Department of Pathology and Pittsburgh Liver Research Center, University of Pittsburgh School of MedicinePittsburgh, PAUSA.
Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical CenterKansas City, KSUSA.
Gene Expr. 2020 Nov 11;20(2):125-138. doi: 10.3727/105221620X15901763757677. Epub 2020 May 22.
Acetaminophen (APAP) overdose is the major cause of acute liver failure (ALF) in the Western world. Extensive research is ongoing to identify the mechanisms of APAP-induced ALF. APAP-induced acute liver injury is also one of the most commonly studied drug-induced liver injury models in the field of hepatotoxicity. APAP toxicity is triphasic and includes three mechanistically interlinked but temporally distinct phases of initiation, progression, and recovery/regeneration. Despite how commonly it is studied, the methods to study APAP toxicity differ significantly, often leading to confusing and contradictory data. There are number of reviews on mechanisms of APAP toxicity, but a detailed mechanism-based comprehensive method and list of assays that covers all phases of APAP hepatotoxicity are missing. The goal of this review is to provide a standard protocol and guidelines to study APAP toxicity in mice including a test battery that can help investigators to comprehensively analyze APAP toxicity in the specific context of their hypothesis. Further, we will identify the major roadblocks and common technical problems that can significantly affect the results. This acetaminophen test battery (ATB) will be an excellent guide for scientists studying this most common and clinically relevant drug-induced liver injury and will also be helpful as a roadmap for hypothesis development to study novel mechanisms.
对乙酰氨基酚(APAP)过量是西方世界急性肝衰竭(ALF)的主要原因。目前正在进行广泛的研究,以确定 APAP 诱导的 ALF 的机制。APAP 诱导的急性肝损伤也是毒理学领域研究最多的药物诱导肝损伤模型之一。APAP 毒性具有三相性,包括三个在机制上相互关联但在时间上不同的起始、进展和恢复/再生阶段。尽管研究得很普遍,但研究 APAP 毒性的方法有很大的不同,经常导致混乱和矛盾的数据。有许多关于 APAP 毒性机制的综述,但缺乏一种详细的基于机制的全面方法和涵盖 APAP 肝毒性所有阶段的检测方法列表。本综述的目的是为在小鼠中研究 APAP 毒性提供一个标准方案和指南,包括一个测试组合,可以帮助研究人员在其假设的具体背景下全面分析 APAP 毒性。此外,我们将确定可能对结果产生重大影响的主要障碍和常见技术问题。这个对乙酰氨基酚测试组合(ATB)将是研究这种最常见和临床相关的药物诱导肝损伤的科学家的极好指南,也将有助于作为研究新机制的假设发展的路线图。