p-benzoquinone imine (NAPQI), by cytochromes P450; NAPQI overwhelms the level of glutathione (GSH), which could otherwise detoxify it. NAPQI binds covalently to proteins, leading to cell death. A number of studies aimed at the prevention and treatment of APAP-induced toxicity are underway. Rats are more resistant than mice to APAP hepatotoxicity, and thus mouse models are mainly used. In the present study, we compared the toxic responses induced by APAP overdose in the liver of ICR mice obtained from three different sources and evaluated the usability of the Korl:ICR stock established by the National Institute of Food and Drug Safety Evaluation in Korea. Administration of APAP (300 mg/kg) by intraperitoneal injection into male ICR mice enhanced CYP2E1 protein expression and depleted hepatic GSH level 2 h after treatment accompanied with significantly increased level of hepatic malondialdehyde, a product of lipid peroxidation. Regardless of the source of the mice, hepatotoxicity, as evidenced by activity of serum alanine aminotransferase, increased from 8 h and peaked at 24 h after APAP treatment. In summary, hepatotoxicity was induced after the onset of oxidative stress by overdose of APAP, and the response was the same over time among mice of different origins.
Highlights
Acetaminophen (APAP) is the most popular analgesic and antipyretic
Because APAP-induced hepatotoxicity is involves excessive oxidative stress following GSH depletion [20], we examined the level of GSH and lipid peroxidation in the liver as well as the parameters of hepatotoxicity including the activity of alanine aminotransferase (ALT) in serum and histopathological analysis
Dynamics of hepatic CYP2E1 protein expression and GSH levels after APAP treatment Large doses of APAP is correlated with increased generation of a reactive metabolite, N-acetyl-p-benzoquinone imine (NAPQI), through enzyme reactions mediated by cytochrome P450 (CYP) enzymes [24]
Summary
Acetaminophen (APAP) is the most popular analgesic and antipyretic. The recommended dose is 4 g/day for adults and 60–75 mg/kg/day for children. Overuse of APAP can cause acute liver failure followed by hepatocellular necrosis [1,2,3,4]. The most common cause of APAP addiction are suicide attempts (47.8%) in adolescents and accidental addiction (42.2%) in infants [5]. The only medication in cases of APAP overdose is N-acetyl cysteine, a well-known antioxidant. The development of new drugs superior to NAC is urgently required.
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