Department of Emergency Medicine, Atrium Health's Carolinas Medical Center, 1000 Blythe Blvd., Medical Education Building 3rd Floor, Charlotte, NC, 28203, USA.
Department of Surgery, Atrium Health's Carolinas Medical Center, 1000 Blythe Blvd., Cannon Research Building, Charlotte, NC, 28203, USA.
J Med Toxicol. 2023 Oct;19(4):341-351. doi: 10.1007/s13181-023-00964-0. Epub 2023 Aug 29.
Acetaminophen (APAP) toxicity remains a significant cause of adult and pediatric liver failure in North America and Europe. Previous research has evaluated the impaired mitochondrial function associated with APAP toxicity. The primary aim of this study was to evaluate the effects of APAP toxicity on platelet mitochondrial function using platelet oxygen consumption in a murine model in vivo. Our secondary objectives were to determine the effect of 4-MP on platelet mitochondrial function and hepatic toxicity in the setting of APAP overdose, and to correlate platelet mitochondrial function with other markers of APAP toxicity.
Male C57Bl/6 mice were randomized to receive APAP (300 or 500 mg/kg) or vehicle followed 90 minutes later by either 4-MP (50 mg/kg) or vehicle via intraperitoneal injection. Mice were euthanized 0, 12, or 24 hours later and platelets isolated from cardiac blood and counted. Platelet oxygen consumption (POC) was determined using a closed-system respirometer. Liver injury was assessed by measuring alanine transferase (ALT) and histological evaluation.
Injection of 500 mg/kg APAP led to increased POC versus pair-matched control (vehicle) (p < 0.001). Administration of 4-MP did not affect POC in control or 300 mg/kg APAP mice. In mice receiving 500 mg/kg APAP and 4-MP, POC decreased significantly compared to mice receiving 500 mg/kg APAP alone (p < 0.01). Serum and histological analysis confirmed APAP-induced hepatic damage in mice receiving 500 mg/kg APAP and these effects blunted by treatment with 4-MP.
Platelet oxygen consumption as a measure of mitochondrial function may be useful as a biomarker of hepatic APAP toxicity in the setting of moderate to severe overdose. Treatment with 4-MP decreases hepatic necrosis and may mitigate the harmful effects of APAP on platelet mitochondrial function detected via POC.
在北美和欧洲,对乙酰氨基酚(APAP)毒性仍是导致成人和儿童肝衰竭的主要原因。先前的研究已经评估了与 APAP 毒性相关的受损线粒体功能。本研究的主要目的是使用体内小鼠模型评估 APAP 毒性对血小板线粒体功能的影响,方法是检测血小板耗氧量。我们的次要目标是确定 4-MP 在 APAP 过量情况下对血小板线粒体功能和肝毒性的影响,并将血小板线粒体功能与 APAP 毒性的其他标志物相关联。
雄性 C57Bl/6 小鼠随机接受 APAP(300 或 500mg/kg)或载体,90 分钟后通过腹腔内注射接受 4-MP(50mg/kg)或载体。0、12 或 24 小时后处死小鼠并从心脏血液中分离血小板并计数。使用封闭系统呼吸计测定血小板耗氧量(POC)。通过测量丙氨酸转氨酶(ALT)和组织学评估来评估肝损伤。
与配对的对照(载体)相比,注射 500mg/kg APAP 导致 POC 增加(p<0.001)。4-MP 的给药不影响对照或 300mg/kg APAP 小鼠的 POC。在接受 500mg/kg APAP 和 4-MP 的小鼠中,与单独接受 500mg/kg APAP 的小鼠相比,POC 显着降低(p<0.01)。血清和组织学分析证实,在接受 500mg/kg APAP 的小鼠中发生了 APAP 诱导的肝损伤,而用 4-MP 治疗则减弱了这些作用。
作为线粒体功能的测量指标,血小板耗氧量可能是中度至重度过量时肝 APAP 毒性的生物标志物。4-MP 的治疗可减少肝坏死,并可能减轻 POC 检测到的 APAP 对血小板线粒体功能的有害影响。