期刊
DRUG METABOLISM REVIEWS
卷 44, 期 1, 页码 88-106出版社
TAYLOR & FRANCIS LTD
DOI: 10.3109/03602532.2011.602688
关键词
Acetaminophen; peroxynitrite; lipid peroxidation; hepatotoxicity; c-jun-N-terminal kinase; membrane permeability transition pore; cyclophilin D; neutrophils; Kupffer cells
资金
- NCRR NIH HHS [P20 RR016475, P20 RR021940] Funding Source: Medline
- NIAAA NIH HHS [R01 AA012916] Funding Source: Medline
- NIDDK NIH HHS [R01 DK070195] Funding Source: Medline
- NIGMS NIH HHS [P20 GM103549] Funding Source: Medline
Hepatotoxicity is a serious problem during drug development and for the use of many established drugs. For example, acetaminophen overdose is currently the most frequent cause of acute liver failure in the United States and Great Britain. Evaluation of the mechanisms of drug-induced liver injury indicates that mitochondria are critical targets for drug toxicity, either directly or indirectly through the formation of reactive metabolites. The consequence of these modifications is generally a mitochondrial oxidant stress and peroxynitrite formation, which leads to structural alterations of proteins and mitochondrial DNA and, eventually, to the opening of mitochondrial membrane permeability transition (MPT) pores. MPT pore formation results in a collapse of mitochondrial membrane potential and cessation of adenosine triphosphate synthesis. In addition, the release of intermembrane proteins, such as apoptosis-inducing factor and endonuclease G, and their translocation to the nucleus, leads to nuclear DNA fragmentation. Together, these events trigger necrotic cell death. Alternatively, the release of cytochrome c and other proapoptotic factors from mitochondria can promote caspase activation and apoptotic cell death. Drug toxicity can also induce an inflammatory response with the formation of reactive oxygen species by Kupffer cells and neutrophils. If not properly detoxified, these extracellularly generated oxidants can diffuse into hepatocytes and trigger mitochondrial dysfunction and oxidant stress, which then induces MPT and necrotic cell death. This review addresses the formation of oxidants and the defense mechanisms available for cells and applies this knowledge to better understand mechanisms of drug hepatotoxicity, especially acetaminophen-induced liver injury.
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