Abstract

Acetaminophen (APAP) is a commonly used analgesic and antipyretic that can cause hepatotoxicity due to production of toxic metabolites via cytochrome P450 (Cyp) 1a2 and Cyp2e1. Previous studies have shown conflicting effects of fructose (the major component in Western diet) on the susceptibility to APAP-induced hepatotoxicity. To evaluate the role of fructose-supplemented diet in modulating the extent of APAP-induced liver injury, male C57BL/6J mice were given 30% (w/v) fructose in water (or regular water) for 8 weeks, followed by oral administration of APAP. APAP-induced liver injury (determined by serum levels of liver enzymes) was decreased by two-fold in mice pretreated with fructose. Fructose-treated mice exhibited (~1.5 fold) higher basal glutathione levels and (~2 fold) lower basal (mRNA and activity) levels of Cyp1a2 and Cyp2e1, suggesting decreased bioactivation of APAP and increased detoxification of toxic metabolite in fructose-fed mice. Hepatic mRNA expression of heat shock protein 70 was also found increased in fructose-fed mice. Analysis of bacterial 16S rRNA gene amplicons from the cecal samples of vehicle groups showed that the fructose diet altered gut bacterial community, leading to increased α-diversity. The abundance of several bacterial taxa including the genus Anaerostipes was found to be significantly correlated with the levels of hepatic Cyp2e1, Cyp1a2 mRNA, and glutathione. Together, these results suggest that the fructose-supplemented diet decreases APAP-induced liver injury in mice, in part by reducing metabolic activation of APAP and inducing detoxification of toxic metabolites, potentially through altered composition of gut microbiota.

Highlights

  • Acetaminophen (APAP) is a commonly used over-the-counter analgesic and antipyretic in the United States

  • APAP-induced hepatotoxicity is a major contributor to acute liver failure, but risk factors leading to serious liver injury after APAP ingestion remain unclear

  • We investigated whether and how dietary fructose modulates APAP hepatotoxicity using a mouse model

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Summary

Introduction

Acetaminophen (APAP) is a commonly used over-the-counter analgesic and antipyretic in the United States. Several risk factors for APAP toxicity have been reported including high dose, alcohol consumption, old age, and concomitant medications [3,4,5]. These factors explain less than half of the inter-individual variability observed in the extent of liver injury by APAP [5]. Gclm-null mice have shown higher susceptibility to APAP toxicity compared to wild-type mice [20], indicating the importance of GCL in modulating APAP hepatotoxicity. The results from our study show that long-term administration of fructose decreases APAP-induced hepatotoxicity in mice, potentially by reduced bioactivation of APAP and increased detoxification of reactive metabolites

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